If you thought the Obama administration and Kathleen Sebelius were the only ones thwarting access to the Plan B emergency contraception pill, you would be wrong. A new study finds that many pharmacies are dispensing bad info to 17-year-old teenage girls, who are legally allowed to obtain the drug, which is available to them without a prescription but kept behind pharmacy counters.
To wit, pharmacies are telling these youngsters who call with questions that it is impossible for them to obtain the pill under any circumstances. In fact, a small percentage of pharmacies are saying similar things to physicians who call on behalf of their patients. "There still appears to be substantial access barriers for adolescents, largely based on misinformation," the study authors conclude.
The study, which was published in Pediatrics this week, had women call 943 pharmacies and pose as 17-year-old teenage girls or physicians calling on behalf of their 17-year-old patients. What happened? Well, 80 percent of the pharmacies told the adolescents and 81 percent told the docs that the morning after pill was available that day. But then it got interesting...
Nearly one in five pharmacies, or 145 of the total, told the adolescent callers that it would be impossible for them to get the pill. By contrast, 23 pharmacies, or 3 percent, told physician callers the same thing. Often, pharmacies conveyed incorrect age info for accessibility - 57 percent of the girls and 61 percent of the doctors, respectively, were given the right information about age limits.
[UPDATE: "I was really surprised that 19 percent of the adolescent callers were being told that, despite emergency contraception being available that day, they couldn't obtain EC simply based on on their age," Tracey Wilkinson, a professor in the Department of Pediatrics at the Boston University School of Medicine, and the lead author, wrote us.]
Meanwhile, the adolescents were put on hold twice as often as the doctors - 54 percent versus 26 percent - and spoke to people who identified themselves as pharmacists less frequently - 3 percent versus 12 percent. When the pill was not available, 36 percent and 33 percent of pharmacies called by adolescents and physicians, respectively, offered no additional suggestions on how to obtain it (here is the study).
[UPDATE: "I think overall this indicates that the current dispensing rules around EC do not guarantee access for adolescents, which is a problem because EC is a safe and effective form of pregnancy prevention that should be available to anyone who needs it, remembering that the sooner it is taken-the better it works," Wilkinson writes.]
What motivated the misinformation? That much is not clear, because the researchers did not incorporate motivation in their study. Although one could speculate that callers are more likely to get incorrect information about medications when speaking with someone other than a pharmacist on the phone. Clearly, the 'teen' callers were treated differently than the 'physicians.'
[UPDATE: "I have no doubt that when we called and identifies ourselves as physicians, we were talking to more senior people in the pharmacy and that could account for part of the difference," Wilkinson writes us. "But I also think that when the physician was calling, the pharmacy staff worked harder to get the correct answers to the questions. So, when an adolescent called, the first person that picked up the phone, no matter what their level of training, answered the questions and left it at that. Interestingly, in the calls that we did know we were talking to a pharmacist, it didn't predict that the right answers were given or not...which was also surprising to me."]
Of course, some pharmacies may have deliberately dispensed bad info, given ongoing controversy. Last month, a federal judge ruled the state of Washington may not force pharmacies to sell the pill or other emergency contraceptives, because the purpose of a controversial law was to suppress religious objections by pharmacists, not to promote access to those who may want or need the pill (read here).
Also last month, a coalition of reproductive rights advocates asked a federal judge to reopen a 2005 lawsuit challenging FDA access restrictions. The suit was effectively ended by an HHS decision late last year to overrule the FDA, which was going to permit teenagers younger than 17 from being able to obtain the pill without a prescription (see this).