Plan B pill would cut costs, pregnancies

By Dar Haddix
UPI Business Correspondent

WASHINGTON, Jan. 27 (UPI) -- If the Food and Drug Administration gives its approval, over-the-counter sales of the emergency contraception known colloquially as the morning after pill, or "Plan B," could finally give women, especially poor and rural women, an affordable way to prevent pregnancy in an emergency. The progestin-only drug levonorgestrel will come for approval by the FDA on Feb. 20 for over-the-counter dispensing after an advisory committee earlier recommended its approval by a vote of 22-5.

Right now only five states -- Washington, California, Hawaii, Alaska, and New Mexico -- allow sales of Plan B without a prescription. "Being able to go directly into a pharmacy and being able to buy this directly over the counter ... will have the potential to cut in half the number of unintended pregnancies," said Sharon Camp, president and chief executive officer of the Alan Guttmacher Institute in Washington, D.C., which tracks sexual health trends.

Emergency contraception prevented an estimated 100,000 unintended pregnancies and an estimated 51,000 abortions in the year 2000 alone, according to the institute. Plan B works by delivering .75 milligrams of levonorgestrel, a progestin hormone -- about three times the dose in a daily birth control pill -- in each of two pills taken 12 hours apart no more than three days after sexual intercourse.

Available by prescription in the United States since 1999, Plan B currently costs around $20-25, said Carol Cox, spokesperson for Barr Laboratories Inc. of Woodcliff, N.J. That is less than one-tenth the average cost of a first-trimester surgical or medical abortion. Cox said that Barr Labs had not yet settled on a price at which to sell the drug over the counter, but a report on FDA.com estimated that it would sell for between $30 and $40.

A prohibition on Medicaid funding and a dearth of state funding programs prevent many poor women who desire an abortion from having one. But emergency contraception needs to be taken quickly -- it's 95 percent effective if taken within 24 hours of unprotected sex -- so waiting for a prescription or driving long distances to a clinic could mean abortion instead of prevention.

This is why over-the-counter access would also benefit rural women. As of 2000, only 3 percent of all non-metropolitan counties had an abortion provider, and 94 percent of all abortion providers were in metropolitan counties. Nearly one in four women obtaining an abortion in 2000 traveled more than 50 miles; 8 percent traveled more than 100 miles, according to the Guttmacher Institute.

Offering the drug over-the-counter would solve the problem of some hospitals not offering the drug to rape victims. An estimated 32,000 women per year get pregnant due to rape or incest, according to the Guttmacher Institute. Only California, Washington, New Mexico and New York have state laws that guarantee rape victims access to emergency contraception. Also, some pharmacies, including Wal-Mart don't carry the drug.

The fact that women do most of the shopping in pharmacies will hurt those pharmacies that don't carry Plan B, Camp said. "Pharmacies that refuse to carry Plan B are going to lose business to the pharmacies that do. This is a product that is so important to women. ... If pharmacists choose to offend women by not carrying something that important, they will lose business to their competitor down the street," she said.

Carol Cox, spokesperson for Barr, described the company as "very committed to female health care," and that it sees Plan B as a "commitment to female health overall." In the end, Camp said she believes that Plan B will be approved. With a few exceptions, "The support of the medical community is virtually unanimous," she said.