September 20, 2013 — The Indian Health Service has issued a verbal directive ordering its facilities to offer emergency contraception without a consultation or prescription for Native American women ages 17 and older, the AP/Atlanta Journal-Constitution reports.
FDA in June lifted age restrictions on the EC drug Plan B One-Step (Fonseca, AP/Atlanta Journal-Constitution, 9/19). Although Native American women could legally purchase EC products from retail pharmacies without a prescription, IHS does not operate any retail pharmacies. As a result, women in federally recognized tribes have had to visit a clinic, emergency department or urgent care facility for a consultation before receiving a prescription.
Critics argued that the process was time-consuming and burdensome. Further, women might live hours from IHS facilities, which cuts into the window of time when EC is most effective. In addition, wait times are inconsistent and not all facilities operate around the clock.
IHS Chief Medical Officer Susan Karol in May 2012 announced that the agency was developing a policy aimed at making EC available without a prescription (Women's Health Policy Report, 10/29/12).
The policy still has not been released. In a response to questions from the Associated Press, the agency wrote that it has "taken this issue seriously, and the IHS has, on several occasions this year, confirmed access to FDA-approved emergency contraceptive products in all IHS federally operated facilities with pharmacies."
Advocates Want Unrestricted Access
Advocates for expanded EC access, including the Native American Women's Health Education Resource Center and Sen. Barbara Boxer (D-Calif.), welcomed the change in policy at IHS facilities.
However, they still want IHS to issue a written rule. "A verbal directive can be rescinded at any time," a Boxer spokesperson said, adding, "We need a permanent policy."
NAWHERC Director Charon Asetoyer said IHS should make Plan B One-Step available without restrictions, as approved by FDA. IHS said it is working to reform its pharmacy policy and will hold pharmacies and their employees accountable for following the verbal directive in the meantime. Additionally, it said that Plan B One-Step will be available to women without a prescription once the product is available with the new FDA labeling (AP/Atlanta Journal-Constitution, 9/19).