Birth Control Prices Rise At Campus Clinics

By ADAM EMERSON The Tampa Tribune

Published: Jul 31, 2007

Returning college students used to paying discounted prices for birth control at campus health clinics will find that costs have more than doubled.

New federal regulations have removed the incentives drug makers had in delivering low-cost contraception to college health centers.

Health leaders, including those in Florida, have pleaded with Congress to no avail to keep the discounts.

Now they worry many students will stop buying birth control, raising the risk of unintended pregnancies and aggravating health problems treated by contraceptives.

"I don't think people are just going to abstain," said Candace Wells, assistant director of nursing at the Florida State University health center's women's clinic. "That's not a reality."

Some students experienced the sticker shock last spring, about the time campus health clinics learned that birth control prices would jump overnight.

Prices for name-brand drugs, such as Ortho Tri-Cyclen Lo, increased from $14 a month to $40 at most Florida universities, including the University of South Florida. The $20 monthly cost for the popular NuvaRing, a vaginal contraceptive, doubled to $40.

Many colleges stockpiled discounted contraceptives throughout last spring, keeping student costs low as long as possible. Egilda Terenzi, USF's student health services director, worries that pending budget cuts to state universities might force them to raise prices even higher.

The USF health clinic loses money on sales of generic birth control pills by keeping monthly costs at $20, Terenzi said. If the health center must cut its budget, that price may have to increase, she said.

Discounts Lost In Spending Cuts

Drug companies stopped offering discounts this year after President Bush signed legislation to reduce federal spending by $39 billion.

The law, however, made it more expensive for drug makers to participate in Medicaid, the public health program that allowed the companies to offer discounted birth control to colleges for years.

Campus health clinics at first thought they were victims of the law's unintended consequence. Leaders at the American College Health Association went to Washington, trying to convince lawmakers that they overlooked student needs.

"Our hope was that they would see there was this technical glitch, that they forgot to include us," said Lesley Sacher, director of FSU's student health center who was recently named president of the association.

It was no glitch. This month, the Centers for Medicare and Medicaid Services issued regulations that excluded college health centers from a list of agencies to which pharmaceutical companies can sell discounted drugs. Those on the approved list include mental health centers and state-run nursing homes.

The center's report doesn't explain why colleges were left out, saying only that, "We believe the entities listed in the statute to be sufficiently inclusive."

Terenzi said students this summer have expressed fear that they cannot afford birth control. The center's response, she said, "seems a cavalier view of students' needs."

Group Leaders Worry About Effects

In a letter to the Centers of Medicare and Medicaid Services, the college health association leaders wrote that, "In the long run, the high cost of drugs ... will undoubtedly lead to reduced testing and use of contraception and a higher rate of unintended pregnancy, undetected health problems, and untreated gynecological disorders."

If that happens, it would reverse the work done by USF senior Jessica Savage, who works as a counselor at the university, talking to schoolmates on health issues such as safe sex.

Most students have little income, but are more likely to pay for birth control out-of-pocket, Savage said.

Many are reluctant to use their family health insurance to cover the cost because they don't want to tell their parents they use contraception, she said.

Savage, a communications major, uses the NuvaRing. Her costs doubled, prompting her to consider a generic brand of birth control.

"It's definitely hard for me, living on a limited budget," she said. "I still use it. I still pay for it. It just kind of hurts the pocketbook."

In addition to preventing pregnancies, birth control pills are used to regulate irregular menstrual cycles or to relieve painful menstruation. They also treat endometriosis, which happens when uterine-like tissue grows outside the uterus.

Pills Commonly Used, Survey Finds

College health leaders are particularly worried about unintended pregnancies. Terenzi fears that students will choose between paying $40 a month and taking their chances.

A fall 2006 study by the health association's National College Health Assessment shows that nearly half of 24,000 students surveyed had sexual intercourse at least once in the prior 30 days. The most common forms of contraception were birth control pills and condoms. Just 1 percent said that pregnancy affected their school performance.

The health clinic at USF, as at most college health centers, offers free condoms for students, Terenzi said. She also has encouraged women to split the cost of birth control with their boyfriends.

USF's student health insurance plan doesn't cover birth control, Terenzi said. FSU requires health insurance of new students this fall, and the insurance the university provides students covers prescriptions.

FSU, however, will have to work to keep the co-pays low, Sacher said. College health directors worry that the premiums on their school insurance plans might increase with the higher cost of contraceptives. FSU's plan cost students at least $1,440 annually.

Reporter Adam Emerson can be reached at (813) 259-8285 or