Emergency contraception over the counter access in Hawaii

Emergency contraception (EC) reduces a woman's risk of pregnancy by 75-94 % if taken within 120 hours after unprotected sex. Quick and easy access to EC can reduce unintended pregnancy rates by 50%. In Hawaii there are three levels of EC accessibility: by prescription from a provider; through the pharmacy-access program; and through over-the-counter (OTC) pharmacy access. This study focused on OTC EC, which can be purchased by anyone 18+ with a valid ID. A four-question survey of 110 out of 261 pharmacies statewide was conducted in January 2007 inquiring about the availability OTC EC and procedures to acquire it. Pharmacies were selected to provide a good cross-section of chain and independent pharmacies in urban and rural areas statewide. Survey findings indicate that OTC EC was accessible at 94 out of 110 (85%) pharmacies surveyed, at about $40-$50. Of those 94 pharmacies that provided EC OTC, 32 (34%) provided incorrect information regarding how to access EC OTC. Some erroneously stated that a woman had to be 21+ to secure EC (rather than 18+) and that the woman herself must purchase the EC (even though another may pick it up for her). Two barriers to EC OTC accessibility identified were: incorrect information given by “front line” pharmacy staff, due to confusion about three levels of EC access, and the cost. To decrease these barriers, more training and education must be provided for pharmacy staff members. Also, OTC EC should be covered by Medicaid or other health insurance plans.