title: Pharmacy access to ulipristal acetate in Hawaii: is a prescription enough?
abstract: To determine pharmacy availability of ulipristal acetate (UPA) and compare to availability of levonorgestrel-containing emergency contraceptive pills (LNG-ECPs).
  
  
  
  We conducted an observational population-based study utilizing a telephone-based secret shopper methodology. Researchers called all 198 unique retail pharmacies in Hawaii on December 2013-June 2014, representing themselves as patients and physicians.
  
  
  
  Only 2.6% of pharmacies had UPA immediately available, though 22.8% reported ability to order UPA. In contrast, 82.4% reported immediate availability of LNG-ECPs. No significant difference in availability was reported to patients and physicians.
  
  
  
  Availability of UPA is limited and significantly lower compared to LNG-ECPs. The study period did overlap with a change in distributor for UPA, likely capturing some disruption of the supply chain.
  
  
  
  Systems-based interventions are needed to address barriers to obtaining UPA.
authors.affiliation: University of Hawai'i at Manoa, John A. Burns School of Medicine, Department of Obstetrics, Gynecology and Women's Health, 1319 Punahou St, Suite 824, Honolulu, HI 96826. Electronic address: bullockh@hawaii.edu.
authors.forename: Holly
authors.initials: H
authors.lastname: Bullock
authors.affiliation: University of Hawai'i at Manoa, John A. Burns School of Medicine, Department of Obstetrics, Gynecology and Women's Health, 1319 Punahou St, Suite 824, Honolulu, HI 96826.
authors.forename: Sarah
authors.initials: S
authors.lastname: Steele
authors.affiliation: University of Hawai'i at Manoa, John A. Burns School of Medicine, Department of Obstetrics, Gynecology and Women's Health, 1319 Punahou St, Suite 824, Honolulu, HI 96826.
authors.forename: Nicole
authors.initials: N
authors.lastname: Kurata
authors.affiliation: University of Hawai'i at Manoa, John A. Burns School of Medicine, Department of Obstetrics, Gynecology and Women's Health, 1319 Punahou St, Suite 824, Honolulu, HI 96826.
authors.forename: Mary
authors.initials: M
authors.lastname: Tschann
authors.affiliation: University of Hawai'i at Manoa, John A. Burns School of Medicine, Department of Obstetrics, Gynecology and Women's Health, 1319 Punahou St, Suite 824, Honolulu, HI 96826.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Elia
authors.affiliation: University of Hawai'i at Manoa, John A. Burns School of Medicine, Department of Obstetrics, Gynecology and Women's Health, 1319 Punahou St, Suite 824, Honolulu, HI 96826.
authors.forename: Bliss
authors.initials: B
authors.lastname: Kaneshiro
authors.affiliation: University of Hawai'i at Manoa, John A. Burns School of Medicine, Department of Obstetrics, Gynecology and Women's Health, 1319 Punahou St, Suite 824, Honolulu, HI 96826.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Salcedo
mesh_terms: D016009:Chi-Square Distribution; D003270:Contraceptive Agents / Q000600:supply & distribution*; D003281:Contraceptives, Postcoital / Q000600:supply & distribution*; D005260:Female; D006254:Hawaii; D006297:Health Services Accessibility; D006801:Humans; D016912:Levonorgestrel / Q000600:supply & distribution*; D009649:Norpregnadienes / Q000600:supply & distribution*; D010594:Pharmacies / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires
chemical_list: D003270:Contraceptive Agents; D003281:Contraceptives, Postcoital; D009649:Norpregnadienes; D016912:Levonorgestrel; C555622:ulipristal acetate
keywords: Availability; Emergency contraception; Hawaii; Pharmacies; Ulipristal acetate; United States