EC and Birth Control Access Program
The Prevention First Colorado research program has completed three large scale surveys on the accessibility and availability of emergency contraception and various methods of birth control for women in Colorado (2005, 2008, 2010). Emergency contraception (EC) is a high dose of levonogestrel. EC remains highly effective for up to 72 hours after unprotected sex, contraceptive failure, or sexual assault. EC was first approved by the FDA in 1999 under the brand name Plan B®. In 2006 the FDA approved Plan B® for over-the-counter access for women age 18 and over. Several years later following a federal judge’s order in March 2009, the FDA extended over-the-counter availability to women aged 17 years old, while retaining the prescription requirement for emergency contraception for women 16 and younger. Then in August 2009, production of Plan B® was discontinued and the two pill regimen was replaced with Plan B One-Step®, which only requires one pill. After the patent expired on the original formulation of Plan B during the summer of 2009, Next Choice, a generic brand of emergency contraception, was introduced to the market, intending to increase the affordability of EC. Despite these recent improvements to access to emergency contraception, Colorado women still encounter barriers to access including product availability, high prices, large distances in which there is no pharmacy, pharmacist refusals, and pharmacists failing to follow updated regulations regarding the sale of emergency contraception.
2005 Emergency Contraception Study
The 2005 round of research concentrated solely on access to emergency contraception. This was before the 2006 FDA decision to provide it to women aged 18 and older without a prescription and before the more recent 2009 decision to include women aged 17 in that category.
2008 Survey Results Summary
NARAL Pro-Choice Colorado Foundation (NPCCF) surveyed pharmacies and health care providers in the state of Colorado to determine the level of access women have to various types of contraceptives, including emergency contraception (EC). Through the survey NPCCF found concerning statistics about contraceptive availability and accessibility in Colorado such as the fact that 22.3% of clinics do not prescribe or provide contraceptives, and that 39.6% of clinics do not provide access to emergency contraception. The Foundation was also able to determine two large issues facing women in Colorado: rural access to contraceptives and the use of Medicaid to obtain contraceptives. Many women in rural areas of Colorado do not have a clinic or pharmacy where they can access birth control or emergency contraception. Women on Medicaid face a unique barrier of needing a prescription to access emergency contraception, reducing the likelihood that they will receive the medication within the 72 hours it is effective. The study preformed by NPCCF provides direction and focus for the state of Colorado to work on increasing access and availability to contraception for women that deserve the opportunity to make educated decisions about reproductive health care. Click the link below for the report!
2008 Accessing Contraceptives in Colorado Report P1st EC & BC Report.pdf
2010 Survey Results Summary
During the summer of 2010 NARAL Pro-Choice Colorado Foundation (NPCCF) surveyed pharmacies in the state of Colorado to determine the level of access women have to various types of contraceptive methods, including emergency contraception (EC), other hormonal methods, barrier methods and non-hormonal methods. This research study was designed to develop a greater understanding of the systematic barriers that prevent women in Colorado from obtaining emergency contraception. Despite the fact that the number of pharmacies that carry emergency contraception has increased by 4% since 2008, there are still a number of counties without access to emergency contraception. Ninety-two percent of pharmacies in the state of Colorado carry emergency contraception, which is a 4 percent increase from the results of the 2008 study. Approximately 21 percent of pharmacists responded that they do not sell emergency contraception to women 17 and older without a prescription; 94 percent of these respondents specified that they believed the law restricted over-the-counter sales to 18 and older. The average cost for Plan B One-Step in Colorado pharmacies is $46.03, and the generic Next Choice remains at a high average cost of $45.04. Out of the pharmacies that do sell emergency contraception, 9 percent responded that at least one pharmacist refuses to sell it. Pharmacies in rural areas are less likely to carry emergency contraception. Women face a higher cost of transportation to get to a pharmacy, especially when the pharmacy nearest them does not carry it. This combination increases the risk that women will need to travel long distances to multiple pharmacies, in order to obtain emergency contraception. A fifth of pharmacy respondents were also unaware that 17-year-olds are legally able to purchase emergency contraception, making it even more difficult for 17-year-olds to obtain emergency contraception.
EC 2010 Brief ECBrief2010.pdf