Increasing access to emergency contraceptive pills through state law enabled dependent pharmacist prescribers.

Abstract

Emergency contraceptive pills ("ECPs"), a form of contraception which has a 75% chance of preventing pregnancy when taken within 72 hours after unprotected intercourse, are currently available only by prescription. Increasing access to ECPs will help to reduce unintended pregnancies and abortions and will help to provide women with an extra level of control over their reproductive futures. Private access initiatives, while helpful, are insufficient to address the access problem; federal level solutions are unlikely to be implemented soon. Thus, this Article proposes that all states adopt the Washington model for dependent pharmacist prescribers, whereby state law enables physicians to create collaborative agreements with pharmacists, pursuant to which the physician can effectively delegate to a pharmacist in a retail setting the power to prescribe ECPs. Dependent pharmacist prescribing of ECPs increases access to contraception, increases patient satisfaction and decreasing cost, while preserving patient safety through screening mechanisms and the good safety profile of ECPs. A state-by-state analysis of pharmacy law reveals that while there is a national trend expanding the scope of pharmacy practice, states vary widely in the amount of prescribing power allowed to pharmacists. However, dependent pharmacist prescribing of ECPs is currently feasible in a few states and close in a number of others, and implementation of dependent pharmacist prescribing in some states may lead to greater nationwide acceptance of both dependent pharmacist prescribing and of ECPs.