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Compromise May Loom for 'Plan B' Pill


Women who need the morning-after pill may be able to get it soon, without a prescription. A compromise is in the works that would allow over-the-counter sales of the drug Plan B to women over 18. It's been a three-year battle.

I spoke earlier with NPR's Julie Rovner. I asked her first to remind us how Plan B works.

JULIE ROVNER reporting:

It's really just two high doses of regular birth control pills. It works very effectively to prevent pregnancy if it's taken within 72 hours of unprotected sex. But time is of the essence, it works better the sooner you take it, and that's the main reason that backers want it to be available without having to go to the doctor first.

BRAND: And that's been held up for a long time, and a compromise has been reached recently. Tell us about that.

ROVNER: Well, this is a compromise that we think is going to happen. What appears to be likely is that the FDA will approve this over the counter, without prescription, for those age 18 and over. Those younger than 18 would still have to get a prescription before they could get this. So there will be a lot of restrictions on how it's going to be available. It will be kept what's called, behind the counter, just at pharmacies and clinics. In other words, you'll have to ask for it.

BRAND: And you have to be 18 or over.

ROVNER: And you have to be 18 or over.

BRAND: So is everyone happy?

ROVNER: Well, no. Obviously, the manufacturer had originally proposed to have it be over the counter for everyone. There's a particular interest in teenagers, who are fairly high users of this. There were some worries that it might encourage teenagers to have more sex, because they could then have a back-up method of birth control. But scientific studies have shown that that seems to be unlikely. That's not the way it gets used.

There was then concern about younger teens, those under age 16, and there really weren't any studies looking at those. And that was what started this sort of two-year decision - will the age be 16, will it be 17 - and now it seems to have come to 18.

BRAND: There is some kind of logic, I assume, behind making this available for women only over the age of 18 and by prescription, because birth-control pills are available only by prescription, and isn't Plan B made up of the same ingredients?

ROVNER: It is, and this is sort of an interesting question, and it's something that the FDA's scientific advisory committee's looked at fairly closely. But the reason it is considered safe without a prescription, while regular birth controls are not, is that side effects of the regular pill happen over a long-term period. It happens from taking it every day, and this obviously isn't something intended to be taken every day.

BRAND: And Julie, this has been going on for years, this struggle over making Plan B available. What's the hold-up?

ROVNER: Well, the hold-up appears to have mostly been politics. There's been politics on both sides. There have been conservatives - religious conservatives - who have been concerned that making it available to teenagers in particular, might encourage teenagers to have more sex, even though studies have suggested that that's not the case. There are also concerns from some anti-abortion groups that the pill could work as an abortive agent by preventing a fertilized egg from implanting in a woman's uterus.

Now that's not the medical definition of pregnancy, and the FDA does classify this as a contraceptive, not an abortive agent. But there has indeed been a lot of pressure around that. And there have been some suggestions that political considerations, rather than scientific considerations - that has held this up -that this bill is being given basically a double standard. It's being treated not simply as a scientific and medical question, but as a moral question.

BRAND: And so when will we be able to actually see Plan B available at pharmacies, albeit behind the counter and for women aged 18 and over only? When will that happen?

ROVNER: Well, we've been sort of led to believe - by both company and the FDA -that a decision could come very quickly, perhaps as soon as next week. And it could then be available in the next couple of months.

BRAND: NPR's Julie Rovner, thank you.

ROVNER: You're very welcome.

(Soundbite of music)

BRAND: Stay with us, NPR's DAY TO DAY continues. Transcript provided by NPR, Copyright NPR.