Prescription access vs. Over-the-counter access: What’s the difference?

As of March 2024, Opill—the US’s first daily birth control pill approved for OTC use—is available online and on shelves in retailers nationwide! Opill is now the most effective form of birth control available without a prescription in the United States. With this new product on the market, it is important to understand the differences between prescription access and OTC access to birth control pills and other forms of OTC contraception (such as emergency contraception, condoms, and spermicide) that are also available in the US. In this fact sheet, we break down how prescription access and OTC access differ across restrictions, coverage, availability, and more.

Note: Many states have expanded access by passing laws to allow pharmacist prescribing, which enables pharmacists to prescribe the pill as well as other hormonal contraceptive methods (including the patch, ring, and/or shot). Oftentimes, pharmacist prescribing is mistakenly referred to as “over-the-counter" access, but that’s not exactly accurate since this type of pharmacy access still requires a prescription.