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Women's Enews (USA), April 12,
2005
Plan B Access
Fight May Stall FDA Nomination
Author : Cynthia L. Cooker
(WOMENSENEWS)--Annie Tummino of Brooklyn scrambled
to find a morning-after pill, worried that
an interruption in her birth control routine
might have put her at risk of unintended pregnancy
after having sex with her boyfriend.
"I realized I was in trouble," said
Tummino.
Available by prescription, Plan B, high-dosage
progestin birth control pills, is emergency
contraception that can prevent the establishment
of a pregnancy if taken soon after intercourse.
Best results occur within 24 hours; good results
within three days to five days.
With her doctor's office closed, Tummino searched
the Internet and lucked out, finding a hotline
in New York that helped her get a prescription.
"I was so thankful," she said. "All
women should be able to get the morning-after
pill this easily, so none of us ever has to
panic," said Tummino.
But not everyone agrees.
The Food and Drug Administration is currently
withholding a decision on a drug company's
latest application to allow Plan B to be sold
over the counter. In the meantime different
states are leaving women around the country
with a patchwork of access regulations.
In March, New Jersey became the seventh state
to permit pharmacists to provide the product
after a consultation at the drugstore, but
without a prescription.
This "behind-the-counter" access is
already available in Alaska, California, Hawaii,
Maine, New Mexico and Washington State. Similar
legislation is proceeding favorably in New
Hampshire, but was rejected this year in Maryland.
Battlefront is FDA
Now, a storm is brewing over the nomination of
acting commissioner Dr. Lester Crawford to
the top position at the FDA.
After meeting with Crawford, Democratic Senators
Patty Murray of Washington and Hillary Clinton
of New York last week said they will put a
"hold" on his nomination to commissioner
until the agency under his watch issues a decision
on the past-due application for direct sales
of Plan B to consumers in drugstores.
Plan B maker Barr Laboratories filed the second
application in July. The FDA had a target date
of January by which to issue a ruling. (By
law, the FDA must meet a high percentage of
these targets.)
The first application to sell Plan B over the
counter was denied on grounds that it might
be inappropriate for younger teens. To move
over-the-counter access forward, Barr Laboratories'
current application limits drug store sales
to anyone 16 and over.
"The FDA continues to drag its feet,"
Murray said after she and Clinton met with
Crawford. "They have jeopardized public
confidence and the health of American women.
This is too important a decision to be endlessly
delayed for ideological reasons."
'People Need an Answer'
"The bottom line is that the FDA has had
the Plan B application for years and the American
people simply need an answer yes or no,"
said Clinton.
Both senators are members of the Health, Education,
Labor and Pensions Committee, which is scheduled
to hold a confirmation hearing on Crawford's
nomination on April 13. The senators said that
they will put a hold on the committee's confirmation
vote, which will prevent a full vote in the
Senate.
The FDA declined to comment on the senators'
statements.
Concerned Women for America, a leading opponent
of Plan B based in Washington, D.C., told Women's
eNews that its spokesperson was out of the
country and unavailable to comment.
The FDA denied Barr Laboratories' first application
in May 2004 in a move that came as a surprise
to many because the application had received
overwhelmingly favorable votes by two scientific
review committees.
Seven months later, the New York-based Center
for Reproductive Rights went to court to pressure
the FDA to release Plan B for over-the-counter
sale.
In the suit, the reproductive-rights organization
charged the FDA with failing to follow its
own procedures in the first Barr application.
Even if the current Barr application is approved,
the lawsuit will continue because it seeks
expanded access to all individuals, including
those under 16.
Activists, such as Tummino, also organized the
Morning After Pill Conspiracy and are generating
petition signatures demanding access to the
product.
Designed to Prevent Pregnancy
Unlike Mifeprex or RU-486, the so-called abortion
pill, Plan B is designed as a last-stop measure
to prevent the establishment of a pregnancy,
as its name indicates. Some of those who oppose
Plan B nonetheless argue that Plan B is, by
their terms, the same as abortion.
The American Life League, an anti-abortion and
anti-contraception group based in Stafford,
Va., for instance, argues that emergency contraception
is the same as the abortion of a fetus because
a fertilized egg might be destroyed.
The American Medical Association has "strongly
encouraged" approval of the second Barr
application, saying that the usual dose Plan
B does not terminate a pregnancy, but prevents
one.
'Label Will Say Prevention'
During Senate hearings in March, Crawford, a
veterinarian by training, was asked whether
he sees emergency contraception as a means
of preventing pregnancy. "I may need to
consult with the experts in the FDA about exactly
what the physiology of it is," he said,
"but it is . . . the label will say prevention."
He said that a decision on the application was
taking longer than scheduled "because
it's a very complex approval process."
FDA spokeswoman Susan Cruzan told Women's eNews
that the application is pending and that the
FDA is "working toward labelability."
Completing the final label is a critical aspect
of every over-the-counter approval. Barr Laboratories
said that there "has been little activity"
on the label since January.
If made available in drugstores, Plan B will
be the first hormonal birth control pill available
to women in the United States without a prescription.
With or without a prescription, it is expensive.
A two-pill packet sells for the same as a month's
worth of birth control pills, between $30 and
$40.
Cynthia L. Cooper is a journalist in New York
who writes frequently about reproductive health
and justice issues.
For more information:
Morning-After Pill Conspiracy Project: - http://www.mapconspiracy.org
Delays Likely for Emergency Contraception:
- http://www.womensenews.org/article.cfm/dyn/aid/1707
<< Women's Enews -- 4/12/05 >>
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