New regulation part of law expanding scope of practice

SACRAMENTO, Calif. — Pharmacists in California can now provide prescription contraceptives to women without a script from their doctor.

A new state regulation that went into effect Friday authorizes California pharmacists to furnish oral (pill), transdermal (patch), vaginal (ring) and Depo injection prescription birth control directly to women.

Jon Roth, California Pharmacists Association CEO

The regulation, “Protocol for Pharmacists Furnishing Self-Administered Hormonal Contraception” (Section 1746.1 of Title 16 of the California Code of Regulations), requires pharmacists to follow a statewide protocol that outlines the clinical considerations for providing the prescription, as well as pharmacist training and reporting to the patient’s primary care provider.

“Today is a wonderful day for women’s health care in California,” said Jon Roth, chief executive officer of the California Pharmacists Association (CPhA). “We thank the California State Board of Pharmacy for completing the contraception regulations and are pleased that pharmacists can now provide direct access to birth control for women.”

CPhA said the regulation follows the Center for Disease Control and Prevention (CDC) U.S. Medical Eligibility Criteria for Contraceptive Use (USMEC), which advises health care providers on the risks and contraindications for types of birth control depending on the woman’s medical conditions.

Under the California regulation, when a patient requests self-administered hormonal contraception, pharmacists must ask the patient to use a self-screening tool; review the self-screening responses; and measure and record the patient’s seated blood pressure if combined hormonal contraceptives are requested or recommended. Pharmacists also must ensure that the patient understands how to administer the contraceptive as well as provide counseling and information on the birth control method selected (including dosage, efficacy, potential side effects and safety), preventive health screenings and the fact that the contraception doesn’t protect against sexually transmitted infections (STIs).

“Self-administered hormonal contraceptives are among the most effective contraceptive medications and devices available to women,” the California regulation stated. “This regulation increases women’s access to these effective forms of birth control by reducing both the time required and the overall cost of obtaining self-administered hormonal contraception. Unintended pregnancies are linked to many maternal and child health problems. Using effective birth control to prevent unintended pregnancies improves both women’s and children’s health.”

CPhA noted that the new regulation stems from state legislation signed into law in October 2013, Senate Bill 493, which expanded the scope of pharmacists’ practice.  The bill, sponsored by CPhA, authorizes pharmacists to provide hormonal contraception, prescription smoking cessation services, travel medications and more immunizations. The measure also creates an Advanced Practice Pharmacist license. Regulations for the travel medications, expanded vaccinations and Advanced Practice license are pending.

“California’s 6,500 community pharmacies are the face of neighborhood health care in this state,” Roth added. “Community pharmacies are open beyond normal business hours, and patients do not need an appointment to see their pharmacist. That means these regulations will go a long way to expanding women’s access to birth control.”