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Pharmacist Contraceptive Prescribing: A New Playbook for States

The resource developed by Manatt provides health care stakeholders with legislative, regulatory, reimbursement, and operational strategies to promote pharmacist prescribing and increase access to contraception for underserved communities.

Birth control pills
A one-month dosage of hormonal birth control pills is shown in Sacramento, California. (Rich Pedroncelli/The Associated Press)

More than 19 million people in the United States lack meaningful access to birth control. The problem is most acute among low-income women, women of color, and individuals from other historically marginalized communities, who face greater difficulties accessing reproductive healthcare writ large, and contraception in particular. 

To address this issue, researchers and advocates are looking at the possibility of authorizing pharmacists to prescribe and dispense contraceptives, a strategy they hope states can deploy to increase contraceptive choice and access while reducing health disparities.

In a new playbook for state leaders, Manatt Health, a health care consulting company with expertise in advocacy and legal initiatives, reviews different types of laws that authorize pharmacist prescribing and outlines strategies to assure effective implementation. While state boards of pharmacy are most commonly charged with leading implementation and ongoing oversight of policies, the strategies listed in playbook — from stakeholder and community engagement to tactics to promote pharmacist uptake — could be implemented by any state regulators charged with leading implementation. 


Number of people in the U.S. who lack meaningful access to birth control

The early experience of states that have implemented pharmacist-prescribing policies demonstrates that such policies increase contraceptive access and choice. In a 2019 study of four states with contraceptive prescribing laws, women who chose to get contraception prescribed by a pharmacist as opposed to a clinician were younger, had less education, and were more likely to be uninsured. Pharmacist prescribing may help address access disparities, particularly for Black women and people living in rural communities, as both of these populations are likely to live closer to a pharmacy than a physician’s office.

In addition, Manatt Health found the pharmacy counter may be a preferred access point for some consumers. Individuals who have obtained pharmacist-prescribed contraceptives report high levels of satisfaction and note, in particular, the convenience of obtaining care at the pharmacy.

Recognizing these benefits, nearly a dozen states have passed legislation to allow pharmacists to prescribe contraceptives. These states’ experiences offer case studies that show what successful pharmacist prescribing initiatives require – and what thoughtful design and implementation of reproductive policy can mean for the health and wellbeing of millions of people.