Pharmacists cite morals for pill bans

As arguments intensify nationwide over pharmacists’ right to dispense prescriptions based on personal beliefs, an unprecedented survey found limited access to emergency contraception, or EC, in Missouri’s pharmacies, particularly in rural areas.

In March and April, the NARAL Pro-Choice Missouri Foundation conducted its Pharmacy Access Survey of 920 pharmacies in Missouri.

The group found that 71 percent of the pharmacies do not stock EC, also known as the morning-after pill. Of those pharmacies, only 39 percent will order the drug. Three-quarters of the pharmacies stocking EC are in metropolitan areas.

The group said 44 percent of Missouri pharmacies that do not stock or order EC cited a specific moral objection when asked about their refusal to dispense it.

In Boone County, 11 of the 21 pharmacies stock EC; five others will order it if asked.

“If we are serious about decreasing the number of unintended pregnancies in Missouri, we must be serious about increasing access to emergency contraception,” NARAL Pro-Choice Missouri Executive Director Carolyn Sullivan said. In the report, the group says widespread access to EC could prevent half of Missouri’s nearly 40,000 annual unwanted pregnancies.

“Emergency contraception is an important part of treatment for sexual assault victims,” said Palle Rillinger, executive director of the Kansas City-based Metropolitan Organization to Counter Sexual Assault. “When you’ve been raped, you have lost control over your body. It’s essential for the victim to have a way to regain control and be assured that the violation won’t continue in the form of an unwanted pregnancy.”

Ron Fitzwater, chief executive officer of the Missouri Pharmacy Association, said that in rural areas, the decision of whether to stock EC is business related.

“In some rural areas, they just don’t see a demand,” he said. “It becomes a business decision when you have a product with a limited shelf life.”

Fitzwater argued that just as patients have a right to choose certain pharmacies, pharmacists have a right to choose whether to dispense certain products. In the case where pharmacists are under contract to dispense their pharmacies’ products, however, the organization believes the pharmacist is obliged to fill prescriptions, he added.

The American Pharmacists’ Association argues that pharmacists should be allowed to refuse prescriptions as long as they ensure customers can get the pills some other way.

EC must be used within 120 hours of sexual intercourse to be effective and is most effective within 24 hours. EC is not the same as the RU-486 pill; it does not cause abortion and will not work if a woman is already pregnant.

The 920 pharmacies contacted were considered non-specialized in service and open to the public. The survey accounted for all such pharmacies. Volunteers posing as customers contacted the pharmacies by phone. Non-pharmacy options for obtaining EC include the nine Planned Parenthood locations in the state or mail-order options such as 888-NOT-TOO-LATE.

In Columbia, D&H Drug Store, Kilgore’s, Gerbes, Walgreens and Hy-Vee are among the pharmacies that stock EC. Although Wal-Mart sells birth-control pills, it has refused to stock EC since 1999.

NARAL Pro-Choice Missouri’s next steps include organizing a statewide project to increase access to EC, compiling a referral guide based on the survey’s findings and supporting legislation to increase access to the contraceptive.