Oral Birth Control Fills Down Slightly After Supreme Court Overturns Roe

In June 2022, the Supreme Court ruled in Dobbs v. Jackson Women's Health Organizationthat the U.S. Constitution does not grant the right to abortion. This decision overruled previous abortion rights cases Roe v. Wade and Planned Parenthood v. Casey and gave states the power to decide their own laws on the matter.

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Even though the Dobbs decision didn't affect birth control access, it may still have had an effect on women's behaviors related to birth control. The GoodRx Research Team examined the percentage of national and state birth control fills (out of all prescription medication fills) from the past year to find out if there's been any change since the Supreme Court's ruling.

National fills

Nationwide, fills for forms of non-oral birth control - including implants, injections, IUDs, patches, rings, and vaginal gels - are down about 0.01 percentage points (0.13% to 0.12%) from June 2022, when Roe was overturned, to May 2023.

However, non-oral birth control fills have fluctuated in that range over the past year and are only down by 0.03 percentage points (0.15% to 0.12%) since January 2019. So, in general, there hasn't been that much of a decline in non-oral birth control fills in the context of the past 4 years.

Fills for oral birth control, or "the pill," also decreased over the past year, but by a higher margin: 0.09 percentage points (0.92% to 0.83%).

State fills

Digging into states, we can see that the rates of oral and non-oral birth control fills in certain regions tended to be higher than the national average (1% of total prescription fills) from May 2022 to June 2023.

Western states in particular had higher fill rates than many other parts of the country. Colorado's fill rate was 1.73%, followed by 1.54% in Montana, 1.48% in Utah, 1.44% in Wyoming, and 1.42% in Washington.

Colorado's policies may have something to do with its high birth control fill rates. It was one of the first states that allowed pharmacists to prescribe oral birth control. And Plan B, or the "morning after pill," has been available over the counter there since 2013.

Parts of the South also saw high fill rates over the same time period, though to a lesser extent. Mississippi's fill rate was 1.27%, followed by 1.23% in Louisiana, and 1.19% in both Georgia and Texas. Each of these states, excluding Georgia, has passed laws in the wake of Dobbs that restrict abortions.

In contrast, Alabama and Missouri had fill rates below the national average, at 0.81% and 0.86%, respectively. These states have also passed abortion restrictions.

Summing it all up

While birth control fills have fallen over the past year, non-oral birth control fills have not declined by as much as oral birth control fills. This may be due to a number of potential factors, including more women considering longer-term solutions, like IUDs, in anticipation of birth control becoming unavailable in their state.

Western states had higher fills for birth control than other regions over the past year. In the case of Colorado, that may be related to a history of making birth control more accessible.

In the South, higher fill rates in states like Texas, Louisiana, and Mississippi may be a response to new abortion restrictions. Meanwhile, lower fill rates in places like Alabama and Missouri may signify unmet needs for contraception in the wake of restrictive abortion laws being enacted.

Methodology

Prescription percentage calculation: Using a representative sample of U.S. prescription fills, we calculated fill percent for birth control options on the national and state level. Fill percent was calculated by taking the fill count for birth control options as a percentage of fills for all medications. (We excluded vaccines from our fill count of all medications). National fill percent was split by oral and non-oral versions of birth control and calculated for each year from 2019 to 2023. State-level fill percent for all forms of birth control was calculated for the period from June 2022 and May 2023. National fill percent was reported using a panel of pharmacies that were present in the sample each month from January 2019 to May 2023. State-level fill percent was reported using a panel of pharmacies that were present in the sample each month from June 2022 to May 2023.

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