Oregon pharmacists have been afforded the opportunity to increase safe access to hormonal birth control in a bill recently signed by Governor Brown. Rep. Knute Buhler, a physician in Bend, Oregon, working with colleagues in the legislature envisioned a process through which patient access to prescriptions for self-administered hormonal birth control could be enhanced. Patient safety concerns were addressed by assuring involvement of one of the country’s most trusted professionals, pharmacists.
The final version of HB 2879 involved consultation with the Oregon State Board of Pharmacy and collaborative discussions among representatives from several health professions. The American College of Obstetricians and Gynecologists has called for improved access to contraceptives for women, including the possibility of over-the-counter status. Their studies indicate that women who are at risk for unintended pregnancy would readily access all forms of self-administered birth control and can effectively self-screen for contraindications to hormonal therapy.
The Oregon law retains prescription status for self-administered hormonal birth control, but asks pharmacists to accept the role of prescriber following collaboratively developed rules that will include completion of a patient-administered self-screening tool. Pharmacists are well prepared with regard to therapeutic options, benefits and risks associated with the use of different hormonal birth control products, but will complete additional specialized education to familiarize them more fully in drug selection when initiating therapy. The State Board of Pharmacy, in consultation with the Oregon Medical Board, State Board of Nursing and Oregon Health Authority are charged to define educational requirements and develop rules that will govern practice.
Pharmacists’ status as healthcare providers and the important role that they play in collaborative patient care was confirmed by the legislature earlier in the 2015 session. Passage of HB 2028 allowed for development of additional protocols for pharmacist initiation of self-diagnostic therapies and collaborative management of chronic diseases. Utilizing pharmacists will assist in decreasing unintended pregnancies, while helping to maximize patient safety. Pharmacist prescribing of self-administered hormonal birth control, like pharmacist administered immunizations, is an opportunity to utilize the capabilities of the drug experts in the health care system to address a significant public health need.
The Oregon State Pharmacy Association (OSPA), an advocate for policies that positively impact Oregon’s pharmacists and patients, is pleased to provide answers to Frequently Asked Questions below regarding the enactment of HB 2879, increasing access to reproductive health for women across the state.
Frequently Asked Questions
What does this really mean? Click on a question to find the answer…
- What is the purpose of this law?
- Who thought of this proposal?
- Are all types of birth control included?
- Will I have to use pharmacist prescribed birth control?
- Will my birth control still be covered by insurance?
- Who can access birth control through their pharmacist?
- Is my pharmacist required to prescribe birth control?
- Are pharmacists qualified to be responsible for my reproductive health?
- Will the pharmacist know what is the best product?
- Is it okay to access birth control without a physician’s visit?
- What if there are side effects resulting from the use of my birth control?
- When will this policy go into effect?
- Does the OSPA support pharmacist prescribing of birth control?
What is the purpose of this law?
The purpose is to increase access to self-administered hormonal birth control, while addressing safety concerns, resulting in a decrease in unwanted pregnancies.
Who thought of this proposal?
Rep. Knute Buhler, a physician in Bend, Oregon, working with colleagues in the legislature envisioned a process through which patient access to prescriptions for self-administered hormonal birth control could be enhanced. The final version involved consultation with the Oregon State Board of Pharmacy and collaborative discussions among representatives from several health professions.
Are all types of birth control included?
No. Only self-administered oral or transdermal products are included.
Will I have to use pharmacist prescribed birth control?
No. The intent of the law is to expand access. It does not eliminate or limit any existing relationships with providers or drug delivery processes currently used by patients.
Will my birth control still be covered by insurance?
Yes. Both state and federal guidelines require insurance coverage for birth control.
Who can access birth control through their pharmacist?
All women 18 years old and greater can obtain medication through pharmacist prescribing. Women under the age of 18 must first demonstrate that they have been previously prescribed an oral contraceptive by a primary care provider. This restriction is scheduled to sunset in two years.
Is my pharmacist required to prescribe birth control?
All pharmacists have the capacity and opportunity to participate. Some pharmacists may decline to participate. This is allowed in Oregon rules, but there is a professional responsibility to refer the patient to an alternative pharmacy service provider.
Are pharmacists qualified to be responsible for my reproductive health?
Yes. Today’s typical pharmacy graduate in Oregon has first completed a Bachelor’s degree, is selected for admission through a competitive process and then completes the equivalent of four years of professional education, including classroom and direct patient care experiential education. All pharmacists are also required to complete ongoing continuing education.
Will the pharmacist know what is the best product?
A patient administered self-assessment survey will help to guide product selection. Pharmacists will also complete additional specialized education, defined by the State Board of Pharmacy, to complement their existing strong knowledge of drug action and drug products.
Is it okay to access birth control without a physician’s visit?
The American College of Obstetricians and Gynecologists has called for improved access to contraceptives for women, including the possibility of over-the-counter status. Studies have suggested that patients with an appropriate survey document can effectively self-screen for risks. California has passed similar legislation and are also in the process of writing rules and enhancing pharmacist education.
What if there are side effects resulting from the use of my birth control?
All medications, including over-the-counter medications, have risks associated with them. The Oregon law involves pharmacists, rather than providing medications over-the-counter, to assure patients have a partner in assessing possible risks or side effects. Pharmacists, as for any professional, accept responsibility for decisions made and carry liability insurance to protect the patient and the pharmacist.
When will this policy go into effect?
The law allows pharmacist prescribing as early as January 1, 2016, but it is likely that it will not be widely implemented until midyear 2016. The State Board of Pharmacy (in consultation with the Oregon Medical Board, State Board of Nursing and Oregon Health Authority) must first define rules to guide practice and any additional educational requirements for pharmacists. Next, pharmacists must complete the educational unit and, finally, pharmacies must determine how to best incorporate this clinical service into their workflow.
Does the OSPA support pharmacist prescribing of birth control?
The Oregon State Pharmacist Association is an advocate for full utilization of pharmacists’ expertise to positively impact the health and wellness of all Oregonians. Pharmacists’ initiation of therapy when a diagnosis is not required or post-diagnostic management of diseases in collaboration with other health professionals is impactful and certainly within the scope of a pharmacist’s education and skill set.