NJ pharmacists may start prescribing birth control … for a fee
New Jersey might join a small but growing list of states, so far limited to the West Coast, that allow women to obtain birth control without a doctor’s prescription by getting it through a pharmacist.
A bill moving through the Legislature, S1073/2060, would allow pharmacists to furnish self-administered hormonal contraceptives – things like birth control pills, vaginal rings and diaphragms – without an individual prescription from a doctor.
Women would have to use a self-screening tool to identify patient risk factors, similar to a survey or questionnaire at a doctor’s office. Pharmacists would have to offer to provide counseling and refer the patient to a primary doctor, regardless of whether the self-screening recommends a contraceptive.
Health insurers would have to cover the prescription, so long as state directives are followed.
Sen. Shirley Turner, D-Mercer, said it’s not always possible for working women to fit a doctor’s appointment into their schedules.
“We need to remove every barrier that we can that prevents women from gaining access to contraception,” Turner said. “Because we do not want unplanned pregnancies ... (and if we prevent them), that can eliminate the need for abortions. And I don’t think we want to see any abortions occurring, either.”
A study by the Guttmacher Institute issued last year found 53 percent of all pregnancies in New Jersey in 2010 were unintended, around 97,000. Forty-eight percent of those pregnancies ended in an abortion, the second highest percentage in the United States behind only New York.
The rate of unintended pregnancies in New Jersey has declined in recent years, from 63 per 1,000 women between the ages of 15 and 44 in 2002, 2004 and 2006 to 56 per 1,000 women in 2010.
Oregon in January became the first state to allow pharmacists to prescribe birth control. A similar program began in March in California. A version of the law takes effect in Washington state in June.
The New Jersey proposal was first made last November. It got its first approval, by the Senate health committee, on Monday and was sent to the Senate budget committee.
Two senators abstained from the vote, with Sen. Diane Allen, R-Burlington, saying she supports the concept but there are too many questions. Sen. Dawn Marie Addiego, R-Burlington, also voted to abstain.
The bill says the rules for the program would be set up by the state Board of Pharmacy and State Board of Medical Examiners, in consultation with the American Congress of Obstetricians and Gynecologists and the New Jersey Pharmacists Association.
The ACOG says oral contraceptives are safe for most women and should be available over-the-counter, without a prescription, even from pharmacists. “Requiring a pharmacist to prescribe and dispense oral contraceptives only replaces one barrier — a physician's prescription — with another,” it says.
The Medical Society of New Jersey declined to comment on the legislation.
The Pharmacists Association is on board but wants to be able to charge a fee of perhaps $10.
“Pharmacies would not participate in it. … It’s additional work. It’s quite a bit of additional work," Clark said.
“You’re providing the prescription drug, and you’re providing a whole different service. You’re going to provide counseling. You’re going to do a self-screening tool. You’re going to do referrals. So yes, it is a separate, identifiable service from the prescription,” she said.
Sponsors are hesitant, saying part of the goal is to reduce consumer costs. Sen. Robert Singer, R-Ocean, suggested requiring insurance companies to pay the fee.
“It’s saving them money. It’s a lot cheaper to have the pharmacist go through this than to have them go to the gynecologist to have to do it,” Singer said.
“People don’t go to doctors because they don’t have the copay. They don’t pick up their prescription because they don’t have the copay,” Singer said. “So what I’m saying is, let’s find out how we can make this easier and really seamless for the person to avail themselves of this.”
Even with the fee, Clark said some pharmacies would opt not to take part.
“This is far beyond the usual,” Clark said. “There’s going to be pharmacist liability, risk if there’s a problem with the drug because they’re actually making a product selection for the patient, which they don’t normally do. So there will be risk involved in it. And it’s different. It’s more providing a service that’s separate and apart from what you are already being provided.”
Sen. Joseph Vitale, D-Middlesex, said the bill will be changed to address concerns about the fee.
“If there’s liability concerns or other concerns, a $5, $8, $10 admin fee is not going to solve that problem. It’s not going to cover the cost of a lawsuit,” Vitale said.
John Tomicki of the League of American Families said he hopes the bill doesn’t become law. His organization of socially conservative activists sees some birth control medications as the equivalent of abortions if they prevent a fertilized egg from being viable, rather than prevent a conception.
“You’re starting to micromanage this issue. You’re dealing with somebody who is sexually active. They should see a doctor,” Tomicki said.