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Pharmacists can prescribe birth control in new, game-changing legislation in California and Oregon

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genesis09

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There are liability issues because you don't have access to medical records. Overall birth control is not super risky but there are some who are at a higher risk for clots.
 
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Eichhoernchen

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Honestly, I don't want to prescribe anything...
 
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ChalupaBatman86

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Price of our liability insurance will be going up!
 
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WVUPharm2007

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This is super ridiculous. Women already get a free "healthy woman check" or whatever the hell its called. In which they get their free birth control. Now all this will do is incentivize them to not use this free preventative checkup, which likely includes mammograms, pap smears, etc. Its a great idea to hold birth control "hostage" and tie it to receiving these other benefits of an annual exam. If only there was a way to coerce men into being seen annually.

This country has a bizarre obsession with womens' access to birth control. Illogical laws everywhere.
 
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Corpseman

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I thought it was written such that we could add refills to existing prescriptions, not just prescribe willy nilly.
 
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deleted723470

I agree that liability is an issue but regulations can protect pharmacists (such as measuring of BP if combined hormonal contraceptive therapy are to be use and pharmacists can only dispense OC products if patients have seen their PCP in a 3 year period). Pharmacists made undeniable impacts in preventive health services when pharmacy-based immunization was introduced. Ten years ago, who would have thought about getting their flu shots done at their local pharmacy for as low as $9.99 (Costco's current price) in less than 15 minutes. Personally, I think by allowing pharmacists' to prescribe birth control under strict regulations, not only will it add economic advantages to our industry, it will also give many underserved women (in underserved areas) access to appropriate reproductive healthcare.
 

Digsbe

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Everyone always freaks out when pharmacists get small expansions in scopes of practice. People freaked out about immunizations, and some still do. Has anything majorly wrong happened from that? What about the good that's happened with increased access and awareness?

Each issue is it's own thing and OC can't be compared to vaccines per se, but I don't understand the kicking many in the profession do over things like this. Do people want to see pharmacy advance at all? Hell, half the time when OC is prescribed there is no exam, sometimes there isn't even a discussion. I have female family members on Accutane for which they must be on OC, all they did was ask if they smoked and if they said no they'd get an estrogen containing one, if yes you get progesterone only. We learned this in school too among other things. It still has restrictions and it's not being used to treat disease. If you are educated on how to use it safely I don't see why pharmacists wouldn't want to expand into this area. It also helps demonstrate how we are worth being paid for clinical services and advancing the profession.
 
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SpartanLaser

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When can we start prescribing percocet?

Prescribe 1 percocet tablet to any patient that is raising hell in the pharmacy and they will leave like happy kids with a lollipop
 
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WVUPharm2007

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If we are going to do this sort of thing, why birth control? I mean, I know the answer already, but why not albuterol for patients having an acute attack? You know, something that would have much more utility in the "I don't have time to see the doctor" realm?
 
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maria1oh

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I wonder how cvs will turn this into another metric like they have with immunizations.
 
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WinslowPringle

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This is super ridiculous. Women already get a free "healthy woman check" or whatever the hell its called. In which they get their free birth control. Now all this will do is incentivize them to not use this free preventative checkup, which likely includes mammograms, pap smears, etc. Its a great idea to hold birth control "hostage" and tie it to receiving these other benefits of an annual exam. If only there was a way to coerce men into being seen annually.

This country has a bizarre obsession with womens' access to birth control. Illogical laws everywhere.

It is a horrible idea to hold birth control hostage. Absolutely horrible. Mammograms are not at all related to needs for birth control, pelvic exams and pap smears only peripherally so. Pap smears are no longer required every year for most women; and pap smears are not required period before birth control prescription per ACOG guidelines. Is it a reasonable idea for an annual check up with a physician? Sure. But reasonable to hold birth control hostage in the way that it currently is? No.

Anyway. I'm neither for nor against this. Should be interesting to see how it plays out. Other countries already have OCPs OTC.
 
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WVUPharm2007

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It is a horrible idea to hold birth control hostage. Absolutely horrible. Mammograms are not at all related to needs for birth control, pelvic exams and pap smears only peripherally so. Pap smears are no longer required every year for most women; and pap smears are not required period before birth control prescription per ACOG guidelines. Is it a reasonable idea for an annual check up with a physician? Sure. But reasonable to hold birth control hostage in the way that it currently is? No.

Anyway. I'm neither for nor against this. Should be interesting to see how it plays out. Other countries already have OCPs OTC.

