Over-The-Counter Birth Control Pills Will Soon Be Available In California
Our top story, starting in October of this year, would in California will be able to walk into pharmacies and get birth-control pills without a prescription. State officials are putting the final touches on regulations surrounding the over-the-counter sale of hormonal contraceptives. California is the first state to allow the nonprescription sale of birth-control pills but it won't be the last. Oregon's governor signed a similar deal. Joining me are Kenny Goldberg, health reporter, KPBS News and Dr. Shira Varon, assistant clinical professor of reproductive medicine, UC San Diego and Dr. Kenny, California is the first in the nation to offer these over-the-counter birth-control pills. It's been in the works of on time. When was at this legislation first approved? The law was passed in 2013. It's taken this long that there is different medical boards in California to get the regulation together and agree on a protocol. They have done that so supposed to be rolled out this fall. Our women going to be able to get birth-control pills also be able to get control patches without a prescription? Yes. The full array of conscious it -- contraceptives will be able to be dispensed over-the-counter. Are these any different from the prescription drugs that are being offered already? They are the same thing. Was a procedure promises will have to follow? A patient will come in and ask for birth-control pills and they look at their blood pressure taken by the pharmacist, they'll have to answer a questionnaire. Is 20 questions, a health assessment tool that is designed to indicate whether a patient may have competitions with birth-control. After that, they will consult with the pharmacist and get the appropriate medication, paper and that's it. Dr., medically speaking is is considered controversial in any way? You see. It has become less so as we know birth-control pills are overwhelmingly safe medications to take with very low rates of severe competitions. Have there been any problems of access for women when it comes to getting prescriptions for birth control? Historically, women have had to see their healthcare provider in order to get a prescription. Sometimes their prescription would last a year and they would need to return for another visit in order to renew their perception. That presents a barrier for patients if they were to lose their healthcare coverage for not getting to see their doctor on time. I think it goes without saying, the intrauterine devices and things of that nature still need to be in a doctors office and with a prescription. Would just go into the doctor was too onerous or too burdensome? I think it boiled down to the simple fact that some women didn't have insurance to see healthcare writer. That is changing. In addition, the timeliness. We know women have higher rates of unintended legacy with their birth-control pills are interrupted. Having access to that without having to get to the doctor would definitely improve rates of unintended pregnancy. Women have never gone to the doctor will now be able to buy pills and patches over-the-counter. To think that's safe? There been studies that show women are able to screen themselves in the absence of a healthcare provider for risk factors that make them not great candidates for birth-control pills. Especially in California where they are going to be filling out a checklist with pharmacist, I don't think this poses a significant health risk. What do you think has prevented the over-the-counter sale of birth-control pills before this time? Was it safety concerns or was it political? Probably both. The risk of severe competition with control pills has been deep vein thrombosis. About 3 to 10 in 10,000. A very low risk. It's hard for me to say it's completely political. We know that our women who had issues with hormonal contraceptives and need to see their providers. As providers we feel the most comfortable enough to cancel our patients appropriately. Which you recommend a yellow -- young woman see a doctor? Ideally yes. How about women over 35? Ideally yes. Oregon law requires Olympic 18 or older before being able to get birth-control over-the-counter. Is that a good idea? That's difficult to comment on. You have to set an age somewhere. Many of the unintended pregnancies occur amongst minors under the age of 18. I think that's an area that still needs a bit of investigation to figure out what the appropriate age is. According to the California law, there's no age requirement. Yes. California law allows minors to get contraceptives, be treated for sexually transmitted diseases or even have an abortion without consulting are getting permission from their parents. This law is consistent with that. Let's talk about an area that seems gray in this. That is about insurance coverage. When these go on sale without a prescription, will insurance cover them? That is the gray area. There a couple of pieces in legislation, competing bills. The Democratic bill would require insurance companies to pay for contraceptive even if they go over-the-counter. The Republican build would not. The affordable care act requires coverage for prescriptions. How the California level work is not clear. There may be some sort of provision in the California law that would still allow patients to bill the insurance company? It is behind the counter rather than truly on the self, I believe that's where it will be. I don't know what the pharmacist could do the same thing with any medication that they provide which is take the insurance information and submit a claim to the insurance company. The California law does not spell that out. No. As it reads now, the whole idea of who's going to pay for these medications is just left out of its. Do we know how much these bills will cost? There some generic versions that are as little as eight dollars a month. They go to 60 and $70 a month. It depends. What you think the price of the drugs themselves, you just mentioned generic versions. It's going to go down as access to the drugs becomes easier, that you can get them without a prescription. If it follows historical trends, yes. What other drugs are made over-the-counter a few years