Thumbs down to Pill’s over-the-counter access

Respondents to the Contraceptive Technology Update 2002 Contraception Survey continue to affirm their stance for continued prescription-only status for the Pill.

The 2002 survey statistics show 63% of respondents against over-the-counter (OTC) access — a virtual standstill from 2001’s 62.9% figure.

Having to renew their pill prescription is one way women will come in for a Pap and breast exam, says Kerry Raghib, CNM, MSN, a certified nurse-midwife at Trinity Medical Center, Medical Arts Clinic in Minot, ND.

"If they could get OCs [oral contraceptives] over the counter, we might not be able to give this yearly physical and education," she comments. "Also, smokers older than 35 and others who have contraindications to the Pill would be able to get them without problems."

Suzanne Schmidt, CRNP, a nurse practitioner at Pacific Coast Women’s Health in Encinitas, CA, says she would like to see OCs move to OTC status.

"I truly believe fewer unwanted pregnancies would occur and therefore fewer children in homes that are not emotionally equipped to meet the huge demands of proper parenting," she states.

However, Schmidt says she would support the move only with addition of heightened consumer education, periodic blood pressure checks, and awareness of warning signs.

EC may have more support

Providers may be more supportive of moving emergency contraception (EC) to OTC status. The Chicago-based American Medical Association and the Washington, DC-based American College of Obstetricians and Gynecologists have approved resolutions supporting expanded access for the method.

When EC is only available by prescription, women face more barriers to accessing it and are thus more likely to take the pills later, states a recent New England Journal of Medicine "Sounding Board" article.1

While EC is effective at preventing pregnancy if taken within 72 hours of sexual intercourse, the pills are most effective when taken as early after unprotected sex as possible.

At press time, Women’s Capital Corp. of Washington, DC, is proceeding with its efforts to move its levonorgestrel emergency contraceptive pill, Plan B, to OTC status. (CTU reported on the status of the project in the article, "OTC access sought for emergency contraception," August 2002, p. 89.)

Women’s Capital Corp. officials were scheduled to meet with the Food and Drug Administration (FDA) in late September 2002 to discuss its data supporting its submission for OTC status, reports Sharon Camp, PhD, company president and chief executive officer.

"We want to establish that the planned submission will be adequate for the FDA and that the timetable for amendments is acceptable," states Camp. "If the meeting goes well, we would hope to submit the application within four to six weeks."

Reference

1. Grimes DA. Switching emergency contraception to over-the-counter status. N Engl J Med 2002; 347:846-849.

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