It isn't a horrible idea at all. If I had my way, it would be law to have a physical examination every year for everyone. Forcing preventative care on the populous would be fantastic.

It cracks me up how birth control is considered some sort of unique, special, emotional thing in this stupid ass country of ours. Its literally the only drug that has to be free by law. Its exponentially more horrible to hold albuterol "hostage" but nobody ever has multiparagraph rants about that. Hell, in fact, if you dare commit the sin of having asthma, that's a guaranteed $1000+ a year you have to spend on steroid inhalers. But, oh lord, don't we dare make women pay for a lifestyle drug that isn't medically necessary the vast majority of the time. **** asthmatics. And every other disease ever. They have to pay.
 
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BenJammin

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CVS pharmacists everywhere are jumping for joy as their supervisor now has another metric to bring to their attention.
 
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297point1

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Forcing preventative care on the populous would be fantastic.

Here's the better question: Why does it have to be forced? Why do Americans collectively not care about preventive health at the same level as citizens of other developed nations do? It's a damn shame that people who care about their personal health and well-being (especially in the 40 and under crowd) are the exception and not the rule. I think about how much morbidity and mortality we could be saving, and it gives me the blues.
 

Ackj

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Here's the better question: Why does it have to be forced? Why do Americans collectively not care about preventive health at the same level as citizens of other developed nations do? It's a damn shame that people who care about their personal health and well-being (especially in the 40 and under crowd) are the exception and not the rule. I think about how much morbidity and mortality we could be saving, and it gives me the blues.
My impression is that they don't want to be professionally told what they already know. "You're overweight and terribly out of shape. Change your diet and start exercising." They won't take the advise anyway, so why make an office visit just to be shamed?
 

genesis09

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If you want to decrease health care costs, you have to place more emphasis on preventative care. A colonoscopy is cheap compared to dealing with colon cancer.
Also, you need to keep people out of the hospital.
I also believe albuterol mdi should be a behind the counter drug. I don't believe it should be a true OTC because of possible non-treatment of asthma. There are a number of drugs which should be behind the counter but FDA is uncertain if current regulations allow for this.
 

VeeSee

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Condoms, Plan B and now this?

Nah I'm not going to be writing for that.

Sorry.
 
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Digsbe

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If we are going to do this sort of thing, why birth control? I mean, I know the answer already, but why not albuterol for patients having an acute attack? You know, something that would have much more utility in the "I don't have time to see the doctor" realm?

The nation seems to care about preventing pregnancy more than managing chronic conditions. I always thought it was crazy regarding the spending on women's reproductive health compared to others. "Free" birth control yet HTN and diabetes meds don't have that same tier of "free" necessity. It's agenda driven in my opinion, either that or trying to buy votes.


Condoms, Plan B and now this?

Nah I'm not going to be writing for that.

Sorry.

We don't write for condoms or plan B, those are OTC products. Plan B was technically OTC but it was restricted to 18+ (now it isn't).
 
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VeeSee

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The nation seems to care about preventing pregnancy more than managing chronic conditions. I always thought it was crazy regarding the spending on women's reproductive health compared to others. "Free" birth control yet HTN and diabetes meds don't have that same tier of "free" necessity. It's agenda driven in my opinion, either that or trying to buy votes.




We don't write for condoms or plan B, those are OTC products. Plan B was technically OTC but it was restricted to 18+ (now it isn't).
I know that

You missed the point entirely
 

bacillus1

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Would these pharmacists receive adequate training to recommend the different types of birth control? From what I recall, we only got an hour or so on this in pharmacy school. Then again I only work with old men, maybe that's why I don't know a thing about the billion types of birth control out there, just hoping that CVS won't expect pharmacists to prescribe without knowing what they're prescribing.
 

zelman

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Would these pharmacists receive adequate training to recommend the different types of birth control? From what I recall, we only got an hour or so on this in pharmacy school. Then again I only work with old men, maybe that's why I don't know a thing about the billion types of birth control out there, just hoping that CVS won't expect pharmacists to prescribe without knowing what they're prescribing.
They'll get a list of the most profitable ones, I'm sure.

Then they'll give the patient whatever they say they want based on a full page ad from Cosmo.
 
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confettiflyer

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Here's the better question: Why does it have to be forced? Why do Americans collectively not care about preventive health at the same level as citizens of other developed nations do? It's a damn shame that people who care about their personal health and well-being (especially in the 40 and under crowd) are the exception and not the rule. I think about how much morbidity and mortality we could be saving, and it gives me the blues.

