College students are beginning to feel the financial pinch from a 2005 bill that led to higher prices for birth control pills at universities, and college administrators, physicians and parents are worried that the cost will deter students from using them, leading to more unintended pregnancies and students dropping out of school.

Kenon White

At some schools, birth control packs that had cost $7 jumped to $40-$50 per pack this fall.

According to the American College Health Association, 39 percent of all undergraduate women use oral contraceptives, totaling about 3 million women in the country.

Drug manufacturers had been supplying university health centers across the country with nominally priced birth control pills. However, in 2005, the Deficit Reduction Act, which went into effect last January, changed the way drug manufacturers calculate the Medicaid rebates they owe the government for medications sold each quarter, making it less financially beneficial to companies to offer the birth control at such low prices to universities.

Some schools have seen birth control packs that had cost students $7 as recently as last school year jump to $40-$50 per pack this fall. The sudden jump now at many schools has been because the universities are running out of the back supply of the pills they had purchased at the nominal prices prior to January.

The case has been different at Spelman College in Atlanta, which saw prices jump in 2006, said Brenda Dalton, director of Spelman's Student Health Center.

Dalton said birth control used to cost "pennies on the dollar." Students were given birth control pills for free and charged $5 to replace lost packs (each pack is one month's supply). They were given full access to the health center's services for the price of the Student Health Insurance Plan, $137 per semester. In order to receive the free pills, however, students were required to get an annual exam to test for sexually transmitted diseases and cervical cancer.

But Dalton said that in early 2006 when she went to order more pills for the health center, she was surprised by the higher prices. Once the back supply of pills ran out, the center started charging students $15 for generic brand birth control and $35 for name brand.

Replacement packs are no longer given out by the college for $5. Dalton said the school has contracted with local pharmacies, particularly a CVS near campus, where students can have their prescriptions from the health center filled.

Dalton said the move to outside contracting was necessary because the new pricing for the pills would have exceeded half of the college's operating budget if given out for free. She said though the price change hit the center hard at first, the college has "moved on."

"I don't ever want to go back to giving things free. When you give people things, they don't appreciate it. Sometimes there is misuse and abuse.I don't think there's value in giving everything away," she said.

Dalton said she understood that the new pricing for the pills may be difficult for some students.

"Is it a palatable situation to all students? I'm sure it's not. By and large, when they look at all the other services, for nominal prices, they don't mind paying $15 for a pack, particularly when their Paps are covered," speaking of Pap smears. "That's covered at 100 percent. You really can't get any better than that," she said.

Many students might be concerned about the health effects of switching from more expensive name brand birth control pills to generic brands, or switching to other methods of contraception in order to save money.

Vanessa Cullins, vice president for medical affairs for Planned Parenthood, said it was important for students to time the switch to make sure they have the new contraception available as soon as they run out of the old type.

"You don't want a time period in between when you're unprotected," she said.

Cullins, a Spelman alumna, said breakthrough bleeding may occur when individuals switch between different types of hormonal contraceptives, such as from progestin only pills to combination pills with estrogen and progestin.

She said the most important thing for students, no matter what type of contraception they use, is to be protected to prevent unintended pregnancy.

"In most situations, when you're an undergrad, for most people that's not the time to start a family or even add to the family because the focus in terms of both undergrad and grad tends to be an intense focus in getting through the coursework in order to get to the career stage so that you're able to nurture relationships with the co-parent and with the children," she said.

Cullins said there is a "historical trap" of looking at family planning only in terms of populating and population control, but that is not the real issue.

"The issue for family planning is giving that woman, that couple, the opportunity to plan and space their children in the way they want to and plan and space their children so they are able to nurture themselves and nurture those kids," she said.

Mary Hoban, director of the American College Health Association National College Health Assessment Program Office, said she hopes legislators will amend the Deficit Reduction Act so that there is not such a "huge financial disincentive" for drug companies to give university health centers the discounts that enabled them to sell birth control pills for "wicked cheap."

She said the higher cost of birth control pills affects more than just women. At many universities, the revenue generated from sales of the pill has been used to support other services at the health centers, like counseling and women's services, that even those who do not use contraception may need. The lost revenue due to the higher cost of the pills may cause other services to be cut back, she said.

Hoban said men and women in sexual relationships should discuss how contraception will be paid for.

"That's an issue that men and women need to work on together. Women can't get pregnant without men. This is not a women's issue," she said.

Cullins said all women should find out where they can get affordable contraception, whether at the university health center or the local health department. She added that birth control pills are not designed to protect against sexually transmitted diseases, so women should protect themselves against disease in sexual situations.

"Those situations tend to be new situations, situations that might not be committed relationships yet. Even if you're in a relationship, there is no guarantee," she said.

Dalton said they key is for students to be prepared.

"We teach students, as a Spelman woman, they need to be knowledgeable, they need to be ready. Don't depend on your partner to come up with your protection. We just teach them: be prepared."

As for the fears of parents about whether the higher cost of birth control pills at Spelman has deterred students from purchasing them, Dalton said since the prices went up the demand has increased.

Shauntel Lowe, a 2006 Black College Wire intern, is a June graduate of the University of California %e2%80%93 Los Angeles. To comment, e-mail This e-mail address is being protected from spam bots, you need JavaScript enabled to view it .

Posted Sept. 19, 2007