Wherein low-income women lose out once again (and wherein Slate almost redeems itself).
No one much noticed, but thousands of family-planning clinics across the country went into a tailspin last month. They were reacting to a drastic price increase by Ortho-McNeil, a major supplier of birth-control pills and maker of the popular contraceptive patch. The company used to charge publicly funded clinics as little as a penny a pack for the pills. Then, as of July 1, the price of some pills jumped to more than $18 a pack. Ortho’s move was apparently legal under federal pricing rules. But it’s anybody’s guess as to why the company chose to do this now, without giving the clinics any real notice.
As a result of the price hike, publicly funded clinics from Maine to New Mexico are running short on popular contraception products, scrambling to find reasonably priced generics, and scaling back on the choices they offer low-income women. Chronically underfunded, the clinics are in no shape to absorb this blow, especially now. The number of women in need of subsidized contraception is rising, while new and expensive advances in screening and prevention, like the HPV vaccine, are coming on line. Yet the national press has ignored the story of the Ortho price hike, which the Charleston Gazette in West Virginia broke in late July.
From a penny to $18. It’s low-income women who will be hit the hardest, and you can bet that few people will be standing up for them.
But so far, the episode demonstrates just how strapped—and politically friendless—the clinics that serve poor women are. Funding for Title X has been shortchanged for years. It’s unlikely to get a boost in 2007, despite the growing number of women who need help paying for contraception. Poor women need a full range of birth-control choices and better access to care, not higher prices and cutbacks at the clinics on which they rely.
Word.
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It’s ridiculous across the board.
Related rant: my insurer changed the status of my birth control pills. They’re now double the price. Not only that, but it kicked them into the next tier for mail-order prescription, so it’s tripled what I used to pay for a three-month supply. And the insurance I receive through school doesn’t cover birth control.
I’m young. I am in no way equipped to handle having a baby. I would much rather be on birth control than deal with the myriad consequences of an unintended pregnancy. And I’m pretty sure most of the women who are affected by Ortho’s price hike feel the same way.
If low-income women cannot afford contraception and do not want to have children, maybe they should consider not having sex or using a condom to avoid an unwanted pregnancy.
It’s about priorities and responsibility. If they can’t afford The Pill, they surely won’t be able to afford an abortion and will face challenges in raising a child.
Hey — that’s my paper! I was on vacation when that article was published, so I wasn’t able to blog about it. So we all know what happens when the supply of contraception goes down — more unwanted pregnancies. But guess what? There’s only one clinic in the entire state (located in Charleston) that performs abortions, and some dude called in a bomb threat to them in June. He was pissed because his girlfriend had decided to abort “his baby.” Luckily, they easily tracked him down and he’s been charged with a federal crime.
That is really scary. I know that I can’t go on the pll right now because we can’t afford the 30 dollars a month it costs with our insurance. I can’t imagine being uninsured or having to go through a clinic with these price hikes.
Having been a Planned Parenthood patient off and on since 1990, I have watched this happen and seen it coming. As a teenager, when I went to PP in MN, I was given EVERYTHING for free. The would not even let me leave the clinic unless I took a bag of condoms and foam. In 1993 I moved to CO and started going to a PP clinic there, even with no income (being a student), I was required to pay $13 a pill pack (remember, this is 1993!) and condoms were $2 each, they did not give them out, you would have thought they were gold. About 1995 I ended up getting a job with insurance and stopped going to PP until 2001 after the birth of my daughter. When I resumed my BC perscription in 2001 it was about $20, and it has been increasing steadily since then. 4 months ago, it went from $25 to $35. OH! and also I used to get my ring mailed to me every month, but since my PP clinic has switched suppliers, they WILL NOT ALLOW the ring to be mailed, so I have to drive to the clinic (45 miles away, 2 towns over…there are only 13 PP clinics in the whole state of CO).
This all smacks of ‘fine, you can have birth control but we’re not going to make it easy…or affordable’…its a backdoor way for BushCO, Pharm Cos, and the Religious Right to make birth control ‘unavaliable’ without getting blasted for it. They know PP no longer has the funding to be able to subsidize the rates they charge thier clients, so if they keep driving up the price, the patient will have to pay it.
