The "buy one, give one" business model made famous by TOMS shoes is genius for its simplicity: you get to buy something you want, and included in your purchase is a do-good (and feel-good) donation. You can do it with eyeglasses, rain boots, and toothbrushes, and the idea has now come to your birth control pills, thanks to a new website called Prjkt Ruby.
Started in February by Peter Ax, a healthcare investor and CEO of Phoenix Capital Management in Scottsdale, Arizona, Prjkt Ruby partnered with the pharmaceutical company Afaxys, as well as a number of physicians around the country, to make birth control pills available for purchase online.
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And every time a woman buys her pills from Prjkt Ruby, Afaxys will donate 25 cents to the non-profit Take1Give1 (which was set up by Prjkt Ruby, so they could also accept straight donations). Then, in turn Take1Give1 transfers 100% of those funds to the global health non-profit Population Services International. "Depending on the region(s) that we are helping it might not be oral contraceptives that are needed, it might be injectables, implants, IUDs, or emergency contraceptives," explains Dan Snyder, Prjkt Ruby's chief marketing officer. With all of the direct donations being made to Take1Give1, Snyder expects the donation per pack sold to be around $1 at the time of their first "pill drop" later this year.
All you have to do is go to the Prjkt Ruby site, make a profile, and then choose from their line-up of three products, which are all FDA-approved generics that cost $20 per pack. Also for sale: Ella, an emergency contraceptive pill, for $59.
Once you've picked a product, the site prompts you to fill out an involved medical questionnaire that asks you to fill in all details you'd give a doctor face-to-face, including your height, weight, and health history, with questions like: When was the last time you had a Pap smear? What was your blood pressure during your most recent reading? (The site advises you to use one of those DIY-machines at local pharmacies if you don't know.)
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Then, the questionnaire and your order are reviewed and approved by a licensed MD in your home state before your pack is shipped (for free) and your credit card is charged. All orders arrive within two to three business days; emergency contraception arrives via FedEx the next business day.
Easy, yes. But is it safe?
"Absolutely. Gaps in contraceptive use is a real problem, and the benefits [of ordering online can] outweigh the risks" for some women, says Mary Rosser, MD, assistant professor of obstetrics and gynecology at Montefiore Medical Center in New York. "This is ideal for someone who's otherwise healthy, who has no other health problems."
In fact, if the American College of Obstetricians and Gynecologists (ACOG) had its way, you wouldn't even need a doctor's approval to get birth control pills: ACOG released a position statement back in 2012 (and re-affirmed last year) that concluded, "weighing the risks versus the benefits based on currently available data, [oral contraceptives] should be available over-the-counter."
Despite the Affordable Care Act, roughly 30% of insured women are still paying something for their birth control. And that doesn't include the (admittedly smaller-than-ever) number of women who remain uninsured, or women who experience a temporary gap in their coverage because they're, say, switching jobs. " You still need [regular check-ups]. It shouldn't replace the relationship with your OB-GYN, but many women still pay out-of-pocket for their birth control, sometimes as much as $80," Dr. Rosser adds.
The only major con is that online prescribing is illegal in Arkansas, Louisiana, Missouri, North Carolina, and Iowa, so women in those states can't use it.
Still, the Prjkt Ruby team is counting on the pros to keep the project going. "We are finding that the convenience, [low] cost, and privacy of being able to order online coupled with the social mission is very powerful," Ax explained in an email to Health.
If your insurance pays for your birth control in full, you're probably not in the market for a new approach like Prjkt Ruby. But if you use condoms and you want to be a help, there's also L. Condoms. For every condom purchased, the company also funds the distribution of condoms in developing countries in Sub-Saharan Africa, a region where the rate of HIV/AIDS infection is the highest in the world.
Launched in 2012, L. Condoms are now available at CVS, Target, and the company's online store (12 condoms for $15, thisisl.com).