How Much Do Americans Pay Annually for Birth Control

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When it comes to birth control, the annual cost can range from $0 to more than $2,400 depending on the method you choose, according to research from GoodRx.

The Affordable Care Act has significantly reduced out-of-pocket costs for birth control. But the financial landscape can be complex. And choosing the best option can be challenging. You must balance cost, insurance coverage, and the many different methods (including the new over-the-counter option, Opill).

Below, we walk through the various contraception options and their costs to help you make an informed decision.

The cost of birth control pills

The birth control pill, often referred to as "the pill," is a prescription form of birth control that typically contains the hormones estrogen and progesterone. Together, these hormones prevent pregnancy by:

• Stopping ovaries from releasing eggs

• Thickening cervical mucus so sperm cannot reach an egg as easily

• Making the uterus a less effective environment for a fertilized egg

Since the passage of the Affordable Care Act (ACA) under former President Barack Obama, the birth control pill's out-of-pocket cost has decreased dramatically. Prior to the ACA Contraceptive Provision in 2012, only about 15% of people on birth control pills had no out-of-pocket costs for oral contraceptives like the pill.

According to our research, that percentage jumped to nearly 77% in 2024, which is consistent with other scientific literature. This is up by 10% from 2018.

While the majority of people using the birth control pill are able to get it for free, many end up paying out of pocket if they lack insurance, have an insurance copay, or find that their insurer doesn't cover their preferred birth control.

Among people who pay for birth control pills, the average annual out-of-pocket cost is $20 for those with insurance and $84 for those without insurance. These out-of-pocket costs have dropped dramatically in the last 5 years - by almost $200 for both the insured and uninsured populations.

Keep in mind that this cost is on top of any required out-of-pocket payment to the health professional for initial consultations, which average $34 annually.

For those paying cash at the pharmacy for birth control pills, prices for 30-day fills range from $18 to $248. Below, you can see that generic norethindrone is the most commonly filled birth control pill, coming in with a cash price of $35 for a 30-day prescription. Lo Loestrin Fe, on the other hand, is a commonly prescribed brand-name medication and has a cash price of $205 per month.

The cost of long-acting reversible contraception

There are two different types of long-acting reversible contraceptives (LARCs): the intrauterine device (IUDs), which is inserted into the uterus, and implants, which are inserted into the arm. IUDs can be either hormonal or nonhormonal (copper). Both types of birth control require clinical approval and administration.

Hormonal IUDs work by releasing progestin, which both blocks ovulation and causes thickening of the cervical mucus so that sperm cannot reach an egg. Nonhormonal IUDs work by releasing copper ions, which are toxic to sperm.

In general, LARCs can range anywhere from $320 to $1,300 for those without insurance. Those with insurance may find that their IUD is free.

The cost of over-the-counter options

Over-the-counter (OTC) birth control medications and supplies offer a convenient option for pregnancy prevention. And the recent introduction of Opill, a new OTC birth control pill, marks a significant advancement in accessible contraceptive options.

Opill costs $340 a year. And with 98% effectiveness (if taken correctly), it's the most reliable OTC option available on the market.

Meanwhile, male condoms remain the cheapest OTC option at $42 per year, followed by spermicide at $84 per year.

The cost of other prescription options

There are other prescription alternatives to the birth control pill and LARCs - namely, the vaginal ring (NuvaRing), the birth control patch, and a quarterly progestin shot.

The vaginal ring

The vaginal ring can be purchased at a pharmacy and self-inserted at-home. Similar to birth control pills, the vaginal ring works by releasing the hormones progestin and estrogen inside the uterus. It prevents ovulation and thickens the cervix mucus lining, which prevents sperm from reaching the egg.

Like other forms of birth control, insurance often fully covers the vaginal ring. Many plans require zero out-of-pocket costs. If the plan requires cost-sharing (where the member is required to pay a portion out of pocket), the average annual cost is just over $87.

The patch

The contraceptive patch also contains a combination of the hormones progestin and estrogen, which help prevent pregnancy. The patch is applied to either the arm, back, lower abdomen, buttocks, or chest. It is typically worn for 3 weeks, removed for 1 week, and then replaced with a new patch.

