The birth control deficit

With skyrocketing costs, West Virginia's public health clinics are facing a crisis in providing affordable birth control.

Published August 1, 2006 7:28PM (EDT)

Women in West Virginia are feeling the heat this week as a result of a major drought in affordable birth control. Ortho-McNeil Pharmaceutical Inc., which supplies 75 percent of West Virginia Family Planning's birth control pills, announced earlier this month that it will drastically raise the prices on contraceptive pills and patches. The Charleston Gazette reports that the increase will take contraceptives from a few cents per patch or pack to more than $20 in some cases -- the maximum price Ortho-McNeil can charge public health services.

Ortho-McNeil spokeswoman Julie Keenan told the Gazette that "the higher costs did not just come out of nowhere -- the company followed federal Medicaid pricing formulas that change every financial quarter, the last being July 1." But even with these guidelines, the birth control supplier is hardly required to implement such a steep price hike. As Marilyn Keefe, vice president for public policy at the National Family Planning and Reproductive Health Association in Washington, D.C., told the Gazette, Ortho-McNeil is "free to sell at a lower price to public clinics" but that "their stance was 'we're allowed to do this, we're able to this, we're doing it.' They should be ashamed of themselves for raising their product prices to a level they know the public health system can't handle." According to the Gazette, the new prices exceed the buying power of West Virginia Family Planning's $6.8 million budget.

The state's family planning program, which contracts with independent health clinics around the state that give out birth control, told the Gazette that last year it provided contraceptives to nearly 60,000 low-income people. As usual, those hardest hit by the increase will be lower-income women who rely on free or cheap contraception from public health clinics. For these women, getting a prescription from a doctor can be out of the question, especially if they lack health insurance. And although condoms and other forms of birth control like shots will be available, these methods have not been proven as effective as the pill or the patch.

In the meantime, public clinics are scrounging for generic brands and trying to obtain less expensive pills from other manufacturers. But as Pam Maddox, a nurse practitioner at a women's health clinic in the state, explained, "switching birth control pills is not like changing your favorite soda or taking a different route to work. Each pill releases different levels and types of hormones with different effects. A pill is not a pill is a pill. All these pills aren't going to work for everybody." And furthermore, a woman is not a woman is a woman. Lower-income women need as much choice in their reproductive health as anyone else. Rather than protect their interests, though, our government leaves women at the mercy of private companies like Ortho-McNeil. Maybe it's time for a new strategy.

By Sarah Goldstein

Sarah Goldstein is an editorial fellow at Salon.

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