What’s in Stock at the Pharmacy “the Morning After”?

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“I’ve gone through most of my life assuming that if I have a prescription from my doctor, I’d be able to go on to any pharmacy and have that prescription filled,” says Hannah Shacter C’06. “It turns out that that’s not true.”

Shacter, who was a biological-basis-of-behavior program major, made that discovery during an independent research project on state pharmaceutical policies and the ways they can affect access to emergency contraception. She found that six years after FDA approval, the emergency contraceptive Plan B (also known as the morning-after pill) isn’t widely available.

Shacter revealed her findings last spring in a talk sponsored by Communications Within the Curriculum (CWiC) titled, “The Morning After: The Politics of Emergency Contraception.” CWiC is a Penn program that promotes student speaking, and Shacter was selected as an “Emerging Scholar” lecturer. Her research advisor for the project was Dr. Judith Long, assistant professor of internal medicine.

“Only a handful of states have a policy that directly relates to emergency contraception and the right of pharmacists to refuse” to fill prescriptions, Shacter notes. “In Massachusetts, pharmacists are not allowed to refuse. In Philadelphia, there’s no policy about pharmacist refusal, and in Georgia, pharmacists are allowed to refuse.”

Shacter made a list of every pharmacy in the metropolitan areas of Boston, Philadelphia, and Atlanta, and received responses from 1,085 of them. She asked the pharmacies if they would be able to fill a prescription of Plan B within 24 hours.

As she suspected, access varied with the policy on refusals. Thirty-five percent of the pharmacies she spoke with in Atlanta could not fill a prescription for Plan B within 24 hours, compared with only four percent in Boston.

What surprised her the most was the response from Philadelphia. “Philadelphia is a northern, liberal city that generally votes for pro-choice candidates,” she notes, “but one in four Philadelphia pharmacies did not carry Plan B.”

While the rate of outright refusals in Philadelphia was lower than in Atlanta, the fact that Plan B has only a five-day window of effectiveness means that not keeping the medication in stock is just as harmful as refusing to dispense it, Shacter says.

Shacter plans to apply to medical school for 2007. In the meantime, she is working in health-services research at the Veterans Administration Medical Center with Long.

Shacter acknowledges that the use of emergency contraception touches on moral and religious issues, but she believes it is important for women to be educated about it: “We need to make sure that women know what they’re doing. For every four children that are born in the United States, there’s one abortion performed. Widespread use of emergency contraception would cut the number of abortions each year by 700,000.” 

—Chelsea Tanimura C’06

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