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 Researchers had women posing as 17-year-old girls in need of
emergency contraception use a standard script to call 979 pharmacies
in five U.S. cities. About 83 percent of the pharmacies said
emergency contraception was available, but drugstores gave correct
information about over-the-counter access only 52 percent of the
time, and 8 percent said it wasn’t for sale under any circumstances.
These results, from calls made in 2015, weren’t much different from
responses researchers got using the same script in 2012 before the
FDA eliminated age restrictions on over-the-counter access to
emergency contraception.
“It is surprising that access hasn’t improved despite the change in
regulations that were intended to improve access for adolescents in
particular,” said lead study author Dr. Tracey Wilkinson, a
pediatrics researcher at Indiana University School of Medicine in
Indianapolis.
“Not having timely access to emergency contraception is a problem -
not only because its efficacy decreases with time but because it is
an important part of pregnancy prevention,” Wilkinson said by email.
“Without access, more unplanned pregnancies can result and for
adolescents in particular the repercussions of unplanned pregnancy
can be substantial and life-long.”
Emergency contraception, also known as the morning-after pill, can
prevent pregnancy by stopping the ovary from releasing an egg,
preventing sperm from fertilizing the egg or blocking the fertilized
egg from implanting in the womb. It works best when taken within 24
hours of unprotected sex or condom failure, although it can work for
up to 72 hours.
The FDA initially cleared over-the-counter emergency contraception
access for people 18 and older, in part because of concerns about
whether younger teen girls would use the medication properly. Later,
the FDA lowered the age for non-prescription access to 17 before
ultimately extending access to people of all ages in 2013.
Pharmacies are more likely to say emergency contraception isn’t
available under any circumstances in low-income neighborhoods than
in more affluent communities, the researchers report in Pediatrics.
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One limitation of the study is that researchers didn’t contact all
the same pharmacies in the two different studies, so they couldn’t
see whether individual drugstores changed policies over time as the
law shifted. What happens on the phone also might not reflect what
would happen when teens walked into the pharmacy, the authors note.
Still, the results suggest that not all pharmacists are clear on who
should get the morning-after-pill, said Abigail R.A. Aiken, a public
policy researcher at the University of Texas at Austin who wasn’t
involved in the study.
“It’s important for people to know the facts on emergency
contraception access for themselves,” Aiken said by email. “Anyone
who receives incorrect information or is denied emergency
contraception by a pharmacy can request to talk with the pharmacist
in charge if a member of staff gives incorrect information or to the
store manager.”
It may also make sense for women to go to a pharmacy in person
instead of calling to find out if they have emergency contraception,
and to consider trying another drugstore if one place turns them
away, Dr. Regina-Maria Renner, a researcher at the University of
British Columbia in Vancouver who wasn’t involved in the study, said
by email.
“Patients may encounter problems in accessing emergency
contraception, but FDA policy is on their side,” said Katy
Kozhimannil, a researcher at the University of Minnesota School of
Public Health in Minneapolis who wasn’t involved in the study.
“It matters because preventing unintended pregnancy, especially for
low-income teens, can influence a person’s life trajectory,”
Kozhimannil said by email.
SOURCE: http://bit.ly/1qyV1oi Pediatrics, online June 30, 2017.
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