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Study: Women Seeking Emergency Contraception In Colorado May Still Face Barriers

Single-dose Levonorgestrel-Only emergency contraception, like Plan B, is available over the counter, meaning a woman of any age can walk in, take it off the shelf and buy it without an ID or prescription.

Federal regulations require that emergency contraception -- such as the brand Plan B -- be available over the counter. But in Colorado, women may still experience barriers when obtaining it. A team of researchers found the drug was fully accessible at less than a quarter of the pharmacies surveyed in the state.

“Around 87 percent of the pharmacies would report that they had emergency contraception,” says Dr. Carol Stamm, who initiated the study at the University of Colorado School of Medicine. “Then as we followed our telephone script--which was standardized--we encountered barriers such as, ‘well, you would need to show an ID,’ or the product was not available on the counter.”

That means a customer couldn’t just walk in and purchase it -- she’d have to go to the pharmacy counter.

“In some cases it was kept in a locked plastic container or a locked cabinet, so you would have to ask the assistance of pharmacy staff or store staff to get it,” Stamm says.

There’s been a few changes in the regulatory status of single-dose Levonorgestrel-Only emergency contraception, but according to Stamm the most wide reaching was in spring of 2014. That’s when it gained “full access” status -- meaning a woman of any age can walk in, take it off the shelf and buy it without an ID or prescription.

But Dr. Stamm and her team of researchers found that it isn’t happening in practice. Part of that could be pharmacists just don’t know what the regulations are.

Laura Borgelt, the associate dean and a professor at the Skaggs School of Pharmacy, says pharmacists might learn about regulatory changes through their association membership or employer, but communication could be better.

Borgelt says what surprised her the most, however, was a general lack of knowledge about the product.

“As we look deeper into the qualitative data, which are the things that the employees said in the course of the conversations,” Borgelt says, “We’re finding that there’s just a lot of misconceptions and I think that we have a lot of work to do in terms of education.”

The researchers found that 24-hour pharmacies were the most likely to have emergency contraception. Independently-owned pharmacies, which mostly serves rural areas, were less likely to have it in stock.  

The study of more than 600 pharmacies in Colorado took place in June and July of 2014, after federal regulators relaxed the rules. Dr. Stamm says she does not know of another statewide study like hers, but a more recent project did look at five major U.S. cities. They drew similar conclusions to Stamm’s team: the majority of pharmacies do have emergency contraception available, but barriers persist despite regulatory changes to improve access.