Advocates again look to states to promote eased access to emergency contraception.By the time the Food and Drug Administration (FDA FDA abbr. Food and Drug Administration FDA, n.pr See Food and Drug Administration. FDA, n.pr the abbreviation for the Food and Drug Administration. ) announced last August--for the third time since 2004--that it was not yet willing to grant over-the-counter (OTC OTC See: Over-the-counter. OTC See over-the-counter market (OTC). ) status to the emergency contraceptive contraceptive /con·tra·cep·tive/ (-sep´tiv) 1. diminishing the likelihood of or preventing conception. 2. an agent that so acts. Plan B, most emergency contraception Emergency Contraception Definition Emergency contraception or emergency birth control uses either emergency contraceptive pills (ECPs) or a Copper-T intrauterine device (IUD) to help prevent pregnancy following unprotected vaginal intercourse. advocates had long since ceased to be surprised. Still, news that the agency was persisting in its refusal to heed the recommendations of both its senior staff and two expert advisory panels sent waves of anger throughout the reproductive health Within the framework of WHO's definition of health[1] as a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity, reproductive health, or sexual health/hygiene community. On Capitol Hill, Plan B's leading champions, Sens. Hillary Rodham Rodham is an English surname which may refer to a number of persons or places. People Family of Hillary Rodham Clinton
Having been blocked by politics at the federal level, advocates are redoubling their efforts at the state level to enable women to have access to back-up birth control within the short window of time in which the method can effectively prevent pregnancy after unprotected intercourse. Much of their attention will continue to focus on state collaborative practice laws, which grant prescriptive pre·scrip·tive adj. 1. Sanctioned or authorized by long-standing custom or usage. 2. Making or giving injunctions, directions, laws, or rules. 3. Law Acquired by or based on uninterrupted possession. authority to pharmacists This is a list of notable pharmacists.
1. the act or process of bringing into proximity or apposition. 2. a numerical value of limited accuracy. of over-the-counter availability. Growing support of other practices, such as advanced prescriptions for Plan B, demonstrates that these avenues are worth pursuing as well. In 2005, the Guttmacher Institute The Guttmacher Institute (formerly The Alan Guttmacher Institute) advances sexual and reproductive health in the United States and globally through an interrelated program of social science research, public education, and policy analysis. conducted an investigation of policies to explore the range of possible options available on the state level and to provide additional strategies, with which advocates are likely to make some progress in the face of federal inaction in·ac·tion n. Lack or absence of action. inaction Noun lack of action; inertia Noun 1. . Collaborative Practice Agreements Collaborative practice laws allow pharmacists to enter into an agreement with physicians to prescribe medication directly in a pharmacy setting. Where applied to emergency contraception, these policies greatly reduce the time it takes for a woman to obtain emergency contraceptives, by removing the need for her to visit a doctor. To date, nine states (Alaska, California, Hawaii, Maine, Massachusetts, New Hampshire New Hampshire, one of the New England states of the NE United States. It is bordered by Massachusetts (S), Vermont, with the Connecticut R. forming the boundary (W), the Canadian province of Quebec (NW), and Maine and a short strip of the Atlantic Ocean (E). , New Mexico New Mexico, state in the SW United States. At its northwestern corner are the so-called Four Corners, where Colorado, New Mexico, Arizona, and Utah meet at right angles; New Mexico is also bordered by Oklahoma (NE), Texas (E, S), and Mexico (S). , Vermont and Washington) have policies that specifically allow pharmacists to dispense emergency contraceptives to women without a prior prescription (see table, page 12); another six states have considered similar legislation this session. According to according to prep. 1. As stated or indicated by; on the authority of: according to historians. 2. In keeping with: according to instructions. 