Despite FDA rule, teens may struggle to get morning-after-pill

(Reuters Health) - - It’s been almost five years since the U.S. Food and Drug Administration made emergency contraception available without a prescription for all consumers, but a new study suggests it may not be any easier for some teens to buy the drug at pharmacies.

Researchers had women posing as 17-year-old girls in need of emergency contraception use a standard script to call 979 pharmacies in five U.S. cities. About 83 percent of the pharmacies said emergency contraception was available, but drugstores gave correct information about over-the-counter access only 52 percent of the time, and 8 percent said it wasn’t for sale under any circumstances.

These results, from calls made in 2015, weren’t much different from responses researchers got using the same script in 2012 before the FDA eliminated age restrictions on over-the-counter access to emergency contraception.

“It is surprising that access hasn’t improved despite the change in regulations that were intended to improve access for adolescents in particular,” said lead study author Dr. Tracey Wilkinson, a pediatrics researcher at Indiana University School of Medicine in Indianapolis.

“Not having timely access to emergency contraception is a problem - not only because its efficacy decreases with time but because it is an important part of pregnancy prevention,” Wilkinson said by email. “Without access, more unplanned pregnancies can result and for adolescents in particular the repercussions of unplanned pregnancy can be substantial and life-long.”

Emergency contraception, also known as the morning-after pill, can prevent pregnancy by stopping the ovary from releasing an egg, preventing sperm from fertilizing the egg or blocking the fertilized egg from implanting in the womb. It works best when taken within 24 hours of unprotected sex or condom failure, although it can work for up to 72 hours.

The FDA initially cleared over-the-counter emergency contraception access for people 18 and older, in part because of concerns about whether younger teen girls would use the medication properly. Later, the FDA lowered the age for non-prescription access to 17 before ultimately extending access to people of all ages in 2013.

Pharmacies are more likely to say emergency contraception isn’t available under any circumstances in low-income neighborhoods than in more affluent communities, the researchers report in Pediatrics.

One limitation of the study is that researchers didn’t contact all the same pharmacies in the two different studies, so they couldn’t see whether individual drugstores changed policies over time as the law shifted. What happens on the phone also might not reflect what would happen when teens walked into the pharmacy, the authors note.

Still, the results suggest that not all pharmacists are clear on who should get the morning-after-pill, said Abigail R.A. Aiken, a public policy researcher at the University of Texas at Austin who wasn’t involved in the study.

“It’s important for people to know the facts on emergency contraception access for themselves,” Aiken said by email. “Anyone who receives incorrect information or is denied emergency contraception by a pharmacy can request to talk with the pharmacist in charge if a member of staff gives incorrect information or to the store manager.”

It may also make sense for women to go to a pharmacy in person instead of calling to find out if they have emergency contraception, and to consider trying another drugstore if one place turns them away, Dr. Regina-Maria Renner, a researcher at the University of British Columbia in Vancouver who wasn’t involved in the study, said by email.

“Patients may encounter problems in accessing emergency contraception, but FDA policy is on their side,” said Katy Kozhimannil, a researcher at the University of Minnesota School of Public Health in Minneapolis who wasn’t involved in the study.

“It matters because preventing unintended pregnancy, especially for low-income teens, can influence a person’s life trajectory,” Kozhimannil said by email.

SOURCE: Pediatrics, online June 30, 2017.