July 28, 2007

The overreactions (on both sides) of pharmacies and the Plan B pill

Posted by LSU @ 12:17 am

Once again an issue has cropped up that is being completely misrepresented by all parties, and once again, it is up to me, your host, to clarify the real issues.

First of all, the Plan B pill, or the morning after pill was developed to act as a preventative to contraception.  It does not terminate pregnancies, it prevents them from happening at all.  Specifically they prevent ovulation, like birth control pills, or they prevent fertilization, like a condom.  The active ingredient is the same as the one in the Norplant birth control implant.

So the conservatives who blast this as an abortion pill need to get a grip.  The only Christians with any moral standing might be catholics, or other faiths who (by dogma) oppose all forms of birth control.

Now.  The pharmacists.  Some pharmacists refuse to dispense it on moral grounds.  Sounds bad, but how bad it is really depends.

Let's break this down with some of the common scenarios and my take on them.

  • If the pharmacy stocks the pill, then the pharmacist should suck it up.  If it's stocked, dispense it.  Period.
  • If there are more then one pharmacists in that same store, then sure, let one of the others do it for you, but consider leaving and finding a job where the choices of products do not cause you so much dilemma.  And I would add that I fully expect you to defer to sell the pill, IUDs, condoms, spermicides and any other kind of contraceptive.  If you want this moral ground, you had damn well better be consistent.
  • If a pharmacy decides to not stock it at all, sorry, the customer does not have a right to demand a product, except by the force of their business.  They vote with their wallets and take their business elsewhere.

It's as easy as that.  Of course, it is never as easy as that.

The WaPo has this to say:

Plan B Use Surges, And So Does Controversy

The popularity of the morning-after pill Plan B has surged in the year since the federal government approved the sale of the controversial emergency contraceptive without a prescription.

Get that?  It isn't even a prescription drug.  I'll address that in a second.

Advocates attribute the increased use despite the limitation both to the easier access and greater awareness of the drug's availability due to educational campaigns by family-planning advocates and media coverage of the controversy.

Sarah, 27, a school counselor who lives in the District, was glad she did not need a prescription after the condom her boyfriend was using came off last month.

"I just went to the pharmacy, and it was so easy," she said, asking that her last name not be used. "It's a really good option."

But…

Despite the change, Plan B remains the focus of intense debate, particularly over whether pharmacists who oppose its use on moral grounds should be required to provide it and whether Catholic hospitals should be required to provide women with either information about the drug or the medication itself.

Several states have passed laws either requiring pharmacists to provide Plan B or protecting those who refuse. Fourteen states now require hospitals to provide women with information about emergency contraception or the medication. At least 19 other states are considering legislation, and a bill was recently introduced in Congress that would require pharmacies to make sure women get access to all forms of birth control, including Plan B.

Surveys and anecdotal reports indicate that some pharmacies refuse to stock the drug, some pharmacists refuse to provide it to women and some pharmacy workers mistakenly believe only the pharmacist can dispense the drug.

"Even though it's now available without a prescription, there are still significant obstacles that customers are facing around the country," said Ted Miller of NARAL Pro-Choice America, which has been surveying pharmacies around the country. "The over-the-counter access is not a cure-all."

Tashina Byrd, 24, said she was turned away by a pharmacist in Springfield, Ohio, in January after her fiance's condom broke and she tried to buy Plan B.

"He just laughed and told the attendant to tell me no one would give it to me," Byrd said. "I was enraged and humiliated."

The pharmacist was acting like a loser, but I cant buy off on her rage and humiliation.  Take your business elsewhere, i am sure Springfield has more then one.

A local radio host blasted the conservative pharmacists.  He is all for moral choices, but this, he said is special.  This is a health issue.  These bastards are withholding medication.

Get a grip.  First, not all pharmacies carry every friggin possible prescription, let alone ever OTC medication.  If a pharmacy decides not to carry this, or condoms, or even some magical organic Peruvian toe fungus cure made with genuine bat guano, that is their choice.  They run a business and the owners have the right to choose what they sell.