The patch can be completely free for individuals with health insurance or access to community health clinics. Those required to pay some portion out of pocket may see annual costs of about $200. The average price for those paying cash at pharmacies is about $150 (for three patches). In one year, this totals $1,800.

The birth control shot

Injections of DMPA, a progestin hormone (often referred to as "Depo-provera" or the "Depo shot"), are another contraceptive option. The typical shot provides about 12 weeks of birth control. Most insurance plans cover the birth control shot. The estimated annual out-of-pocket cost for those without insurance is $600.

The cost of surgical options

Surgical forms of contraception are a popular option for people looking for a permanent (and often irreversible) form of birth control. For people who menstruate, this is tubal ligation (or "female sterilization").

There are two common surgeries for tubal ligation. In essence, these types of surgeries require the fallopian tubes to be either tied, cut, closed, or removed to prevent either an egg or sperm from reaching them. Tubal ligation is considered a permanent procedure.

To identify the cost of surgical birth control, we looked at a representative sample of self-identified men and women in the U.S. In our analysis of individuals who self-identified as women in 2021, the average age of those receiving this type of surgery was just over 31 years old. The cost was about $114 for the procedure for those with insurance plans requiring some out-of-pocket payment.

Since a woman at age 31 has about 14 fertile years left, the total expenditure for this procedure is about $8 per year for this group.

For those without insurance, the estimated cost can reach $6,000, or about $430 per year.

The additional cost of health professional visits

All forms of prescription birth control require at least one visit to a healthcare professional. Many clinician visits for birth control are covered by insurance, federal/state health clinics, or nonprofit organizations like Planned Parenthood.

The average annual cost is $89 for those who pay out of pocket.

Summing it all up

The Affordable Care Act helped eliminate many of the barriers women face when it comes to getting accessible and affordable healthcare. Nevertheless, there are still plenty of women who pay out of pocket for their contraception.

For those who are paying out of pocket for birth control, many community health clinics like

Planned Parenthood can offer services and medication for free or at a reduced rate. Sites like GoodRx can also help save money on prescription medications like the birth control pill or NuvaRing.

There are free methods of birth control, such as the withdrawal (or "pull out") method and fertility awareness tracking. But they are typically not as effective as the methods mentioned in this article.

Methodology

Average annual out-of-pocket spending on contraception: Average annual out-of-pocket spending for medications and all clinician/facility visits were calculated using the Medical Expenditure Panel Survey (MEPS) for 2017 and 2018. Specifically, we used the Full Year Consolidated Data Files (HC-192 and HC-201), Medical Conditions Files (HC-190 and HC-199), Prescribed Medicines Files (HC-188A and HC-197A), Inpatient and Outpatient Stay Files, Emergency Department Files, Office-Based Visit Files, and Home Health Files. We identified patients as having at least one expenditure with a primary indication of contraceptive management, using ICD-10 code Z30. Medical events were identified as contraception related if the primary diagnosis for the event had a three-digit ICD-10 code of Z30.

To calculate surgical costs associated with contraceptive management (vasectomy and tubal ligation) we identified all patients with a health event coded as ICD-10 code Z30, where a surgery was performed. For males, we considered this a vasectomy, and for females we considered this a tubal ligation.

Average retail price of birth control medications (birth control pill, vaginal ring, and patch): This GoodRx analysis is based on a representative sample of U.S. prescription fills (not GoodRx fills) and comes from several sources, including pharmacies and insurers. The reported prices are based on average retail prices, the so-called "usual and customary" prices or retail prices at the pharmacy (not including insurance copays or coinsurance). All prices listed in this article are based on data from January 1, 2020 to December 31, 2020.

Average cost of over-the-counter birth control: The average cost is based on prices for three over-the-counter birth control methods: spermicide, male condoms, and female condoms. Prices were obtained from four online medical supplies sources: Amazon, Walgreens, CVS Pharmacy, and Walmart.

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