Expanding Emergency Contraception Access — An Analysis of Plan B's Transition From Prescription Status to Over the Counter

Plan B was approved by the FDA for over-the-counter (OTC) dispensation, for women > 18 yrs, in August 2006. Prior to approval, Plan B emergency contraceptive (EC) drug was available only with a physician's prescription or from a certified EC pharmacist. Two cross-sectional surveys were conducted in San Diego, CA to assess the impact of this policy change at pharmacies and with Planned Parenthood patients. At the pharmacy level, the survey included dispensing practices, demand for Plan B, both prescription and OTC, and gender breakdown of customers. At Planned Parenthood, survey themes included attitudes towards Plan B, knowledge of its OTC status and future purchasing and EC sharing intentions. The overall sales of Plan B in the pharmacies rose by 21% from November 2006 to April 2007. This closely mirrored data provided by local Planned Parenthood clinics. Differences in amounts dispensed were seen when data were broken down by location, pharmacy type, and EC-dispensing status. Supermarket pharmacies saw a decline in sales, while independent and drugstore pharmacies saw an increase. Pharmacies which had an EC-certified pharmacist saw sales decline and vice versa. At Planned Parenthood, there were relatively low levels of knowledge of the policy change among patients with roughly half of women sampled saying that they approved of the new OTC status. The overall increase in sales of Plan B suggests that people are taking advantage of improved access. However, barriers such as high cost and the age-restriction remain. Other policy implications will be discussed.