Due to changes in federal law, Tufts Health Service can no longer offer the significantly reduced prices on birth control pills to which many students have grown accustomed.
While students were previously able to buy "clinic packs" of pills from a variety of brands for $7 or $8 per month, many of them will now have to bear higher costs, according to Tufts' Health Service Medical Director Dr. Margaret Higham.
She said that this change has little to do with her office. "Obviously we would love to keep things as cheap as possible for people but we really didn't have a say in it," she said.
According to Higham, Health Service began offering birth control prescriptions at reduced rates starting about 15 to 20 years ago, largely because "at that time, very few insurance plans covered contraceptives," she said.
Until recently, students had been able to benefit from "a federal program that allowed drug manufacturers to provide very cheap sample packets of pills to what were called 'underserved populations,'" she said.
Under this arrangement, students were able to pay directly for their prescriptions rather than going through insurance companies.
Though not all drug manufacturers participated in the program, many did and "that worked great for a long time," Higham said.
Over the years, however, the number of brands that provided low-price clinic packs to Health Service decreased from the original 10 down to only three: Ortho Tri-cyclen Lo, NuvaRing and Cyclessa.
Changes in law have primarily accounted for these limitations. Over time, she said that more and more states have passed laws requiring insurance companies to cover contraception. According to the National Conference of State Legislatures' Web site, Massachusetts has had this requirement on the books since 2002.
As a result of this trend, many companies stopped providing the low-priced clinic packs.
The federal government has also redefined the term "underserved population." Tightened regulations that were instituted this fall provided "the final nail in the coffin," Higham said, because most Tufts students do not fit into this group anymore.
"In order to be considered, you had to submit a lot of paperwork about poverty levels, etc. which really aren't pertinent to our student population," Higham said. "So drug companies in the fall told our pharmacy that they could no longer provide the brands of pills that were left at the reduced rate."
Even so, the pharmacy foresaw these changes and overbought the lower priced samples, according to Higham. This supply, however, has nearly been depleted.
"Now students will need to use their health insurance for their birth control just like they use it for any other prescription," Higham said.
Many students had already started to do this anyway because so few options were available to them at the lower prices, she said.
Sophomore Amanda Schneider stopped getting the clinic packs from Health Service because she decided to use a different brand. But she said that the option to get her prescriptions at low prices was convenient. "I got it from the health center because it was so cheap," she said. After switching brands, she started paying $20 rather than $7 per month.
Higham said that the new costs for the prescriptions will vary. "People come here from all over the country with hundreds of different kinds of insurances," she said. "It varies based on what your insurance is and whether the product is generic or brand name."
For example, "If you have student health insurance and you're getting a generic pill that costs around $30 a month full price, your co-pay will be around $10," she said. Brand names will be more expensive than the generic options.
Since all students must have health insurance, the price change should not be too drastic in most cases, Higham said. "The main issue is that students are required to have health insurance and they should use it," she said.
Many students, however, who have obtained birth control from Health Service are hesitant about using insurance to pay for the prescription because they do not want records of their purchases to be sent to their houses.
Sophomore Lily Safran said that an assurance of confidentiality was her reason for getting birth control from Health Service. "I didn't care about the price," she said.
But Higham said that these concerns likely stem from "urban myths."
"My understanding is that very few insurance companies send home info about the prescription because usually it goes to the pharmacy and students pay for the medication when they pick it up ... but I think students who are concerned about that should definitely call their insurance company and check that out," she said.
Obtaining this information from the companies, she said, can be a good experience. "It's going to force students to have to learn more about their insurance and to be more aware of how it works, which is actually a good thing," she said. "That's kind of a life skill."
