Prescription requirements and over-the-counter access to oral contraceptives: a global review

Background: Since the prescription requirement for oral contraceptives (OCs) can act as a barrier for some women, over-the-counter (OTC) access may improve uptake and continuation. The goal of this study was to ascertain the prescription requirements and informal OTC availability of OCs worldwide.

Study design: From April 2011 to September 2012, we researched official documentation and conducted an online survey with government officials and pharmaceutical and reproductive health specialists on OC availability in countries worldwide. Results were compiled in a database and entered into a map for analysis of regional patterns.

Results: Data were obtained for 147 countries. OCs were informally available without prescription in 38% of countries, legally available without prescription (no screening by a health professional required) in 24% of countries, legally available without prescription (screening required) in 8% of countries and available only by prescription in 31% of countries. Notable regional patterns in OC prescription requirements emerged.

Conclusions: OCs are available without prescription in the majority of countries. Country experiences with OTC provision may provide evidence about the safety and effectiveness of OTC provision as a strategy to improve access to effective family planning.