3. the 2005 Guttmacher Institute investigation, 28 additional states have some type of collaborative practice policy on the books, which could be used to expand access to emergency contraceptives; however, some of these laws are extremely general, whereas others are comparatively restrictive. For example, some limit agreements to specific patient populations, such as patients explicitly named by the prescriber, patients who have a relationship with the prescriber or patients referred to the pharmacist pharmacist /phar·ma·cist/ (fahr´mah-sist) one who is licensed to prepare and sell or dispense drugs and compounds, and to make up prescriptions. phar·ma·cist n. by the prescriber. Although the laws vary considerably by state, supportive policymakers can use them as frameworks to develop agreements that specifically apply to the provision of emergency contraceptives. Utilizing State Pharmacy Boards In states where the likelihood of enacting a collaborative practice agreement specific to Plan B is slim because of the political makeup of the state legislature A state legislature may refer to a legislative branch or body of a political subdivision in a federal system. The following legislatures exist in the following political subdivisions: Areas of pharmacy practice include:
Time limits for prescriptions are one component of state pharmacy policy that could be used to increase women's access to emergency contraceptives. According to the Guttmacher analysis, most pharmacy board policies allow pharmacists to fill a prescription up to a year after it is written; after that time, the prescription becomes invalid and the patient must obtain a new one if she wishes to receive medication. Some providers are using these existing time limits to prescribe emergency contraceptives to their patients in advance, with the hope that women will either have the prescription filled and store the pills or keep the prescription in case of future need. Many advocates and public health organizations, including the American College of Obstetricians and Gynecologists The American College of Obstetricians and Gynecologists (ACOG) is a professional association of medical doctors specializing in obstetrics and gynecology in the United States. It has a membership of over 49,000[1] and represents 90 percent of U.S. (ACOG ACOG American College of Obstetricians and Gynecologists. ACOG American College of Obstetricians & Gynecologists ), readily support this method. In addition, advocates could work in tandem Adv. 1. in tandem - one behind the other; "ride tandem on a bicycle built for two"; "riding horses down the path in tandem" tandem with their state pharmacy board to have these limits extended or waived altogether. Another opportunity to increase access to emergency contraceptives is through the use of policies related to prescription refills. Most state policies firmly restrict the number of refills allowed under a particular prescription order. Thirteen states, however, allow pharmacists--after first trying to contact the prescriber--to refill refill noun A second allotment of a prescription agent obtained from a pharmacy, which is allowed by the original prescription verb Pharmacology To obtain more of a particular drug, after the initially prescribed amount of the agent has been used or any previously prescribed drug to a patient whose refills have run out. In some states, this can be done solely on the basis of a pharmacist's professional judgment. In other states, a pharmacist may refill an otherwise expended ex·pend tr.v. ex·pend·ed, ex·pend·ing, ex·pends 1. To lay out; spend: expending tax revenues on government operations. See Synonyms at spend. 2. prescription to prevent "patient suffering" or an "undesired health consequence"--outcomes that could certainly be interpreted to apply to an unplanned, unwanted pregnancy unwanted pregnancy Obstetrics A pregnancy that is not desired by one or both biologic parents. See Teen pregnancy. . Although these policies have not yet been applied to the refilling of prescriptions for emergency contraceptives, they may prove to be a successful means of using existing pharmacy rules to dispense the method. Plan C: Best Practices on the Ground In light of the inescapable reality that the effectiveness of emergency contraceptives is directly related to the timeliness with which they are taken, other means of expediting women's access to the method beyond official state policies are being explored. Advocates across the country are launching grassroots campaigns to raise awareness of emergency contraception among providers and the general public, to ensure that key stakeholders Stakeholders All parties that have an interest, financial or otherwise, in a firm-stockholders, creditors, bondholders, employees, customers, management, the community, and the government. are stocking and dispensing the drug, and to increase women's access to it through the promotion of online pharmacies  This article or section may deal primarily with the U.S. and may not present a worldwide view. and telephone prescriptions.
