By Jason Poquette, Bpharm, R.Ph
I’ve never been a big fan of heated political debates. On my blog I much prefer to focus on topics that provide helpful resources to patients and health care professionals alike. But the recent Supreme Court decision about Hobby Lobby and their right to not cover certain forms of contraception has received so much attention that silence seems impossible. Since the issue largely revolves around contraceptive products, which are pharmaceuticals, it would seem appropriate that a pharmacist should say something.
I cannot count the number of articles that I have read that suggested Hobby Lobby was refusing to cover contraception altogether. Some articles even portrayed this company as reluctant to provide any “health care” coverage for their employees. Still other critics chose to paint the picture that this employer was anti-woman. Exaggeration is typically the weapon of those who are afraid of the truth, or too lazy to find it. All of these characterizations of Hobby Lobby are, of course, patently wrong. Their prescription benefit covers all sorts of oral contraceptives; they offer a full spectrum health benefit and probably cater more to women (both employees and shoppers) than the average company does.
From a pharmaceutical perspective, the owners of Hobby Lobby decided that a specific oral product (known as “Plan B”) and certain IUDs (intrauterine devices) or IUSs (intrauterine systems) were not in keeping with their Christian faith. They apparently believed these products cause an abortion, and given the massive amount of confusion around these medications, I cannot say that I blame them.
However, from a medical perspective the owners were (from what I can tell) mistaken. None of these products are “abortifacients.” Many studies have been done to explain the mechanism of action (MOA) that makes these forms of contraception work. They prevent the release of an egg (ovulation) and also may make it more difficult for sperm to reach the egg. Because Plan B is used “after” the fact, it is sometimes assumed that it works by destroying an already fertilized egg. But this is just a misunderstanding of the biology involved. The science is pretty clear. If Plan B is used AFTER ovulation, the rate of pregnancy is the same as if it wasn’t used at all.
But, as I mentioned already, I do not blame the owners of Hobby Lobby for their opinions. The issue is confusing and the contradictory information available on popular websites doesn’t help. Whether they were right or wrong, however, doesn’t settle the issue. The question remains whether they, as business owners, should be free to decide how to run their own business and benefits. I personally am glad the Supreme Court upheld their right to make this choice. I believe our nation and our liberties are better protected when both businesses and people are allowed to make their own decisions. Remember, no one who works for Hobby Lobby has to work there, nor are they denied access to any of these products if they choose to purchase them. It’s merely a question of who pays.
It is sad, in my opinion, that we as a nation talk more about pregnancy prevention rather than pregnancy promotion. Half of pregnancies today are unplanned. Family sizes are getting smaller. Abortions, true abortions, are still way too frequent. The backbones of great societies and cultures are strong families. Children are a blessing. And I would much rather spend my energy promoting the value of families and children and homes than slugging it out over the politics of prevention.
Jason Poquette, BPharm, R,Ph, is a practicing pharmacist who lives in Whitinsville. His columns comment on drugs and pharmaceuticals in the news. He maintains the blog www.TheHonestApothecary.com.