For those antsy about getting their birth control online, a new study should offer some reassurance. With the help of secret shoppers, researchers found that several online sites and apps that prescribed contraceptives were generally affordable, timely, and safe.
Researchers at Harvard Medical School and the University of California Davis teamed up for the study, published Wednesday in the New England Journal of Medicine. They enlisted volunteers to role-play as customers who attempted to have oral contraception prescribed and sold to them from one of nine online vendors available in the U.S. In total, they carried out 63 online visits to these vendors, which included Planned Parenthood, Nurx, Prjkt Ruby, Virtuwell, Lemonaid, The Pill Club, Pandia Health, HeyDoctor, and Maven.
The visits, which included the users being questioned about relevant medical history, lasted on average less than eight minutes. The vast majority—93 percent—followed the guidelines for prescribing contraceptives established by the Centers for Disease Control, the researchers found.
Sometimes, for example, the “patient” disclosed having a past medical condition that could make contraceptive use unsafe or ineffective, such as a blood clot formed in the deep veins of the leg. Nearly every time this happened, the patient was contacted by a prescriber via text, video, and phone, where it was explained why they shouldn’t receive their prescription (in some cases, they would still be eligible for a less risky contraceptive). Out of 45 such visits, only three ended up with a prescription they probably shouldn’t have gotten.
There were other benefits, too. Often, the prescriptions could be picked up from a local pharmacy immediately, and even when the prescription was mailed, it usually arrived within a week’s time. Sometimes, the vendor did accept health insurance. But even the average uninsured cost for a year’s supply of birth control ($313, though it could be as low as $67) was slightly less than you might expect to pay if you had visited a doctor in-person.
The findings, according to study author Ateev Mehrotra, show that birth control can be easily and safely provided through telemedicine.
“For most health conditions, a visit to the doctor remains essential, but there are certain clinical scenarios for which this model appears to be overall safe and efficient,” said Mehrotra, associate professor of health care policy and medicine at Harvard Medical School, in a statement released by the school.
There were some aspects of these apps that could be improved, Mehrotra and his team added.
For instance, the reason why these apps stuck to the CDC guidelines so well is likely because they rely on automated checklists and questionnaires that include most everything that might make someone ineligible for oral birth control. The few times that such people were still able to get contraceptives involved rare conditions that these checklists probably weren’t programmed to identify. That suggests they can be further refined.
The apps also never discussed the possibility that patients might benefit more from long-term, reversible contraception, which would require further medical consultation from an in-person visit to a doctor. And they never included questions that might screen out people who don’t feel capable of sticking to a daily pill-taking regimen.
Still, given that women in many regions of the U.S. continue to face an increasingly difficult time affording and accessing birth control, it’s good to know that not every medical treatment sold online is a scam.