Availability of Oral Emergency Contraception in German Community Pharmacies—A Nationwide Cross‐Sectional Mystery Caller Study

ABSTRACT Background and Aims In Germany, the “morning after pill” (oral emergency contraception [EC]), which contains the active ingredients ulipristal acetate (UPA) and levonorgestrel (LNG), can only be dispensed by community pharmacies (CPs). Consequently, German CPs bear significant responsibility with regard to the availability of oral EC, which is an important criterion for immediate and unhindered access. This study aimed to investigate the availability of oral EC in CPs nationwide for the first time in the world. In addition, the influence of possible factors on availability was examined. Methods This cross‐sectional study was based on the simulated patient methodology, which is considered the “gold standard”. Each of the 392 CPs was called once by one of six trained mystery callers (MCs), representing a nationwide sample. At the beginning of the conversation, the MCs asked about the “morning after pill” without naming a specific oral EC. In the conversation about UPA (scenario‐related appropriate outcome due to unprotected sexual intercourse 4 days ago) or LNG preparations (scenario‐related inappropriate outcome), the MCs asked about the respective immediate availability. Results Three hundred and ninety‐two planned mystery calls were successfully carried out. Information on the availability of UPA preparations was obtained in 318 mystery calls, and of LNG preparations in 38 mystery calls. UPA preparations were immediately available in 97.5% (310/318) and LNG preparations in 100% (38/38) of the CPs. None of the investigated factors had a significant influence on availability. Conclusion While oral EC is generally immediately available in Germany, the optimal rate of 100% immediate availability was not reached for UPA preparations, which may hinder access.