States lead effort to let pharmacists prescribe birth control

Groundbreaking laws in two Western states will soon make access to birth control easier for millions of women by allowing them to obtain contraceptives from pharmacists without a doctor’s prescription.

Even as the Supreme Court prepares to consider yet another divisive case involving access to contraception, public health advocates hope these arrangements could spread across the country, as states grappling with persistently high rates of unintended pregnancy seek to increase access to birth control with measures that so far have been unavailable under federal law.

Most Western countries require a doctor’s prescription for hormonal contraceptives like pills, patches and rings, but starting sometime in the next few months, women in California and Oregon will be able to obtain these types of birth control by getting a prescription directly from the pharmacist who dispenses them, a more convenient and potentially less expensive option than going to the doctor.

[...] unlike other recent debates over contraception — including the firestorm over the Obama administration’s requirement under the Affordable Care Act that all health plans pay for contraceptives — these legislative efforts have been largely free of political rancor.

Reproductive health groups and medical associations increasingly say the ultimate goal should be to make contraceptives available without a prescription, and some worry that the push for pharmacist-prescribed contraceptives could thwart that.

A bill introduced in Congress in May by Republican senators would help expedite the process in which contraceptive manufacturers apply to the FDA for over-the-counter approval, but some Democrats and women’s groups say it might ultimately reduce birth control use because it does not specify insurance coverage for over-the-counter methods.

Many reproductive health experts have come to support pharmacist-prescribed contraceptives, persuaded that pharmacists can safely dispense contraception without a doctor’s prescription and that women can assess their health risks on questionnaires.

“There’s a growing body of evidence that there isn’t a safety concern,” said Dr. Daniel Grossman, vice president for research at Ibis Reproductive Health and a professor of obstetrics and gynecology at UCSF.