AMA Seeks to Improve Access to Morning After Pill
Dec. 6, 2000 (Orlando) -- It's Friday night on a holiday
weekend and you won't be able to talk to your doctor until Tuesday. But you
can't wait that long -- you've got reason to be believe you may be
The situation describes the plight of many women seeking
emergency contraception pills, sometimes known as "morning after"
pills. Since they must be taken within 72 hours of sexual intercourse in order
to be effective -- the sooner the better -- ready access is critical; yet in
most areas a prescription from a doctor is required, and in many areas
pharmacies do not stock the drugs.
This week, physicians at the meeting of the American Medical
Association's House of Delegates approved motions designed to improve access to
emergency contraception. Members of the policy-making body passed the
recommendations of a report by the association's Council on Medical Service
(CMS) calling on the AMA "to enhance efforts to expand access to emergency
contraception, including making emergency contraception pills more readily
available through hospitals, clinics, emergency rooms, acute care centers, and
And the association will also "support and monitor"
efforts by manufacturers of emergency contraception seeking approval from the
FDA to market the agents over-the-counter, according to the report approved by
There are two morning-after pills on the market: Preven and
Plan B. Both were approved for use in the U.S. during the past two years.
In a press conference following the House action, AMA Trustee
Edward J. Hill, MD, said it is not the AMA's job to recommend drugs for
over-the-counter status. "We do not want the implication that AMA supports
over-the-counter status for any drug," Hill says. "That is the FDA's
A statement released by AMA following the House action sought
to clarify the association's position on over-the-counter status. According to
that statement, "If the FDA determines that [emergency contraception pills]
are safe for over-the-counter use, the AMA would support that increased
Joseph P. Annis, MD, of the CMS and a delegate from Austin,
Texas, said physicians frequently neglect to educate patients about emergency
contraception during regular family planning counseling. And many low-income
and uninsured women may be unable to access emergency contraception, even
during regular hours, he said.
"This is an access issue," said Annis. "The more we
looked at this, the more we talked about how most unintended pregnancies occur
among uninsured and low income women for whom access is a problem. And once we
started to talk about access, we had to think about how to make this more
Most of the recommendations in the report call for physicians
to educate their patients about the availability of emergency contraception.
But clearly, over-the-counter status was the most controversial aspect of
debates about the issue. During hearings on the subject, Richard W. Whitten,
MD, a delegate from Olympia, Washington, informed physicians about a pilot
project in his state in which physicians formed collaborative arrangements with
pharmacies to dispense emergency contraception over-the-counter.