Tennessee Pharmacists Could Soon Prescribe Birth Control

Tennessee could become the next US state to permit pharmacists to prescribe birth control.

House Bill 1847, which has already advanced out of the state’s Senate, would allow pharmacists to prescribe hormonal contraceptive patches and oral hormonal contraceptives to women regardless of whether they have received a previous prescription from a primary care provider.

If the bill becomes law, pharmacists in Tennessee who desire to dispense birth control would need to enter into a collaborative practice agreement (CPA) with a physician and complete a training program approved by the state pharmacy board. Tennessee would join Washington State and Washington, DC, in allowing pharmacists to distribute hormonal contraception under CPA laws.

Like other states, Tennessee would require pharmacists to provide a self-screening risk assessment tool prior to prescribing. Based on the results, the pharmacist could either dispense the contraceptive or refer the woman to a physician.

Meanwhile, California’s birth control law requires pharmacists to review the self-screening results with the patient and discuss the best product option, assess the patient’s needs for birth control, and determine the patient’s health status. Oregon’s law contains similar pharmacist-patient interaction requirements.

Practicing pharmacist Jordan Morrison expressed concern that without an overt counseling requirement in Tennessee’s law, pharmacists in large, busy retail pharmacies might not take the time to suggest more ideal options or explain the potential risks associated with hormonal contraceptive use, which include blood clots, stroke, and estrogen-dependent tumors such as breast or uterine cancer.

“Those pharmacists aren’t going to be able to handle, in a great manner, seeing that patient [and] making sure that the right product is selected…and that it’s done with the patient’s best interest in mind,” Morrison told News Channel 9-Chattanooga.

Bill sponsor Representative Patsy Hazlewood exclusively told Pharmacy Times that these and other concerns can be placated by looking at data from states like Oregon and Washington, which have been used to evaluate both the efficacy and safety of less restrictive access to contraception.

“There have been some concerns expressed that women may seek medical attention less frequently once they can secure contraceptives without a doctor’s visit,” she explained. “In Oregon, where similar legislation is in place, studies have not shown that to be the case.”

Rep. Hazlewood said questions were also raised in the state Senate about contraindications that a woman might not make note of in the questionnaire. However, she pointed out, “a study in Washington State showed that women were more conservative in their self-prescribing than physicians.”

Since January 1, 2016, pharmacists in Oregon have had full legal authority to furnish birth control, as long as they follow a statewide protocol. California pharmacists will have the same authority beginning in mid-April.

Meanwhile, a federal bill that would make oral contraceptives available OTC has been introduced in the US Senate.