The Pill portrays love and relationships far closer to reality than we usually see in movies. Rather than give us a manufactured romance with two wonderful people we get a snapshot of events in the lives of two people who seem far more real - and far more flawed - than the archetypes we're typically presented with. People cheat, they lie, they manipulate situations to serve their own ends, they latch on to others to fulfill a variety of emotional and practical needs, and that's what we see in The Pill. I feel like I've met these people before, I even embody more of Fred's flaws than I'd probably care to admit. Fred is in many ways a bit of an ass, but aren't we all? The writer doesn't take the easy way out and make him a villain - nor do I get the impression that even though things have changed in his life that he has drastically changed by the end of the film. He hasn't had some miraculous catharsis that has transformed him into the white knight by the credits. Some things may be a little better for him - but I get the feeling that there's every possibility he'll make the same mistakes again - just like most of us do.
The ending veers a little into the cliche, but even then it's not the convenient Hollywood story-line they could have latched onto; She isn't pregnant - the pill really has kept her from conceiving, and we just have two people texting each other - which while framed a little cute is entirely probable - unlike a forced I love you realization or a wedding breakup or a kiss in the rain or some other rom-com cliche. No, instead we just have two people who hooked up texting - which is a pretty believable next step, particularly - a jaded part of me thinks, considering Fred is now single and looking for an easy lay - though I think this movie makes the point that lust and some genuine affection are not mutually exclusive, just as they are not codependent.