Evolving availability of over-the-counter emergency contraception in Tampa pharmacies: A reproductive health justice concern

Background: Since the shift of emergency contraception (EC), a controversial post-coital contraceptive that can be used up to 120 hours after intercourse to prevent pregnancy, to over-the-counter (OTC) status, its actual availability for women in need remains unclear. Purpose: This presentation explores the evolving availability of OTC EC in Tampa, Florida pharmacies. Methods: At two points in time, a telephone survey was conducted with the same sample of Tampa pharmacies randomly selected from an online telephone directory. The baseline survey (n=42; 20% of 209 listed pharmacies) was conducted in November 2006, after the FDA's approval of OTC EC for consumers aged 18 and older. The follow-up survey (n=38, due to pharmacy closures) was conducted in May 2009 after the FDA's March 2009 approval of OTC EC for consumers aged 17 and older. The mystery-shopper survey instrument assessed EC's OTC availability, cost, pharmacy staff's knowledge of EC, and processes for obtaining OTC EC. Results: At baseline, 33% (12) of pharmacies surveyed had EC available for OTC dispensation, with an average cost of $39. At follow-up, 52.6% (20) of pharmacies survey had EC available for OTC dispensation, with an average cost of $47. At both baseline and follow-up, analysis revealed confusion among pharmacy staff regarding EC's mechanism of action, time frame for effectiveness, and OTC age requirements. Conclusions: While the availability of OTC EC in Tampa pharmacies increased over time, multiple barriers, including pharmacists' stocking and dispensation refusals, pharmacy staff's lack of knowledge, and increasing cost, continue to hinder reproductive health justice.