On Tuesday, a panel of independent medical experts advising the Food and Drug Administration heard testimony on whether or not to approve Opill, the first birth control pill available without a prescription in the United States.
HRA Pharma, now acquired by Perrigo, is the pill’s maker, and throughout the eight-hour session, they and many other medical groups and reproductive health professionals testified that the evidence strongly supported approval. They argued that making Opill, a prescription medicine authorised 50 years ago, available over the counter was desperately required to reduce the high number of unwanted births in the nation.
Company data said to indicate that users would take the pill at around the same time every day and obey with advice to refrain from sex or temporarily use alternative birth control if they missed a dosage was questioned by F.D.A. scientists as unreliable. The government was particularly worried about whether teenagers and those with low literacy would use it appropriately, and if women with breast cancer or unexplained vaginal bleeding would make the right choice not to use Opill.
The panel will have a nonbinding vote on Wednesday to determine whether the potential downsides of an OTC drug exceed their potential advantages. A final ruling from the F.D.A. is anticipated this summer.
Specialists in reproductive and adolescent health, as well as organisations like the American Medical Association, the American College of Obstetricians and Gynaecologists, and the American Academy of Family Physicians, have voiced strong support for the decision to make a nonprescription pill available to people of all ages.
More than seventy-five percent of reproductive-age women favoured an OTC pill in a poll by the health care research organisation KFF.
Despite the heated debate around the use of abortion pills, many organisations who oppose abortion have been notably silent on the topic of over-the-counter birth control. Some Catholic groups seem to be the main source of opposition. The majority of the hundreds of comments filed before to Tuesday’s hearing and the majority of the 37 persons who spoke during the public comment phase of the hearing all voiced their support.
Both types of pills are safe and about 93% effective in preventing pregnancy with typical use, according to Dr. Daniel Grossman, a professor of obstetrics, gynaecology, and reproductive sciences at the University of California, San Francisco, who spoke in favour of the over-the-counter effort in public comments on Tuesday.
He noted that more women would be unable to use combination tablets, which prevent pregnancy by preventing the ovaries from releasing eggs but also carry the risk of producing blood clots, than progestin-only pills.
The danger of blood clots is very low while taking progestin-only tablets, which work by thickening the cervical mucus, making it more difficult for sperm to fertilise eggs, and perhaps disrupting the release of eggs. According to the data, taking progestin-only pills at around the same time every day (inside the same three-hour window) may be more crucial than with combination pills, which provide a little more leeway.
Director of the F.D.A.’s division for over-the-counter medications, Dr. Pamela Horn, said Tuesday that she “cares deeply about women’s health” and would “love to have unambiguous data” to back the application.
About 30 percent of research participants reported taking more tablets than they had gotten, which the F.D.A. referred to as “overreporting” or “improbable dosing.” An F.D.A. medical officer, Dr. Jeena Jacob, observed that this not only caused worry for the individuals in the improbable dose group, but also for the chance that “other participants who are not members of the unlikely dosing group may have incorrectly used or omitted use.”
And the deputy director of the agency’s Office of Nonprescription Drugs, Dr. Karen Murry, challenged the widely-accepted claim that more than a hundred nations provide OTC medications. She noted that in many of these nations, chemists are responsible for doling out these medications, suggesting that Americans might have a different experience. It was here that she made the remark that “if this product is approved, people might get it in a pharmacy, but they might also get it in a petrol station or a big box store with no health care professionals around.”
Other speakers, including those who spoke during the public comment session, emphasised the product’s usefulness for women in low-income, rural, and marginalised communities who lack health insurance or who have trouble getting to a doctor for a prescription due to factors such as distance, time, cost, or the need to arrange for child care.
Breast cancer oncologist Dr. Pamela Goodwin from Toronto’s Sinai Health System testified that only a small percentage of their patients would be at danger since they would be strongly discouraged from using the product. According to the company’s research, almost all breast cancer patients who decided against taking the tablet made the right choice.
Dr. Stephanie Sober, the company’s U.S. medical liaison, said that 92.5% of the research participants took the tablet as prescribed. She claimed that at least 85% of people in the study took some kind of medication on at least 85% of the days. Dr. Sober revealed that only six women out of 955 had become pregnant while taking Opill, and that most of those women had taken the precautions recommended on the label in the event that they had missed a pill.
