ECs at Low Cost from Vending Machines Could Improve Access

By Melinda Young

Executive Summary

Universities and other places frequented by young people are increasingly offering emergency contraceptives in vending machines to make access easier and cheaper.

• Vending machines that offer lower priced emergency contraception are a popular idea that 90% of university students said they would use, according to one study.
• The typical over-the-counter emergency contraception costs $30 to $50 at a pharmacy; the vending machine price can be as low as $5 for the same product.
• Another strategy for increasing access to emergency contraception is for providers to talk with patients about 30-mg ulipristal acetate tablets (ella), the prescription emergency contraceptive. They could encourage patients to obtain a prescription in advance of needing one.

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Young people sometimes fail to get emergency contraception (EC) when they need it because of access barriers involving cost and lack of the product in a store near them. For college students, a potential solution is to place emergency contraceptives in campus vending machines — a prospect that is so popular that 90% of university students surveyed for one study said they would use an on-campus EC vending machine. A similar strategy could make EC available at doctors’ offices, clinics, bars, coffee shops, and bookstores.¹

The study surveyed students across undergraduate and graduate programs at a mid-size, private Illinois university. They were recruited through flyers, social media, email listservs, and internal communications from an on-campus health clinic.¹

“Over-the-counter emergency contraception in our neighborhood costs around $50 for Plan B, which is out of reach for a lot of college students,” says Sophie Knifton, a research assistant at the Complex Family Planning Research Center of the University of Chicago.

Privacy is another issue. Buying Plan B at a drug store could draw unwanted attention, while going to a vending machine that carries various items might seem more discreet. Campus vending machines could have a healthcare focus, carrying menstrual products and over-the-counter medication, as well as EC. The key to its success is for the university or machine vendor to obtain low-cost EC.

“We asked people what else they would want to see in a vending machine, and they said cold medication or Advil, and things like that,” Knifton says. “These are other things students might be buying to reduce the stigma of using the machine.”

Knifton’s study asked students about barriers to obtaining EC, and 18.3% found it was difficult. The most common barrier cited was the cost. Plan B typically sells for $25-$50 at retail pharmacies. Some people also said they had difficulty accessing a pharmacy that sold EC.¹ Students also expressed concern for confidentiality, agreeing that they were concerned about being noticed by others or interacting with a pharmacist or store staff when purchasing EC.¹

Some states have encouraged public colleges to include EC in campus vending machines. For private colleges or colleges in states where state laws do not encourage EC use, students could advocate for EC access via vending machines or through EC distribution networks on campus, Knifton suggests.

“I work for EC4EC [EC for Every Campus] — advocates for youth — on establishing emergency contraception distribution networks on campuses through peer-to-peer distribution,” she says. “I received a donation of emergency contraceptives from this organization, and we installed a free pick-up distribution system in one of the bathrooms in a building on campus so people could get free emergency contraception if they needed it.”

EC4EC has a team that helps connect college campuses with companies that offer generic EC at affordable prices — sometimes below $5. The organization looks for lower-price options than what someone might find at discount retailers like Walmart and Costco. “We have a list of companies that will sell emergency contraceptives for $5, and it could be even less if one of the big organizations is purchasing a lot,” says Kelly Cleland, MPA, MPH, executive director of the American Society for Emergency Contraception in Lawrenceville, NJ.

“They place a bulk order and can distribute EC or mail it out — however it best meets the needs of the population,” she explains. “Generic manufacturers are charging $5, and to make EC costs about a dollar, so when you buy it directly from the manufacturer, it becomes an affordable option.” When EC is sold for $50, it is because it passes through a number of companies, and each company is marking up the price, Cleland says. “A lot of the companies we work with are mission-oriented, but they are still looking to make a profit at that $5 price point,” she adds.

There are about 150 college campuses that have EC in vending machines, and dozens more are working on making this happen, she says. At a $5 price point for EC, there probably is capacity for 1,500 campus vending machines to carry the drug, Cleland notes. “Part of the challenge is EC manufacturers will need to plan for it; I can’t just put in an order today for 500,000 units,” she says. “They need to ramp up production and plan for it months in advance.”

Larger family planning clinics could include emergency contraceptives in vending machines, and these could be installed in other places convenient to young people, such as bars, restaurants, and community centers. An option for smaller OB/GYN offices, coffee shops, bookstores, and libraries might be to have EC in a basket with a note that it is free, but donations are welcomed. Both the vending machine model and EC in baskets could be sustainable once the initial costs are covered by a nonprofit, Cleland says.

The doctor’s office or bookstore could have a note with a basket, saying people could donate for the emergency contraceptives, but they do not have to donate, she says. “That’s a really nice, low-cost way that could become cost neutral if people end up making donations, and it’s a nice way to serve the community,” Cleland adds.”

