67. Barriers to Emergency Contraception Access in the State of Wyoming

Gaffaney, Michelle; Stamm, Carol A.; Borgelt, Laura M.; Chau, Van; Rupp, Leanne; Blumhagen, Rachel Z.; Gilroy, Christine

doi:10.1016/j.jadohealth.2014.10.073

Cited by 3 publications

(2 citation statements)

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“…Regarding the availability of oral EC, international SPM studies [37][38][39]41,42,45] suggest that there are problems-especially with UPA. Some price differences-even between identical preparations-could also be identified, as in addition to international SPM studies on oral EC [11,12,[41][42][43][44][45][46][47]97,98], a national SPM study on a different indication has already identified significant price differences between CPs that are even located in the same city and in some cases only a few hundred metres apart [15].…”

Section: Discussionmentioning

confidence: 99%

“…Unlike other countries such as the USA [11,12,[30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47], the study situation for Germany for the provision of self-medication consultations, availability and pricing is rather poor so far. In nationwide interviews of 25 CPs conducted at the end of 2015, i.e., after the OTC switch in March 2015, 96% of the respondents reported using a checklist for the provision of self-medication consultations for oral EC.…”

Section: Introductionmentioning

confidence: 99%

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A Nationwide Mystery Caller Evaluation of Oral Emergency Contraception Practices from German Community Pharmacies: An Observational Study Protocol

et al. 2021

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To prevent unwanted pregnancies, oral emergency contraception (EC) with the active ingredients levonorgestrel (LNG) and ulipristal acetate (UPA) is recommended by the guidelines of the German Federal Chamber of Pharmacists (BAK). In this respect, community pharmacies (CPs) in Germany have a major responsibility for information gathering, selecting the appropriate medicine, availability and pricing, among other things. Therefore, it would be appropriate to conduct a study with the aim of investigating information gathering, a possible recommendation as well as availability and pricing for oral EC in German CPs. A representative nationwide observational study based on the simulated patient methodology (SPM) in the form of covert mystery calls will be conducted in a random sample of German CPs stratified according to the 16 federal states. Each selected CP will be randomly called once successfully by one of six both female and male trained mystery callers (MCs). The MCs will simulate a product-based scenario using the request for oral EC. For quality assurance of the data collection, a second observer accompanying the MC is planned. After all mystery calls have been made, each CP will receive written, pharmacy-specific performance feedback. The only national SPM study on oral EC to date has identified deficits in the provision of self-medication consultations with the help of visits in the CPs studied. International studies suggest that UPA in particular is not always available. Significant price differences could be found analogous to another German study for a different indication.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Nationwide Mystery Caller Evaluation of Oral Emergency Contraception Practices from German Community Pharmacies: An Observational Study Protocol

et al. 2021

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Oral emergency contraception practices of community pharmacies: a mystery caller study in the capital of Germany, Berlin

Lungfiel

Mandlmeier

Kunow

et al. 2023

J of Pharm Policy and Pract

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Background In Germany, oral emergency contraception (EC) with the active ingredients levonorgestrel (LNG) and ulipristal acetate (UPA) is available as over-the-counter (OTC) medicine only from community pharmacies (CPs). Because of the window of effect, which is limited to only a few days, CPs have a great responsibility to provide rapid and unimpeded access, while also ensuring “adequate” counseling. The aim was—for the first time in Europe and thus also in Germany for the methodology used in this study—to investigate immediate availability, pricing, and aspects of counseling. Methods Covert mystery calls were conducted in a random sample of CPs stratified by districts in the German capital Berlin. Each of the 263 CPs included was called once at random by one of two trained female student mystery callers. They simulated a product-based scenario for the UPA original ellaOne®, citing a contraceptive failure one day ago as the reason. Results Of 257 successfully called CPs, UPA preparations were immediately available in 98.4% (253/257) and LNG preparations in 86.8% (184/212) of CPs. Prices for UPA preparations varied from €15.95 to €42.95 (∆ 169%; median €35.00 [interquartile range (IQR) €5.91]) and for LNG preparations from €10.60 to €32.49 (Δ 207%; median €22.00 [IQR €5.76]). Information about the correct different window of effect of UPA and LNG preparations was provided in 69.8% (127/182) of CPs. UPA preparations were recommended in 63.1% (111/176) and LNG preparations in 17.2% (30/174) of CPs. Information was provided on how to take them as soon as possible in 30.8% (44/143) of CPs and on how to use them after vomiting in 46.0% (64/139). Conclusions Berlin CPs support access through high immediate availability, especially to UPA preparations. However, access is hampered by high absolute price ranges of both UPA and LNG preparations, which could ideally be minimized by a comparison app. It is positive that CPs promote the benefits of UPA preparations by recommending them noticeably more often than LNG preparations. However, there are deficiencies in giving advice, so there is a need to raise awareness among pharmacy staff to ensure “adequate” counseling in advance over the phone.

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