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Published on: September 20, 2019
The Opill®: a nationwide secret shopper study
Mikaela Koch1, Hasmik Adetyan2, Serena Gill2
1Department of Obstetrics and Gynecology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Summary
Over-the-counter Opill® is available in 65% of pharmacies nationwide, but access is reduced in less populated areas. State abortion restrictions did not significantly impact Opill® availability or cost.
Area of Science:
- Reproductive Health
- Pharmaceutical Access
- Public Health Policy
Background:
- The U.S. Food and Drug Administration (FDA) approved Opill® (norgestrel) for over-the-counter (OTC) sales, marking a significant step in expanding contraceptive access.
- Understanding the real-world availability, cost, and pharmacist counseling accuracy of OTC Opill® is crucial for assessing its impact on reproductive healthcare.
- Previous research suggests potential disparities in contraceptive access based on geographic location and state-level policies, necessitating investigation into OTC Opill® distribution.
Purpose of the Study:
- To evaluate the nationwide availability and affordability of OTC Opill® following its FDA approval.
- To assess the accuracy of information provided by pharmacists regarding Opill®.
- To determine if state abortion restrictions or population size influence Opill® availability and cost.
Main Methods:
- A "secret shopper" methodology was employed, involving calls to 513 pharmacies across 530 randomly selected U.S. cities.
- Cities were categorized based on population size (above or below 50,000) and a modified Guttmacher abortion restriction metric.
- Pharmacists were questioned about Opill® availability, monthly cost, and differentiation from abortifacient medications; data analyzed using Chi-square or Fischer's exact tests.
Main Results:
- Opill® was available in 65% of surveyed pharmacies, with 47% reporting a monthly cost under $20.
- Pharmacies in areas with populations below 50,000 demonstrated lower availability (56%) and higher reported costs compared to those in larger areas (73%).
- No significant differences in Opill® availability or cost were observed based on state abortion restriction levels.
Conclusions:
- While Opill® is available in a majority of pharmacies, access is significantly limited in less populated regions.
- State-level abortion restrictions do not appear to be a significant factor influencing the availability or cost of OTC Opill®.
- Further strategies are needed to ensure equitable access to OTC contraception, particularly in rural and underserved areas.
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