Another way physicians could increase access to emergency contraceptives is by telling patients about the 30-mg ulipristal acetate tablet (ella), the prescription EC. They could encourage patients to obtain a prescription in advance of needing one, so they might have it on hand when it is needed. The prescription EC is more effective at preventing pregnancy than Plan B, and it lowers a person’s chances of getting pregnant by 85% if they take it within five days after unprotected sex. It also works better for people who weigh between 165 and 185 pounds.²

“Ella is more effective, and we want people to have it before they need it,” Cleland says. “In any encounter with a person at risk of pregnancy, it’s a good idea to say, ‘Hey, I can write this prescription for you, and you can have it when you need it.’” While ella is recommended over Plan B for anyone who weighs more than 165 pounds, it also is more effective than over-the-counter EC and could be used by anyone, she adds.

Improving access to ella is on EC4EC’s list of dream projects, Cleland notes. “We had an annual conference [in October 2025], and we had providers talk about how you can help patients get ella in advance,” she says. “I would love funding for that; patients don’t know that ella exists, so [access] is really hard.”

Programs could increase clinician knowledge about prescribing ella, but these will not be as successful as possible if patients do not know the drug is a more effective option to emergency pregnancy contraception, she adds. “The reality is that if patients don’t know there is a more effective option, they may not show up in the first place and may not ask for it,” Cleland explains. “There really needs to be more education on it.” Both providers and community-based organizations focused on reproductive health could help educate young people about EC, including ella.

Both the need for a prescription and the price of ella are the chief drawbacks. “We’re hearing that out-of-pocket it costs about $50,” Cleland says. “For folks with insurance it might be better because ella may be covered.”

When organizations and clinicians work to improve access to EC, one of their big challenges may be sustainability. Even if they have obtained donations to fund the vending machine and first product supply, will they continue to have funding to keep it going — especially if they are offering the product at a steep discount?

“We’re talking with our partners about sustainability,” Cleland says. “There was a massive influx of donated emergency contraception available for a while right after Dobbs, and then some of the companies that were doing that started to pull back in a major way.” As of October 2025, there was only one company that did large-scale distribution of free product with no strings attached, she says.

“Some will give product for free if you do a TikTok video, but that one is not enough for the demand,” she adds. “We’re talking with partners in communities about how they can make it sustainable over the long term, and that starts with a supply of donated product, putting in vending machines, charging $5 for each EC, and using the money you recoup to buy your next supply.” It is not a money-making venture, but it is possible for the vending machines’ EC supply to become cost neutral, Cleland says.

The same strategy could be employed for EC baskets on a store countertop or in public restrooms. They could sell EC at a low cost or offer it for free on an optional donation basis.

“One project that is really cool is the Omaha women’s fund that sets up vending machines in several community places; one is in a bar; one is in an AIDS outreach center, and this is growing throughout the state,” Cleland says. “They meet people in their daily routines so they don’t have to go somewhere unusual or unfamiliar to get the product.”

The Women’s Fund of Omaha provides a low-barrier pathway to sexual and reproductive health through its sexual health vending machines, launched in 2023 by its initiative Access Granted. The vending machines offer EC at $8 and pregnancy tests for $3. The price is low enough to keep EC accessible.³

For other organizations seeking to expand access to EC, EC4EC can help provide them with information about how to obtain affordable EC for youth. The EC4EC team connects campuses with companies that offer low-cost EC.⁴

Clinicians could advocate for state laws to allow for EC in vending machines on campuses and elsewhere in public spaces. “We have a project in Maryland working with community colleges to meet their requirement to put EC in vending machines,” Cleland says. “One of the barriers we see is a lack of knowledge and awareness that this is truly an over-the-counter product that you can put in a vending machine.”

There is an outdated mentality about EC that someone needs to control access to it because they do not want students to use it too much. But the reality is that anyone can go into a local pharmacy and buy an emergency contraceptive, she adds.

“The Food and Drug Administration says it’s safe and effective,” Cleland says. “It’s exciting to see emergency contraception for sale much more broadly than before but just having it on the shelf is not enough if people cannot afford it.”

Melinda Young has been a healthcare and medical writer for 30 years. She currently writes about contraceptive technology.

References

1. Knifton S, Quasebarth M, Hasselbacher L. Barriers and facilitators to emergency contraception access among university students: Vending machines as a potential solution. J Am Coll Health. 2025; Sep 3:1-8. [Online ahead of print].

2. What’s the ella morning-after pill? Planned Parenthood. https://www.plannedparenthood.org/learn/morning-after-pill-emergency-contraception/whats-ella-morning-after-pill

3. Women’s Fund of Omaha. Sexual literacy: Affordable, convenient access to emergency contraception. https://www.omahawomensfund.org/our-work/sexual-literacy/

4. EC For Every Campus (EC4EC). Student activists expanding access to emergency contraception. https://www.ec4ec.org/ec-vending-machines/