The prices for birth control pills will rise significantly in university health centers and pharmacies because of a recent change in tax codes.

The Northwestern pharmacy sells about 30 different types of oral contraceptives, most of which are generic brands.

Although the exact changes in prices are not yet available, the university is expecting substantial increases. For example, one common medication is Desogen, a brand-name drug that costs students about $15 per month. According to NU pharmacist Jeff Rappaport, the university hopes the new price will be less than $50 per month.

"We had contracts with some (pharmaceutical companies) but those contracts have expired. We’re trying to replace them as competitively as we can," Rappaport said.

The university is trying to negotiate with pharmaceutical wholesalers and manufacturers, but it has relatively little bargaining power because NU is only one of many college campuses nationally that will be affected by the rising prices.

Pharmaceutical companies used to sell the drugs at large discounts to health care providers, such as universities. But under the Deficit Reduction Act of 2005, having discounts increased the money companies must pay to participate in Medicaid. The effect of the bill on college students became apparent only recently because enforcement of the bill just began and many universities have been temporarily able to keep prices low using drug stockpiles.

"As usual, (the price rise) was an unintended consequence," said Dr. Donald Misch, executive director of University Health Services.

The rising prices will especially affect those students who are not covered by university insurance and pay for oral contraceptives out of pocket, Rappaport said.

Because a number of students buy birth control off-campus, the number of NU students who use oral contraception is not available. The American College Health Association’s National College Health Assessment states that in fall 2005, about 37 percent of college students used birth control pills.

Some students, such as Weinberg and Music senior Anna-Louise Burdett, said they think the rising birth control prices will hurt NU’s efforts to promote safe sex on campus.

"Students have a hard enough time just affording tuition," Burdett said. "I feel like safe sex is something that isn’t addressed much here, and this won’t help."

The ACHA is asking the Centers for Medicare and Medical Services to reconsider the position of universities, and to include universities on the list of exceptions to the bill, Misch said.

The organization said that if university health care providers are not excluded from the bill, schools will have to increase the prices of oral contraceptives, raise student insurance premiums, reduce the availability of health care services designed to combat and detect the spread of sexually transmitted diseases and increase the money students will have to pay out of pocket.

The ACHA also expressed worries that students who cannot pay the new prices will stop using contraceptives altogether, which will increase the number of unwanted pregnancies among college students.

"The bottom line is that it’s going to be more costly," Rappaport said. "We’re really trying to take care of the students as best as possible under the circumstances."

When Malia Mason went into her university health center last December to refill her birth control prescription, she got some shocking news: She’d soon be shelling out $42 for each four-week pill pack of Ortho Tri-Cyclen Lo, she was told, instead of her usual $14. The 19-year-old sophomore at the University of Pittsburgh filled the rest of her yearly prescription at the old price, but she finally ran out this month and will have to come up with an additional $360 a year. "That’s the cost of my yearly electric bill or half my books for a semester," she says. "I haven’t yet figured out what I’m going to do."

University pharmacies nationwide have recently doubled or tripled the prices they charge for prescription contraceptives. A quirk in a new federal law, designed to save taxpayers money on Medicaid reimbursements for drugs, has effectively persuaded pharmaceutical companies to stop selling their products to these pharmacies at deeply discounted rates. (If companies continue to offer such discounts, the law stipulates, they will also receive lower payments from Medicaid.) As a result, 3 million college women who use birth control pills are now paying $30 to $50 a month for their favorite brand, up from an average of $5 to $10, according to the American College Health Association. "Some campuses had the resources to stockpile before the legislation took effect, but most are running out or have already run out," says Mary Hoban, who directs the ACHA’s national college health assessment program office.

Clinics have already seen a drop-off in students filling prescriptions. The number of pill packs being dispensed at the University of North Carolina-Wilmington’s student health center, for example, has fallen by a third since September, says pharmacist manager Ann Roth. Some health centers, like the one at Bowdoin College in Brunswick, Maine, have stopped stocking oral contraceptives altogether because they can’t afford to maintain the pricier inventory. And many more are struggling to provide a full range of services because they can no longer rely on profits made from marking up the discounted products. The UNC health center used to earn about $5 to $10 from every pill pack sold, which subsidized physical exams, HIV testing, and medication counseling, says Roth.

