Nearly 20 percent of callers were refused emergency contraception at all cost, despite meeting the legal age requirement.
MONDAY, Dec. 19, 2011 (MedPage Today) —
In almost one in five undercover calls to pharmacies in various U.S. cities, women posing as 17-year-olds trying to acquire Plan B were told by pharmacists that they couldn’t obtain the contraceptive under any circumstance, Tracey Wilkinson, MD, MPH, of Boston Medical Center, and colleagues reported online in the Journal of the American Medical Association
And girls were nearly twice as likely to be denied if the pharmacies were in poorer neighborhoods, they found.
“Our study found that 19 percent of callers were told that they could not obtain emergency contraception at all based on their age, even with a prescription, and this happened more often at pharmacies in low-income neighborhoods,” Wilkinson said in an email to MedPage Today
In the U.S., Plan B is available over-the-counter to girls age 17 and older.
The FDA had signaled that it was willing to expand that access to younger teens, but Health and Human Services Secretary Kathleen Sebelius stepped in and ordered the FDA to deny an application to make the emergency contraceptive accessible without a prescription to all women of childbearing age.
Beyond age restrictions, Wilkinson and colleagues said it is unclear how access to the medication differs by neighborhood. Given that girls in low-income areas are more susceptible to teenage pregnancy, some speculate that pharmacies in these communities may be more well-versed in dispensing emergency contraception.
On the other hand, disadvantaged neighborhoods have poorer access to health service and pharmacy staff may be less well educated about contraception.
To investigate the differences in access, Wilkinson and colleagues had female research assistants call pharmacies in several U.S. cities — Nashville, Philadelphia, Cleveland, Austin, and Portland, Ore. — posing as teens who’d recently had unprotected sex.
The callers asked about the same-day availability of the medication, whether they could obtain it based on their stated age, and whether the pharmacy knew the correct age for dispensing the drug over-the-counter.
Wilkinson's team? used 2010 census data to determine the income status of the area in which the pharmacy was located.
They rang a total of 943 pharmacies, 432 of which were in low-income neighborhoods.
Pharmacies had Plan B in hand about 80 percent of the time, no matter where they were located, Wilkinson and colleagues found.
But in 19 percent of queries, the caller was told she couldn’t get Plan B under any circumstance, even with a prescription — something more likely to happen in pharmacies in low-income neighborhoods, the researchers found.
When the callers asked about the required age for over-the-counter access, pharmacists in poorer neighborhoods were more likely to get it wrong.
“The most often cited age was 18,” Wilkinson told MedPage Today
They couldn’t assess the causes of the misinformation, but it could be due to differences in pharmacy staffing or training, the frequency of requests for information, or organizational cultures and customer service, they wrote.
They said the finding that mistakes about the requisite age for getting Plan B over-the-counter are more often made in neighborhoods “with the highest teen pregnancy rates suggests that targeted education for consumers and pharmacy staff may be necessary,” they concluded.
The study was limited because surveying was only done over the phone, and not in person.
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