The "Back Up Your Birth Control" (BUYBC) campaign, for example, promotes emergency contraception by visiting local pharmacies and distributing educational materials to pharmacists in training. In addition, they have developed information packets for the general public in both English and Spanish. Along these same lines, the Pharmacy Access Partnership has created "family planning family planning Use of measures designed to regulate the number and spacing of children within a family, largely to curb population growth and ensure each family’s access to limited resources. centers" in some retail pharmacy settings, where promotional and educational materials on emergency contraception are on display and available to the public. More recently, ACOG launched the "Ask Me" campaign, aimed at educating women about emergency contraception and encouraging them to get advanced prescriptions from their doctor. ACOG encourages doctors to wear buttons that read "Ask Me" to spur conversations between the doctor and the patient about Plan B. In addition to providing information about emergency contraception, advocates are working to ensure that stakeholders in the private sector are stocking and dispensing Plan B. For example, in March, after years of refusing to stock Plan B because of "low demand," the multibillion-dollar Wal-Mart corporation buckled under mounting political pressure and agreed to stock it in all its pharmacies nationwide (after already having been required to sell the product in Massachusetts and Illinois). This decision was a huge victory for advocates because Wal-Mart--the third largest U.S. pharmacy chain, with over 3,600 locations nationwide--plays an important role in the timely provision of Plan B, especially for women living in rural communities where Wal-Mart may be the only local pharmacy. As a follow-up to this announcement, the BUYBC campaign spearheaded an initiative that enlists volunteers to visit local Wal-Mart stores and conduct surveys of pharmacists, to ensure that Wal-Mart complies with its new nationwide policy. In an earlier effort to promote the provision of Plan B in the private sector, the New York City Council The New York City Council is the lawmaking body of the City of New York. It comprises 51 members from 51 council districts throughout the five boroughs. The Council serves as balance of power against the mayor in a "strong" mayor-council government model. in 2003 enacted several measures. One prohibits city agencies from contracting with hospitals that do not either provide counseling about emergency contraception or dispense the actual medication to victims of sexual assault upon request. A second measure requires pharmacies that do not carry emergency contraceptives to post a sign indicating such. To date, a handful of public officials from other cities and states are considering similar sign-posting policies, including Illinois Gov. Rod Blagojevich Milorad Blagojevich, commonly known as Rod R. Blagojevich (pronounced IPA: [blə.ˈgɔɪ.ə.ˌvɪtʃ] listen (D), who announced such a proposal in March 2006. (Also, the council simultaneously enacted a measure to require all city clinics and health centers that provide STD (Subscriber Trunk Dialing) Long distance dialing outside of the U.S. that does not require operator intervention. STD prefix codes are required and billing is based on call units, which are a fixed amount of money in the currency of that country. treatment to provide emergency contraceptives.) Another initiative that has significant potential to increase women's access to emergency contraceptives is the promotion of the Internet as a means of obtaining prescriptions. For example, Not-2-Late.com, a Web site set up by Princeton University Princeton University, at Princeton, N.J.; coeducational; chartered 1746, opened 1747, rechartered 1748, called the College of New Jersey until 1896. Schools and Research Facilities , allows women to search by zip code zip code System of postal-zone codes (zip stands for “zone improvement plan”) introduced in the U.S. in 1963 to improve mail delivery and exploit electronic reading and sorting capabilities. for pharmacies and clinics that provide Plan B, and Getthepill.com provides prescriptions to women after they have completed an online medical questionnaire. (For the time being, however, Getthepill.com has its limitations; it does not provide prescriptions for patients living in 31 states.) Finally, advocates urge providers to prescribe emergency contraceptives over the phone, obviating ob·vi·ate tr.v. ob·vi·at·ed, ob·vi·at·ing, ob·vi·ates To anticipate and dispose of effectively; render unnecessary. See Synonyms at prevent. the need for women to see a clinician clinician /cli·ni·cian/ (kli-nish´in) an expert clinical physician and teacher. cli·ni·cian n. in person. The most recent systematic data available, which were compiled by the Guttmacher Institute, reveal that in 2003 more than one-third of publicly funded family planning agencies that provided emergency contraceptives also prescribed the method over the phone. Recent anecdotal evidence anecdotal evidence, n information obtained from personal accounts, examples, and observations. Usually not considered scientifically valid but may indicate areas for further investigation and research. gathered from Planned Parenthood Planned Parenthood A service mark used for an organization that provides family planning services. affiliates across the country suggests that, in the years since, the use of phone and Internet to prescribe Plan B has accelerated. Some clinicians have even started writing a standard prescription for every woman who makes a visit to the clinic. All in all, these multilayered mul·ti·lay·ered adj. Consisting of or involving several individual layers or levels. efforts demonstrate a commitment among advocates to support widespread and timely access to Plan B by whatever means available. By advancing policies in both the public and private sectors, advocates are incrementally creating greater access for women all across the country despite a series of disappointments--all with the hope that emergency contraception will one day be approved as a nonprescription non·pre·scrip·tion adj. Sold legally without a physician's prescription; over-the-counter. product, once and for all.
