![]() 17 For example, in 2014, Illinois established a $35 dispensing fee. States often delay developing payment policies for contraception prescribing, so pharmacists may consider temporarily increasing dispensing fees for the additional services. 8 Paying pharmacists reasonable fees for patient assessment and prescribing or referral is critical. Pharmacist participation varies across states, and reimbursement influences participation. 14 Without insurance, contraception’s average out-of-pocket cost is $240 to $900 yearly including secondary expenses (eg, lost wages and transportation). 16Ĭost remains a barrier for 11.7% of women of reproductive age who are uninsured or underinsured. Contraindications to prescription birth control require physician referral, and states often require pharmacists to inform the patient about the importance of regular exams. ![]() Might access at the pharmacy decrease regular physician visits? On the contrary, pharmacist-patient interaction could encourage regular physician visits. 8 Patients may also prefer pharmacies because of the availability of multilingual staff, pharmacy hours, and the facility’s proximity to their home. 15 Expanding pharmacy services is the very definition of health care convenience. Limited appointment availability and having to miss work cause patients to avoid office visits. 14īarriers affecting all health care curb access to contraception. 13 Birth control is a journey for women, and Table 2 lists factors that influence their selection of methods. Pharmacists can guide patient decisions and discuss alternatives that may alleviate undesired effects. Women hesitant to start birth control are most concerned with potential adverse effects. 11 The CDC offers CE on the US MEC’s clinical application ( ). The US MEC is updated at least every 5 years, and its components are available as mobile apps and include an easy-to-use summary chart. ![]() The evidence-based US Medical Eligibility Criteria (US MEC) for Contraceptive Use and the Selected Practice Recommendations for Contraceptive Use guide contraception choice based on medical conditions and help with managing challenges. The CDC has great contraception-prescribing resources. 5,9 Patient questionnaires address health history and pregnancy status, identify patient preferences, require blood pressure measurement, and screen for eligibility and interacting medications. Most locations use statewide protocols that identify when physician referral is required. ![]() 9 Typically, training involves certification or continuing education (CE) modules. 8Īll states require training and patient visit documentation. Already, 46% of Oregon’s pharmacies prescribe contraception. 7 Successful pharmacist prescribing initiatives demonstrate its potential. 6įifteen states already allow pharmacists to prescribe birth control without collaborative practice agreements, and that number is increasing (Table 1). 5 Pharmacists can refer patients who need to use other methods. 2 Studies show that women can self-screen and nonphysicians can safely assess contraindications to using oral contraception. 5 Although combined oral contraception creates a venous thromboembolism risk, it is small com- pared with the risk during pregnancy and post partum. Oral contraception’s safety is well established. 3 Pharmacists address antimicrobial stewardship, chronic conditions, immunization, and the opioid crisis (eg, naloxone) every day. 1 Accessible, affordable birth control could decrease unintended pregnancies and maternal mortality by 30%.1 Family planning allows women to obtain college educations, pursue advanced professional degrees, and join the nation’s workforce.1 The American Gynecological and Obstetrical Society advocates for full unrestricted access to contraception, 2 and pharmacists are poised to help.įorty-nine states have awarded some form of prescriptive authority to pharmacists with variable prescriber oversight and restrictions. 1 Globally, maternal mortality has declined steadily over the past 3 decades, 1 but tragically, the number of American women dying during childbirth continues to climb. In the United States, almost half of pregnancies are unintended.
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