One Reason To Sell Plan B Over The Counter: Many Pharmacists Won't Provide It To Teen Girls


Just last month, the United States Food and Drug Administration announced that Plan B One-Step (a form of emergency contraception) had been approved for sale over the counter to women and girls age 15 and over. Prior to that, the only way to get the drug was to ask a pharmacist. In addition, women under age 17 could not get it without a doctor's prescription. The FDA's recent decision has been met with controversy, particularly the lowering of the age limit. However, taking control of the drug away from pharmacists is a positive development because research reveals that a shockingly high number of teen  girls of legal age are being incorrectly told by their pharmacists that they cannot  purchase the medication, even in pharmacies where the drug is in stock.

In this study, female research assistants posed as either 17-year-old  girls who were trying to obtain Plan B for themselves or physicians who  were trying to obtain it for a 17-year-old patient [1]. The  women called 943 drug stores in five major cities (Philadelphia,  Nashville, Cleveland, Portland, and Austin). Each pharmacy was called  twice—once by the "adolescent" and once by the "doctor," with the calls  placed a few weeks apart. The vast majority of the contacted pharmacies  (80%) stocked Plan B.

Results indicated that 19% of adolescent callers were (incorrectly)  told that they could not get the medication under any circumstances,  whereas only 3% of physicians were told the same thing. When asked how  old a patient needs to be to obtain Plan B without a prescription, only 3  out of 5 pharmacists reported the correct age of 17 (this study was conducted when 17 was still the legal age limit). In almost all  cases where an incorrect age was given, the pharmacist gave an answer  that was higher than the actual, legal age.

The study also found that adolescent callers were more likely to be  put on hold during their call and were less likely to end up speaking  with someone who identified themselves as a pharmacist. In addition, in  cases where Plan B was out of stock and the pharmacist offered to place  an order for it, the estimated wait time for delivery was significantly  longer for teens than it was for doctors.

These findings indicate that teenage girls are frequently given  incorrect information about their ability to access emergency  contraception, while this same information is far less likely to be  given to doctors. Because the same pharmacies were phoned twice and the  calls were placed in a random order a few weeks apart, the results  suggest that the misinformation given to teens was unlikely to have  occurred by accident. However, because we do not know whether callers  were speaking to the same employees each time, we cannot say whether the pharmacists intentionally misled the adolescents  or if the teenage callers just happened to be more likely to speak with  misinformed staff workers.

Nonetheless, this research has important implications because this  kind of misinformation reduces teens’ ability to acquire Plan B in a  timely fashion. Taking emergency contraception as soon as possible is of  the utmost importance in order for it to work—every 12-hour delay in  taking it increases the likelihood of pregnancy by 50% [2]. This  means that even a short holdup can have major consequences. The FDA's recent decision to remove some of the barriers to accessing this medication will only help to ensure that more women have timely access to Plan B.

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[1] Wilkinson, T. A., Fahey, N., Shields, C., Suther, E.,  Cabral, H. J., & Silverstein, M. (2012). Pharmacy communication to  adolescents and their physicians regarding access to emergency  contraception. Pediatrics, 129, 624-629.

[2] Piaggio, G., von Hertzen, H., Grimes, D. A., & Van  Look, P. F. (1999). Timing of emergency contraception with  levonorgestrel or the Yuzpe regimen. Task Force on Postovulatory Methods  of Fertility Regulation. Lancet, 353, 721.

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