Honestly, I don’t know how to stop it or control it. PP funding is very screwed up. At least, if you do stil donate to PP, please make sure you are donating to your state chapter and not to national. National does not pass on donations to state clinics anymore, all that money goes to the Head’s salary and political lobbying. The only way the money you donate actually gets to a clinic is if you give to your state. Its not enough, but its something…
Just Saying:
Just a mention that some of us are on birth control for reasons other than JUST not getting pregnant. I personally have a history of ovarian cancer in my family, and this is a preventative. Many women have simply hideous, like debilitating, periods, and the birth control pill controls the symptoms so that they can be functional all month. Does this change your perspective any?
And I find it amazing that the answer to “my prescription medicine prices just went through the f*cking roof* is “just don’t have sex”. ‘Cause that is so fair, right? How about the married women? Do they just get to cut off their husbands because the pill has gotten unaffordable? How about the women who are allergic to latex? And there *are* an unfortunate number of men who will not even consider using a condom in a committed relationship. (Yeah, they’re jerks, and they should be chewed out but GOOD, but it doesn’t change the reality of the situation, does it?)
Get your head around this — using the Pill IS responsible, and the pharm company just made it that much harder for low income women the BE responsible.
What Laurie said.
So only women who can afford contraception should be able to have sex when they want? Nice.
As for using a condom, that leaves the control 100% in the hands of a woman’s male partner. I’m a big proponent of women and men having the widest variety of options possible to prevent unintended pregnancy and disease transmission. There are women who lack negotiating skills in their relationships, and aren’t able to demand condom use from their partners. Obviously these relationships are probably less than healthy, and in an ideal world these women would get out of those relationships, but that’s not how life works for a lot of people. The least they can do is try not to compound an already bad situation by bringing an unwanted pregnancy into it. That’s one reason why female birth control like the pill is important, and why condoms are not sufficent replacements.
(Also, condoms usually cost money too, and can be pretty expensive at drug stores and pharmacies).
Thank you, Laurie! #6 is a lot of the things that were sputtering around in my head after reading #2. I’d like to add that in any comparison of efficacy between modes of birth control, the pill consistently ranks highest/ has the lowest failure rate.
That is fucked up.
I picked up a prescription for another medication today, and I noticed once again the check box on the back of the prescription form to indicate that you’re getting contraceptives (because in that case the prescription is free unless you’re super-rich). Socialised medicine UK-style isn’t perfect, but that’s one thing I’m very grateful for.
I will admit, that my response was very much a flippant, knee-jerk response. I know that people take birth control for reasons other than to prevent a pregnantcy.
The article points out that, although the rates went up, they are still lower than the retail price and generics are available lower than retail.
The pills may not be free, but they are still at lower cost. It is about working with women to figure out where the priorities are adjusting the budget accordingly instead of getting pissed off when the medical industry shows it’s true colors – it is not about altruism, it is a business – or when the government proves once again, that it really doesn’t care about supporting low-income people.
It’s called working with low-income women to develop a sense of independence and a self-sufficiency and making smart choices. What better place to start than with their reproductive health?
It makes NO SENSE from the point of the insurance company not to cover it – what’s more expensive, a few years’ worth of BC pills, or a pregnancy? Mine cost upwards of 6K all told, and that was several years ago. Not to mention the extra cost from having the extra dependent who needs shots, gets sick a lot, etc. All insurance should be giving those pills out for free. Wouldn’t help people without insurance, but would still be something.
Shorter Just Saying:
Quit whining about rich people screwing you over big time. You should expect that already. In fact, you should have already worked into your budget a yearly screwing-over by government, big pharma, and society in general.
Obviously this cannot be changed or altered or even spoken against, so I will constantly repeat the tired mantra of suggestions for how to “manage” your life. If you werent stupid and poor you would have already figured this out.
That Girl – Lovely. Thanks for paraphrasing! So glad that you’ve managed to get inside my head and reveal my “true colors”.
