Recap After two years of regulatory discussions, California’s officials finally announced last Friday allowing the state’s pharmacists to directly dispense birth control to patients without physicians’ order. Note that the law applies to hormonal contraceptives, which include oral medications, transdermal patches, subcutaneous injections, and vaginal rings, but not intrauterine devices and implantations. The bill known as SB 493, was passed in 2013, but suffered major delays during the approval process. California will be the third state to make birth control more readily available, joining Washington and Oregon. The states of Hawaii, Missouri, Tennessee, and South Carolina are expected to consider similar legislations.
What’s the big deal? In the U.S., there are roughly 61 million childbearing women and approximately 70% of the aforementioned population do not want to become pregnant intentionally.1 In California alone, more than half of the pregnancies are unintentional.2 The use of alcohol, unlawful drugs, and numerous prescription drugs can have damaging, teratogenic effects on newborns. Advocating to expand access to birth control can lessened the numbers of poverty-driven, unplanned pregnancies, and as well as cutting the rate of babies being born with birth defects.
What does this mean for consumers? So let me get this straight, you can walk into any pharmacy in California and ask for birth control (as if it were an OTC item)? It’s not quite that simple or else it wouldn’t have taken legislators two years to formulate and agree on protocols. Instead, patients are obligated to a questionnaire, a blood pressure screening, and a consultation session with the pharmacists. These are instruments to assist pharmacists in isolating patients with medical conditions contraindicated to the administration birth control, and to provide a more lucrative contraceptive in the selection process. For example, women with history of breast cancer, cardiovascular complications, elevated clotting risks, or previously intolerable to estrogen may want to avoid certain estrogen-containing contraceptives.
An opportunity for independent pharmacies? Although the law is legitimate, California pharmacies are not expected to jump on the latest opportunity straightaway. Complicated legislations, like SB 493, demand lots of preparations and are difficult to implement at the macro level. Your “household name” pharmacy chains tend to take much longer time to adapt; thus, family-owned/independent pharmacies are in favor to take advantage of this opportunity much sooner.
What does this mean for pharmacists? While there’s a shortage of physicians at the national level, an increasingly abundance in well-trained, competent pharmacists are willing to fulfill this demand. “The uninsured rate remains at an all time low”3, which translates into longer wait-times at doctor’s offices, diminished quality of care, and declination in patient’s accessibility to healthcare. In the perspectives of cost savings and improved patient outcomes, I am persuaded that total societal welfare can benefit from this progress. Nonetheless, it will be interesting to see how things will pan out now that pharmacists are one step closer to procuring prescriber status. iAPPEblog’s guide to birth control and infertility can assists you in refreshing your knowledge on birth controls. (below)
Feature photo credit:
- Shapiro, Karen, Sherry A. Brown, and John An. RxPrep Course Book. San Diego, CA: RxPrep, 2016. Print.
- lexicomp online