How Pharmacists Are Expanding Reproductive Care Access

Drug Topics JournalDrug Topics April 2024
Volume 168
Issue 03

Drug Topics sat down with Sally Rafie, founder of Birth Control Pharmacist, to discuss how pharmacists are well positioned to expand access to reproductive care.

Pharmacists are emerging as crucial players in ensuring access to safe reproductive care, especially as changes in abortion legislation create a thorny landscape of access. These health care professionals are widely distributed—90% of the US population lives within 5 miles of a community pharmacy1— and can counsel patients on proper use, potential adverse effects, and drug interactions of abortion medication like mifepristone. Unlike doctors’ offices or hospital settings, which may be intimidating for some, pharmacies offer patients a familiar environment in which to seek reproductive care.

CVS and Walgreens, 2 of the largest retail pharmacy chains in the country, announced they will begin dispensing mifepristone in March 2024.2 The decision to do so comes after a ruling from the FDA to remove the in-person requirement to obtain the medicine, thereby allowing both brick-and-mortar stores and online pharmacies to dispense mifepristone after completing a certification process. The move from the retail giants represents a critical step in the right direction toward expanding access to patients for important reproductive care.

Drug Topics sat down with Sally Rafie, PharmD, founder of Birth Control Pharmacist, to discuss how pharmacists’ unique position makes them well suited to address existing abortion care gaps.

Drug Topics: Pharmacists are widely considered to be the most accessible health care professionals. How are they uniquely positioned to address the abortion access gap?

Sally Rafie, PharmD: Pharmacists are conveniently positioned in communities and neighborhoods to serve folks nearby where they live, work, or go to school. Pharmacies are a trusted source of health services and medications. There are many “abortion deserts” throughout the country where people must travel more than 100 miles to reach a clinic for abortion care. One can imagine the time off work, transportation, childcare, and travel costs would be prohibitive for lots of folks. With the rise of telehealth services and the proven safety of abortion care without any tests or ultrasounds, people are able to get a prescription for medication abortion and should be able to fill that at their local pharmacy for timely care.

Drug Topics: On the contrary, what boundaries do they face in addressing the abortion access gap?

Rafie: The FDA-imposed Risk Evaluation and Mitigation Strategies requirements on mifepristone prohibited pharmacists from participating in abortion care, historically. That changed last year when pharmacies were allowed to dispense mifepristone once certified to do so. Pharmacy education has historically not included abortion care, despite the fact that 1 in 4 women have an abortion in their lifetimes. Pharmacists may benefit from continuing education on abortion and related services such as contraception.

Drug Topics: How have you seen misunderstandings about abortion legislation or abortion in general impact patients and pharmacists alike?

Rafie: Confusion around OTC access to emergency contraception seems to linger despite Plan B and generics being OTC for people of all ages for over a decade. Some people may confuse emergency contraception and medication abortion, though I don’t see this among my peer pharmacists.

Drug Topics: How might visiting a pharmacist for medication abortion look different than visiting a physician or abortion clinic and how might having a pharmacist pathway ease the journey for women?

Rafie: Pharmacies are very neutral sources of care, meaning that there’s no stigma with walking into a pharmacy like there might be for visiting a family planning clinic. People are in the pharmacy regularly to purchase OTC medication, toiletries, cosmetics, snacks, greeting cards, etc.

Pharmacies also tend to have extended hours of operation in the evenings and weekends. People appreciate the convenience of their local pharmacies.

READ MORE: Women's Health Resource Center

1. 9 out of 10 Americans live close to community pharmacy. EurekAlert. News release. July 28, 2022. Accessed March 20, 2024.
2. Biscaldi L. Breaking: CVS, Walgreens to begin mifepristone dispensing this month. News article. Drug Topics. March 1, 2024. Accessed March 20, 2024.
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