Anchorage Daily News

Ellen Thomas, who's working full time on a master's degree at the University of Alaska Anchorage, was unpleasantly surprised during her last visit to the student health center for birth control.

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The NuvaRing, a birth control insert she'd been using for months, had quadrupled in price.

"I had to switch and I'm getting the shot now," she said, referring to Depo-Provera, a shot that stops ovulation for three months at a time. She doesn't like it as much, but, she said, "Considering my options it was all I could really afford."

Birth control prices in student health clinics and Planned Parenthood offices across the state and the country have leapt up this summer, in some cases increasing from $5 a month for pills to $40, according to providers.

The reason? An unintended consequence of the federal Deficit Reduction Act of 2005, a law that went into effect in January. It changes how drug companies calculate Medicaid rebates to states, and in the process makes it expensive for drug companies to offer deep discounts to schools and some Planned Parenthood clinics like they have previously.

For the thousands of women in Alaska used to purchasing an array of low-cost birth control, the change means higher prices and fewer choices, especially in smaller communities. Popular birth control options that don't have generic alternatives, like the NuvaRing or the Ortho Evra patch, are particularly out of reach.

Some providers worry that the lack of affordable birth control will lead women to skip it or use a method they are less comfortable with, leading to unwanted pregnancies.

"Being in school it's hard enough financially to make it through," said Mary Anne Wilson, the director of the Student Health and Counseling Center at UAA. "They are forced to make a decision between maybe books or food and contraception."

Many clinics stocked up on cheaper birth control before the change took effect. They are just now running out of supplies and forced to raise prices. In the university system, each clinic has come up with a different solution, but none are ideal.

At UAA, the clinic offers some brands of generic birth control at a somewhat lower price, along with the higher-priced NuvaRing. At University of Alaska Fairbanks, the clinic offers a few brands of generic pills at a low price but quit dispensing other popular options. In Juneau, for the students who used to pay $5 for pills, but can't pay the $28 the pills now cost, there aren't many good alternatives.

"Some of them are just going to condoms, which is not really satisfactory," said Colleen Stansbury, the physician's assistant who runs the student health center at UAS.

Only Planned Parenthood's two largest clinics, in Anchorage and Fairbanks, will feel the impact of the changes. Other clinics are funded differently and aren't affected by the law change. Once the large clinics run out of their stock of lower-cost drugs, they are going to switch to all generic birth control pills, and limited supplies of everything else. Customers can still get any pill they want at a pharmacy but, "it means they're looking at $45 to $50 a month," said Clover Simon, executive director of Planned Parenthood of Alaska.

Directors of the university clinics and Planned Parenthood have been asking Sen. Lisa Murkowski to help fix the problem, but so far haven't seen any movement from her office, said Simon.

Brittany Goodnight, who made a lobbying trip to Washington, D.C., in July, met with Murkowski in her office on July 19. Murkowski was familiar with the issue and gave her the impression it was a mistake that needed to be corrected, Goodnight said.

"I definitely got the impression this is something she cares about deeply. ... It was my impression we can count on her to fix it."

But Kevin Sweeney, a spokesman for Murkowski's office in Anchorage, was noncommittal Tuesday. In an e-mail exchange he would say only that the senator is reviewing the issue.

The offices of Sen. Ted Stevens and Rep. Don Young said they had not been contacted.

Find Julia O'Malley online at adn.com/contact/jomalley or call 257-4591. Erika Bolstad at the McClatchy bureau in Washington, D.C., contributed to this story.