No Rx birth control: Ready, set, dispense?

Although California and Oregon now allow pharmacists to dispense birth control to customers without a prescription, not many pharmacists are taking part–at least not yet.

Even so, retail chains, pharmacy educators, and some pharmacists say it is a great opportunity for pharmacists to expand their services and to use the knowledge they have. “We appreciate the new law’s recognition of the valuable role that pharmacists can play as healthcare providers. We are currently assessing the law’s procedural requirements and how we might be able to incorporate the service into our pharmacy operations,” said Jim Graham, Walgreens’ senior manager of media relations.

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In the next several weeks, Walgreens plans to test the service in a small number of pharmacies, “which will also give us an indication of the demand for this service,” Graham said.

The ability to dispense birth control “is a great practice advancement opportunity for pharmacists and the first opening to truly practice at the top of our license/training,” said Cortney Mospan, PharmD, assistant professor of pharmacy at Wingate University School of Pharmacy in Wingate, N.C. “For me as a community pharmacist, I want the opportunity to fully use my training and education while practicing in the community setting and the provision of birth control is a greater opportunity for pharmacists as the medication experts on the healthcare team to really use our knowledge.”

However, along with the ability to dispense birth control comes greater responsibilities and time away from dispensing scripts. “Pharmacists will need to be thorough in their patient assessment as well as their monitoring and knowledge of the differences in the types of birth control, such as the patch versus the NuvaRing versus injectables versus the multitude of oral contraception,” Mospan said.

So far, not many pharmacists are taking advantage of the opportunity, according to published reports. Mospan said the lack of reimbursement for providing the service, fear of change, and the extra time required for counseling are among the barriers to more widespread adoption of birth control dispensing by pharmacists.

“Pharmacies are very busy (especially chains like Walgreens and CVS) and to do this and do this well will take some reengineering of workflow, practice models, and more pharmacists working at once to handle patient assessment while also dispensing and counseling patients,” Mospan said.

“To see that happen, there has to be a way to pay the pharmacists. We need to be recognized by Medicare as providers and see changes in insurance code to be able to bill for the time and cognitive benefit we provide patients,” Mospan said.