Just Saying:
There are some months when the budget won’t stretch any further, no matter how you crunch the numbers. There are months when something unexpected happens that puts the whole budget out of whack enough that it *can’t* be fixed (think ‘the furnace DIED’ in mid-winter because there wasn’t enough money to replace it when it started acting up kind of scenario. Up here in MN, that’ll run you something like $5000 plus installation. If you can get someone out to do it when you need it done.). There are months when the only way you can eat is to go to the local food shelf, and hope they don’t SHAME YOU for trying to feed your existing family. Because you are poor, and that obviously means you are stupid, or have done irresponsible things. Otherwise you wouldn’t be poor.
There are any number of low income people whose only issue with “independence” and “responsibility” is that they have jobs that pay less than it takes to survive. What, exactly, can we teach them? Unless you are talking about better skills for better paying jobs — I can get behind that. But I think you have to admit that your statement about “working with low-income women to develop a sense of independence and a self-sufficiency and making smart choices” sounds awfully smug, like ‘these dumb chicks don’t have a clue about how to manage their money and their lives, so we’ll help them out.’ Maybe that’s just the inability of the internet to convey emotion and nuance. I hope so.
As far as big pharm/government goes, well…. I personally feel that there are ethical boundaries that should not be crossed, that I personally would not cross as a business person (which I am, BTW. I own my own small business). I am continually disappointed with how things are run in this country, both in private industry and in the gov’t. Does this mean I don’t get to bitch about it? Because I shouldn’t *expect* anyone else to act like a decent human being with ethics?
Dude, they raised the cost to the clinics **1800** times. (Is my math right? From a penny a pack to $18.00?) Yeah, it’s still cheaper than retail. Yeah, generics are less than name brands. I suspect that the clinics get the generics anyway, but that’s a bit beside the point. The point is — EIGHTEEN HUNDRED PERCENT!!!! If it were any other drug, there would be rioting in the streets! And then there’s the fact that it was done on short notice, for no apparent reason. I think THAT is what most of us are pissed off about. No time for anyone to MAKE any other plans, or rework the budget to encompass a larger outlay for medical costs. Just another slap upside the wallet.
Yay, Capitalism. /snark
BTW, Just Saying. I am glad to hear that was mostly a knee jerk reaction. Big of you to admit it. Obviously, not a constructive reaction, wouldn’t you agree?
Am I the only person who hung around people for whom $18 was a fairly large chunk of change?
Seriously, not everybody can stretch a dollar to infinity.
No, same here. Plus, they’re probably gonna have to pass that increased cost along by hiking up contributions for things like exams.
The Charleston Gazette did another follow-up article about this just today. They’ve been continuing to report on this story since Morgan Kelly (my occasional drinking buddy!) first broke it. Here’s the link.
I want to highlight something about the generic vs. name-brand issue that people have brought up here. The prices that Ortho-McNeil had been charging were cheaper than generic prices. Clinics could not get generics for $0.01 for a 30-day supply of pills, so they bought the name brands. For example, more than 75% of the WV Family Planning Clinic’s supply of pills was name brand.
So after Ortho-McNeil jacked up their prices, clinics used up what they had left of the name brands, then replaced their supply with generics. As it currently stands, generics are now cheaper than name brands, but they cost much more than what Ortho-McNeil had been charging before.
Also, since clinics all over the country are scrambling to buy generics, many of the pills are on back order due to the increased demand. As a result, some clinics have no pills left and are handing out condoms as a substitute. For reasons given by other commenters here, condoms are definitely not a perfect substitute for birth control pills.
Ortho-McNeil has not given an adequate explanation for why they increased prices. They say they are now charging the maximum allowed under Medicaid laws, but they had previously been charging less than the maximum. I’m not sure if there was some change in the law that they are exploiting or what. Personally, I’d like to see the NYTimes or the Wash. Post or somebody get their asses on this to try to get a better explanation.
Oh, I should also add that Ortho-McNeil did lower its prices a bit since its initial huge price hike.
And the company hasn’t been willing to talk to clinics any further about negotiating lower prices.
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