Access to Emergency Contraception in the Over-the-Counter Era

Abstract

Introduction After years of complex regulatory changes, levonorgestrel emergency contraception (LNG EC) is now approved for unrestricted sale in the US. Timely access to EC pills is critical because they are more likely to work the sooner they are taken. This study assesses whether LNG EC is sold in accordance with current Food and Drug Administration regulations. Methods We distributed an online questionnaire through an EC-focused listserv for reproductive health professionals, asking data collectors to visit local stores and document product names, price, over-the-counter (OTC) shelf availability, and misinformation about age restrictions. We used Chi-square analysis to assess bivariate associations and t-tests and Wilcoxon rank-sum tests to determine differences in means. Results We collected information about 220 stores. The majority (65%) stocked EC on OTC shelves, although only 22% of these displayed it without a locked security enclosure. Chain pharmacies were more likely to shelf-stock EC than independent pharmacies (77% vs 5%; p=0.000), but variation existed among stores within the same chain. Among stores that were asked, 40% incorrectly reported an age restriction for non-prescription purchase of LNG EC, while 95% correctly reported that men can buy LNG EC. The average price of branded and generic LNG EC was $49.64 and $40.05, respectively. Conclusion Changes in the regulatory status of LNG EC have resulted in widespread confusion about how EC can be sold, and its high price contributes to access barriers. Retailers should ensure that consumers can access LNG EC quickly and easily by stocking the product on OTC shelves and educating staff about current regulations.

A Call for Action: Supporting and Engaging Pharmacists in the Provision of Emergency Contraception

“…Wilkinson's findings are similar to previous work by their group and others [2À10]. Findings from these mystery caller studies showed commonly that access was encouragingly high [1,3,5,7] but that pharmacy advice was not always accurate regarding product use or adverse effects [1,3,5,8,9]. Most importantly, many studies conducted after the 2014 legislative changes found misinformation was given about age restrictions [1,3,5,8À10].…”

Trends in dispensing oral emergency contraceptives and safety issues: a survey of German community pharmacists

“…LNG and UPA are suggested to have a similar safety profile, with serious adverse drug reactions essentially unknown [27][28][29]. But as LNG is approved as OTC much longer, more is known about its adverse effects through pharmacovigilance activities [30]. Potential reasons for concerns regarding the effective and safe use of EC.…”

Barriers to Single-Dose Levonorgestrel-Only Emergency Contraception Access in Retail Pharmacies

“…Further, this study highlights numerous opportunities for pharmacy staff education, especially regarding citing incorrect age restrictions. Environmental changes, such as package labeling, and increased public awareness of LNG-EC access (Cleland, Bass, Doci & Foster, 2016) may further improve accessibility rates.…”