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Pharmacists react to 'morning-after pill' ruling

A new federal court ruling has essentially turned the controversial “morning-after pill” into an over-the-counter drug, likely making the medication far more available to teens fearing pregnancy, even in states like Washington and Illinois where pharmacists currently can refuse to sell it.

The new ruling threw out the Food and Drug Administration’s requirement that girls younger than 17 have a prescription before a pharmacist could dispense Plan B. Because of the age requirement, pharmacists ended up controlling who received the medication because IDs had to be checked before any medication could be dispensed.

The FDA has 30 days to appeal. If it fails to get the new ruling overturned, Plan B and other emergency contraception will become, essentially, an OTC medication that could share shelf space with condoms and yeast busting medications.

Up until now, pharmacists in Washington and Illinois had been assured by the courts that they could choose not to dispense Plan B if they so chose. A federal judge ruled in February of 2012 that Washington state couldn’t force pharmacies to sell Plan B. Then in September of the same year, an Illinois appellate court affirmed a lower court’s ruling that pharmacists could not be forced by the state to sell Plan B if they had religious objections.

As an OTC drug, Plan B would not need to be kept behind the counter, meaning that pharmacists would have little control over its sales.

But with the issue still up in the air because of a possible appeal, it’s hard to know how everything will shake out.

“It will be interesting to see how the case plays out,” said Garth Reynolds, executive director of the Illinois Pharmacist Association. “I’m not sure what the immediate impact will be on current dispensing.”

Until there’s a final answer, Reynolds said, “it will be up to individual pharmacists how to deal with the new ruling. If it’s upheld, pharmacies will obey the law. ”

Even without the change, pharmacies in Illinois are required by law to fill prescriptions when they are presented, said Susan Hofer Hofer, a spokesperson for the Illinois Department of Financial and Professional Regulation, which oversees pharmacies and the professionals who work in them.

“We have a law that says that an individual pharmacist may refuse to provide any medicine they choose, but the pharmacy must make an arrangement so the patient can get served at that pharmacy,” Hofer said. “We’re in court right now with pharmacists who say they don’t want to do it.”

How does that square with the law? These are pharmacies that are owned by a pharmacist who is refusing not only to fill prescriptions for Plan B himself, but also to find someone else to do the job, Hofer explained.

In Washington state, pharmacist Steve Lee says the new ruling won’t make much of a difference.

“I think people who have a need for that should be able to buy it,” he says.

None of his pharmacists have refused to sell Plan B to any woman, however, he adds that the “morning after pill” – which sells for approximately $50 -- is not a big seller at his small pharmacy in the Ballard neighborhood of Seattle.

“We have it in the store but we’ve never sold one,” he says. “We’ve had it since it became available. We always have one but they just sit here and expire.”

Jim Krell, a pharmacist in Mt. Vernon, Wash., echoes Lee’s comments regarding the limited usage of the "morning-after pill."

“When you read about this in the press, it sounds like this product is being used a lot,” he says. “In this community – and my feeling is it’s the same statewide – the demand for Plan B is not that great. On average, we might sell it once a month, maybe. And it’s being used responsibly when it is being used. We don’t see what the big deal is.”

If the new ruling stands, individual pharmacists will have very little wiggle room when it comes to Plan B and other emergency contraception, predicted Carmen Catizone, executive director of the National Association of Boards of Pharmacy. “If it becomes an over-the-counter product, there isn’t much they can do, unless the pharmacy chooses not to stock that product. The judge cannot mandate that every pharmacy carries it.”

Even if the morning-after pill does become an OTC product, women, especially younger ones may still have trouble getting their hands on it.

“When I was 18, I tried to get Plan B but it was just so expensive that I didn’t get it,” says Melissa, a 26-year-old service industry employee from Seattle. “I went to the pharmacy to see how much it was but it was over $50. I didn’t have the money. I didn’t have insurance. And I ended up getting pregnant and then getting an abortion. It was very sad, but my boyfriend had just dumped me.”

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