Two days ago I found myself in the sticky situation of having to run out to my local Walgreen’s and pick up Plan B. A few aspects of the popular morning after pill have been modified in the year-plus-change since I last bought it–firstly, it’s now Plan B “One Step,” so you only have to swallow one crazy-large pill, instead of two medium-sized ones at a twelve-hour interval. Secondly, and far less convenient, Walgreen’s now charges a whopping $50 for one dose of Plan B instead of $40.
Now, I remember thinking that $40 was an awfully big hunk of money to be handing over to my friendly neighborhood pharmacists, but I justified it by comparing the relative cost and emotional distress of having a child (at this point, anyway) to the inconvenience of making a pit stop at the pharmacy, the mild embarrassment of having to request Plan B, and the short-term pinch my wallet would feel from shelling out for the drug.
But $50? Really, pharmaceutical industry and, by extension, Walgreen’s and RiteAid and Duane Reed and all the other chain/locally owned businesses? Really? You think that’s a fair price for what’s essentially a mega-dose of daily birth control pills?
After compliantly paying for Plan B, popping it out of its blister package and taking it in my car, I indulged my anger by soliloquizing at my husband about how the burden of birth control falls disproportionately on women, and how the pharmaceutical industry is capitalizing on the panic a woman undoubtedly feels when she needs emergency birth control and is running out of options (literally, there is a clock ticking on Plan B’s effectiveness, which peaks at up to 95% during the first 24 hours after sex but declines rapidly thereafter). Since many women simply do not have fifty spare dollars lying around, they wind up either taking their chances or using some kind of home-brewed, dangerous abortifacient.
When I got home, I vowed to scour the Internet for proof that $50 is an obscene amount to charge for a single, hormone-packed pill. And I found it.
First things first–the active (and only, discounting filler) ingredient in Plan B is levonorgestrel, a progestin found in some birth control pills, primarily those that operate on an “extended regimen” which reduces period to 4 times a year or less. Plan B’s dosage of levonorgestrel is 1.5 milligrams, very high compared to daily birth control pills.
A website operated by Princeton’s Office of Population Research has a handy chart that lists just how many pills of various levonorgestrel-containing medications one would have to swallow in order to simulate a Plan B dosage. For one of the most popular birth control pills on the chart, Seasonique, one would have to take a total of four pills–one dosage of four, then a second dosage of four after twelve hours.
I called Walgreen’s and asked a pharmacist what the cost of Seasonique for a non-insured woman would be*, and she told me it was currently $224.99 for three months’ worth of the pill, which comes out to $74.99 a month. Personal experience (Yaz cost me $80 per month when I was uninsured) and more internet sleuthing confirmed that monthly sticker is about the same for the majority of name-brand birth control pills.
If eight pills comprise roughly 29% of a 28-pill pack, then the DIY equivalent of one dose of Plan B costs only $21.75, less than half Plan B’s price.
Not satisfied with taking the website’s word as golden, I looked up the exact number of milligrams of levonorgestrel in Seasonique, which is .15 mg per pill, so you would actually need to take ten pills to ingest exactly 1.5 mg of levonorgestrel. Even then, the cost of simulating Plan B only comes out to $26.78.
I’ll concede differences in manufacturing may contribute to the price jump for Plan B, such as the popularity of daily birth control pills allowing companies to produce them in bulk, driving prices down. Conversely, while I’m no chemist, it would seem to me that manufacturing a product with one active ingredient (Plan B) would be cheaper than manufacturing a product with multiple active ingredients (Seasonique and other birth control pills, which usually contain an estrogen in addition to a progestin).
Cost-cutting options for Plan B users are few and far between. According to Princeton’s website, Medicaid’s coverage of OTC products is spotty, with one-third of states providing no coverage of OTC medications at all. Private insurers differ on their coverage–mine, which is very comprehensive, will only cover Plan B if one has a prescription.
The obvious fly in the milk there is that one would likely have to pay for the appointment to get the prescription, and scheduling an appointment within 24 hours (when Plan B is most effective) of unprotected sex is well-nigh impossible for most people.
There is a generic equivalent of Plan B called Next Choice–but it’s $42.99, so still prohibitively expensive fir many women. Savings-wise, your best bet is to visit Plan B’s website, where they have a printable $10-off coupon for the drug (apparently “restrictions apply,” but I could not find any actual enumeration of those restrictions), which is super-awesome if you have the time and forethought to check Plan B’s website before running off to Walgreen’s in a tizzy (yes, I’m bitter right now).
While I’m not sure whether the disproportionately high cost of Plan B is actually a result of the patriarchy devaluing women, or whether it’s just another case of the pharmaceutical-complex getting greedy, I still think the whole situation stinks.
So should access to affordable birth control be a right? I don’t really want to open that can of worms just now, but I strongly believe it should be a priority, and that a developed country like the U.S. would be making highly-profitable long- and short-term investments by prioritizing its citizens’ health**, in this particular arena and others.
*I worked off the non-insured price for a name brand product because it’s the highest and should yield the greatest possible cost when calculating Plan B’s value.
**An example of non-prioritization: when generic Next Choice was introduced to the market in June, 2009, it was only legally available via prescription for two months, because Plan B’s manufacturer had wrangled a marketing monopoly on the product which competitors could not breach. Ugh.