Format

Send to

Choose Destination
Contraception. 2018 Mar;97(3):264-269. doi: 10.1016/j.contraception.2017.10.009. Epub 2017 Oct 31.

Pharmacy access to Ulipristal acetate in major cities throughout the United States.

Author information

1
Department of Obstetrics, Gynecology & Women's Health, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI. Electronic address: maryssas@hawaii.edu.
2
Department of Obstetrics, Gynecology & Women's Health, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI.
3
Department of Obstetrics & Gynecology, University of Utah School of Medicine, Salt Lake City, UT.
4
Office of Public Health Studies, University of Hawaii at Manoa, Honolulu, HI.

Abstract

OBJECTIVE:

Ulipristal acetate (UPA) is a prescription emergency contraceptive pill (ECP). Despite the potential for UPA to reduce the risk of unintended pregnancies, a recent study in Hawaii demonstrated less than 3% of pharmacies stocked UPA and less than 23% reported the ability to order it. The primary outcome of our study was to assess the availability of UPA in a sample of large cities nationwide.

STUDY DESIGN:

We conducted a telephone-based secret shopper study of 533 retail pharmacies sampled proportionally from 10 large cities in five geographic regions across the US. Callers represented themselves as uninsured 18-year-old women attempting to fill prescriptions for UPA between February and May 2016. Using a semi-structured questionnaire, callers inquired regarding availability and use of UPA.

RESULTS:

Less than 10% (33/344; 95% CI: 6.5-12.7%) of pharmacies indicated the ability to immediately fill a UPA prescription, while 72% (224/311; 95% CI: 65.0-77.0%) of pharmacies without immediate availability reported the ability to order UPA, with the median predicted wait time of 24 h (IQR: 21.5 to 26.0 h).

CONCLUSION:

Despite evidence for increased efficacy of UPA over levonorgestrel (LNG) ECPs, the availability of UPA in a sample of US major cities is extremely limited. Given that ECPs should be taken as soon as possible after unprotected sex, the long wait times when ordering UPA present an access barrier. Efforts to improve the availability of UPA are important to optimize the potential of ECPs to decrease unintended pregnancy following unprotected sex.

IMPLICATIONS:

Interventions are needed to address barriers to obtaining UPA from retail pharmacies nationwide.

KEYWORDS:

Contraceptive access; Emergency contraception; Pharmacy availability; Ulipristal acetate

[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Elsevier Science Icon for PubMed Central
Loading ...
Support Center