"Plan B Availability Differs Depending on US State Laws: Presented at ACOG"
By Ed Susman
SAN DIEGO, CA -- May 9, 2007 -- The availability of emergency contraception in the United States appears to vary with differences in state laws, researchers said here at the 55[th annual clinical meeting of the American College of Obstetricians and Gynecologists.
Researchers led by Rebekah Gee, MD, Robert Wood Johnson clinical scholar, University of Pennsylvania, Philadelphia, Pennsylvania, United States, surveyed more than a thousand pharmacies in the states of Atlanta, Philadelphia and Boston.
Dr. Gee presented the results of the survey here at the 55th annual clinical meeting of the American College of Obstetricians and Gynecologists (ACOG).
Results showed that 35% of pharmacies in Atlanta did not have Plan B available to consumers. On the other hand, in virtually every pharmacy in Massachusetts, Plan B was available or could be made available within 24 hours of receiving a consumer request for the drug.
The difference between states was due to subtle differences in state laws, Dr. Gee said.
In Georgia, pharmacists can elect not to carry Plan B, also known as the "morning after pill". In Massachusetts, it is mandatory that pharmacies stock the drug if there is a demand for it. In Pennsylvania, no laws have been enacted regarding whether the drug should be stocked.
In the city of Philadelphia, Dr. Gee said about 23% of pharmacies did not have Plan B available.
Emergency contraceptives -- which contain levonorgestrel -- are not effective if the woman is already pregnant. Plan B is believed to act as an emergency contraceptive principally by preventing ovulation or fertilization. In addition, it may inhibit implantation by altering the endometrium. It is not effective once the process of implantation has begun.
"The action of the Food and Drug Administration to make Plan B available without a prescription for persons over 18 years of age does not affect state regulations," said Kathryn Moore, director, ACOG Department of State Legislative and Regulatory Activities, Washington, DC.
The FDA program, she said, "overlays the state laws but doesn't smooth out the wrinkles. In fact, it may create new wrinkles."
For example, Moore noted that the FDA ruling provides that Plan B is available without prescription, while the Massachusetts law applies to Plan B as a prescription medication. "How the FDA ruling may impact the situation in Massachusetts is not known yet," she said.
Dr. Gee and colleagues sent their survey to 1,445 pharmacies and received responses from 1,085 (75%).
When asked if they were able to dispense Plan B within 24 hours, negative responses were reported in 35% of the pharmacies in Atlanta, 23% of pharmacies in Philadelphia, and less than 5% of pharmacies in Massachusetts. The differences in availability proved statistically significant (P <.001), Dr. Gee said.
Plan B was not stocked in 35% of surveyed pharmacies in Atlanta, 20% of pharmacies in Philadelphia, and 5% of pharmacies in Boston.
The researchers also found that 9% of the pharmacists in Atlanta and 5% of the pharmacists in Philadelphia said they would refuse to dispense the drug.
[Presentation title: Variation in Access to Emergency Contraception. Abstract 4 (May 7)]
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