Period.

I might buy an argument for prescription drugs, but there is no way a pharmacy can stock them all.  So the pharmacy has to decode which are the most cost effective, and arrange to order or otherwise deal with requests for drugs they do not.

This argument really irritates me because it insists on some right to prescriptions.

My Cholesterol medication which is a necessity for my health costs me 20 bucks a month, but were it not for my insurance, it would cost about $100 bucks.  If I was low income, I would be out of luck.

There is no right involved.  It is a market choice.

And in this case, the pill is OTC, so there is more compelling right to it then there is for cream to cure jock itch or a yeast infection.

My sate of course, as only it can, has lost its mind and has intervened, and the State Pharmacy Board has ordered them to dispense the prescriptions.

Now I cannot find the details, so I am unsure whether the pharmacies are required to stock it or not, but it seems to imply they are.

If they must stock it, I have an issue with the ruling.  If they already stock it, then I can't argue against it.

Look, if you are a pharmacist and you work at a place you had better be able to fulfill the duties required of you.  If someone can step in and do it for you, fine, but the first time you refused, you would be in job jeopardy.

If you are the owner and sole pharmacist, don't stock it and take your chances.

That is the common sense way around it.

The state's actions have caused a lawsuit, of course.  The whole matter has been misrepresented on all sides, all the way up.

This is not a life saving medication, this is not a necessary medication.  It is an over the counter contraceptive. 

It is not an abortion in a bottle, nor is it a moral quagmire.

It's a business choice.

And frankly I'm sick of hearing about it.

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  1. On July 28, 2007 at 8:51 am, Playin' Possum wrote:

    "My Cholesterol medication which is a necessity for my health costs me 20 bucks a month, but were it not for my insurance, it would cost about $100 bucks.  If I was low income, I would be out of luck."
     
    Which is why this should be Nationalized into a single payer system. The fact is no matter how much you - they, I should say - prate about the drug "belonging" to a pharmaceutical company, it wouldn’t exist without the massive government funded infrastructure that does and always has propped all basic research. We pay for that…
     
    BTW, I assume that’s veterans insurance?
     
    Which brings up the real point. Screw morals all around. It doesn’t matter whether or not this is OTC - there is still a restriction of access due to the history and the nature of the business. Look at the language - you’re using it too. On one hand, you say OTC. On the other, you use the word "prescription." It doesn’t really matter if it is OTC, if there are only a few venues where it is available - and if individuals can shut down the market significantly - if people think it’s restricted, it is.
     
    Your argument fails until every 7-11 carries "Plan B." Then you can say there is enough access one mudhead can’t affect it.
     
    Beyond that, I contend any pharmacist who refuses to fill any lawful prescription should lose license immediately and permanently. They wouldn’t have their license or their professional monopoly without the government’s shameless arrogation of my right to self-medication. The government’s arrogation gives me the right to demand their performance unconditionally. And frankly if some mudhead refused something really important, I’d call that justification for homicide: Self defense.
     
    And I contend its just plain ugly and uncivilized to try to inject you morals into someone else’s privacy. People who do that aren’t fit to be Americans… But that’s what passes as my morals - which only restrict someone else’s right to restrict, a necessary and proper function. The prohibitionist - the pro-lifer, for example - does not deserve a place in the debate and I will do what I can to deny them one. Every pro-lifer starts out pro-choice. They make their choice - to eschew an activity - and then seek to impose their will on others.
     
    And if there is such a thing as a devil, that’s what’s in his soul - and damn all prohibitionists to his demense…
     
    But its interesting to note your "moral" [pubic?] hair splitting: Please note, Karl doesn’t believe life begins at conception. He believes it begins at implantation, and that artificial means of preventing implantation are OK…
     
    Such a finely split [pubic?] hair that is…
     
     

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