Anyone who's ever tried to obtain birth control knows it's not always as simple or convenient as it may seem. Between finding a clinic, dealing with insurance, or a lack thereof, scheduling an appointment, and then taking time off work for the visit, getting or renewing a birth control prescription can be time consuming, making it inaccessible for many. But a new study suggests pharmacist-prescribed birth control can help expand access to this vital reproductive health resource.
Researchers in Oregon, which became one of the first states to allow pharmacists to prescribe hormonal birth control in 2016, sought to compare the amount of hormonal contraceptive supply dispensed directly by prescribing pharmacists vs. through prescriptions patients obtained at clinic visits.
For the study, researchers surveyed 410 women aged 18 to 50 who obtained hormonal contraception (either prescribed by a pharmacist or a clinician) from pharmacies in California, Colorado, Hawaii, and Oregon between Jan. 30 and Nov. 1, 2019. And what they found was that while more women received their prescription from a clinician (64.9% compared to 35.1%), pharmacist-prescribed birth control was a promising strategy for expanding access and improving breaks in contraceptive use.
"It's important that we have a variety of different ways [available] to try and help meet people's contraceptive needs," Dr. Maria I. Rodriguez, an associate professor of obstetrics and gynecology at Oregon Health & Science University and the study's lead author, tells Romper. "Pharmacists' prescription of contraception was meeting the needs of kind of a unique group of women for whom it was faster, more convenient, or cheaper for them to access care in the pharmacy."
The study, which was published Wednesday in JAMA Network Open, showed women who obtained pharmacist-prescribed birth control were significantly younger than the women with clinic-based contraception. In fact, 56.9% of women with pharmacist-prescribed birth control were between the ages of 18 and 24, compared to 43.2% of those whose birth control was prescribed by a clinician.
Rodriguez and her team also found that those who obtained pharmacist-prescribed birth control tended to have less education; 26.4% of women reported having a bachelor's degree compared to the 37.6% who reported having one among clinician-prescribed participants. Additionally, women who obtained their birth control direct from a pharmacist were also more likely to be uninsured. A little more than 11% of women picking up pharmacist-prescribed hormonal contraception were uninsured compared to just 3% of women in the clinician prescribed group.
"This isn't replacing clinic-based prescription of contraception," Rodriguez says. "It's adding to it." According to Rodriguez, pharmacies can be better access points for people seeking contraception as they have multiple locations directly within the community and often have extended hours. For many, it might be significantly more convenient to stop at the local pharmacy on the way home from work than it is to take time off to travel to a clinic across town for an appointment scheduled during business hours.
But Rodriguez and her team also found another benefit to pharmacist-prescribed birth control: pharmacists were much more likely than clinicians to prescribe at least a six months' supply of contraceptives and significantly less likely to prescribe only a one month supply. That means people who obtained their prescription from a pharmacist were more likely to experience improved contraceptive continuation rates and fewer breaks in coverage.
"As any of us know who have used a method like the pill or the patch, something where you need refills, life gets busy and many pharmacies, or providers, or insurance companies only cover a very short amount of the supply," Rodriguez says. "That makes it really easy to find it be Friday night at 10 p.m. when you realize that you’re out and don’t have anything to take tomorrow."
At the moment, only 11 states enable pharmacists to prescribe hormonal birth control. And while there are some people on both sides of the political aisle who have previously appeared to dismiss the potential benefits of pharmacist-prescribed birth control, Rodriguez maintains it's a viable strategy for improving access. "What we're seeing from the data is that this is a valuable option to improve contraception access for women at high risk of unintended pregnancy and that it's an option women value and appreciate."
Rodriguez, M. I., Edelman, A. B., Skye, M., Anderson, L., & Darney, B. G. (2020). Association of Pharmacist Prescription With Dispensed Duration of Hormonal Contraception. JAMA Network Open. doi: 10.1001/jamanetworkopen.2020.5252
Maria I. Rodriguez, MD, MPH, associate professor of obstetrics and gynecology at Oregon Health & Science University