Emergency Contraception in Pharmacies

Pharmacies offer many advantages for access to EC. They are conveniently located and open nights and weekends when it is more difficult to contact a medical provider. Pharmacists are knowledgeable about medications and trained to respond to consumers’ questions and concerns.

On August 24, 2006, the US Food and Drug Administration approved Plan B®, the only dedicated EC product, for over-the-counter sale for women and men 18 and older and kept it a prescription product for women 17 and younger. This dual status is unusual and has presented a number of logistical difficulties for pharmacists, health care practitioners, consumers, and regulators. No other country that makes EC available over-the-counter restricts teen access.

Because emergency contraception is a time-sensitive medication, most effective within the first 24 hours after unprotected sex, it is crucial that all women have ready access to it. In the United States advocates have been pursuing various methods to make EC more easily available in pharmacies and health centers.

Methods for Making EC available

1. Over-the-counter in pharmacies
   Now, women and men 18 years and older can purchase Plan B® in pharmacies without a prescription. However, Plan B® must be kept behind the pharmacy counter, rather than on open shelves, because a pharmacist or staff with access to it must ask consumers for proof of age. While there is no federal requirement for counseling, a pharmacist can offer the type of information normally given consumers about a pharmacy product if requested.
   
   
2. By prescription from a medical provider
   In New York State, if a women age 17 years and younger wants Plan B®, she needs a prescription from a medical provider who is authorized to prescribe pharmaceuticals. She can have the prescription filled at a pharmacy of her choice. Planned Parenthood and other family planning centers also provide Plan B® to patients 17 and younger through a prescription. A prescription is also needed for the oral contraceptive products that can be used for emergency contraception.
   
   
3. Pharmacy access
   This is a term used for direct consumer access to EC without a prescription. In states with pharmacy access laws, trained pharmacists and registered nurses can dispense EC to the patient, using a non-patient-specific order written in advance by a licensed medical provider. The pharmacist generally asks the consumer a predetermined set of questions and provides EC according to a set protocol. In pharmacy access states, a woman age 17 and under can obtain Plan B® directly from a pharmacist without first going to her health care provider for a prescription.
   
   To date, nine states—not New York—have passed pharmacy access laws enabling women to obtain EC in pharmacies without a prescription. These states are Alaska, Hawaii, Washington, California, New Mexico, Maine, Massachusetts, New Hampshire and Vermont. Several states, including New York have introduced pharmacy access bills. For more information on EC pharmacy policies throughout the country go to: www.go2ec.org.

What is NYS doing?

NY's first pharmacy access bill, allowing pharmacists and nurses to dispense EC through a non-patient specific order written by a licensed physician, certified nurse practitioner, or licensed midwife, was introduced in the state legislature in 2002. The bill, known as the Unintended Pregnancy Prevention Act has been reintroduced and passed by the Assembly each year since but it has not yet been enacted. In 2005, the bill passed both the Assembly and the Senate but was vetoed by then Governor Pataki.

What we are doing?

FPA is part of the Emergency Contraception Access Campaign, a statewide coalition of public health advocates, medical and health professionals and community organizations working to pass the Unintended Pregnancy Prevention Act.

In addition, the Education Fund, with the support of the Compton Foundation and the John Merck Fund, is conducting a project entitled Building Bridges: New York State Pharmacists and Emergency Contraception. The purpose of the project is to work for widespread implementation of Plan B® as an over-the-counter product with emphasis on increasing access to teens, women who are Medicaid-eligible, and immigrants. Because pharmacists are central to making EC accessible, the project seeks to build partnerships with pharmacists at the local and state level to increase EC awareness and access and to pass the Unintended Pregnancy Prevention Act.