December 20, 2011 — Pharmacies denied requests for emergency contraception from nearly one in five callers posing as 17-year-olds, even though people that age can legally purchase the drug without a prescription, according to a study published in the Journal of the American Medical Association, MedPage Today reports. The EC drug Plan B One-Step is FDA-approved for nonprescription sale to people ages 17 and older, while girls ages 16 and younger must have a prescription (Fiore, MedPage Today, 12/19). The drug can prevent pregnancy and is most effective if taken within 72 hours after sex (Women's Health Policy Report, 12/9).
For the study, female researchers called 943 pharmacies in Austin, Texas; Cleveland, Nashville, Tenn.; Philadelphia; and Portland, Ore., posing as teens who recently had unprotected sex. The callers asked pharmacists about same-day availability of Plan B, whether they could obtain the drug based on their stated age and whether the pharmacist knew the correct age for dispensing the drug without a prescription.
Researchers found that 80% of the pharmacies had Plan B in stock. Nineteen percent of callers were told they could not obtain Plan B, even if they had a prescription; this response was twice as likely in pharmacies in low-income areas. Pharmacists in low-income neighborhoods also were more likely to state the incorrect age limit for nonprescription sale.
Tracey Wilkinson, a general pediatrics fellow at Boston Medical Center and lead author of the study, said the most frequently cited age was 18. The researchers did not assess the cause of the misinformation but suggested that differences in pharmacy staffing and training, the frequency of requests for information about EC, or organizational culture and customer service issues contributed to the findings (Fiore, MedPage Today, 12/19).
Wilkinson said, "We have a really efficacious form of pregnancy prevention that might not be accessible because of misinformation that's out there." She suggested that "multiple avenues of change have to occur" to increase access to EC. For example, it is important for teens to know that they do not need a prescription once they turn 17, but pharmacy staff also need better training on the rules, Wilkinson said. In addition, clinicians should be aware that patients may need assistance in accessing EC (Goldberg, "Common Health," WBUR, 12/19).