• The right call on Plan B

    Given my repeated lambasting of the Obama administration for their seemingly anti-science view of Plan B, it’s only fitting that I also note their reversal:

    The Obama administration has decided to stop trying to block over-the-counter availability of the most popular morning-after contraceptive pill for all women and girls, a move fraught with political repercussions for President Obama.

    The reversal by the government means that any woman or girl will soon be able to walk into a drugstore and buy the pill, Plan B One-Step, without a prescription.

    The Justice Department had been fighting to prevent that outcome, but said late Monday afternoon that it would drop its appeal of a judge’s order to make the drug more widely available. In a letter to Judge Edward R. Korman of the United States District Court for the Eastern District of New York, the administration said it would comply with his demands that the Food and Drug Administration be allowed to certify the drug for nonprescription use.

    It’s important to remember that this isn’t the Obama administration striking out into uncharted territory. This is them now getting in line with science. When Sec. Sebelius previously overruled the FDA, that was the first time ever a secretary of HHS had done so. It’s also important to remember that no matter how much they claimed that “research was needed” to understand how adolescents would use the drug, that research had already been conducted, and was why the FDA had granted its approval.

    Before any of you start in on your own safety concerns, remember this:

    In 2009, there were over 70,000 calls to poison control centers for concerns about acetaminophen and more than 88,000 for ibuprofen. More than 30,000 calls were made for diphenhydramine, and 4 of those cases resulted in deaths. Just looking at kids 5 years of age and under, there were more than 130,000 calls for analgesics, 53,000 for vitamins, 48,000 for antihistamines, and 45,000 for cough and cold preparations.

    No one is demanding any of those drugs be restricted in this manner.

    And if any of you make a crack about Plan B being sold next to “bubblegum and batteries”, I’ll remind you again that battery ingestions kill a couple kids each year. Plan B kills no one.


    UPDATE: Sarah Kliff points out to me that President Obama has not changed his mind about Plan B, according to officials. It’s just that the Justice Department thought they couldn’t defend his position in court and win. So I suppose I should laud the outcome, but continue to scowl in President Obama’s general direction. On this, he should know better.

    • Aaron C, on an unrelated issue: Interested in blogging about this paper on flu vaccines? It’s rather anti-vaccine and I thought you would be interested in responding or at least reading it. It was published in JAMA Internal Medicine recently.

      • I’ll take a look!

      • From what I’ve heard, the crux of the problem is that since it is so widely believed that the vaccine has a large impact lowering the mortality rate, it’s considered unethical to do a randomized controlled trial to measure the impact on mortality. One thing we do know is that the estimates we get from population studies are implausibly large, with the reduction in annual mortality often exceeding the estimated number of influenza infections.

    • A quick check of Planned Parenthood states that they think birth control pills cost $15 to $50/month and Plan B $10 to $45, making Plan B no more expensive than contraception. Without a prescription, will teens start using it as birth control? Is it safe to do so?

      • I doubt it, any more than adults do. They’d have to use it multiple times, and it’s less effective (I believe) than regular birth control.

        And if they do?

    • I think the logic and science behind the Plan B decision is correct; however, I find it disturbing that no one seems to be scaling up this logic to the numerous other drugs that we require prescriptions for when other comparable countries do not. Is there a reason why we have such a restrictive drug access regime? Why is Plan B a special case that deserves loosening as opposed to other drugs?

      My sense is that for once, the strong attention by activists, worked.

      • I don’t think you’re entirely wrong here. There are likely many more drugs that could be made over-the-counter. I think one reason there isn’t much of a fight is that prescription drugs are covered by insurance.

        • If birth control pills were no longer prescription (perhaps needing just a pharmacist consult) and no longer covered by insurance, I’d expect to see costs drop to copay levels or lower (~$5/month), access dramatically increase, and the need for Plan B to drop.

    • “Plan B kills no one.” —except little tiny fertilized ovum

    • As someone who frequently travels to the US (from Canada) I am surprised at the number of medications that I can buy off the shelf or over the counter, but require a prescription in the US. As someone with a back condition (DISH) it’s very apparent. The two medications I use (Methocarbamol/Robaxin and Orphenadrine/Norflex) are on the shelf in the case of the former, and OTC for the latter, in Canada.

      But when I could not find them in a pharmacy in the US and asked the pharmacist, I was surprised to be asked for a prescription.

      I’m *guessing* it has some cultural connection with the long-running and largely failed “war on drugs.”

    • Is metformin so dangerous that a prescription is really needed?