Facing steep increases in the price of birth control, many local college students are weighing whether to shell out several hundred more dollars each year, switch medications or just go without oral contraceptives.

Prices have tripled at universities around the country, including Houston, because of a change in the Medicaid rebate law that discourages pharmaceutical companies from offering big discounts on medications to college health centers.

Starting last week, the most popular oral contraceptive at the University of Houston's health center, Ortho Tri-Cyclen Lo, sold for $35 for a monthly pack, compared with the previous $10.

"That's a huge hike," said the center's chief nurse, Laura Moore, who is helping students identify alternatives, such as cheaper generics or condoms. She can sympathize; until last week, she, too, bought Ortho Tri-Cyclen Lo at the university's reduced rate.

Before this year, college health centers could buy contraceptives and other drugs at nominal prices from pharmaceutical companies. But the Deficit Reduction Act of 2005, which went into effect in January, imposes a disincentive for companies to sell discounted drugs by requiring those that do so to pay more to participate in Medicaid.