In 2021, women spent $22.1 billion on birth control globally.
That number is expected to soar.
And since the overturning of Roe v Wade, more women are quite literally
turning to Plan B, America's most recognized morning-after pill.
Amazon is limiting sales of Plan B.
Limiting the amount of emergency contraceptives.
Following last week's US Supreme Court ruling.
Although it's over the counter, it's not always accessible.
At an average price tag of $40 to $50, many low-income consumers can't afford
it. Some states allow pharmacists to deny dispensing it, and retailers tend
to place the product out of reach for consumers.
This product should be available to anyone.
I mean, I can send my 16-year-old son to go pick it up.
It shouldn't be restricted in any way, but it is.
Following the abortion ban, even more restrictions could be on the way for
Plan B. The labeling warns that it may prevent a fertilized egg from attaching
to the womb. A notion with no scientific evidence was included on the
label in order to get its over-the-counter status approved.
Many anti-abortion activists point at the label arguing that any interference
with an egg is considered an abortion, medical professionals say otherwise.
It is a medication that stops ovulation .
If you're already pregnant, which means that a fertilized egg has implanted in
your uterus, the morning-after pill is not going to do anything to prevent that
pregnancy.
Following the Supreme Court's decision, Justice Clarence Thomas suggested that
the court revisit its past ruling on contraception.
Confusion around the language on the label could mean trouble for the brand
and its consumers.
So what does the future look like for Plan B?
In 1999, the FDA approved the first progestin-only emergency contraceptive
called Plan B.
It was originally developed by Women's Capital Corporation to improve access to
contraception for all people and lower unintended pregnancy rates.
When we were working with, originally, Women's Capital Corporation to determine
what the price might be to consumers— the price then it was very inexpensive
to make. But clearly at the point where Plan B came to market, my work with my
colleagues had shown that pharmacists were the preferred location place to get
Plan B. And the idea behind Plan B was to improve access to contraception for
all people, not just privileged people, not just people with insurance, but it
would be affordable to all.
Don Downing, a practicing pharmacist at the time, helped develop Plan B and get
it on the market.
I was on the small team that actually came up with the name Plan B.
FDA, hated the name, tried to get us to change it, but we prevailed.
But anyway, so now we had a still a prescription-only product, but we had a
mechanism to give a dedicated product that actually, it turns out, worked
better than the Yuzpe regimen.
Plan B was profitable when it was sold as a prescription drug by Barr.
According to analysts, it had more than 85% profit margin
In 2008, Plan B's distributor, Barr, was acquired by Teva, making it the fourth
largest generic drug company at the time.
The next few years became a long battle to get over-the-counter status approval.
There was a great struggle.
We found that there were a lot of folks who didn't understand the science of how
Plan B worked and who decided to make it a product more akin to an abortion
medication than it was to a contraceptive.
In fact, a member of the FDA committee evaluating it quit her job with the FDA
because the science was being ignored to, for the most point, for
political reasons.
In 2013, Plan B One Step was finally approved by the FDA for over-the-counter
sales with no age restrictions, and it became widely available at retail
pharmacies nationwide.
In 2017, Teva sold Plan B for $675 million to private equity firms Kelso
and Company and Juggernaut Capital Partners.
Their portfolio ranges from sports to retirement services to organic snacks.
And now the firms are in the crosshairs of a messy debate that it has remained
silent on. CNBC reached out to Plan B's parent company Foundation Consumer
Healthcare, but the company did not respond to requests for comment.
On June 24, 2022, the US Supreme Court overturned the constitutional right to
an abortion, reversing Roe v Wade.
Worries about access to Plan B began immediately following the ruling when
sales of the morning-after pill surged .
Online retailer, Wisp, saw sales of emergency contraception jump 3,000%
after the ban.
In an attempt to prevent stockpiling or reselling for profit, retailers like
CVS, Walmart and Amazon put temporary purchase limits on the morning-after
pill. The court was clear that the constitutional right to access
contraceptives remains untouched.
However, many lawmakers and women's reproductive rights advocates feared
that in overturning Roe v Wade would lead to the court revisiting other
privacy-related cases.
That fear became eminent when Justice Clarence Thomas suggested the court
reconsider past rulings on same-sex marriage and contraception.
I really think it's just a matter of when and not if.
There have been a number of attacks on contraception in recent years.
For example, there have been attacks on the Title X program, which is a federal
program that provides free or low-cost family planning.
There have been attempts to give really broad religious exemptions to employers
so that they don't have to cover contraception.
