'Morning after' pills confusing pharmacists
Different programs offering "morning after" contraception pills have caused confusion and misinformation from many isle pharmacies, a statewide survey indicates.
A telephone survey of 111 statewide pharmacies conducted for the Healthy Mothers, Healthy Babies Coalition of Hawaii showed about half were providing contradictory or erroneous information.
"The pharmacies generally are doing a great job in emergency contraception access," said Nancy Partika, executive director of the coalition. "I think confusion comes from an overlay of a new program over the existing state access program."
Under the state program established in 2004, pharmacies can provide emergency contraception pills to women and girls ages 14 and up with a prescription written by a doctor or generated by the pharmacist after consultation with the patient.
The Food and Drug Administration last year allowed over-the-counter sales of the Plan B emergency contraception pills to women 18 and older without a prescription, but customers must go to the counter and request them.
Angelina Ahedo surveyed 52 pharmacies on Oahu, 23 on the Big Island, 13 on Kauai, 21 on Maui and one on Molokai. She asked if EC was available over the counter and if so, the average price, official procedures to receive it and if someone other than the woman requesting the contraceptive could purchase it.
Half the pharmacies said the person needing the contraceptives had to pick them up herself, Ahedo reported. That isn't correct because men or women can purchase EC pills over the counter if they are 18 or older and have a valid ID, she said. They can stock them in their medicine cabinet for emergency use.
Misinformation also was presented that counseling was mandatory for over- the-counter emergency contraception purchases, Ahedo said.
Counseling is required only for teens and women who receive prescription pills through the state access program.
Contradictory information was given by some pharmacy employees that mandatory counseling was required for over-the-counter EC but the patient didn't have to be present to pick up the pills, Ahedo said.
The average price for the over-the-counter EC pills was $40 to $45, which is a concern, Partika said. Labeling for the pills allowing them to be sold without a prescription increased the price, she said.
"We clearly recognize it's cheaper than an unintended pregnancy, but may be beyond reach of someone on a limited income," she said.
Most drug plans don't cover over-the-counter emergency contraception purchases, Partika said. But there are several options, she pointed out.
While it's less convenient than an over-the-counter purchase, women who have a drug plan under health insurance can go though the state's EC access program or get a prescription from a doctor.
Most insurance plans also cover prescriptions generated by pharmacists after consultation with patients in the state access program, Partika said.
Medicaid coverage for over-the-counter EC is proposed for Medicaid recipients in a bill moving through the Legislature. New York state just made that change, Partika said.
Girls ages 14 through 17 can't get over-the-counter EC pills but can obtain them through the state access program after filling out forms, answering questions and undergoing consultation with the pharmacist.
Partika said the survey points to the need for more education on the state and federal emergency contraception access programs for pharmacies, especially technicians and nonprofessionals answering the phones.
The coalition is modifying a two-page summary of what pharmacists need to know about EC and also what consumers need to know, she said. They will be distributed through the Hawaii Pharmacists' Association.
The coalition also is encouraging the association to have a brief overview for members about differences between over-the-counter and state EC access programs at its annual meeting, she said.
Emergency contraception pills are provided in two doses, the first taken within 120 hours of unprotected intercourse and the second 12 hours after the first dose. They contain the same medications as regular birth control pills and don't interfere with a pregnancy.