Usage of morning-after pill surges and so does controversy

WASHINGTON — The popularity of the morning-after pill Plan B has surged in the year since the federal government approved the sale of the emergency contraceptive without a prescription.

Plan B sales have doubled since the Food and Drug Administration authorized the switch for women 18 and older last August, rising from about $40 million a year to what will probably be close to $80 million for 2007, according to Barr Pharmaceuticals, which makes Plan B.

The sharp rise was hailed by women's health and family-planning advocates, who say it illustrates the value of easing access to birth control to help prevent unwanted pregnancies.

"This is exactly what we hoped would happen," said Susan Wood of the George Washington University School of Public Health. As assistant commissioner for women's health and director of the Office of Women's Health at the FDA, Wood pushed for the switch. "What we're seeing is women who needed this product now finally having access to it. For a woman in that position, it can make a real difference in her life."

But conservative groups that fought the change say they are disturbed by the surging use. "This is very concerning," said Charmaine Yoest of the Family Research Council, which is among several groups suing the FDA to reverse the decision. "We think this is putting women's health at risk."

Plan B consists of higher doses of the hormones found in standard birth-control pills. Taken within 72 hours of unprotected sex, Plan B has been shown to be highly effective at preventing pregnancies. Despite endorsements by outside advisers and internal reviewers, the FDA delayed for three years making it available without a prescription, leading to intense criticism that the agency was allowing politics to influence the decision.

The Aug. 25 ruling that finally permitted the change was criticized both by conservatives and by proponents, who were disappointed that the agency limited the easier availability to women 18 and older. The agency said there was too little safety data to approve the drug for teenagers younger than 18.

Surveys and anecdotal reports indicate some pharmacies refuse to stock the drug, some pharmacists refuse to provide it, and some pharmacy workers mistakenly believe only the pharmacist can dispense the drug.