One consequence could be a rise in unintended pregnancies, a major cause of college dropouts. What’s more, without the incentive to get their yearly prescription renewed, fewer women are coming to health centers for gynecological exams, says Hoban. This means they also aren’t getting screened for sexually transmitted diseases or being offered the new HPV vaccine, which can prevent cervical cancer. "We really have to get this issue fixed," says Cecile Richards, president of Planned Parenthood.

In the meantime, students can look for cheaper alternatives. Most university pharmacies now dispense generic oral contraceptives for $20 to $25 per pack. But about half a dozen brands of pills—as well as the vaginal insert NuvaRing and the patch—still have no generic equivalent, and some women may need to stay on a particular brand to avoid side effects like nausea, headaches, or frequent spotting, says Steven Sondheimer, a professor of obstetrics and gynecology at the University of Pennsylvania School of Medicine. Students covered by their parents’ health insurance might get a price break, but they’ll probably have to go off campus since most university clinics don’t accept insurance. Planned Parenthood clinics are another option; the vast majority still offer reduced rates for brand-name contraceptives. Women can log on to plannedparenthood.org to find the nearest clinic, though they should call ahead, says Richards, to make sure it has the discount.

Student organizations are also trying to find ways to ease the financial burden. At the University of New Mexico, a group called Spiritual Youth for Reproductive Justice has been helping to subsidize the cost of contraception. So far, it has given eight students an average of $103 each. "But this shouldn’t be the end solution," says Ambrosia Ortiz, 22, who served as vice president of the group before she graduated last year. Students at New Mexico and other schools nationwide are organizing call-in campaigns directed at legislators, in an effort to get the discounts reinstated. Mason hopes that change will come soon. "I’ve had friends go off their birth control because they can’t afford it," she says. "It’s just completely ridiculous. If the government wants to promote safe sex on campus and no unintended pregnancy, they’re really not sending a good message."

Vaden Health Center began stocking up on oral contraceptives when Congress announced an act that would cause costs to skyrocket. But now, the low-cost pill packs stockpiled at Vaden are on the verge of expiring.

Before the Deficit Reduction Act of 2005, which went into effect in 2007, pharmaceutical companies received government subsidies to reduce the price of oral contraceptives at college health centers and low-income health clinics. These clinics no longer receive the pills at substantial discounts, resulting in a cost increase for patients.

College campuses and over 400 health clinics that provide health care for underprivileged women have been affected. Some colleges, like Bowdoin College in Maine, have stopped stocking contraceptives altogether. Others are stocking only the morning after pill.

Robyn Tepper, director of Medical Services at Vaden, said that while costs have been creeping up over the years, Vaden has no plans to stop providing contraceptives.

“That won’t ever be an issue here,” she said. “It’s just not something we would do. I don’t ever have to worry that a student can’t get what they need.”

Previously, students paid at most about $25 per month for birth control pills purchased at Vaden. Patients with Stanford’s Cardinal Care insurance plan paid $10 per month for generic pills and $25 for brand name medications. Those without Cardinal Care could still buy generic pills at Vaden for $10 per month out of pocket.

Once the low-cost pill packs run out all students purchasing pills at Vaden must pay the full price for oral contraceptives. Some drugs have doubled in price. Ortho Tri-Cyclen Lo has quintupled in price — from $10 to $50 per month. Those with outside insurance plans may get reimbursed, however.

While some students are already paying the full price of the medications, depending on brand, others may be unaware of the changes. One Stanford student, who wished to remain anonymous due to privacy issues, was shocked by the impending dramatic increase in price. After finding out that her monthly supply of medication may no longer cost $10, she is now considering switching the brand of her birth control.

“I’m going to use the two packs they gave me, and then check out my insurance policy,” she said, referring to the stockpiled clinic packs she received from Vaden. “If I can’t get subsidized by insurance, then I’ll have to switch birth control.”

Staff at the student-run Sexual Health Peer Resource Center (SHPRC) said the organization has been unaffected by the legislation. Its funds are already limited, and while the SHPRC provides contraceptive barrier methods, it can neither afford to provide oral contraceptives nor is it licensed to prescribe them. At the moment, the SHPRC has no plan of increasing its stock in condoms or spermicide to counteract the availability of other contraceptives.

At Vaden, however, Tepper said the staff is trying to do everything it can.

“We’re willing to help out students to figure out what would be most economical for them,” she said.