PRESCRIPTION DRUG POLICIES
Some states already have various policies in place that have been or
could be used to promote easier access to the emergency contraceptive
Plan B.
Collaborative Practice Policies
Policy Current
currently policy could
allows accommodate
direct direct
pharmacy pharmacy
access to EC access to EC
Alabama
Alaska X
Arizona
Arkansas
California X
Colorado X
Connecticut
Delaware
Dist. of Columbia
Florida
Georgia
Hawaii X
Idaho
Illinois X
Indiana
Iowa
Kansas X
Kentucky
Louisiana
Maine X
Maryland
Massachusetts X
Michigan X
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire X
New Jersey
New Mexico X
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina X
South Dakota X
Tennessee X
Texas
Utah X
Vermont X **
Virginia
Washington X
West Virginia
Wisconsin X
Wyoming
Limited Agreements Possible
No policy
Applies to Pharmacists or no
patient may modify agreement
named by an existing possible
the prescriber prescription
Alabama X
Alaska
Arizona X [dagger]
Arkansas X
California
Colorado
Connecticut X [dagger]
Delaware X
Dist. of Columbia X
Florida X
Georgia X X
Hawaii
Idaho X
[double dagger]
Illinois
Indiana X [dagger]
Iowa X
Kansas
Kentucky X
Louisiana X
Maine
Maryland X X
Massachusetts
Michigan
Minnesota X
Mississippi X
Missouri X
Montana X
Nebraska X
Nevada X
New Hampshire
New Jersey X X
New Mexico
New York X
North Carolina X
North Dakota X [dagger]
Ohio X X
Oklahoma X
Oregon X
Pennsylvania X [dagger]
Rhode Island X X
South Carolina
South Dakota
Tennessee
Texas X
[section]
Utah
Vermont
Virginia X [dagger]
Washington
West Virginia X
Wisconsin
Wyoming X
Time limit on Emergency
prescriptions refills
(in years) permitted *
Alabama No limit
Alaska 1
Arizona 1
Arkansas 1
California No limit Maintenance of health
Colorado 1 Maintenance of health
Connecticut No limit Maintenance of health
Delaware 1
Dist. of Columbia No limit
Florida 1
Georgia No limit Maintenance of health
Hawaii 15 months
Idaho 1 Professional judgment
Illinois 1
Indiana 1
Iowa 18 months Maintenance of health
Kansas 1
Kentucky 1
Louisiana 1 Professional judgment
Maine 1
Maryland 1
Massachusetts No limit
Michigan 1
Minnesota 1
Mississippi 1 Maintenance of health
Missouri 1
Montana 1
Nebraska 1
Nevada 1
New Hampshire 1 Maintenance of health
New Jersey 1
New Mexico 1 Maintenance of health
New York No limit
North Carolina 1
North Dakota 1
Ohio 1
Oklahoma 1
Oregon 2 Professional judgment
Pennsylvania 1
Rhode Island 1
South Carolina 2
South Dakota No limit
Tennessee 1
Texas 1
Utah 1 Professional judgment
Vermont 1
Virginia 2
Washington 1 Professional judgment
West Virginia 1
Wisconsin 1
Wyoming 2
* In the case of "maintenance of health," a refill may only be
dispensed to prevent undesirable health consequences, to prevent
patient suffering or to protect the patient's health, safety and
welfare. [dagger] Agreement is limited to hospitals or other
institutions that are inaccessible to most women. [double dagger]
Patient must be referred by a prescriber. [section] Prescriber must
have a relationship with the patient. ** Policy goes into effect in
July 2006.
Source: Guttmacher Institute, 2005.
www.guttmacher.org |
|
||||||||||||||||||
Printer friendly
Cite/link
Email
Feedback
Reader Opinion