Prescribing Contraceptives: Oregon Pharmacists Help the Medicaid Population

The rate of unintended pregnancy (currently at 45%) has been decreasing slowly, due to the intervention of health care professionals and their prescribing of oral contraceptives.

An unintended pregnancy is determined or classified based on whether the woman wanted or “intended” to become pregnant immediately before the pregnancy occurred. Unintended pregnancies come with consequences: health disparities and economic costs that strain women giving birth and their families.

According to the CDC’s National Health Statistics Report, the most common reason for not using contraceptives was that the female didn’t think she could become pregnant. Contraceptives are both a popular and effective birth control method, and Medicaid fully covers them for its beneficiaries.

To address unintended pregnancy, Oregon has permitted pharmacists—commonly described as the most accessible health care professionals—to begin prescribing oral contraceptives to the general public. This is a voluntary program.

Researchers from Oregon State University report on this change’s success in the June 2019 issue of Obstetrics & Gynecology.

The researchers cite the policy change’s many benefits, including the following:

• Increased accessibility to contraceptives for patients who don’t have access to a primary care provider or clinic
• Improved timing of administration
• Prevention of co-administration with contraindicated medications and conditions.

Examples of contraindicated conditions include thrombophlebitis, cerebrovascular or coronary artery disease, known or suspected pregnancy, and liver tumors.

In the first 5 months after the policy change, pharmacists prescribed 10% of all contraceptives in Oregon’s Medicaid population. The authors indicate that pharmacists are reaching women who previously had no access to prescription contraception.

Not only does the patient benefit in that their oral contraceptive is fully covered by Medicaid, but the pharmacist also benefits financially. Oregon Medicaid compensates for the time spent in counseling patients through Medicaid Fee for Service, although not all states compensate in this way.

Reference

Anderson L, Hartung DM, Middleton L, Rodriguez MI. Pharmacist Provision of Hormonal Contraception in the Oregon Medicaid Population. Obstet Gynecol. 2019;133(6):1231-1237.