Birth control prices at school clinics rise sharply
July 25, 2007
Since 2000, students at Wright State University could buy several forms of prescription birth control for less than a six-pack of import beer.
At Wittenberg University’s health clinic, students used to get birth control free thanks to oodles of samples provided by drug companies.
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At Miami University in Oxford, students paid as little as $10 for generics and $12 for the NuvaRing.
But since January, drug companies began notifying college health clinics they would no longer reap the significant discounts they received for years.
The average price for name-brand birth control pills has increased to at least $35 and as high as $50. Most students are now opting for generics costing about $20 a month.
“The question now is what are they going to have to give up if they want to buy birth control?” said Wendy McGonigal, WSU’s director of student health services.
Drug companies in the past provided college health clinics with prescription contraceptives at a nominal price as part of a Medicaid rebate practice that put cheap prescription drugs into the hands of low-income populations.
But Congress, concerned that drug companies were abusing the rebates to provide low-cost drugs to commercial customers as a marketing tool, embedded changes to those reimbursement rules in the Deficit Reduction Act of 2005.
The law, which went effect in January, has had unintentional consequences on college health clinics, according to the American College Health Association, which represents 900 college health clinics and their 17 million student patients nationwide.
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The group wrote to the Centers for Medicare & Medicaid services in February asking it to exempt them from the new pricing regulations.
“It was a big stink,” McGonigal said.
But the agency denied their request last week.
The resulting price hikes could be a problem for students who depended on their college health clinics for birth control services, college health officials said this week.
At Wittenberg, more than half of its daily clinic visits — about nine students — are for “women’s services,” according to registered nurse Eryn Smith.
“That’s mainly what we see here.”
Students prefer name-brand drugs, bringing in magazine advertisements and coupons for heavily marketed brands, she said. But their high costs put clinicians like McGonigal and Smith in the position of writing prescriptions based on what students can afford.
“It’s part of the screening process now. We ask ‘Can you afford $40 a month?’ and they always say no,” Smith said. “We have to give them what they can afford, otherwise they’ll go back to using nothing.”
Students with no health-insurance are the most affected, because they pay out-of-pocket for their healthcare.
Students on their parents’ insurance are also affected, either because insurers typically don’t cover prescription birth control, or because students choose to pay out of their pockets to keep parents in the dark.
“Just about everyone who comes in says ‘I don’t want my mom and dad to know I’m on birth control’ and then want it as cheap as possible,” Smith said. At WSU, McGonigal estimated she writes an average 40 birth control prescriptions a month and thinks about their costs every day.
After New Jersey-based Organon Inc. terminated WSU’s discount contract, the university “dug around and finally found two generics for $17. I pray every day it stays at that price,” McGonigal said. “But they could raise it any time.
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