Few California pharmacies prescribe birth control despite new law, study finds

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Despite a new state law that expanded the role of pharmacists as healthcare providers by allowing them to prescribe contraception, a recent study led by campus assistant professor of social welfare Anu Manchikanti Gómez found that only a few pharmacies have begun providing the service.

The law, implemented in April 2016 by the California State Board of Pharmacy, permits but does not mandate pharmacies to provide contraceptive services without prescriptions from a doctor. More than a year after the law was put into practice, Gómez and her team at the Sexual Health and Reproductive Equity Program, or SHARE, at the UC Berkeley School of Social Welfare found that only 11 percent of community-based pharmacies in California provide prescription contraception service.

In order to provide birth control, pharmacies are required to conduct a patient screening and a blood pressure check, as well as communicate with the patient’s primary care providerPharmacists must also be trained before they can advise patients.

In the study, Gómez and her team surveyed both independent and chain pharmacies to evaluate how and whether the changes had been implemented. Many chain pharmacies are still not offering the services, Gómez said, or are still in the pilot process.

“Just because a policy exists doesn’t mean a service is available,” Gómez said.

When Gómez and her team interviewed pharmacists at independent stores, many approved of the new law but voiced that the time and logistics required for its implementation outweighed the positive effects it could have.

While birth control remains covered by health insurance, the new law does not enable pharmacies to be reimbursed for providing these new services, Gómez said, which means that pharmacies carry the charges to their patients.

In 2016, California passed another law that will allow MediCal to reimburse the pharmacies for providing these services. The law, which is expected to be implemented by 2021, would be important to incentivize the pharmacies, Gómez said.

In terms of providers and programs, women in California generally have much better access to contraception than women in other states, Gómez said. But providing contraception services in pharmacies, while not the “end all, be all,” also gives women more anonymity and ease of access, she added.

“If you’re a farm worker in the Central Valley and can’t go to a doctor in between a 9-to-5 job, then being able to go to a pharmacy to get birth control could be really helpful,” Gómez said.

For Ilhaam Burny, a campus sophomore on Gómez’s research team, while requiring doctor visits in order to receive contraception may at first make sense, after a while the added step takes too much extra time and becomes an “unnecessary barrier” to receiving protection.

Birth control is a top pharmacy item provided by the Tang Center, according to Tina Hadaway-Mellis, the clinical services director of University Health Services. In August 2017, the Tang Center rolled out a new pilot program that about 300 students accessed, Hadaway-Mellis said.

The program allows students to start, refill, or renew oral contraceptives, patches or rings without scheduling an appointment. Instead, students can fill out a questionnaire and be screened electronically. The Tang Center’s system would then allow them to move forward in the process or indicate that a primary care provider should be consulted first, Hadaway-Mellis said.

The process is “fairly resource-intensive,” Hadaway-Mellis said, as it requires full-time pharmacists to be available every day. While Berkeley is “certainly” not the only UC campus providing contraceptive access, Hadaway-Mellis said, there are several other UC campuses that have yet to offer prescription contraception without an appointment through their pharmacies.

Hadaway-Mellis said she had hoped that the numbers of community pharmacies providing these services would have been higher than what Gómez’s research uncovered.

“I think the word needs to get out a little more,” Hadaway-Mellis said. “I don’t think it’s as advertised as well in the community as it could be.”

Contact Alicia Kim at [email protected] and follow her on Twitter at @aliciackim.