Belle: WA pharmacists can legally prescribe birth control, so why don’t many do it?

It is now legal for pharmacists to prescribe birth control in 13 US states, including here in Washington where it’s been legal since 1979. Washington was the first state to pass a law allowing pharmacists to prescribe a variety of drugs. But even though it’s legal, very few Washington state pharmacies actually prescribe birth control. And not many women know the service exists.

When I started to investigate, it was hard to get answers. Even the director of Washington’s Pharmacy Quality Assurance Commission didn’t know much.

The Washington State Pharmacy Association has a map that shows participating pharmacies but they only list 12. The Birth Control Pharmacy website also has a map, and theirs shows 87.

Kate Grindlay Kelly is project director for Free The Pill. She says the more pharmacies that can prescribe, the better access women get to birth control. Many women struggle to take off work to get to a doctor’s appointment or they don’t have insurance. But getting to a pharmacy is easy. You can get a flu shot at a pharmacy and she says it’s also perfectly safe to get hormonal birth control.

“Birth control pills and other hormonal birth control methods are some of the best studied medicines on the market today, showing that they are safe and effective,” said Kelly. “In fact, the birth control pill is already available over the counter in over 100 countries. So we know that pharmacists have the training and the expertise to advise people on their birth control choices and to help screen potential users.”

So why doesn’t every pharmacy in the state prescribe it? One barrier is the Collaborative Practice Agreement. If a Washington pharmacist wants to prescribe birth control, they need to get a doctor or nurse, someone with prescriptive authority, to sign this agreement; basically co-signing their right to prescribe.

“They are easy and hard to get,” said Don Downing, Clinical Professor at the University of Washington School Of Pharmacy. “The thing is, they expire after two years so you have to renew. You have to find somebody willing to sign them and right now in Washington state, with most physicians working for large corporations, the corporations sometimes don’t want their doctors signing these things because they’re concerned with liability. If something goes wrong with a pharmacist’s prescription, they worry about being held co-responsible for that. But we contacted every medical insurer in the country and they couldn’t find any record of any lawsuits.”

A couple months ago Kroger announced it would start prescribing birth control in all of its pharmacies where it was legal, including Fred Meyer and QFC stores in our state. Kroger corporate turned down my interview request, so I called a few local Fred Meyer pharmacies. One pharmacist said they are prescribing birth control, you just need to make an appointment and pay $35 since insurance does not cover the visit. You’ll have a consultation, get your blood pressure taken and walk out with birth control that is covered by insurance. But the pharmacist at another Fred Meyer said she has yet to be trained and can’t imagine having the time to sit down for a birth control consultation since she’s the only pharmacist on duty for her 12-hour shift.

“You’re so busy trying to fill enough prescriptions to keep your doors open that doing these other services gets pushed to the side because the only thing you’re going to get paid for is for the drug,” Downing said.

Kelly, from Free the Pill, says it would make a lot more sense to make birth control an over-the-counter medicine.

“Actually moving the birth control pill over the counter would have immediate, sweeping impacts for people across the country,” Kelly said.

But for now, both Kelly and Downing just want to get the word out to the public and to pharmacists.

“There are ambassadors that go out there [to pharmacies],” said Downing. “They’ll hand them a collaborative agreement protocol, a template and say, ‘Here, let me help you get this started.’ Or they’re actively going to multiple pharmacy chains and talking to them about getting these services in place. We show them how to do it.”

Click here to see a map of Washington pharmacies that prescribe birth control or call your local Fred Meyer or QFC store.

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