And there are some states and some individuals who believe that emergency
contraception is actually a form of abortion.
And I really do think that eventually one of those cases is going to make it
back up to the Supreme Court, that the courts are going to have to decide
whether states can define emergency contraception as a form of abortion or
not.
Plan B's packaging reads that it may prevent a fertilized embryo from
attaching to the uterus.
This notion was required by the FDA to be included on the label during the drug
approval process.
But recent studies have proven that's not how it works.
Still, some anti-abortion advocates point at the label and argue that
interfering with a fertilized egg is an abortion, which could create grounds for
a Plan B ban.
There is confusion about what these laws that are not written by scientists, that
are not written by medical experts, actually mean for the practice of
medicine. It's confusing when they pass laws that classify something like
emergency contraception as an abortion pill or as an abortifacient when that's
not scientifically true.
On the House floor in June of 2021, US Representative Marjorie Taylor Greene
spoke out against emergency contraception.
The Plan B pill kills a baby in the womb once a woman is already pregnant.
According to medical professionals.
Plan B does not interrupt or harm an existing pregnancy.
It uses a synthetic version of progesterone to stop or delay the
release of an egg before it has a chance to be fertilized.
If you've already ovulated, Plan B does not work.
Plan B is a progestin drug.
It it essentially fools the body into thinking that there's an existing
pregnancy already there.
Ironically, there's much more evidence that taking Plan B after you're pregnant
enhances your fertility rather than eliminates an established pregnancy.
Otherwise, why would we use the same ingredient in Plan B to improve the
receptivity of the womb when when in vitro fertilization is occurring?
In July of 2022, Democrats introduced the Right to Contraception Act to
protect access to contraception.
It was blocked in the Senate a few days later.
It would be significant because it would be the first time that the federal
government has passed a law like this, and it would be a law that applies and
restricts the states, so prevent them from acting to ban emergency
contraception as well as other forms of contraception.
Some argue that while Plan B has been singled out, the outdated language on
its packaging is similar to that of any other birth control.
In other words, the product itself isn't the issue, but it's rather a
stigma depending on if the contraceptive is taken before or after
sex. Some states allow pharmacists to refuse to sell a customer Plan B due to
personal or religious beliefs.
I think it's the timing of when you take it, rather than the labeling that causes
people to feel this way.
There have been some people who said, well, if women are going to have sex,
then they should not be given a second opportunity not to get pregnant because
shame on them for having unprotected sex.
It shouldn't be restricted in any way.
But it is.
It's because it's not Tylenol.
It's a contraceptive.
And it comes with stigma and certain beliefs and personal
objections to whether it's used or how it's used or when it's used.
In 2015, European regulators changed the language on the European version of Plan
B to state that it cannot stop a fertilized egg from attaching to the
womb. Neither the company behind Plan B nor the FDA has made a similar attempt
in the U.S.
Plan B was originally developed to improve access to contraception.
The percentage of women using emergency contraception jumped from 4.2% in 2002,
3 years after Plan B came to market, to 56% by 2015.
But access hasn't improved for everyone, depending on the socioeconomic
status or even age and weight, Plan B is out of reach to many.
For example, the pill is less effective for women weighing 170 lbs and above,
and costs $40 to $50 for one dose.
It's the number one dollar-selling OTC SKU in the US, according to Foundation
Consumer Healthcare.
The generic version can cost as little as $8.
Those barriers always disproportionately impact people who are marginalized in
our society. So people of color, LGBTQ individuals, those who are adolescent or
still living at home, those who don't have the money to afford $50 to purchase
a pill.
Some retailers create an additional barrier to access by placing it behind
the counter with prescription drugs or behind locked cases with other high
value items.
You have to go to the pharmacy, which means the pharmacy has to be open.
And we know the pharmacy sometimes closes before the actual store does.
It allows the pharmacists to kind of intervene and ask for information or ID
when it doesn't really need to.
It should be over the counter, but it should be truly over the counter.
And that over-the counter should have certain other kind of requirements,
especially things like pharmacists should sell it to anyone that comes in
wanting to buy it.
It should be low cost.
Title X funding should cover OTC Plan B and emergency
contraceptives sold at pharmacies if someone someone's uninsured or the
insurance doesn't cover it.
So there's kind of ways to mitigate these barriers.
Communities of women in the US have historically had trouble accessing
emergency contraception.
Women's health advocates say if the FDA doesn't correct outdated wording on the
product's label, the state of Plan B could be in trouble for a lot more
people.