Birth control raises the cost of the drugs

The argument

Over the counter drugs are generally more expensive for customers when compared to drug prescriptions covered by insurance. If birth control was made available over the counter, the cost would increase significantly. An example of this is Plan B, known as the “morning after pill”. Before Plan B was available in pharmacies, it required a prescription from a doctor. The insured cost of Plan B was inexpensive, around $5 for a generic brand, or $12 for a brand name. It now costs around $40 to buy a generic brand of Plan B, or $50 for a brand name. The difference in cost is significantly higher, which would mean the same result for birth control pills if they were available over the counter. Many women already face financial barriers when it comes to having access to birth control. Though making it available over the counter sounds like a good idea, it would actually raise the cost significantly. If a woman does not have insurance, using services like Nurx would be the better way to go. Prices of birth control range from $0 to $15 when using these services, even for women without insurance.

Premises

Counter-arguments

The comparison is between the wrong two things. Setting an insured co-payment for a prescription against the retail cash price of an over-the-counter product compares insurance status rather than prescription status, so it does not show that removing the prescription requirement raises the underlying cost. The like-for-like comparison for an uninsured buyer is the full cash price with a prescription — including the consultation, the visit and the dispensing fee — against the shelf price without one, and on that comparison dropping the requirement removes costs rather than adding them. The argument's own closing recommendation undercuts it as well: it points uninsured women toward low-cost telehealth services, which concedes that the burden lies in the administrative overhead of obtaining a prescription rather than in over-the-counter availability. Coverage and availability are also independent variables. Where rules require health plans to cover contraception, they can be and have been written to cover it without a prescription, so any price effect follows from how coverage is drafted rather than from where the product sits; and the emergency-contraception example is a poor guide, since its retail price fell substantially as generic competition entered, indicating a transitional new-market price rather than a permanent consequence of the switch. Finally the accounting is one-sided. It omits the costs a prescription imposes — the appointment, the wait for it, the travel, the time away from work, and the gap in supply when a renewal is late — which fall hardest on precisely the women the argument says already face financial barriers.

Rejecting the premises

[Rejecting P1] Comparing an insured co-payment with a retail cash price compares insurance status rather than prescription status; the like-for-like comparison for an uninsured buyer is the cash price plus consultation and dispensing costs against the shelf price alone. [Rejecting P2] The Plan B example does not generalise, since its retail price fell as generic competition entered, and coverage rules can require plans to cover contraception without a prescription — so any price effect follows from how coverage is written rather than from over-the-counter status. [Rejecting P3] The premise's own recommendation of low-cost telehealth concedes that the burden lies in the prescription requirement's overhead, while the comparison omits the appointment, waiting, travel, lost work time and supply gaps a prescription imposes.