Levonorgestrel Emergency Contraception Availability in Louisiana Independent and Chain Pharmacies Post-Dobbs v Jackson Women’s Health Organization [ID: 1376654

Abstract

INTRODUCTION: Following recent legal changes, there is increased confusion regarding availability of medications for reproductive health, including emergency contraception (EC). We aimed to quantify over-the-counter (OTC) access to levonorgestrel EC in three metropolitan Louisiana parishes (counties) among chain and independent pharmacies. METHODS: This cross-sectional study took place during August and September 2022. Secret shoppers surveyed all retail pharmacies in Jefferson, Orleans, and Terrebonne parishes. Pharmacies were classified as independent or chain based on affiliation with supermarket or drug store chains. Odds ratios (ORs) with 95% CIs were used to compare availability of OTC EC. RESULTS: Among 212 retail pharmacies, 55% (n=117) were large chain pharmacies and 45% were independent stores. Only 67% (n=141) had EC in stock. Chain pharmacies were more likely to offer EC than independent pharmacies (92% versus 35%, OR 22.6, 95% CI [10.1, 50.2]). Independent pharmacies were more likely to keep OTC EC behind the counter (91% versus 11%, OR 80.0, 95% CI [21.2, 302.5]), require identification (45% versus 4%, OR 21.7, 95% CI [6.5, 72.7]), and carry no EC less than $50 (24% versus 2%, OR 17.0, 95% CI [3.4, 84.8]). Among pharmacies without EC available, no chain pharmacies described recent changes in EC stock, while 5 out of 28 (18%) respondent independent pharmacies attributed loss of EC stock to recent legislation. CONCLUSION: Independent pharmacies were less likely to carry OTC EC and more likely to enforce multiple barriers to purchase. Recent legislation has disproportionately further reduced EC availability at these pharmacies.