Dear Secretary Burwell:
We write today to follow up on the status of an important issue impacting health care for Native American women: access to emergency contraception through Indian Health Services (IHS) facilities.
In 2013, the Food and Drug Administration (FDA) approved Plan B One-Step as an over-the-counter drug, lifting all previous age and point-of-sale restrictions. Your Department has committed to addressing the problem of inadequate access for Native American women by ensuring that these FDA protocols are followed in every IHS facility.
In a previous letter to the Department in 2013, some of us asked Secretary Sebelius to put in place a long term solution, such as national policy guidance to all IHS funded health facilities, to expand Native American women's timely access to emergency contraception. The Department replied that an update of the IHS pharmacy policy was in progress. Now, almost two years later, we have seen no such written directive or policy to ensure that IHS pharmacies are indeed complying with FDA standards.
Recently, Senator Boxer's staff contacted more than twenty IHS health centers to inquire about the availability of emergency contraception and the process for accessing it. After speaking directly with pharmacists in the same manner a typical IHS patient would, it became immediately clear that there are inconsistencies in the provision of emergency contraception at these pharmacies. According to pharmacists, some locations do not offer emergency contraception at all and of those that do, many imposed age restrictions varying from 14 to 18, contrary to FDA approval and product labeling. This problem demands a clear written directive to ensure that all IHS pharmacies are aware of and operating under the same rules.
Emergency contraception is a crucial element of women's health care and can safely prevent pregnancy, including after sexual assault. It is estimated that one in three Native American women is a survivor of rape or attempted rape--nearly twice the national average. These numbers make it all the more important that women who depend on IHS for their health care have timely over-the-counter access to emergency contraception.
We request that you share the steps your Department has taken towards updating its policy and provide a clear timeline for when that process will be completed. Further, we ask that you share with us data from surveys of pharmacies the IHS has undertaken in order to assess access to emergency contraception and the steps that the Department and IHS plan to take to monitor patient access moving forward. We appreciate your consideration of this request.
Sincerely,
Barbara Boxer
United States Senator
Patty Murray
United States Senator
Jon Tester
United States Senator
Richard Blumenthal
United States Senator
Tammy Baldwin
United States Senator
Maria Cantwell
United State Senator