College women paying more for contraceptives

Change in U.S. law brings rise in cost of 300% to 400%

November 22, 2007|By New York Times News Service

In health centers at hundreds of colleges and universities around the country, young women are paying sharply higher prices for prescription contraceptives because of a change in federal law.

The increases have meant that some students using popular birth control pills and other products are paying three and four times as much as they did several months ago. The higher prices have also affected about 400 community health centers nationwide used by poor women.

The change is owed to a provision in a federal law that ended a practice by which drug manufacturers provided prescription contraception to the health centers at deeply discounted rates.

Some lawmakers in Washington are pressing for new legislation by year's end that would reverse the provision, which they say was inadvertently included in a law intended to reduce Medicaid abuse.

Some students have reported switching to less expensive contraceptives or considering alternatives such as the so-called morning-after pill, and some clinics have stopped stocking some prescription contraceptives, saying they are too expensive.

"The potential is that women will stop taking it, and whether or not you can pay for it, that doesn't mean that you'll stop having sex," said Katie Ryan, a senior at the University of North Dakota in Grand Forks, who said that the monthly cost of her Ortho Tri-Cyclen Lo jumped from $12 to nearly $50.

Ryan, 22, said she had considered switching to another contraceptive to save money but was unsure which one to pick. She has ended up paying the higher price.

"I do less because of this - less shopping, less going out to eat," said Ryan, who has helped organize efforts to educate others on campus about the price jump. "For students, this is very, very expensive."

Not everyone is troubled by the price increases. Some people said they wondered why college students should have been given such discounted birth control to begin with, and why drug companies should be granted such a captive audience of students. Others said low-priced, easy-to-attain contraception might encourage a false sense of security about sex.

The price change came as part of the tangled method by which drug manufacturers pay rebates to states for prescription drugs covered by Medicaid, the federal drug program for low-income people. Those rebates are set by calculations that take into account the lowest prices paid for certain drugs. Since 1990, the steeply discounted contraception given to university health centers and low-income clinics was considered exempt from those calculations.

The arrangement helped those who could least afford the contraceptives to receive them. Yet it was also seen as potentially beneficial to drug companies, which might not make money on the college clinic sales but were able to market their products to young women who might grow accustomed to one brand over another.

More recently, though, legislators, worried about abuse in the rebate calculations, set strict limits about which facilities would be exempt. Student health centers, among others, were left out - an unintended oversight, some lawmakers say.

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