Because we're not all tall, financially secure, well educated Danes. We have a sizable population that's disenfranchised with society as a whole.

So let's compare like for like...homogenous European and Japanese societies with minimal wealth gap and similar past history among its citizens vs. high income hipsters and organic/yoga/Whole Foods connoisseurs in San Francisco ... Bet you they have similar rates of health maintenance and outcomes.
 

trailerpark

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They'll get a list of the most profitable ones, I'm sure.

Then they'll give the patient whatever they say they want based on a full page ad from Cosmo.
The only articles in Cosmo are 25 ways to make your man go goo goo gah gah in bed and every article is just a variation on that. Women need to stop reading that garbage and stop thinking every guy wants a finger inserted in his arse.
 
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Corpseman

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The only articles in Cosmo are 25 ways to make your man go goo goo gah gah in bed and every article is just a variation on that. Women need to stop reading that garbage and stop thinking every guy wants a finger inserted in his arse.

Don't go ruining the fun for the rest of us.
 
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pillpharmer14

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From a reputable CVS source, community responsibility scorecard will now include how many unplanned pregnancies you prevented.
 
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CARph

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Would these pharmacists receive adequate training to recommend the different types of birth control? From what I recall, we only got an hour or so on this in pharmacy school. Then again I only work with old men, maybe that's why I don't know a thing about the billion types of birth control out there, just hoping that CVS won't expect pharmacists to prescribe without knowing what they're prescribing.
CVS will probably have weekly and monthly targets on how many OC we prescribe just like the flu shots....
 
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deleted723470

CVS will probably have weekly and monthly targets on how many OC we prescribe just like the flu shots....
and then find ways to justify it, brainwash the new graduates onto implementing it, and ultimately lure in (blind) investors.
 

txpharmguy

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Would these pharmacists receive adequate training to recommend the different types of birth control? From what I recall, we only got an hour or so on this in pharmacy school. Then again I only work with old men, maybe that's why I don't know a thing about the billion types of birth control out there, just hoping that CVS won't expect pharmacists to prescribe without knowing what they're prescribing.
Pharmacists Letter from October 2015 has Detail Document on this with a great chart for assessing appropriate OCP.

The real challenge will be fitting this into an already overworked day
 
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Digsbe

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Pharmacists Letter from October 2015 has Detail Document on this with a great chart for assessing appropriate OCP.

The real challenge will be fitting this into an already overworked day

The states should provide a means for reimbursement or have insurance companies give a higher dispensing fee on OC to cover the costs. I don't think we should be asked to do this for "free."

The way I see it OC when used to prevent pregnancy is not done to treat a disease or requires a diagnosis. Pharmacists should know when OC is unsafe, as if you dispense it and the patient has a dangerous adverse event because of that you will be held liable (smoker and high risk for clots getting an estrogen containing contraceptive would be an example). If you know when it's not safe to give and should be able to assess whether an OC prescription is appropriate why not be competent enough to make a product selection when it's indicated and not treating an illness? It might also help women out if the pharmacist can write a new prescription for a healthy woman that wants to try a different OC brand due to adverse effects like weight gain and whatnot. I know many women who change around between 2-4 OC brands before finding one that they tolerate or one that doesn't have any side effects. For each change they have to go through the prescriber's office and that does cost the system money and time on something relatively simple.
 
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swatchgirl

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It isn't a horrible idea at all. If I had my way, it would be law to have a physical examination every year for everyone. Forcing preventative care on the populous would be fantastic.

It cracks me up how birth control is considered some sort of unique, special, emotional thing in this stupid ass country of ours. Its literally the only drug that has to be free by law. Its exponentially more horrible to hold albuterol "hostage" but nobody ever has multiparagraph rants about that. Hell, in fact, if you dare commit the sin of having asthma, that's a guaranteed $1000+ a year you have to spend on steroid inhalers. But, oh lord, don't we dare make women pay for a lifestyle drug that isn't medically necessary the vast majority of the time. **** asthmatics. And every other disease ever. They have to pay.

I agree. Going in for a physical exam every year is much more important than access to "maintenance" birth control pills. The safest and most effective contraceptive on earth is still abstinence, and you can get that over-the-counter for an unlimited supply at no charge. One would just have to have a very understanding partner who believes in the same.
 

confettiflyer

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I agree. Going in for a physical exam every year is much more important than access to "maintenance" birth control pills. The safest and most effective contraceptive on earth is still abstinence, and you can get that over-the-counter for an unlimited supply at no charge. One would just have to have a very understanding partner who believes in the same.

