Wider but still restricted access to the morning-after pill may not have the dramatic effect on unintended pregnancy and abortion rates touted by some advocates, reproductive health experts say.
Expanded access should spur increased sales of the pills, called Plan B, it probably won’t have a major public health impact, they said Friday.
“That doesn’t mean zero, but it will be hard to measure because it will be so small,” said James Trussell, director of the Office of Population Research at Princeton University. “If you look at the number of acts of unprotected intercourse on one hand, and the use of Plan B on the other, it’s like a cork on the ocean.”
Planned Parenthood hailed Thursday’s decision by the Food and Drug Administration on Thursday to allow nonprescription sales of the pills to adult women, saying expanded access could prevent up to 1.5 million unintended pregnancies and 800,000 abortions a year.
On Friday, it revised that estimate downward:
“It will not reach that potential,” said Jackie Payne, the group’s director of government relations. Payne cited the FDA requirement that girls 17 and younger still obtain a prescription before buying the pills, saying that would hinder efforts to reduce the more than 800,000 teen pregnancies a year in the U.S.
Barr Pharmaceuticals Inc. has sold Plan B as a prescription drug since 1999. Nonprescription pill sales should begin by year’s end. The cost “could be slightly higher” than the $25 to $40 now charged, said Barr spokeswoman Carol Cox.
Diana Zuckerman, president of the National Research Center for Women & Families, said increased availability will have a big effect on both pregnancy and abortion numbers.
Zuckerman didn’t provide an estimate, but said the cost of the drug and the nausea associated with it likely will continue to limit its use to women who are “highly motivated.” Zuckerman cited the examples of rape victims and married women who don’t want any more children.
About 1.5 million packets of the pills are now dispensed each year, Barr estimates. Sales should increase further, Cox said, without providing an estimate.
Use also should increase, though not to dramatic effect. A January 2005 study found that women who didn’t have to go through a pharmacist or clinic to obtain emergency contraception did increase their use of the pills — but with no significant reduction in their pregnancy rate. That suggests the overall public health impact of removing barriers could be negligible, because of underlying high rates of unprotected sex and relative underuse of the pills, according to the Journal of the American Medical Association study.
“It really doesn’t work if it’s left in the drawer,” Trussell said.
Women who don’t use birth control account for about half of all unintended pregnancies. Whether they would turn to Plan B — when they didn’t have a plan A — remains unclear.
“That’s the population we hope could make better use — or more frequent use — of this particular type of method,” said Dr. Douglas Laube, president of the American College of Obstetricians and Gynecologists.
“That’s the population we hope could make better use — or more frequent use — of this particular type of method,” said Dr. Douglas Laube, president of the American College of Obstetricians and Gynecologists.
Religion also many curtail wider use. A study published this year in the Journal of American College Health found 51 percent of the colleges surveyed in the mid-Atlantic region didn’t distribute the pills to students, most commonly for religious reasons, followed by staffing and funding issues.
On campuses that do offer them, such as the University of Virginia, the change in Plan B’s status won’t have much of an effect, said Dr. Christine Peterson, director of gynecology for UVA’s department of student health. At UVA, female students already can call for a prescription at any hour of the day, she said.
In 2000, the availability of emergency contraception prevented more than 100,000 pregnancies, about half of which would have ended in abortion, according to Guttmacher Institute estimates. There are roughly 3.1 million unplanned pregnancies in the United States each year.