Key Points
• Source: Journal of the American Pharmacists Association
• Conclusion: “Although gender-based restrictions to EC are rare, more than half of pharmacy staff continue to report age-based restrictions. Inability to verify the female partner’s age may underlie cases where men are unable to purchase OTC EC [emergency contraception].”
• Safe and effective OTC levonorgestrel emergency contraception (OTC EC) is underused for postcoital pregnancy prevention. Plan B was made available for unrestricted in 2013—without age- or gender-based restrictions. Extraneous restrictions by pharmacies and pharmacy workers could play a role in diminished utilization, thus investigators assessed the persistence of age- and gender-based barriers to OTC EC among Los Angeles pharmacists and pharmacies. They recruited 139 staff members (45% pharmacists, 20% technicians, 26% retail) from 93 publicly accessible pharmacies.
• In total, 13 pharmacies did not sell OTC EC. In total, half of respondents cited age-based restrictions and 4% cited gender-based restrictions. Greater than 75% of respondents reported being asked for EC by a man, and 7% did not sell to a man. The most common concern about selling to men was the inability to confirm the age of the female partner.
• Pharmacists and pharmacy technicians more commonly reported age-based restrictions, whereas cashiers and managers were less likely to restrict access. About 30% of retail staff noted age-based restrictions to EC use, which could hinder young adults from obtaining EC at the register.
• “The imposition of unnecessary age-based restrictions may impede men’s access, even among staff members who know that men can legally purchase EC,” wrote the authors.
• “Even within stores stocking EC, keeping EC behind the counter or locked in a cabinet or display box perpetuates the idea that the product is risky or should not be freely accessed or used, despite evidence of safety for adolescents and adults,” stated the authors. “Such placement puts the burden on the consumer to find the item and specifically ask for assistance, which can be confusing or embarrassing for individuals.” This restrictive placement could further limit access and contribute to adolescents and young men not realizing that Plan B was freely available.
• One limitation of the current study is that the investigators were directed to retail staff because the pharmacists were often busy with patients. Furthermore, the data were taken from Los Angeles-area pharmacies and staff, thus the generalizability of results to other areas may be hindered.