Do people actually still think abstinence is a realistic form of birth control?
 
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swatchgirl

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Do people actually still think abstinence is a realistic form of birth control?

Why is it not realistic? It's just like quitting soda. I haven't had a single drop of soda in 9 years, and I didn't think anything of it? What's different about not having sexual intercourse that involves penetration, if you are not planning to make a baby?
 

confettiflyer

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Why is it not realistic? It's just like quitting soda. I haven't had a single drop of soda in 9 years, and I didn't think anything of it? What's different about not having sexual intercourse that involves penetration, if you are not planning to make a baby?

I dunno, I'd like to know if my future life partner is sexually compatible. Would hate to end up on wedding night finding out they're a dead fish.

That, and I mean it's sex...that's like standard part of any dating/relationship, at least to most people I know. I guess oral only is cool, too.

:::shrugs:::
 
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PharFromNormal

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Why is it not realistic? It's just like quitting soda. I haven't had a single drop of soda in 9 years, and I didn't think anything of it? What's different about not having sexual intercourse that involves penetration, if you are not planning to make a baby?

Did you quit soda for a specific reason or you just didn't like it anymore?
Doesn't really matter. I think there is a part of society that makes choices without regard to consequences. It's not that they have unprotected sex with the intent on making a baby. They have unprotected sex... And making a baby might be an after thought or a risk they are willing to take if the barriers to obtaining contraception (cost or access) are too high or they personally felt they have extremely low likliehood of conceiving a child. I totally agree with you that everyone should attempt to make rationale decisions and fully understand and accept the risk of potential outcomes for the actions we take but humans often make decisions when unaware of all the information or on an irrational basis. We all can't make wise, informed choices all the time.
 
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samuricool

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Why is it not realistic? It's just like quitting soda. I haven't had a single drop of soda in 9 years, and I didn't think anything of it? What's different about not having sexual intercourse that involves penetration, if you are not planning to make a baby?

Did you really just compare sex to pop? ... You clearly aren't having good sex.
 
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confettiflyer

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Yeah most of the bible thumpers who were open/borderline bragging about abstinence (virginity rings/pledges) were super slutty and/or divorced by the time we all hit ~25.

When you put sex on a pedestal like that (it's good intimate fun, not some sacred sacrificial goat offering), bad things happen.

But if you're just not into it or are that afraid of an unplanned pregnancy you need the 100% coverage, by all means. Different strokes for different folks (pun intended).
 
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Genericrph2012

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I dunno, I'd like to know if my future life partner is sexually compatible. Would hate to end up on wedding night finding out they're a dead fish.

That, and I mean it's sex...that's like standard part of any dating/relationship, at least to most people I know. I guess oral only is cool, too.

:::shrugs:::
Oral only is so high school
 
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BidingMyTime

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My impression is that they don't want to be professionally told what they already know. "You're overweight and terribly out of shape. Change your diet and start exercising." They won't take the advise anyway, so why make an office visit just to be shamed?

Exactly! What in the world do preventative health care visits do? Nothing....because either 1) people won't care and won't make changes anyway or 2) they can't afford all the treatments or follow-up visits that are necessary, so they still go untreated. "Free" preventative health care only makes sense when "free" treatments/follow-ups are included. Until/if ever the US is ready to go for nationalized health care, there is no point in mandating "free" preventative check-ups.

The nation seems to care about preventing pregnancy more than managing chronic conditions. I always thought it was crazy regarding the spending on women's reproductive health compared to others. "Free" birth control yet HTN and diabetes meds don't have that same tier of "free" necessity. It's agenda driven in my opinion, either that or trying to buy votes.

Here the real reason, that nobody talks about I guess, because its politically incorrect. Unplanned pregnancies are likely to end up on Medicaid, with mother and new child being paid for with tax dollars. Politicians don't care if people with chronic conditions die or have to pay their life savings for treatment (obviously, that is why they took all generic inhalers off the market.) Politicians do care about having to pay for expensive pregnancies and adding new members to the Medicaid roll. That is why politicians want BC to be free and other drugs aren't (exactly why prior to Obamacare, BC has always been free to Medicaid recipients in IL, even though all other drugs had a co-pay....and why Il medicaid pays for Plan B without a prescription.)

Coke Zero is pretty delicious.

Still, sex has the advantage of burning calories, so it still beats out soda.
 

genesis09

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Coke rewards was allowing you to get a coupon for a free 12 pack for only 30 points. :nod:
 
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