Unresolved issues in contraceptive health policy

The year 2000 marked the fortieth anniversary of the oral contraceptive known as the "pill." Despite the availability of the pill, and other contraceptives, many unresolved issues remain. Concerns with contraceptive side effects, high use-failure rates, and high rates of both unintended pregnancies and abortions indicate a need for improved contraceptive choices. Experts have called for a second contraceptive revolution that would bring radically new contraceptive products to the market. Unfortunately, this second revolution has not occurred, and contraceptive research has been virtually abandoned by most major pharmaceutical firms. We suggest that inclusion of contraceptives within the 1983 Orphan Drug Act and U.S. federal legislation known as the Food and Drug Administration (FDA) defense could provide the economic incentives needed to spark the second contraceptive revolution.