EMPOWERING WOMEN
TO OWN THEIR HEALTH

Evolving Access to
Contraception:
State-Specific Legislation

Access to prescription contraception has evolved in the United States, thanks in part to the Affordable Care Act (ACA),12 which requires most health plans to cover some types of birth control at no cost to patients.13 The ACA mandate has especially benefited patients who use oral contraceptives. In fact, according to a 2015 study by Becker and Polsky, the average user of birth control pills saved approximately $255 per year, subsequent to implementation of the mandate. The study also states that the mandate has reduced women’s annual overall out-of-pocket spending on oral contraceptives by $1.4 billion.14

In California and Oregon, access to birth control has evolved even further as the result of legislation allowing qualified retail pharmacists in those states to prescribe and dispense certain methods of contraception.15,16 The number of additional states considering this type of legislation is growing rapidly.

A New Prescribing Role for Pharmacists

In both California and Oregon, a female patient who visits a specially trained pharmacist to obtain prescription birth control will be required to complete a self-screening questionnaire. The retail pharmacist will then review the patient’s answers and determine whether it is safe to prescribe and dispense a contraceptive product to her.15,16

Any patient who is prescribed contraception by a pharmacist should be encouraged to consult a primary care provider or women’s healthcare professional for a clinical examination.15,16 She should also be reminded that hormonal contraception will not protect her from sexually transmitted infections.

For more information, please consult the following resources:

MPR Ask the Expert
MPR Ask the Expert

MPR Ask the Expert shares the insights of 2 prescribing pharmacists on the topic of oral contraception. It also explains how pharmacists in California and Oregon can become qualified to prescribe birth control products.

MPR Concise Consult
MPR Concise Consult

MPR Concise Consult provides an overview of oral contraceptives and summarizes state-specific legislation allowing pharmacists to prescribe contraceptive products. It also includes a tear sheet for patients. Written in both English and Spanish, the tear sheet answers frequently asked questions about birth control pills.

California-Specific Guidance for Retail Pharmacists

Map of the United States, with California highlighted Map of the United States, with California highlighted

In California, female patients can now visit a pharmacy to obtain a prescription for contraception (no age restrictions).15

Qualified retail pharmacists in California have been granted the authority to prescribe and dispense the following types of birth control20:

  • Oral contraceptive
  • Transdermal contraceptive patch
  • Vaginal contraceptive ring
  • Contraceptive injection

To become qualified, pharmacists will need to complete training that includes 1 hour of continuing education covering the use of hormonal contraception in accordance with:

Please note that a color chart summarizing the US MEC is available online.

Oregon-Specific Guidance for Retail Pharmacists

Map of the United States, with Oregon highlighted Map of the United States, with Oregon highlighted

In Oregon, a qualified retail pharmacist now has the authority to prescribe and dispense oral contraceptives or the transdermal contraceptive patch to16:

  • Female patients 18 years of age and older
  • Female patients younger than 18 years, as long as they had previously received a prescription for birth control from a primary care provider or a women’s healthcare professional

To become qualified, pharmacists will need to complete a training program that is approved by the Oregon State Board of Pharmacy and is related to prescribing birth control pills and patches.16

The regulations regarding retail pharmacists’ authority to prescribe oral and transdermal contraception in Oregon prohibit pharmacists from16:

  • Requiring appointments for patients in need of contraception
  • Prescribing and dispensing contraception to any patient who does not have evidence of a clinical visit within 3 years of her initial prescription of hormonal contraception

Oregon law stipulates that female patients younger than 18 years who have never received a prescription for birth control will need to obtain their first prescription from a primary care provider or a women’s healthcare professional, rather than a pharmacist.16