Can pharmacists prescribe birth control?

The role of the community pharmacist is ever-evolving. Pharmacists can administer vaccines and work under physician protocols to monitor and adjust warfarin medications, insulin dosing scales, and cardiovascular medications. But, can pharmacists prescribe birth control? There are many other important ways pharmacists can take on key roles in healthcare—and women’s health is a big opportunity.

Many women in the U.S. struggle to access hormonal contraceptives, which historically had to be prescribed through a physician. They may not know where to get birth control, or are unable to afford the cost of a doctor’s visit. Pharmacists, however, are typically very accessible. In recent years, there has been a push to evaluate the pharmacist’s potential role in providing prescriptions for hormonal contraceptives.

Pharmacists’ role in women’s health

A 2003 study found that pharmacists were able to safely screen and appropriately recommend hormonal contraceptive options for patients. Moreover, patients were very satisfied with the ease of access to the pharmacist and the prescription, while maintaining that they would follow up with their medical doctor every three years for other necessary screening.

The results of this groundbreaking study led Oregon and California to pass legislation allowing pharmacists to prescribe and dispense hormonal contraceptives. Today, 11 states and the District of Columbia allow pharmacists to prescribe and dispense self-administered hormonal birth control. These states include: California, Colorado, Hawaii, Maryland, New Hampshire, New Mexico, Oregon, Tennessee, Utah, Washington, and West Virginia. Many other states are in various stages of evaluating similar legislation. 

Can pharmacists prescribe birth control? 

The answer to that varies in each state. Each state passed its own legislation, and it may or may not include certain types of self-administered hormonal contraceptives, such as oral contraceptives, transdermal patches, the vaginal ring, and injectable hormonal contraceptives. While all 11 states allow the oral contraceptive pills and transdermal patch to be prescribed, only Oregon, California, and New Mexico specifically allow the injectable hormonal contraceptive to be prescribed by the pharmacist. If you are seeking contraceptives in these states, it is best to speak to the pharmacist to find out what specific options are available there.

Can I get contraceptives at any pharmacy in these states?

No, not every pharmacist or pharmacy offers these services. Pharmacists who wish to prescribe contraceptives must take part in training required by their state. 

Even if a pharmacy has a pharmacist on staff who is certified, that doesn’t mean you can always get a prescription at that pharmacy. Washington, D.C., requires that the hours a certified pharmacist is available be listed. Washington State requires that an emblem or sticker be placed on the outside of the pharmacy to indicate that this pharmacy can prescribe and dispense self-administered hormonal contraceptives.

The best way to know if a pharmacy can give you access to contraceptives in these states is to ask the pharmacist on duty. Not all states have had equal participation. In California, it is estimated that only 11% of pharmacies are offering this service. In contrast, a study in Oregon found that 75% of its population lives in the same zip code as a pharmacy offering this service, and pharmacists were responsible for writing more than 10% of the total prescriptions for contraceptives in Oregon.

What will a visit with the pharmacist entail? Should I see my doctor instead?

At your pharmacy visit, the pharmacist will have you fill out a self-guided questionnaire, which will gather information on your medical and family history as well as your history of contraceptive use. The pharmacist will also take your blood pressure. Depending on the state, patients with a blood pressure reading above 140/90 may have to go to a primary care or women’s healthcare provider. That’s also true of patients who are above the age of 35 with a history of smoking or those with a history of certain cancers. 

Some states require proof that you have seen your primary healthcare provider within a certain period of time for other preventative health screenings, such as a Pap smear, regardless of health history. In Colorado, pharmacists are required to ensure you’ve had a well woman visit within three years. In New Mexico, it’s required in the past year.

In most states, pharmacists are required to give you a written summary of your visit, and to notify your primary provider of the visit within a reasonable amount of time. In most cases, you will be able to get your prescription immediately upon completion of your visit with the pharmacist.

FAQ: Getting birth control at the pharmacy

How old do I have to be in order to see the pharmacist for a contraceptive prescription?

The protocols in each state vary, but many require you to be 18. Oregon will allow pharmacists to prescribe to a person under 18 if she has had a previous prescription issued by her primary care provider. Tennessee will allow a patient who is emancipated under the age of 18 to see the pharmacist for a prescription.

Is there a charge to see the pharmacist for a prescription? Will my insurance cover it?

Many pharmacies charge a flat fee, often in the range of $30-$50, to see the pharmacist and be evaluated for a prescription. Some pharmacies have been successful in billing medical insurance and/or Medicaid for the visit. It’s best to speak with the pharmacist about cost before your visit.

RELATED: How to get free (birth control even without insurance)

Is the cost of the actual prescription covered in the visit fee?

The prescription may carry an additional charge depending on which contraceptive you choose and your insurance coverage. Insurance plans are required to offer some contraceptive options at no charge to you, but not all may be included. If you are uninsured or your chosen method is not covered, check out SingleCare for potential cost savings on your prescription.

Will my prescription have refills?

While the length of time may vary from state to state, pharmacists are allowed to offer refills on the prescription. Prescriptions will be subject to the same expiration limits as others in the same state. Once a prescription is expired, you will be required to see either the pharmacist or your medical provider again in order to continue your prescription.

What is the best way to find out what type of access I have in the state I live in?

Your local pharmacy is the easiest and most accessible source of information. The state board of pharmacy in your state may provide some information on their website. Many states are still working on legislation which will allow pharmacists to prescribe, and it may be possible that you can become active in the process to make it happen in your state.