One Reason To Sell Plan B Over The Counter: Many Pharmacists Won’t Provide It To Teen Girls

Just last month, the United States Food and Drug Administration announced that Plan B One-Step (a form of emergency contraception) had been approved for sale over the counter to women and girls age 15 and over. Prior to that, the only way to get the drug was to ask a pharmacist. In addition, women under age 17 could not get it without a doctor’s prescription. The FDA’s recent decision has been met with controversy, particularly the lowering of the age limit. However, taking control of the drug away from pharmacists is a positive development because research reveals that a shockingly high number of teen girls of legal age are being incorrectly told by their pharmacists that they cannot purchase the medication, even in pharmacies where the drug is in stock.

In this study, female research assistants posed as either 17-year-old girls who were trying to obtain Plan B for themselves or physicians who were trying to obtain it for a 17-year-old patient [1]. The women called 943 drug stores in five major cities (Philadelphia, Nashville, Cleveland, Portland, and Austin). Each pharmacy was called twice—once by the “adolescent” and once by the “doctor,” with the calls placed a few weeks apart. The vast majority of the contacted pharmacies (80%) stocked Plan B.

Results indicated that 19% of adolescent callers were (incorrectly) told that they could not get the medication under any circumstances, whereas only 3% of physicians were told the same thing. When asked how old a patient needs to be to obtain Plan B without a prescription, only 3 out of 5 pharmacists reported the correct age of 17 (this study was conducted when 17 was still the legal age limit). In almost all cases where an incorrect age was given, the pharmacist gave an answer that was higher than the actual, legal age.

The study also found that adolescent callers were more likely to be put on hold during their call and were less likely to end up speaking with someone who identified themselves as a pharmacist. In addition, in cases where Plan B was out of stock and the pharmacist offered to place an order for it, the estimated wait time for delivery was significantly longer for teens than it was for doctors.

These findings indicate that teenage girls are frequently given incorrect information about their ability to access emergency contraception, while this same information is far less likely to be given to doctors. Because the same pharmacies were phoned twice and the calls were placed in a random order a few weeks apart, the results suggest that the misinformation given to teens was unlikely to have occurred by accident. However, because we do not know whether callers were speaking to the same employees each time, we cannot say whether the pharmacists intentionally misled the adolescents or if the teenage callers just happened to be more likely to speak with misinformed staff workers.

Nonetheless, this research has important implications because this kind of misinformation reduces teens’ ability to acquire Plan B in a timely fashion. Taking emergency contraception as soon as possible is of the utmost importance in order for it to work—every 12-hour delay in taking it increases the likelihood of pregnancy by 50% [2]. This means that even a short holdup can have major consequences. The FDA’s recent decision to remove some of the barriers to accessing this medication will only help to ensure that more women have timely access to Plan B.

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[1] Wilkinson, T. A., Fahey, N., Shields, C., Suther, E., Cabral, H. J., & Silverstein, M. (2012). Pharmacy communication to adolescents and their physicians regarding access to emergency contraception. Pediatrics, 129, 624-629.

[2] Piaggio, G., von Hertzen, H., Grimes, D. A., & Van Look, P. F. (1999). Timing of emergency contraception with levonorgestrel or the Yuzpe regimen. Task Force on Postovulatory Methods of Fertility Regulation. Lancet, 353, 721.

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