Contraceptive
pill bill OK’dPharmacists may sell
birth control designed
for morning-after use
without a prescription
Gov. Linda Lingle quietly signed an emergency contraception bill into law June 24 that its supporters thought she might veto.
Hawaii is the third state after Washington and California to enact a law providing access to "morning after" pills without prescriptions through pharmacies.
Pharmacists must be certified before they can offer the service.
"It was an extremely progressive move to make," said Nancy Partika, executive director for the Healthy Mothers, Healthy Babies Coalition of Hawaii. "It is significant nationally, not just locally."
Russell Pang, spokesman for the governor, said there were some issues about the process and how pharmacists would distribute the pills, but they were addressed to her satisfaction.
Dr. Linda Rosen, state Health Department deputy director for health resources, who had worked on access to emergency contraception in the Family Health Services Division, said, "I was hopeful but had heard some news to prepare to be disappointed, so I was pleasantly surprised."
Contraceptive pills are birth control pills in stronger doses. They temporarily stop eggs from being released when used within 72 hours after unprotected sex.
Allowing women to get the pills from pharmacists without a prescription is key to providing contraception in time to be effective, Rosen said. After hours and weekends, it may be difficult for women to see a physician for a prescription, and young women, who are most at risk, may use community clinics or health services that are not available, she pointed out.
Barbara Kashiwabara, Kaiser Permanente director of pharmaceutical services and chairwoman of the Pharmacy Association's government affairs committee, said the law provides "just one more way to open up access so women can make choices."
Healthy Mothers Healthy Babies and other organizations looked into emergency contraception systems last year in Washington and California.
Partika said about 53 percent of all pregnancies in Hawaii are unintended, and 78 percent of teen pregnancies are unintended.
"We want women to be healthy and happy and well supported when they are pregnant, and in many situations it is not possible for a woman or teen at that point in their life," she said. "This (law) offers them an option."
The potential cost savings "is just astounding," Partika added, noting the program saved Medicaid $22 million in one year in Washington. It reduced unintended pregnancies, abortions and temporary assistance to women, she said.
HMA Executive Director Paula Arsena said: "We feel it's important for women to have access to emergency contraception through their physician, and we're happy with the bill because it achieves two things: It keeps physicians in the loop as well as provides wider access through pharmacies. ... They're working in tandem for better patient care."
Pharmacists will make an effort to refer patients to a physician if they do not have one, or a community health clinic if they lack health insurance, she said.
The "real key piece" for pharmacists is a collaborative agreement being developed by the Board of Pharmacy that must be co-signed by participating doctors and pharmacists, Kashiwabara said.
It will require steps to follow to determine if the contraceptive pill would be effective for a woman and to rule out any possible adverse effects, she said. "The window now is 72 hours, but it is best done in 48 hours."
A proposed draft of the agreement is on the pharmacy board's agenda for a meeting at 9 a.m. Thursday at the Department of Commerce & Consumer Affairs.
Pharmacists must be trained and certified by the American College of Pharmacy Education before offering emergency contraception service. The University of Southern California School of Pharmacy will begin some training on Maui next month, possibly followed by some sessions in Honolulu, Partika said.
Supporters of the new law also feel more education about emergency contraception is needed for physicians and women of childbearing age. "Many women don't realize emergency contraception is an option for them," Partika said.