More than four years after the Food and Drug Administration authorized retailers to sell Plan B One-Step over-the-counter without age or point-of-sale restrictions, mid-Atlantic regional grocer and pharmacy chain Harris Teeter continues to direct customers to the pharmacy or the customer service desk in order to purchase the emergency contraceptive.
Why? Well, that’s a great question, and one for which national representatives of the chain have supplied a variety of confusing, incorrect, and self-contradicting answers.
Last month, during a routine grocery run, I noticed out of the corner of my eye a card on the shelf advising customers looking for Plan B One-Step to go to the pharmacy or customer service desk.
After I posted about it on Twitter, a member of Harris Teeter’s social media team sent me the following direct message:
Hi! Our practice is that the product will be sold by another pharmacy associate or by the salaried Manager on duty or other [Health Insurance Portability and Accountability Act] trained clerk. The product can be sold through the Pharmacy register or the front checkout. This is why we have the customer go to the Pharmacy for this product, or speak with a member of management, because they are all HIPPA [sic] certified!
According to its website, Harris Teeter operates more than 230 stores in seven states and the District of Columbia. Lamar Hardman, director of pharmacy for Harris Teeter, told me that this is part of the chain’s policy where Plan B is concerned. “It’s really simple. We just follow the FDA [and] the new guidelines they put together in 2013, and make it accessible to the customers that desire the product, so it’s not much more complicated than that,” he said via phone after I asked for more information.
Representatives from the Kroger grocery store chain, which bought Harris Teeter in 2013, did not return requests for comment.
The FDA framework does not force retailers to put Plan B One-Step and other forms of levonorgestrel emergency contraception on the shelf. As of 2015, 64 percent of stores stocking emergency contraception had it there, up from 49 percent in 2014.
Still, putting a card on the shelf for presentation to the pharmacy seems to be an awfully convoluted practice of making a product available over the counter.
“We now have a regulatory framework in which women and men should be able to get this product very easily, and they are not able to, and it affects people’s lives,” Kelly Cleland, executive director of the American Society for Emergency Contraception and a researcher at Princeton University, told me. “I think retailers can do better and they need to start doing better.”
About Harris Teeter’s policy, she said, “I do not think putting a card on the shelf versus the product on the shelf follows the spirit of the FDA regulations.”
Further, she pointed out, the chain’s claims via Twitter about prioritizing HIPAA—which protects patient privacy—are called into question by its practices. “It just doesn’t make any sense,” Cleland said. “They’re obviously compromising the privacy of customers by making someone take a card and go talk to somebody about it, because it’s obviously more private to take it to the front and buy it.”
This matters because emergency contraception is a product needed urgently by people who have just had unprotected sex and don’t want to get pregnant. Plan B One-Step and generic levonorgestrel emergency contraceptives prevent pregnancy by stopping egg release, fertilization, or implantation. They are indicated for use up to 72 hours after unprotected sex, and they are more effective the sooner they are is taken. When someone needs emergency contraception, the last thing they need is a retail obstacle course.
And make no mistake: Putting Plan B behind the counter does make the process more difficult. Rebecca Lerdau, a 13-year-old in Charlottesville, Virginia, agreed to attempt to purchase emergency contraceptives at Harris Teeter as part of research for this story. Both Rebecca and I were able to buy Plan B One-Step at Harris Teeter—although it took Rebecca visiting three stores, including one competitor, before she was able to locate and feel comfortable purchasing the product.
“Me, my mom, and my babysitter Elana first went to the Harris Teeter near the University,” she wrote to me. “When we arrived at Harris Teeter we discovered that there was no pharmacy.” This represents just one level of unnecessary complication in Harris Teeter’s reported process for selling emergency contraception, since theoretically a person can go to the customer service desk if there is no pharmacy or the pharmacy is closed, but that was not clear to three people motivated to find the product.
Rebecca then decided to go to a nearby competitor, where she struggled to find Plan B One-Step before realizing that it was locked in a box that would need to be taken to the pharmacy or a staff member. She decided to leave, saying, “I just felt really uncomfortable.”
“Several days later me, my mother, and Elana decided to go to the Harris Teeter with a pharmacy …. When I started looking around the pharmacy area, I couldn’t find it. There was no section called family planning, there was nothing that made it obvious. I saw things that had the word ‘prenatal’ so I looked at that area and I still couldn’t find it,” Lerdau wrote to me.
“I was kind of just pacing around when the pharmacist (a young-looking man) asked me if I needed help. Hesitantly I went up to the counter and asked if they had Plan B. The man said he had it in the back. When he came, he looked a bit concerned, which is understandable. As I was paying for it, he asked me several times if I needed any help or if I had any questions. I said no. When I was finished paying the pharmacist told me that if I had any questions I could call the number at the top of the receipt. I then said thank you and walked away,” she continued.
“When I was done I felt a strange rush of adrenaline. I’m not sure why. I think it was a good experience to have. … I will probably give the Plan B to Elana for her dorm because one of the girls there is a lot more likely to need it than I will.”
I wanted to see for myself, so I went to a Harris Teeter and took the card off the shelf.
When I brought it to a pharmacist, he asked, “Do you have your, uh … actually, I don’t need that anymore.”
Poor guy. He was nice. I got the feeling we both felt awkward, though he was professional and rang me up quickly. My guess is he was about to ask for my identification. Indeed, thanks to a convoluted regulatory history that Rewire editor in chief Jodi Jacobson called “a decade-long case of scientific and public health malfeasance,” it is true that some years ago a person buying emergency contraception had to be a certain age and fork up a driver’s license. But that is no longer the case—and nor should it be.
Emergency contraception is something that when you need it, you need it quick. But policies like these can make it embarrassing or unnecessarily complicated. According to Harris Teeter’s own materials, the chain’s “pharmacies provide shoppers with a number of services to make their experience easier.”
That is decidedly not happening with emergency contraception. Nor will it, until Plan B One-Step finds itself on the shelf where the FDA has permitted it to be.
UPDATE: This article’s headline has been updated to clarify that Plan B One-Step is available without a prescription at Harris Teeter.