Vending machine to dispense “morning after pills” at college sparks debate

By Dr. Ananya Mandal, MDFeb 7 2012

Now students at Shippensburg University in Pennsylvania can get the “morning after” pill by sliding $25 into a vending machine, an idea that has drawn the attention of federal regulators and raised questions about how accessible emergency contraception should be.

The student health center at Shippensburg is a secluded public institution of 8,300 students between mountain ridges in the Cumberland Valley, provides the Plan B One Step emergency contraceptive in the vending machine along with condoms, decongestants and pregnancy tests.

Federal law makes the pill available without a prescription to anyone 17 or older, and the school checked records and found that all current students are that age or older, a spokesman said. It doesn't appear that any other vending machine in the U.S. dispenses the contraceptive, which can prevent pregnancy if taken soon after sexual intercourse. The machine has been in place for about two years, and its existence wasn't widely known until recently. The U.S. Food and Drug Administration are contacting state officials and the university to gather facts, agency spokeswoman Stephanie Yao said Tuesday.

Taking Plan B within 72 hours of rape, condom failure or just forgetting regular contraception can cut the chances of pregnancy by up to 89 percent. It works best if taken within 24 hours. Some religious conservatives consider the emergency contraceptive tantamount to an abortion drug.

Consumers have long been able to insert a few coins for the likes of aspirin, ibuprofen, antacids and other common over-the-counter remedies. But some experts see a worrisome trend in making drugs like Plan B, which is kept behind the pharmacy counter, available in a vending machine.

Alexandra Stern, a professor of the history of medicine at the University of Michigan, said she wasn't questioning a woman's right to have access to Plan B, but whether making it so easily available is a good idea. “Perhaps it is personalized medicine taken too far,” she said. “It's part of the general trend that drugs are available for consumers without interface with a pharmacist or doctors. This trend has serious pitfalls.”

The idea for a vending machine started at Shippensburg after a survey about health center services several years ago. Eighty-five percent of the respondents supported making Plan B available, school spokesman Peter Gigliotti said. The student government endorsed the idea. The machine is in the school's Etter Health Center, which only students and university employees can access, Gigliotti said in a statement. In addition, “no one can walk in off the street and go into the health center,” he said; students must check in at a lobby desk before being allowed in.

Denise Bradley, a spokeswoman for Teva Pharmaceuticals, which makes Plan B, said in a statement that it sells the product only to “licensed pharmacies or other licensed healthcare clinics, which are required to follow federal guidelines for the distribution of pharmaceutical products.”

On whether the machine might violate the law, “I don't have a definite yes or no,” said Ron Ruman, a spokesman for the Pennsylvania Department of State, which oversees the state pharmacy board. If a person younger than 17 used the machine, it “potentially could be a violation,” he said.

Rob Maher, a professor at the Duquesne University School of Pharmacy in Pittsburgh, said he had never heard of a vending machine dispensing Plan B, but noted that there have been vending machines in doctor's offices, and even a specialized machine designed to fill prescriptions. Still, he questioned whether the machine would make it possible for a young person to buy the drug without discussing their risk factors with a health care professional. “That's the big risk with a vending machine like this,” he said.

Jessica Sheets Pika, a spokeswoman for the National Campaign to Prevent Teen and Unplanned Pregnancy, said that “if the health center is manned 24/7, that sounds like it's a sufficient protection.” “But if there's a chance that people under 17 are able to access it, that's a problem,” she added.

Carol Tobias, president of the anti-abortion group National Right to Life, said other services would be more appropriate. “It would be a much more productive use of funds if universities would partner with local pregnancy resource centers where students can get real help if they need it,” Tobias said.

The drug isn't covered or subsidized by the school. Its price at the vending machine is set by the school's cost to the pharmaceutical company and is less than at off-campus pharmacies.