Abstract
Introduction
After years of complex regulatory changes, levonorgestrel (LNG) emergency contraception
(EC) is now approved for unrestricted sale in the United States. Timely access to
EC pills is critical because they are more likely to work the sooner they are taken.
This study assesses whether LNG EC is sold in accordance with current Food and Drug
Administration regulations.
Methods
We distributed an online questionnaire through an EC-focused listserv for reproductive
health professionals, asking data collectors to visit local stores and document product
names, price, over-the-counter shelf availability, and misinformation about age restrictions.
We used χ2 analysis to assess bivariate associations and t tests and Wilcoxon rank-sum tests to determine differences in means.
Results
We collected information about 220 stores. The majority (65%) stocked EC on over-the-counter
shelves, although only 22% of these displayed it without a locked security enclosure.
Chain pharmacies were more likely to shelf-stock EC than independent pharmacies (77%
vs. 5%; p = .000), but variation existed among stores within the same chain. Among stores that
were asked, 40% incorrectly reported an age restriction for non-prescription purchase
of LNG EC, whereas 95% correctly reported that men can buy LNG EC. The average price
of branded and generic LNG EC was $49.64 and $40.05, respectively.
Conclusions
Changes in the regulatory status of LNG EC have resulted in widespread confusion about
how EC can be sold, and its high price contributes to access barriers. Retailers should
ensure that consumers can access LNG EC quickly and easily by stocking the product
on over-the-counter shelves and educating staff about current regulations.
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Biography
Kelly Cleland, MPA, MPH, is a reproductive health researcher at Princeton University and the Executive Director of the American Society for Emergency Contraception. Her work focuses primarily on emergency contraception and medical abortion.
Biography
Jamie Bass, MPH, consults with the American Society for Emergency Contraception, the International Consortium for Emergency Contraception, and the European Consortium for Emergency Contraception. Her work focuses on increasing access to emergency contraceptives.
Biography
Florida Doci, BSc, BA, is currently an MSc candidate in Interdisciplinary Health Sciences at the University of Ottawa. Her research work is focused on women's reproductive health choices and needs primarily in low-income and developing countries.
Biography
Angel M. Foster, DPhil, MD, AM, holds an Endowed Chair in Women's Health Research at the University of Ottawa. Her research focuses on emergency contraception, abortion, and health professions education. She leads projects in North America, the Middle East, and Asia.
Article info
Publication history
Published online: September 24, 2016
Accepted:
August 19,
2016
Received in revised form:
August 15,
2016
Received:
March 10,
2016
Footnotes
Funding information: This work was supported in part by the Eunice Kennedy Shriver National Institute of Child Health and Human Development grant for Infrastructure for Population Research at Princeton University, Grant R24HD047879 (KC). AF's Endowed Chair in Women's Health Research is funded by the Ministry of Health and Long-Term Care in Ontario and we appreciate the general support for her time that made this project possible. The conclusions and opinions expressed in this article are those of the authors and do not necessarily represent the views of the organizations with which the authors are affiliated or the funders.
Identification
Copyright
© 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc.