ago, the price started to get quite medically after they were over-the-counter for a while. One would expect birth-control pills would follow that same trend. Dr., how do expect this might actually affect women's lives? I think anything that can protect women against unintended pregnancies could improve upon their lives. We know unintended pregnancies poses a significant public health dilemma. Women who get pregnant unintentionally are less likely to get prenatal care. Have worse health outcomes for themselves and their babies. I think this has an overall protective effect on women in on babies. You are involved in writing about this. Is that right? Yes. What kind of pushback did you get? There wasn't much pushback. I think some in the community of providers, if they didn't need their birth-control pills from their doctor, what would be their incentive to come in for their screening examinations tax tying of those issues together is that the correct thing to do. Study show women who get their pills over-the-counter have similar rates of screening examinations to women who get their prescriptions of purpose -- physician. Doctors were afraid women would avoid making annual visits and come in and get the other kinds of screening that they really needed. You don't see a link? I can see a link, but it has been shown not to be valid. What about it birth-control site easier to obtain, are you concerned that condom use it might go down and we would see a rise in sexually transmitted diseases? No. Historically, that has not been the case. As a result of this law, you see a rise in women's reproductive health because of it? Yes. This move allowing pharmacist to dispense without a prescription seems part of an overall trend. Allowing pharmacist to give more medical services. Yes. It's part of a trend in California. We have seen pharmacist give flu shots, travel vacations, they can get pneumonia shots, I think it's part of a trend to try to relieve doctors of some of these mundane tasks. Let them concentrate on other things and other health providers for highly educated and trained take over some of these tasks for doctors. This is certainly part of that overall movement to give him assist the ability to do more things. How has that been accepted by the medical community? Are you looking at that as a helpful thing, or are the questions? In general it's helpful. If patients have problems with medications, they will still come back to their doctors for advice and counseling. It's acceptable to most providers except the pharmacist may not have access to the entire health record of the patient the way the primary care provider does. The communication between pharmacist and primary care provider is usually pretty good. Not always. There's that area that may become a problem. I want to ask a little more about what's going on in the U.S. Congress about all this? You told us there was a bipartisan support for allowing a birth-control pill to be sold over-the-counter. Where is the area of disagreement? The area of disagreement is who will pay for them. Democrats support the idea that insurance companies should cover them. Republicans say no. That's where the differences lie. Is a timeframe as to when this might be resolved by Congress or is this just one of the ongoing fights that doesn't look like it will be resolved anytime soon. That's an interesting question. I am not educated enough about the ways of Congress to answer that. It's not one of their top priorities. I think a lot of states will look to California and Oregon to see how this rules out any becomes widely accepted and increases women's access to birth control, will be some impetus to get this result on the federal level. Kenny, you said the pharmaceutical companies or not overwhelmingly happy? The concept was if the drugs are available by prescription only, the Pharma companies can make more money off of them. That would be the reason to have interested. Haven't laid out all the pressure to fight either. They're going to acquiesce in this will go straight ahead in California. The last couple years, people going to pharmacies can find lots of things that used to be prescription drugs available over-the-counter. Things like smoking cessation in travel medicine. This is a question that you can't answer actually but I suppose we should expect to see more of that happening. I read one study of 147 countries around the world. Only about a third of them including United states require prescriptions for contraceptives. Most of the countries around the world, these are already available over-the-counter. Whenever expecting to see them here in California? They are saying October one but I would anticipate sometime this fall. I've been speaking with Kenny Goldberg, health reporter, KPBS News and Dr. Shira Varon, assistant clinical professor of reproductive medicine, UC San Diego and Dr.
California women will be able to buy birth control pills and other hormonal contraceptives without a prescription starting this fall, but they'll have to go through a few preliminary steps.
The Legislature passed the measure in 2013 and Gov. Jerry Brown signed it into law, but it has taken nearly two years for the various medical boards to agree on regulations to carry it out.
Under the measure, patients will first have to get their blood pressure taken by a pharmacist. Next, they’ll need to answer a health questionnaire that’s designed to indicate whether they may have problems with the medication.
The California Right To Life Committee Inc. believes the health of women who use self-administered hormonal contraceptives could be at risk without a doctor's supervision.
Sarah McBane, president of the California Pharmacists Association, said those concerns are unjustified.
“Birth control, in general, is very, very safe and effective," McBane said. "And really, we’re looking at this as a way to make it more accessible to more women.”
The law authorizing the sale of contraceptives over-the-counter has no age restrictions. In California, minors already have the right to obtain family planning services without a parent's permission.
California and Oregon are the only states that have passed laws making hormonal contraceptives available without a prescription.