Agency takes in millions in morning-after pill sales
WASHINGTON -- When the Food and Drug Administration on Aug. 26 delayed its decision on whether emergency contraception pills could be purchased without a prescription, the Planned Parenthood Federation of America called it ''a terrible day for women's health."
When the FDA's top women's health advocate resigned in protest, Planned Parenthood applauded her response to what it called ''the agency's shameful failure to uphold its public health responsibility."
And the group's Massachusetts affiliate said FDA inaction adds urgency to enacting ''our own emergency contraception legislation at the state level."
But none of the public announcements mentioned that the national not-for-profit organization reaps millions of dollars in revenue by dispensing Plan B, the morning-after pill that has embroiled the FDA in controversy.
Internal e-mails exchanged between Planned Parenthood employees, and provided to the Globe by an attorney who filed a wrongful firing lawsuit on behalf of a former executive, indicate the drug's manufacturer sells Plan B kits -- with one or two pills in each -- to Planned Parenthood clinics at a ''special" price of $4.25 apiece. The kits are usually sold to consumers for about $30.
The price per kit Planned Parenthood pays is 25 cents lower than the discount rate its maker,
Planned Parenthood said its distribution of emergency contraception has grown by 4,484 percent since 1995. In 2003, the most recent year statistics are available, it distributed 774,482 emergency contraception kits. A spokeswoman, Elizabeth Toledo, said the agency distributes some kits for free or at sliding rate scales, though she declined to provide specifics.
Concerned Women for America, a Washington-based group that opposes abortion, said Planned Parenthood should be more forthcoming about its financial stake in the drug.
''The profit motive behind Planned Parenthood's involvement in making the morning-after pill [available over the counter] is something that needs to be seriously looked at and questioned," said Wendy Wright, senior policy director for that group.
But Toledo, Planned Parenthood's vice president of communications, said its support of Plan B is based on women's health issues, not revenue.
''The advocacy that we're doing for emergency contraception to have over-the-counter status in no way is related to anything but our desire to have the most number of women possible get access to good birth control in a timely fashion," Toledo said.
Over-the-counter sales of Plan B remain in limbo.
Barr two years ago sought to sell it without prescriptions to women of all ages. When FDA leadership rejected that plan last summer, the company amended its request to sell it to women 16 and older.
Late last month, the FDA said it determined women 17 and older could safely take it without a doctor's guidance, but indefinitely delayed its decision to gather comment on how to enforce the age restriction.
At the state level, seven states have eased access, as Massachusetts is poised to do, to permit women of any age to purchase Plan B directly from pharmacists who write prescriptions on the spot. Planned Parenthood has lobbied on behalf of both the federal and state options.
The changes could actually diminish the revenue Plan B generates for the organization because women could buy it in more places, Toledo said.
She would not comment on Planned Parenthood's pricing agreement with Barr, except to say that low prices help it to provide emergency contraception to more women.
P. Victor Gonzalez, the former employee of Planned Parenthood's Los Angeles affiliate, is seeking $1.2 million in damages, alleging he was fired after questioning ''unlawful, unfair, and unethical" billing practices.
During Gonzalez's tenure, Planned Parenthood's mark-ups for contraceptives were questioned by the state of California's Department of Health Services, which conducted an audit. E-mail provided by Gonzalez as part of the suit indicates the Los Angeles affiliate paid as little as $1 for oral contraceptives, yet billed the state up to $48, amassing about $4 million in revenue per year.
Planned Parenthood's lawyers sought to have the e-mails stricken from the court's record, but a judge denied the motion, said Richard Ackerman, a Pro-Family Law Center lawyer in Temecula, Calif., who represents Gonzalez.
Gary D. Fields, the Long Beach, Calif., attorney representing Planned Parenthood in the case, did not return phone calls seeking comment.
Planned Parenthood's 850 health centers provide medical services for about 5 million people each year, including abortions, contraception, and sex education. The New York-based agency reported $59 million in total revenue and $76.8 million in expenses for the fiscal year ending June 30, 2004, according to its most recent tax return.
Diedtra Henderson can be reached at dhenderson@globe.com. 
