Over-The-Counter Availability of Levonorgestrel Emergency Contraception in Pharmacies on Oahu

Abstract

Since the United States Food and Drug Administration’s approval of over-the-counter levonorgestrel emergency contraception, access to this time-sensitive medication has improved. However, multiple barriers, including the cost of the medication and pharmacy availability, still exist. The objective of this study was to determine the over-the-counter availability of levonorgestrel emergency contraception in pharmacies on Oahu, Hawaii. We conducted a cross-sectional population-based study using in-person simulated patient encounters at all pharmacies on Oahu. Out of 109 chain pharmacies and 13 independent pharmacies, 102 (84%) pharmacies had levonorgestrel emergency contraception available over the counter. Of pharmacies in which it was available, 12.7% required an employee to unlock the medication, 37.3% required the medication to be unlocked at the register, 29.4% were packaged in a large plastic box, and 3.9% were packaged in a blister pack. Levonorgestrel emergency contraception is widely available as an over-the-counter medication in pharmacies on Oahu, yet there are packaging and display practices that make it less accessible. Many of these practices could be improved with pharmacy education or changes in store policies. Systems-based interventions are needed to improve the access to levonorgestrel emergency contraception as an over-the-counter medication.

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

“…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].…”

“…Oral EC may only be dispensed by community pharmacies (CPs) in Germany [10]. German CPs, therefore, have a great responsibility with regard to availability and pricing as important criteria for unhindered access [11,12]. With regard to the availability, this is particularly important in view of the fact that the effectiveness of oral EC is higher the faster it is taken [1].…”

“…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.…”

Clinical availability of the copper IUD in rural versus urban settings: A simulated patient study

“…The strengths of our study include the consistency of a single caller and a scripted conversation. Researchers have had success in evaluating access to contraception with simulated patient studies [10] . We note that several methods are available to define urban and rural, so use of other methods could result in different findings.…”

Pharmacy availability of emergency contraception in southwestern Pennsylvania: A simulated patient study

“…EC is widely used, with 23% of people in the United States reporting using it at least once to prevent pregnancy and 45% of those who have ever used EC using it more than once [3] . Though both medications are safe, effective, and well tolerated, access to both is hampered by pharmacy availability and stocking practices [ 4 , 5 ].…”