The Morning After

Pharmacies and medical freedom

Makers of Plan B, one of the two brands of "morning after" pills -- high-dose birth control pills that are only effective within 72 hours of unprotected sex -- are planning to petition the FDA for over-the-counter status. Such a move would make the drug much more useful: It's most effective within 12 hours of a slip-up, so having to get it directly from a doctor is practically prohibitive.

Already, four states allow doctors to give pharmacists standing prescriptions to dispense the pills. California is one, but a recent Los Angeles Times piece suggests that well-meaning guardians of women's health are out to make buying the drug more burdensome than "over-the-counter" would imply.

One of the benefits of selling pills without a prescription is financial; a woman without insurance wouldn't have to pay for a doctor's visit to protect herself against pregnancy. But California pharmacists have been tacking a $20 to $40 "consulting fee" onto the drug's $25 price for women without prescriptions. They say it's to pay for the 15 to 20 minutes they spend questioning a patient before doling out the drug.

Many pharmacists are also asking women to fill out a one-page questionnaire that asks about sexually transmitted diseases, among other things. It was developed by a group that seeks to make pharmacies more active in promoting community health.

"It was not the intent of the law to make pharmacists into public health officials," Shannon Smith-Crowley, a lobbyist for the California Medical Association, told the Times in May. "What information do they really need to gather?"

At this point, it's unclear whether FDA approval would factor both the pharmacist and the doctor out of the purchase. The agency often adds restrictions to over-the-counter sales.

"We are hoping that it will just be on the shelf, next to the condoms," says a spokeswoman for Women's Capital Corporation, Plan B's distributor. "But it will ultimately depend on decisions made with the FDA during the 10-month application process."

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