Pharmacy access to emergency hormonal contraception in Jacksonville, FL: a secret shopper survey

Emergency hormonal contraception (EC) has the potential to reduce the number of unintended pregnancies and induced abortions, but many barriers to more prevalent usage exist. We evaluated one aspect of access--pharmacy availability of levonorgestrel EC (Plan B) or alternatives--in Jacksonville, FL.

Female "secret shoppers" presented in person and by telephone to pharmacies in Jacksonville, FL, and inquired if Plan B would be available if they were to return with a prescription. Availability of the medication, as well as offers of EC alternatives or alternate methods of obtaining EC, was noted. Furthermore, pharmacist and pharmacy staff knowledge regarding appropriate use of the product was assessed.

Of 54 pharmacies visited by secret shoppers, 21 (39%) had Plan B in stock and were willing to dispense it. Sixteen pharmacies (29%) could order it and have it available within 24 h, or knew of nearby pharmacies that stocked the medication. Neither Plan B nor other EC options were offered by 17 pharmacies (31%). One hundred thirty-three pharmacies, including those that were visited in person, were contacted by telephone. Forty-two (32%) of these had Plan B in stock. Another 22 pharmacies (17%) offered to order Plan B for availability within 24 h or less. Furthermore, 11 pharmacies suggested other stores that were more likely to carry it. Of 40 pharmacy staff members asked how long following unprotected intercourse a patient had to take the product, 20 (50%) correctly stated 72 h.

Plan B was not in stock in a majority of pharmacies within this large city. Availability was increased by offers to order the medication or by suggestions to seek the prescription at nearby pharmacies. Many pharmacists and their staff were unfamiliar with the medication and its correct usage.