June 30, 2022

Pharmacists Can Prescribe Hormonal Contraceptives in 20 U.S. States

As of March 2022, Pharmacists can directly prescribe and dispense hormonal contraceptives without a CPA (collaborative practice agreement) in 20 states (including the District of Columbia).

Legislation is pending in many additional states. This expanded authority is a huge step forward in the role of pharmacists as providers and eliminates barriers to access for patients. National Alliance of State Pharmacy Associations (NASPA) specifies that these 20 jurisdictions are without a collaborative practice agreement, which is an important factor in how independent the pharmacist authority is.

NASPA

According to Power to Decide, a group dedicated to preventing unplanned pregnancies,

“More than 19 million individuals in the United States lack meaningful access to birth control within their communities. Low-income women, women of color, and individuals from other historically marginalized communities have greater difficulty accessing reproductive healthcare services, in particular, hormonal contraception.”

Access issues arise due to cost of care, lack of insurance coverage, challenges navigating a complex healthcare system, challenges obtaining a clinic appointment (often due to absence of an established primary care provider/clinic relationship), lack of transportation to a clinic visit, and other social determinants.

Recognizing these challenges and the fact that contraceptives are generally accepted as safe enough for complete over-the-counter access, the medical community has banded together since 2016 to advocate for legislation that allows pharmacists to reach uninsured individuals and women in lower income or rural communities.

This type of legislation can have a dramatic impact on populations. For example, Oregon pharmacists prescribed 10% of all contraceptives in the state and 74% of the prescriptions written by pharmacists were for women who had not previously been on birth control, clearly showing pharmacists’ ability to reach at-risk populations.

According to a study published in 2021 by US Pharmacist, “The pharmacists’ prescriptive authority benefits both patients and physicians; not only does it help to take a load off physicians’ busy schedules but it also addresses barriers to care for women who need the contraceptives.”

The below list includes the states that allow pharmacists to prescribe. If you are a pharmacist and are interested in learning more about implementing contraceptive prescribing, check out Manatt’s 2021 guide ‘Implementing Pharmacist Contraceptive Prescribing: A Playbook for States and Stakeholders.’ Additionally, Birth Control Pharmacist published a 2019 free report detailing approaches and experiences implementing direct access to contraception.

US Pharmacist

Our team is committed to helping pharmacies implement and expand reproductive healthcare services like prescribing hormonal contraception and obtaining reimbursement for these services, if applicable.

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The 20 U.S. jurisdictions with statutes or regulations that allow pharmacists to prescribe contraceptives (without a CPA)

  • Arizona
  • Arkansas
  • California
  • Colorado
  • Delaware
  • District of Columbia
  • Hawaii
  • Idaho
  • Illinois
  • Maryland
  • Minnesota
  • Nevada
  • New Hampshire
  • New Mexico
  • North Carolina
  • Oregon
  • Utah
  • Vermont
  • Virginia
  • West Virginia

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Sources:

“Birth Control Access.” 2022 | Power to Decide, Power to Decide, 2020, https://powertodecide.org/what-we-do/access/birth-control-access.

Dehlendorf, Christine et al. “Disparities in family planning.” American journal of obstetrics and gynecology vol. 202,3 (2010): 214–20. doi:10.1016/j.ajog.2009.08.022

Grindlay, Kate, and Daniel Grossman. “Prescription Birth Control Access Among U.S. Women at Risk of Unintended Pregnancy.” Journal of women’s health (2002) vol.25,3 (2016): 249–54. doi:10.1089/jwh.2015.5312

Chim, Christine, and Pallak Sharma. “Pharmacists Prescribing Hormonal Contraceptives: A Status Update.” U.S. Pharmacist — The Leading Journal in Pharmacy, U.S. Pharmacist, 17 Sept. 2021, https://www.uspharmacist.com/article/pharmacists-prescribing-hormonal-contraceptives-a-status-update.