Hormonal Birth Control Now Available Directly At Pharmacies in California

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.

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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.

Expert Interview: Dr. Tracey Wilkinson

With the recent changes to expand access to birth control for youth, pediatrician Dr. Tracey Wilkinson helps explain the importance of the progress so far and what still remains to be done.Dr. Tracey Wilkinson

What changes have you seen recently with birth control for youth?

In 2013, emergency contraception (EC), also known as the morning-after pill, was made an over-the-counter medication for everyone.  This means that anyone (girls or boys) can walk into a retail pharmacy or drugstore and purchase EC without having to show identification or find a pharmacy that is open.

How has over-the-counter EC impacted your patients?

Having EC over-the-counter helps ensure that everyone (regardless of age) can access this medication when they need it.  Remember, EC works better the sooner it is taken–so, it is important that when someone needs to get this medication to prevent pregnancy, there are no delays when they go to the pharmacy, doctor’s office, or clinic.

What challenges are your patients facing despite these changes?

There have been a lot of changes to the law regarding EC access over the last few years.  So, it is not surprising that there is a lot of confusion–amongst clinicians, pharmacy staff and even teenagers–as to who can get this medication and when it should be taken.

What needs to be done to address these challenges?

We are going to need to have a lot of education and outreach to both the public and the medical community about the recent changes around EC access.  It is important that youth know about this medication and when to take it, that doctors talk about it with their patients and that pharmacy staff know how to answer questions from consumers buying this medication.

What advice would give youth who would like to get birth control?

First, do some research before you go to the doctor on what types of birth control is out there and what may be a good fit for what you are looking for. Second, it is important that youth find a clinician who they feel comfortable talking to about options for birth control.  These conversations rely on trust and it is important that you find that relationship with a clinician.  Also, remember your rights when going to the doctor’s office, clinic, or pharmacy–you have a right to privacy and confidentiality no matter how old you are.

Is there anything else you’d like to share?  

One of my favorite things as a pediatrician is talking to adolescents as they transition to adults and start making decisions around sexual activity and how to be safe.  Remember, there are a lot of ways to do that and it is important to find a birth control method that works well for you and your partner so that you can stay healthy and also not get pregnant until you are ready.  The number of contraceptive methods continues to increase and so if you don’t like one method–there are a lot of other ones to try!

About the Expert: Dr. Tracey Wilkinson, MD, MPH is a board-certified pediatrician practicing at the Children’s Hospital Los Angeles.  She is also an Assistant Professor of Clinical Pediatrics at the University of Southern California Keck School of Medicine.  Dr. Wilkinson’s research interests are pregnancy prevention and access to contraception.  To make an appointment with Dr. Wilkinson, call (323)669-2113.

Summer Research Students Say Hello

This summer, I’ve had the pleasure of working with two motivated pharmacy students on research projects related to family planning services at community pharmacies. They’d like to say “hello” and tell you why they are doing this work.

Kevin Vu and Emily Richards, Summer Research Students

Kevin Vu and Emily Richards, Summer Research Students

Allow me to introduce myself. My name is Kevin.

I chose to do a reproductive health-related summer research project because as the pharmacy profession is evolving, pharmacists are playing larger roles in providing family planning services directly to patients. My research for instance, is a survey study of pharmacists’ attitudes towards a recent California law that will allow pharmacists to provide hormonal birth control directly to patients without a prescription (under a protocol that is currently under development…more to come on this).

Family planning is a topic that I come across frequently at the chain community pharmacy where I work. For example, I recently had the opportunity to counsel a patient on proper use of the over-the-counter emergency contraception, Plan B One-Step, and the appropriate time frame to take it. But, many people may feel awkward discussing these topics.  I hope you find this site to be a place where you can comfortably voice your opinions and get any of your burning questions answered. After all, protecting your sexual and reproductive health is important to your overall health.

Hi there! My name is Emily.

Since starting pharmacy school, I have constantly been shown the ways in which the pharmacist plays a vital role in healthcare…in ways I didn’t even expect. The passing of the new law Kevin mentioned expands the role of the pharmacist even further. Once pharmacists can provide hormonal birth control methods directly to patients, this will be very helpful for women who prefer getting their birth control directly at the pharmacy.

I am also conducting a summer research project. I am interviewing pharmacists in order to understand their interest in providing pharmacy access to family planning services, as well as challenges they may face in doing so.  I chose this topic because this expanding pharmacist role places pharmacists in the unique position to provide family planning services, which is especially important for those who may be unable to afford or scared to obtain services otherwise. I am not quite finished with the project, but I have already become more aware about how important women’s health and family planning services are to the community. I am learning a lot and hope you too can learn from this website and use it as a resource.

Kevin Vu is a third-year student and Emily Richards is a second-year student at the University of California San Diego Skaggs School of Pharmacy and Pharmaceutical Sciences.