MADELEINE BRAND, host:
This is DAY TO DAY from NPR News. I'm Madeleine Brand.
ALEX CHADWICK, host:
And I'm Alex Chadwick. A big decision on birth control today. Women can now buy the morning after pill without a prescription as long as long as they're 18 or older. The Food and Drug Administration issued the ruling today after years of debate approving sales of the drug called Plan B that can prevent pregnancy up to 72 hours after intercourse. Girls 17 and younger still will need a doctor's note. The drug's manufacturer says it's going to fight that remaining restriction. Meanwhile, family planning clinics around the country are dealing with a sudden case of sticker shock.
BRAND: The price of birth control pills has soared for family planning clinics that serve poor women. These clinics had been paying as little as one cent per pack for the pill, now the price has lept to more than $18 a pack. Amanda Schaffer wrote about this for the online magazine Slate, and she joins me now. And Amanda, to be clear, the company involved here is Ortho-McNeill. And they are the major supplier of birth control pills?
Ms. AMANDA SCHAFFER (Reporter, Slate.com): That's right. In some states, Ortho-McNeill was supplying over 70 percent of the pills being distributed through the family planning clinic system, at least until last month.
BRAND: And why the price hike?
Ms. SCHAFFER: That's a really good question. It's been baffling to people who watch these issues, and there's really no explanation.
BRAND: Yeah, this is what - an 1,800 percent price increase?
Ms. SCHAFFER: Yeah, 1,800 fold increase.
BRAND: And what did they tell you?
Ms. SCHAFFER: Well, Ortho really only gave a very simple statement, saying that its products were comparably priced with other forms of hormonal contraception. And it noted that generics are available, which is true. The problem is that generics are also expensive, relative at least to the prices that these clinics were paying for Ortho's products. In other words, generics might cost these clinics somewhere between $5 and $18 dollars a pack - which isn't a lot compared to retail prices, but it's certainly a whole lot more than a penny a pack.
BRAND: And how many women do these clinics serve?
Ms. SCHAFFER: We're talking about a network of about 4,500 clinics across the country serving around 5 million women.
BRAND: So a substantial number of women will now do what? Pay more?
Ms. SCHAFFER: Well, the clinics are limited in the price hikes that they can pass on to patients under federal law, but really what's going to happen is that the clinics - and this is already beginning to happen - but the clinics are going to have to limit the options that they offer women. They're going to be able to offer fewer different kinds of birth control pills for one thing. And that's really a problem because women respond differently to different hormonal formulations. So one pill might cause break through bleeding or bloating or moodiness, where another pill type wouldn't. And the other thing that's going to happen is really that many of these clinics are going to need to cut hours of operation. Some of them are talking about closing some locations in some states. So it's really going to be something that limits women's access to care.
BRAND: And Amanda, just to be clear, this price increase only affects the pills available at these publicly funded clinics. It doesn't have anything to do with pills available on the open market. So why would they originally price these pills at once cent per pack so low?
Ms. SCHAFFER: There's been quite a bit of speculation that Ortho kept its prices extremely low in order to build brand loyalty among women who it thought might one day switch to private insurance. However, with many more private insurance companies requiring women or pressing women to use generic drugs, it may be that the company felt this strategy wasn't going to work to its advantage. On the other hand, I think that that's a limited explanation because generic birth control pills have actually been available for a while. So that doesn't really explain why the company would make such a radical increase. This price hike is not illegal. It's just really radical and comes as a shock to the clinic system.
BRAND: Amanda Schaffer writes for the online magazine Slate. Thank you, Amanda.
Ms. SCHAFFER: Thank you.
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