Over the past 15 years, there has been a national shift to making contraception more accessible outside of a clinical setting. New pathways include: allowing pharmacists to prescribe birth control, making contraception available via telehealth and efforts to making contraception available over the counter without a prescription. Many of these options are widely acceptable to women, with the majority of women comfortable with pharmacists prescribing birth control and making contraception available over the counter without a prescription. In recent years, a growing number of companies providing contraception through online platforms (“telecontraception”) have entered the market and are providing a new option for people to conveniently obtain contraceptive supplies that need a prescription without the need for an in-person visit. Some of these companies specialize in contraceptive care and others have expanded services into sexually transmitted infection (STI) testing and treatment, as well as other primary healthcare services. The COVID-19 pandemic has amplified the interest and need for such services and accelerated the evolution of these platforms over the last year as more people have sought ways to obtain care from home.
Research into these online platforms has been limited. One study focused on characteristics of patients seeking services through one telecontraception platform and found that women ages 18-24 and 25-34 make up the majority of telecontraception users and that combined oral contraceptives were the most dispensed contraceptives. Another study found that among clients using a primary care telehealth platform, women seeking contraception were more likely to use coupons and less likely to provide insurance information compared to women seeking other primary care services. Studies have also found these platforms are relatively safe and that for the most the part they adequately screen for birth control contraindications (such as high blood pressure and migraines with auras), but could further improve contraindication screenings.
The share of women nationally that relies on these companies to obtain contraceptives is still relatively small. The 2020 KFF Women’s Health Survey found that 4% of women 18 to 49 had ordered birth control from an online birth control platform. Women 18 to 35 (6%), Hispanic women (5%), and low-income women (6%) were more likely to use these platforms than older women (1%), white women (3%), and higher income women (3%).
Many of these companies are seizing on the opportunities to expand, especially during the pandemic, to more states, accept insurance and Medicaid, and offer additional services. Over the past year, companies have expanded to offer the newest contraceptive methods like Annovera, the one-year ring, and services like acne treatment and anxiety medication. Companies are reporting up to a 100% year-over-year increase during 2020 due to the pandemic.
KFF has been tracking these companies and the sexual health services they offer since the beginning of the COVID-19 pandemic and conducted a study to better understanding the policies and practices of 16 telecontraception companies in November 2020 through January 2021. We received responses from 13 of the 16 companies we reached out to. Of the 13 companies, three provided partial information (28%-48% complete) and 10 companies responded to nearly all of the questions. This report presents the results of that study and discusses the implications of the findings.