A law was passed in 2013 to allow pharmacists at locations like CVS and Rite Aid to initiate therapy and dispense birth control medications WITHOUT patients first seeing a physician or other healthcare provider. The law aims to make it easier for women to get hormonal contraceptives. That 2013 law was supposed to have been initiated in October of last year; however, to date the implementation details of the law are still being worked out.
Pharmacy Law, SB493, has hit a bit of a political rough patch. As of now, California and Oregon are the only states in the US with a law of this type – and Oregon’s legislation went into effect on January 1st. Despite the trailblazing nature of the law, you have to wonder: What’s the issue?
The legislation is currently caught in a crossfire of regulatory debate. Questions regarding the medical procedures pharmacists should be following when distributing the birth control have been the major reason for the holdback. The struggle to make acquiring birth control a less convoluted and maddening process might not be sorted out until, at the very earliest, April or May.
“It is important to recognize that whenever implementing such a significant change to the law that proper implementation planning takes place to make sure it roles out smoothly and appropriately,” said Dr. Daniel Tomaszewski, a professor at the Chapman University School of Pharmacy (CUSP). “This means including a number of regulating agencies and working to develop a consensus among all necessary experts, which does take time.”
The American College of Obstetricians and Gynecologists (ACOG) argued that a standard medical practice is to take a seated blood pressure prior to prescribing hormonal contraceptives, thus the regulations were amended to accommodate this procedure.
One of Dr. Tomaszewski’s areas of research is in pharmacist’s involvement in political activity and his takeaway from these developments is less than positive. “It is unfortunate to see the substantial delay that has occurred in finalizing the regulations around implementing this portion of the Pharmacist Provider Status Law… This law will allow pharmacists to increase access to these crucial medications for women to properly prevent unintended pregnancies. In addition, it will have a positive impact of increasing patient-pharmacist interaction, which will help the public to better understand the clinical skill and abilities that their pharmacist has to offer.”
Dr. Souhiela Fawaz, also a professor at CUSP, has a keen interest in women’s health and, like her colleague Dr. Tomaszewski, says the delays to the birth control portion of the law are unfortunate but also gives a chance to increase the relationship between consumer and pharmacist. “Many women who currently use contraception do not use them appropriately, which ultimately decreases their effectiveness. As the medication experts, pharmacists are in a key position to provide accurate and timely information about these important medications. SB493, will not only increase access to contraception but it will also enable pharmacists to have greater opportunity to educate and provide information on their safe and effective use.”
SB493 doesn’t just deal with contraceptives; in addition to initiating birth control medications, the law would also allow pharmacists to initiate therapy with prescription-strength inhalers, gum and lozenges for nicotine addiction. Also, with enhanced independence for pharmacists providing vaccinations, California becomes the first in the nation to allow pharmacists to furnish all prescription medications related to travel without first seeing a physician. Dr. Jeff Goad, Professor and Chair of the Department of Pharmacy Practice and travel health expert, noted that international travelers can now receive the medications, vaccinations and disease education they need to stay healthy while traveling by just visiting their local pharmacist.
Both Dr. Fawaz and Dr. Tomaszewski are optimistic that the all provisions of the law will eventually go into effect and be successful, with Dr. Tomaszewski saying that he is “hopeful that all groups are able to work to complete this regulatory process and allow pharmacists to better serve their communities as soon as possible.“
What will this mean for Chapman University’s School of Pharmacy? The way Dr. Fawaz sees it, this could mean some changes in the structure and curriculum. “I am confident that the law will be implemented in the near future. It is also incredibly important that adequate training materials, implementation processes and pharmacist protocols are developed so that pharmacists are able to adopt this new law and provide these crucial services to their community.”