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Plan B access to get easier

More than 1,100 women each month in the Inland Northwest take the morning-after pill to avoid pregnancy, a number that could rise after the federal Food and Drug Administration agreed Thursday that adults can buy the drug without a prescription.

The move is expected to provide easier access to emergency contraception in Idaho and to broaden it in Washington, where select pharmacists already are able to provide the pills, known as Plan B, without a doctor’s visit. Girls 17 and younger in Washington will still need a pharmacist’s approval to buy the pills, which are expected to be available by the end of the year. In Idaho, girls will need a prescription. Those seeking the drugs will have to prove they’re at least 18 to a pharmacist, who will keep the drug behind a counter.

Despite reports that the drug was unavailable elsewhere because of providers’ moral objections to the drug, Spokane stocks of Plan B remain more than adequate – and are expected to stay strong, pharmacists said.

“I personally have never met a pharmacist who was opposed in this area – and I know a lot of pharmacists,” said Candy Kennedy, a pharmacist at Jones Pharmacy and Home Health Care in Spokane. “I’ve never heard of anyone turning anyone away.”

In Idaho, Coeur d’Alene pharmacist Barry Feely said demand for Plan B was almost non-existent, but he still keeps it in stock.

“I keep one package here at my store,” said Feely, who operates several Medicine Man pharmacies. “If someone asks for it at the other two stores, I’ll send it over.”

Thursday’s FDA approval capped three years of contentious political wrangling, with women’s advocacy and medical groups contending the move would cut in half the nation’s 3 million unplanned pregnancies. Opponents argued that wider access could encourage promiscuity and that the medication is actually a form of early abortion.

Last year, an estimated 13,000 women in Eastern Washington and North Idaho – 1,100 each month – used Plan B contraceptives obtained at Planned Parenthood regional offices, said Jet Tilley, public policy director for the agency.

Dozens more received the drugs from area pharmacies, some by using a doctor’s prescription and some through Washington’s program that certifies supervised pharmacists to prescribe.

The FDA approval was aimed at providing greater access, proponents said.

“Of course we think this is a great day for women and a great day for women’s health,” Tilley said. “Any time you open up access and remove barriers, particularly with something like emergency contraception, which is time sensitive, it’s a great day.”

Advocates were disappointed at the FDA’s decision to limit over-the-counter sales to those 18 and older. Manufacturer Barr Pharmaceuticals Inc. had asked the age limit be set at 16.

Some area pharmacists supported the age restriction, saying that younger teens needed the guidance and supervision provided by medical professionals.

“I think there’s a bigger problem, that more education is needed. It really worries me. This is not a form of birth control,” said Jennifer Dailey, pharmacist at Sixth Avenue Pharmacy.

She said she hoped other states adopt Washington’s model of dispensing Plan B without a prescription. Pharmacists must take special training and work under a collaborative agreement with a doctor or other professional in order to be authorized to dispense the drugs.

“I’m glad for the accessibility, but there needs to be some accountability as well,” said Dailey.

About 1,000 of the state’s 5,000 pharmacists are certified under such agreements, said Steve Saxe, former executive director of the Washington State Pharmacy Board who is still overseeing the agency.

Sixteen providers in Spokane have been issued collaborative agreements, which might include several pharmacists each, he added.

Under state rules, pharmacies are not required to stock any drug, prescription or not, Saxe noted.

Next week, the Washington pharmacy board is expected to reconsider the language of a rule that would allow pharmacists who oppose emergency contraception to refuse to dispense the medication.

Some pharmacists in Western Washington have refused to stock the drug because they oppose it on moral grounds, a view echoed by the United States Conference of Catholic Bishops.

“We find the FDA’s unprecedented decision to make Plan B available without a prescription completely unacceptable,” Deirdre McQuade, a spokesperson for the group said in a written statement. “… While Plan B can prevent fertilization, the manufacturer admits it may also prevent a newly-conceived embryo from implanting and surviving in the womb. This is properly understood as causing an early abortion.”

Saxe said he didn’t know whether the FDA ruling would quell controversy by making the drug more widely available or increase criticism of those who object to providing it.

Plan B consists of two pills that are a concentrated dose of the synthetic hormone found in many regular birth-control pills. Cost is estimated at $25 to $40 a dose nationwide, though at least one Spokane pharmacy charges $55. Taken within 72 hours of unprotected sex, Plan B can lower a risk of pregnancy by nearly 90 percent. If a woman is already pregnant, the pills have no effect.

Timing is crucial to Plan B’s effectiveness. Proponents argued that it has been difficult to find a doctor to write a prescription, particularly on weekends and holidays.

Spokane pharmacists say that pharmacies open on weekends see more demand for the drug.

But an informal survey of several pharmacies revealed sales of 10 or fewer doses of Plan B a month.

At the Spokane Regional Health District, which also provides the drug, about two Plan B packages are dispensed a month, said Kathleen Henrickson, a public health nurse.

Many pharmacists would like to avoid the controversy surrounding emergency contraception, said Feely. He has no problem providing Plan B, prescription or not, but he knows of professionals who do.

“In some places, they don’t want to deal with it,” he said. “You know what they’ll do? They just won’t carry it.”