Overview

• The study surveyed 986 individuals aged 15–45 across 44 states who obtained a progestin-only oral contraceptive either over the counter or by prescription between April 2024 and February 2025.
• OTC access was linked to a 31.8 percentage point increase in initiation among prior nonusers and a 41.0 point rise in switching from less-effective methods compared with prescription users.
• Uninsured individuals made up 31.6% of OTC users versus 3.5% of prescription users, and rural residents accounted for 14.4% compared with 8.4%, indicating improved reach to populations facing care barriers.
• Retail cost averaged about $50 for a three-month supply, and most private insurers do not cover OTC contraceptives without a prescription, posing potential affordability challenges.
• Researchers cautioned that these early, cross-sectional findings cannot yet assess long-term continuation, adherence or impacts on unintended pregnancy rates.