City Desk

Easier Access to Birth Control Won’t Alleviate High Cost of Medicine

For women who can’t get to—or can’t afford—an OB-GYN, a bill introduced by At-Large Councilmember David Catania could be a boon.

Catania is proposing that women should be able to access birth control pills without an OB-GYN appointment, which includes a Pap smear and urine tests and typically costs more than the average checkup. The bill, introduced this week, would allow pharmacists to prescribe birth control to women after a consultation; it takes its cues from a similarly-structured system in Washington state.

There, pharmacists that enter collaborative agreements with physicians have been able to prescribe birth control—and a slew of other medications, including some narcotics and blood thinners—since 1979. Don Downing, a clinical professor of pharmacy at the University of Washington’s School of Pharmacy, has assisted 28 states in improving access to contraceptives and says “Pharmacists are grossly underused in the District. Pharmacy has shot itself in the foot in D.C., and too many people are being harmed by not having access.”

Avoiding a yearly OB-GYN appointment is certainly a money-saver. But, will the actual cost of contraceptives change with channels of access?

“We’re not that far down the road yet,” says Ben Young, Catania’s chief of staff. “Basically, what’s been introduced is a law mandating that the Board of Medicine and the Board of Pharmacy would come together and come up with some rules and protocols for a system that would allow women to go directly to the pharmacist.” He continues, “No one would have any idea on the pricing. The government isn’t even involved in the pricing. When the government suggests there’s an issue with pricing, they’re immediately under fire from the pharmaceutical lobby.”

The allergy medication Claritin made its own prescription-to-over-the-counter transition in 2002. The drug’s costs skyrocketed: Insurers reaped the benefits of lower-cost drugs, but, as The New York Times noted in 2003, “...consumers now pay the full price themselves...a month's supply costs them roughly $30, instead of the $15 to $20 co-payments that people with health insurance used to pay.”

But, were pharmacist-prescribed birth control to become legal in the District, it’s doubtful the Claritin effect would occur. “Just because the pharmacist is involved doesn’t mean the medicine costs less. Probably 90% of all prescriptions in this country are determined by insurance companies. They determine your co-pay and the cost of your drug,” says Downing. Pricing is also determined by the type of birth control—pill, ring, patch, or shot—and whether or not the medicine is generic or name-brand.

A contraceptive prescribed by a pharmacist would likely be identical in cost to a contraceptive prescribed by a doctor—both of which would be at the whim of a patient’s insurance company. Catania’s bill is a step forward in increasing access to birth control. But this particular pill doesn't prevent having to pay for pricey medicine.

Photo by Flickr user clevercupcakes using an Attribution-ShareAlike 2.0 Generic Creative Commons license

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  • Ward One Resident

    I totally appreciate the idea of what Catania is doing, but there is something to be said for a yearly exam. No matter how unfun they are and how expensive they are, they do provide a valuable check for a woman's health especially a breast exam and the pap.

  • Razia

    I think this is a good idea. It should not necessarily replace an annual. It seems most people need this to help them stay responsible. I would rather see more people having access to birth control then kids growing up struggling because the parents weren't ready for the child. There is certainly a higher liability with this idea though. Medical malpractice is a big problem for health care in the US ( http://www.equotemd.com/blog )and I could see this being an easy target for plantiff attorney's going after medical malpractice insurance awards.

    Razia

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