As early as this fall, California women who have long had to schedule a doctor’s appointment for a birth control prescription will be able to go straight to the pharmacy for the contraception.
A state law, passed in 2013 with plans to be implemented in October, gives licensed pharmacists authorization to prescribe self-administered hormonal contraceptives, without the need for a patient to see a physician. A similar bill in Oregon was signed into law in July.
California’s law, SB 493, also allows pharmacists to prescribe nicotine replacement products and travel medication, and gives pharmacists status as health care providers.
“Pharmacists are very excited to be able to use more of the training that they went to school for,” said Kathleen Besinque, an associate professor in the University of Southern California School of Pharmacy. “It’s the start of a better health care system for citizens of California where they can access things that they need when they need them.”
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Reproductive health advocates such as the Planned Parenthood Affiliates of California see the new law as a way to expand access to birth control.
Besinque, a board member of the Association of Reproductive Health Professionals, said it’s more than a matter of convenience. She said picking up contraceptives at the pharmacy will “demedicalize” the pill.
“There’s no reason a woman needs to have a physical exam or a Pap smear before being prescribed,” she said. “Contraception is a wellness thing, not a sickness thing.”
And with the new law, pharmacists say they will be better equipped to provide “wellness.”
“It’s a great example of where community pharmacies can really expand access to health care,” said Jon Roth, CEO of the California Pharmacy Association.
Roth said the law grew out of a shift toward seeing pharmacists as health care providers rather than dispensers of medication. With the passage of the Affordable Care Act, increased patient demand and a shortage of physicians, Roth said the medical community began seeing pharmacists as “an underutilized resource” to prescribe medications that don’t require a diagnosis.
State officials hope to implement the law later this year after passing regulations, said California Board of Pharmacy spokeswoman Joyia Emard. The board has received public comments on the proposed regulations and will consider them at the end of the month, Emard said.
Before prescribing birth control, pharmacists would be required to take the patient’s blood pressure to ensure the medication is safe, counsel the patient on using the medication and provide informational materials.
If the regulations pass as planned, pharmacists can start writing prescriptions for hormonal contraception as early as Oct. 1. Because the law allows pharmacists to prescribe multiple different medications, regulators had to develop protocols for each one, Emard said.
“It’s been a lengthy process to get regulations adopted, more time than we would have liked,” Roth said. “But we’ve ramped up with the required training.”
Since April, the California Pharmacy Association has been offering one-hour training sessions for pharmacists on contraception and the other medications they will soon be able to prescribe. Besinque said pharmacy schools are also working to meet the training requirements in their curricula.
Some pharmacies, including West Sacramento-based chain Raley’s, already plan to offer pharmacist-prescribed birth control, once regulations are approved and their pharmacists are trained.
“We’re excited about that special authorization,” said Chelsea Minor, spokeswoman for Raley’s, which runs about 80 pharmacies in Northern California. “We’re anticipating putting those through in terms of services, as soon as those rules come out.”
Some local independent pharmacies said they don’t see demand for the new service and don’t plan to start offering birth control prescriptions. Others, such as CVS/pharmacy, said they’re waiting to see the approved regulations before deciding whether to offer the new services.
“I have all these clinics around me, there’s Planned Parenthood and free walk-ins,” said Tom Nelson, owner and pharmacist at Pucci’s Leader Pharmacy in midtown Sacramento. “This might be something that would be embraced more by people in rural areas where they aren’t surrounded by other medical providers.”