No teen rush for Plan B expected
New Mexico pharmacists have seen only occasional requests
New Mexico pharmacists say they don’t expect a rush on the emergency contraceptive Plan B by teenagers, even though it is now available without a prescription to those 15 and older.
That’s because many pharmacists in New Mexico have had the ability for years to prescribe and give Plan B to teens of all ages without a doctor or parent’s permission. And, yet, pharmacists say they don’t get a lot of young girls asking for the drug.
Amy Bachyrycz, president of the New Mex-
ico Pharmacy Association, is certified to prescribe the contraceptive, but she says she receives only occasional requests from teenage girls for Plan B.
“It’s not requested heavily by those under the age of 17, believe it or not,” Bachyrycz said.
Last week’s ruling by the U.S. Food and Drug Administration has reignited the debate over whether young girls should have easy access to Plan B One-Step, an emergency contraceptive intended to reduce the possibility of pregnancy if taken within 72 hours following unprotected sexual intercourse.
The FDA issued rules allowing Plan B to be sold to girls as young as 15 years old without a prescription. And it allows stores to sell Plan B on store shelves next to other over-thecounter products.
Previously, the drug was available without a prescription to women 17 and older. And it was required to be behind the pharmacy counter so a woman had to ask the pharmacist for it.
Reaction to the new FDA rules has been all over the map — from those who oppose Plan B entirely to those who believe it should be as accessible as aspirin to girls and women of all ages.
Bachyrycz said she agrees with the FDA’s decision, but would prefer the agency lift age restrictions entirely.
“This is not a therapy that would harm a 15-year-old,” said Bachyrycz, a pharmacy professor at the University of New Mexico. “It is a safe therapy.”
In 2002, New Mexico became the fourth state in the nation to authorize pharmacists trained and certified to prescribe Plan B. About 400 pharmacists are trained to do so and can prescribe the drug to a girl of any age.
However, teenage girls may not know that they can obtain Plan B from a certified pharmacist, Bachyrycz said. The drug sells briskly to adults, she said.
High teen birth rate
On Tuesday, the FDA approved an application from the drug’s manufacturer, Teva Women’s Health Inc., to market Plan B One-Step to women ages 15 and older without a prescription. Girls 14 and younger still need a prescription.
The manufacturer must label “not for sale to those under 15 years of age” on the box. Cashiers will be required to check IDs to verify the buyers’ age.
However, in New Mexico, those younger than 15 can still go to a certified pharmacist for a prescription.
Many health professionals say the FDA should remove all age limits on sales of the drug. A Federal District Court decision in New York, issued April 5, ordered the FDA to grant a citizen’s petition that sought to remove all age restrictions. That decision is on hold after the U.S. Department of Justice on Wednesday appealed the ruling.
“My view is, people shouldn’t have babies unless they choose to have them,” said Dale Tinker, executive director of the New Mexico Pharmacists Association. “We have such a disastrous unintended pregnancy rate for teenagers in this state, that I think (Plan B) is an option that should be available.”
New Mexico’s teen birth rate is second only to Mississippi’s, according to the Centers for Disease Control and Prevention.
New Mexico mothers ages 15-19 had 53 births per 1,000, compared with a national rate of 34 per 1,000 in 2010, according to the most recent CDC figures.
Martha Edmands, a spokeswoman for Planned Parenthood of New Mexico, called the decision to lower the age to 15 “a positive step,” but that all age restrictions should be eliminated.
Nancy Sokkary, a pediatric and adolescent gynecologist at UNM Hospital, said any kind of age limit poses a barrier to teens who need an emergency contraceptive.
“If you have to have an ID, a lot of 15-year-olds don’t have their license yet,” Sokkary said. “So that right there is going to make it difficult to obtain (Plan B).”
Side effects of Plan B are typically mild, Sokkary said. Common side effects of the drug are mild bleeding, cramping and nausea.
But Roman Catholic leaders this week criticized the FDA for approving the sale of Plan B One-Step to 15 year olds without a prescription.
“It is beyond reason that our federal government would justify the sale of this potent drug to a child as young as 15 years old,” said Celine Radigan, a spokeswoman for the Archdiocese of Santa Fe.
Behind the counter
Despite the FDA’s ruling that Plan B can be placed on store shelves, some local pharmacists say they plan to keep the drug behind the pharmacy counter.
“I don’t think it will get taken from behind the counter, because there’s a huge chance for education,” Bachyrycz said. “It’s a time to educate them (customers) about future birth control options and also about STDs (sexually transmitted diseases).”
Bachyrycz said she also wants to make sure the woman is taking Plan B within 72 hours after having unprotected sex. After that, the drug is dramatically less likely to prevent pregnancy.
James Graham, a spokesman for Walgreen Co. in Chicago, said the nationwide pharmacy chain has not made a decision about whether to display Plan B on store shelves.
“We are working with the manufacturer of Plan B on packaging and other issues related to the FDA’s new guidance,” Graham said in written statement.
Bob Addison, owner of Addison Drug in Fort Stanton, said he plans to keep the drug behind his pharmacy counter.
“I honestly like the idea of the pharmacist handing (Plan B) to the patient,” said Addison, who is certified to prescribe the drug. “There’s a right way and a wrong way of taking this stuff.”
For example, Addison said he typically recommends that patients take an anti-nausea medication when they take Plan B, particularly for women prone to nausea, a common side effect of the drug. If a woman vomits within two hours of taking the pill, she needs to take another dose, he said.
“You really need that oneon-one contact with a pharmacist,” he said. But Addison believes Plan B should be available without a prescription to girls 15 and older “because that’s when a lot of them become sexually active.”