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Why Limiting Over-The-Counter Plan B To Girls Over 15 Is Still An Ineffective Policy

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"Why Limiting Over-The-Counter Plan B To Girls Over 15 Is Still An Ineffective Policy"

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(Credit: Boston Globe)

On Tuesday, the FDA announced that it will lower the age restriction on over-the-counter emergency contraception sales, allowing teens 15 years old and up to purchase Plan B without a prescription. Currently, only those 17 and older can buy this type of contraception over the counter. The new FDA guidelines will also move Plan B onto pharmacy shelves next to the condoms; previously, it was kept behind the counter and those who wanted to purchase it had to ask a pharmacist to retrieve it.

As Planned Parenthood noted in a statement on Tuesday, removing the restrictions on Plan B for 15- and 16-year-olds is certainly a step in the right direction in terms of expanding access to birth control. But, even though the age has been lowered, maintaining an unnecessary age restriction on over-the-counter sales is still a policy that ultimately undermines women’s health. Here’s why the FDA’s new policy is still problematic:

– It still isn’t based in science. There’s no scientific reason to impose age restrictions on Plan B. In fact, back in 2011, the FDA determined that the contraceptive can be used safely by girls and women of any age. Nevertheless, the Department of Health and Human Services overruled the FDA to restrict Plan B for Americans under 17 years old — a move that a U.S. federal judge recently criticized as “political interference.” Studies have shown that Plan B is safer than aspirin, which is obviously available for purchase over the counter for people of any age. Multiple medical groups have come out in favor of making emergency contraception available to all women over the counter. The continued efforts to police it — earlier this month, the Obama administration falsely asserted that Plan B could be too “dangerous” for young women to take correctly — seem to be based in paternalism rather than in actual scientific fact.

– It imposes an additional burden on women of every age who will have to provide proof of age. When the old FDA guidelines restricted emergency contraception for those under 17, it created issues even for those who were well above the age limit. Women’s health advocates argue that this type of age restriction perpetrates a stigma that makes it harder for everyone to access Plan B, as pharmacists often falsely tell older women they may not purchase emergency contraception without a prescription or incorrectly deny Plan B to men. And requiring women to prove their age — the new Plan B packaging will include a product code that prompts the cashier to verify the customer’s age — could present a significant hurdle for women who don’t have ID on them.

– It leaves out undocumented women and potentially younger teens. Undocumented immigrant women do not necessarily have the proof of age that the FDA stipulates is required under its policy, like a driver’s license, a passport, or a birth certificate. Even the immigrant women who are much older than 17 may not be able to purchase emergency contraception if the cashier insists on seeing one of those government-issued documents. And younger teens who may not have a license or a passport, which could apply to many 15-year-olds, will be denied emergency contraception. “If a 15-year-old is unable to verify their age, they will not be able to purchase Plan B One-Step,” an FDA spokeswoman told the Washington Post.

– It doesn’t fully address a recent ruling that the FDA must make Plan B available to all women over the counter. The FDA clarified that Tuesday’s announcement is completely unrelated to a recent court decision that ordered the agency to remove all age restrictions for Plan B. At the beginning of April, a federal judge ruled that the FDA must make emergency contraception over the counter for all women. The Obama administration has four days left to decide whether to comply with that ruling or appeal it. This separate announcement may be seen as somewhat of a compromise, but since it’s not actually in response to that judge’s order, it doesn’t really do anything to address that pending legal issue.

Another unresolved issue with the Obama administration’s Plan B policy is the matter of insurance coverage. Obamacare requires insurers to cover all FDA-approved contraceptives without charging a co-pay, and that includes over-the-counter emergency contraception. But as the policy stands now, women must still have a prescription from their doctor in order to get insurance coverage for the birth control that they purchase over the counter — without that prescription, they have to pay for it out of pocket. Many women, particularly younger teens, may not be able to afford the full cost of Plan B, which is typically around $50. But requiring them to get a prescription for this time-sensitive medication often defeats the point.

Update

The American College of Obstrecians and Gynecologists has released a statement in response to the FDA’s new policy. The group of medical experts commends the FDA’s attempt to expand access to emergency contraception for teens, but reiterates that “the medical evidence demonstrates that EC is safe and effective in preventing pregnancy for all reproductive-age females” and “the College strongly encourages the FDA to reaffirm its earlier decision to approve EC for unrestricted over-the-counter access.”

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