Don’t want to spend half of your day waiting at the OBGYN office just for a birth control prescription? Worry no more, the pharmacists in California and Oregon are coming to your rescue! Now your friendly, local pharmacists–currently just in the aforementioned states–can prescribe and dispense your oral contraceptives in less than 15 minutes!
Hail to California and Oregon on continuing to build momentous progress–leading the nation in the legalization of same sex marriages and medical cannabis use–and now allowing pharmacists to prescribe hormonal contraceptives. Known as SB 493, this legislation was passed in 2013 in California and are in the finalizing stages. SB 493 also empower pharmacists to dispense nicotine replace products, travel medications, and lab test orders without the need for a physician’s prescription. Oregon governor–Kate Brown–signed a similar bill–known as HB2879– into law last week. Note that the two states have different age requirement for obtaining birth control through the pharmacy. While there are no age restrictions set in California, the patient must be at least 18 years of age in Oregon.
When my niece sent me this article last night, as a student pharmacist, I was overjoyed with excitement and enthusiasm. This is a small, yet trivial step towards the ultimate goal of achieving provider status and the integration of pharmacists into a collaborative healthcare model. Pharmacists nowadays have more pivotal roles in healthcare than ever before, and our scope of practice have grown well beyond the mere responsibility of medication dispensing. If the states of California and Oregon can successfully demonstrate positive healthcare outcomes and validate the cost effectiveness predictions, I hope for similar legislations to be adopted by all 50 states. Most notably, Colorado and Washington State are the next two states expected to vote on similar reforms.
The Benefits: Advocates argue that the initiative will correct the existing primary care physician shortages due to the recent expansion of the Affordable Care Act. Most importantly, it will save the consumers time and money, and provide stress-free, convenient access to reproductive healthcare. Contrary to men–who have the luxury of purchasing contraceptive (ie. condoms) with ease–women obviously more hurdles to overcome. Furthermore, it eliminates unnecessary, long wait times at the doctor’s office and will enhance patient’s access to birth controls to ultimately reduce unintended pregnancies (especially teen pregnancies). Besides, cost of healthcare will be significantly reduced based on the assumption that pharmacists’ reimbursement rates are much lower than that of the physicians’. To top it off, oral contraceptives will still be covered by patient’s insurance. Nevertheless, giant pharmacy chains are still hesitant to take advantage of this opportunity–due to the lack of pharmacist’s reimbursement regulations. Pharmacy organizations in California and Oregon are working together to resolving this issue.
Dr. Pharmacist?: The ongoing going “turf-war” between pharmacists seeking prescribing powers and physicians seeking dispensing authorities are expected to become more aggressive. Opponents of SB 493 and similar legislations are primarily physicians. Physicians are concerned about patient safety issues which includes the lack of adequate screenings for cervical cancer, STDs, and cardiovascular risks associated with prescribing oral contraceptives. Do not worry doctors, pharmacists are forbid to prescribe OC if patients have not seen their PCP for physical examination in a period of three years. In another word, Dr. pharmacist do not replace your physician, and you are encourage to continue seeking comprehensive care from your PCP (primary care physicians).
Exploring pharmacists’ role as a provider:As someone who is about to enter the profession, I look forward to the expansions that empowers pharmacists with prescribing authorities. In my opinion, the benefit clearly outweighs the risks. Why? As our role in healthcare continues to evolve, pharmacists have proven our competencies by improving patient’s access and reducing costs in other preventive services–such as immunization. Pharmacist, however, should only prescribe as they are comfortable according to the pharmacists’ scope of practice, training and expertise. To ensure the highest quality of healthcare and to achieve the desired therapeutic outcomes, stricter continuing education requirements should be implemented. Perhaps, something more than just the one-hour CE proposed by the state of California.
I would love to hear your thoughts and opinions on this matter. I also welcome feedbacks and suggestions. Thank you!
Highlights and summary to California’s Board of Pharmacy Proposed regulation for pharmacists furnishing self-administration of oral contraceptives (that will hopefully be important for your future practice in pharmacy)
- The following ROA are considered self-administered OC: oral, transdermal, vaginal, depot injection
- Pharmacists must follow screening process
- Ask patient to use and complete self-screening tool
- Review the self-screening answers and clarify responses if needed
- The screening tools are developed by the CDC and are to mandatory to be complete yearly or whenever the patient indicates a major health change
- Copy of most recently completed screenings shall be stored on records for at least 3 years
- Must be provided in alternative languages for those whose primary language is not English
- Measure and record patient’s seated BP if combined hormonal contraceptive therapy are to be used
- Pharmacists can dispense OC products up to three years before requiring the patient to see their PCP .
- Provide appropriate counseling and information on the OC products
- Pharmacists shall notify patient’s PCP
- Pharmacists have authorization to product selection
- Pharmacists must complete a minimum one hour of a board-approved CE program specific to self-administered hormonal contraception (a more rigorous CE is pending for the state Oregon)