Making All Births Intended and Wanted: Cadence OTC and Samantha Miller

Did you know that nearly half of all pregnancies in America are unintended? And that percentage skyrockets when we're talking about teen pregnancies, more than three-quarters of which are unintended.

While teen pregnancies and teen births are thankfully at an all-time low in the US, we're still behind countries like the UK and Canada in this regard. A big reason teen pregnancies have fallen so dramatically in recent decades is simply that it's much easier to have access to contraceptives. But as evidenced by nations like the UK and Canada, there's still more work we Americans can do. After all, it's easy for men to get condoms everywhere, but not nearly as easy for women to get birth control.

Females who have babies as teenagers are more likely to stay or fall into poverty, attain lower levels of education, have more health problems, and generally have worse life outcomes for the mother and child. I should note that I happen to be married to someone who defied these odds and turned out just fine despite being the product of teen pregnancy, but still, the statistics speak volumes. And in a world with eight billion of us and counting, it goes without saying that it'd be preferable if the only new people joining us were both intended and wanted by their parents.

A big barrier toward that end is that if women want to go on birth control, typically they require a prescription from a doctor, which is of course a hurdle, especially for teens. That's a hurdle that Cadence OTC is working to overcome, and we've got their CEO Samantha Miller on the show to talk all about it. (Side note unrelated to this episode: Samantha's is also a plant-based foods advocate and is affiliated with the Good Food Institute!)

Cadence has raised $35 million in venture capital over the past six years to bring to market over-the-counter (OTC) birth control pills for females, both in the form of OTC birth control pills and OTC morning after pills. As you can imagine, this is important work no matter what, but especially in light of the Supreme Court decision ending federal protections for abortion rights, greater and easier access to contraceptives is something all of us should be able to support. In fact, just this year, in 2023, the FDA for the first time approved an OTC birth control pills for women.

Impressively, Cadence just inked a deal with Lil Drug Store Products, which services 180,000 retail locations, including convenience stores, to start carrying Cadence's Morning After pill starting in January 2024. Not only will this pill be OTC, but it will be half the price of the leading Morning After pill.

As Samantha points out, it's imperative that we make it as easy, cheap, and convenient for women to control their reproductive destiny, which is exactly what Cadence OTC is working to do.

Discussed in this episode

• Our past episodes on family planning with Your Choice Therapeutics (male contraceptives), Dr. Escar Guarin (World Vasectomy Day), and Family Empowerment Media (family planning in the developing world).

• Pew Reserarch Center says US teen birth rates are falling thanks to greater access to contraceptive care.

• Samantha recommends reading The Birth of the Pill and listening to How I Built This

More about Samantha Miller

Samantha serves as co-Founder and CEO of Cadence OTC, on a mission to increase over-the-counter (OTC) access to safe, effective, affordable contraceptives. She is a small pharma executive leader with more than two decades of experience in strategic partnering, product and technology acquisitions, commercial planning, supply chain, regulatory management, and corporate financing.

Samantha started her career as a scientist, and quickly found her passion for building new companies. She has deep entrepreneurial experience having served as chief business officer for pharma start-ups InCarda Therapeutics and Dance Biopharm. She also led business development for mid-market ventures Theravance, Nektar, and Onyx, and values her early training at P&G Pharmaceuticals.

She has negotiated and closed more than 50 licensing & partnering agreements with a total aggregate deal value of over $3 billion, and she has led more than fifteen equity financing rounds with total funds raised >$300 million. Samantha holds a BS in biochemistry from the University of California, San Diego, an MSc in microbiology & immunology and an MBA from the University of Rochester.