Oregon Expands Pharmacists’ Authority to Dispense Contraceptives

July 27, 2017|2:25 p.m.| ASTHO State Health Policy Staff

In 2015, Oregon enacted HB 2879, which allowed pharmacists to dispense self-administered oral contraceptives and hormonal contraceptive patches. While pharmacists can prescribe these contraceptive methods to individuals over the age of 18 without a prior prescription, the law requires such evidence before pharmacists can prescribe contraceptives to individuals under 18. Additionally, the law required the Oregon Board of Pharmacy to establish standard procedures, including a screening tool to determine if certain contraceptives are contraindicated, in consultation with other stakeholder groups such as the Oregon Medical Board, the Oregon State Board of Nursing, and the Oregon Health Authority.

The law also required pharmacists to complete an approved training program prior to prescribing. The Oregon Board of Pharmacy, in consultation with Oregon State University’s School of Pharmacy, developed a comprehensive education module that met statutory requirements for quality control and consistent levels of care. Pharmacists began prescribing birth control on Jan. 1, 2016, and since then nearly 3,000 pharmacists have completed the training. This training meets state requirements for comprehensive contraceptive education for pharmacists prescribing birth control in California, Colorado, and Washington state.

During the 2017 legislative session, Oregon lawmakers expanded this policy. As introduced, HB 2527 expanded the contraceptive methods that pharmacists can prescribe to include drugs “composed of a hormone or a combination of hormones that is approved by FDA to prevent pregnancy that the patient to whom the drug is prescribed may administer to oneself.”

In addition, the Oregon House of Representatives adopted two amendments to HB 2527. The first, amendment 4, authorized pharmacists to prescribe and administer “injectable hormonal contraceptives.” The second, amendment 5, required prescription drug benefits to cover the cost of a pharmacist’s consultations for prescribing birth control, if such consultations are covered for other drug benefits. As pharmacists have not historically been considered independent healthcare providers, reimbursement mechanisms were not in place. Sen. Steiner Hayward, the chief sponsor of the bill in the Senate, addressed the issue, saying, “We think it is appropriate that women receive counselling and a true consultation, which takes time. It’s not inappropriate for pharmacists to charge for this. However, they should be reimbursed by the insurance company and not by the woman herself.” The bill passed both chambers with bipartisan support and Gov. Brown signed the bill into law on June 14.

Leveraging the role of pharmacists is one approach that states have been exploring to address barriers to contraceptive access. Through funding from CDC, the Centers from Medicare and Medicaid Services, as well as the Office of Population Affairs, ASTHO currently supports a learning community of 27 states and territories to identify and disseminate strategies and best practices to implement policies and programs that increase access to the full range of contraceptive options.