Like our neighboring state to the north, pharmacists in California can now prescribe and dispense birth control directly to women. Now this warrants a happy dance! Women now have another choice in how they get their birth control. They can either go see their primary care provider, Ob/Gyn, family planning clinic, or go straight to the pharmacy. At the pharmacy, women will have their choice of birth control pills, patch, ring, or injection. All thanks to a state law passed back in 2013. So why the delay? It took 2 and 1/2 years to develop and approve the protocol because of the multiple rounds of revisions.
Is this safe? What about the pap smear? A pelvic examination and a pap smear are not necessary to initiate hormonal birth control. They are important for other health reasons. Women will need to complete a health history questionnaire and have their blood pressure taken at the pharmacy. This helps the pharmacist figure out which methods of birth control are safe. If the pharmacist finds something concerning in your health history or if you want a long-acting birth control device like the implant or IUDs, then you’ll be referred to a provider who can help with that. Ultimately, the goal is to improve access to medications where there is a public health benefit. After the visit, the pharmacist will send a note to your primary care physician to fill them in — unless you don’t want the pharmacist to do that of course.
Interested in getting your birth control directly from your pharmacist? Give them a call first to find out if they are providing this service. Just because pharmacists CAN provide this service doesn’t mean they WILL. California pharmacists want to participate but they are worried about time constraints at the pharmacy that prevent them from taking the time to do this. Over time, more and more pharmacists will provide this service. When you call the pharmacy, ask when would be a good time to come in for this service. Pharmacies have “rush hours” and the pharmacist will be able to give you more time if you come in when it’s slower. Some pharmacies may even make appointments for this service. In California, women of any age can access this service from a participating pharmacist. No age minimums and no ID checks. This service is completely confidential and no information can be shared with your parents or anyone else!
What’s this going to cost me? If you go to the pharmacist for your birth control visit and fill your prescription, the prescription costs will be covered by your insurance the same as if it was written by a different provider. Unfortunately, insurance companies aren’t paying pharmacists for the visit like they pay physicians and the long list of others who can provide birth control, including nurse practitioners, physician assistants, nurse midwives, and even nurses. So you may have to pay out of pocket for the visit and submit the receipt to your insurance company and hope they reimburse you (if you try this, please let us know if this works or not!).
Is this a good idea? This is an enormous step forward in increasing access to birth control. Hopefully women will appreciate having more choices in where to get birth control. Next steps? Ideally more states will pass similar laws expanding access with pharmacist prescribing — Tennessee is already moving forward with legislation and many other states are considering it. There is also growing support for over-the-counter birth control pills.
Want to consult with Dr. Sally Rafie, PharmD, BCPS about your birth control and get a prescription? Fill out the contact form and let her know how to reach you.