Abstract
Since the United States Food and Drug Administration’s approval of over-the-counter levonorgestrel emergency contraception, access to this time-sensitive medication has improved. However, multiple barriers, including the cost of the medication and pharmacy availability, still exist. The objective of this study was to determine the over-the-counter availability of levonorgestrel emergency contraception in pharmacies on Oahu, Hawaii. We conducted a cross-sectional population-based study using in-person simulated patient encounters at all pharmacies on Oahu. Out of 109 chain pharmacies and 13 independent pharmacies, 102 (84%) pharmacies had levonorgestrel emergency contraception available over the counter. Of pharmacies in which it was available, 12.7% required an employee to unlock the medication, 37.3% required the medication to be unlocked at the register, 29.4% were packaged in a large plastic box, and 3.9% were packaged in a blister pack. Levonorgestrel emergency contraception is widely available as an over-the-counter medication in pharmacies on Oahu, yet there are packaging and display practices that make it less accessible. Many of these practices could be improved with pharmacy education or changes in store policies. Systems-based interventions are needed to improve the access to levonorgestrel emergency contraception as an over-the-counter medication.
Highlights
Levonorgestrel emergency contraception (LNG EC) is a medication that can be taken up to 120 h after unprotected intercourse to avoid pregnancy
In 2013, the United States Food and Drug Administration (FDA) approved LNG EC to be available to all people over the counter (OTC) without a prescription
A study in New York found that males were able to purchase LNG EC OTC
Summary
Levonorgestrel emergency contraception (LNG EC) is a medication that can be taken up to 120 h after unprotected intercourse to avoid pregnancy. In 2013, the United States Food and Drug Administration (FDA) approved LNG EC to be available to all people over the counter (OTC) without a prescription. This has increased access to LNG EC, multiple studies have shown that barriers to access remain. [2] A study conducted in Colorado found that only 23% of pharmacies had LNG EC completely accessible, meaning available for purchase without an identification card or prescription [3]. Women face similar barriers to access, including the cost of the medication, pharmacy availability, age restrictions, and feeling “judged and patronized” after consultation with a pharmacist [5,6].
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