A state bill with potential to grant prescriptive authority to Hawaii pharmacists for the first time in the state’s history is nearing a vote by the full Legislature.
SB 513 has been recommended for passage by the House and Senate conference committee.
The bill, if passed, will give pharmacists “authority to prescribe and dispense self-administered hormonal contraceptive supplies” to women who meet the criteria of a standardized checklist.
Proponents say women who have better access to contraceptives are more likely to use them and less likely to develop unintended pregnancies, language that is included in the bill.
Opponents of contraception argue that all life is precious and therefore contraception should not be used.
Last year, the Legislature granted women the right to get a full year’s supply of contraceptives so they no longer would need to make repeated visits to the doctor’s office to get prescriptions for refills. Insurers in the state were required to cover a full year’s supply instead of capping at one month, for example.
The new legislation would allow women to stop in at a pharmacy whenever it’s convenient and specifically bans requiring patients to make an appointment in order to seek a prescription.
“From the beginning, the University of Hawaii-Hilo has backed the bill,” said Carolyn Ma, dean of the Daniel K. Inouye College of Pharmacy.
The college has offered that support from an educational standpoint, Ma said, because “our curriculum does address the education that all pharmacy students and graduate students have the experience to perform this function.”
The Hawaii Board of Pharmacy also supports the bill.
According to the board, pharmacists already work, under the direction of health practitioners such as physicians and nurse practitioners, to provide “the morning-after pill.”
But pharmacists in Hawaii have never had the authority themselves to prescribe a drug.
“Our current law does not allow pharmacists to prescribe any drug,” said Lee Ann Teshima, executive officer for the Board of Pharmacy.
The morning-after pill was instituted because federal law allows women to receive the drug over the counter. But the Legislature changed Hawaii’s law so pharmacists also could provide the pill to female teens.
State Sen. Lorraine Inouye’s office said the new bill’s language matches the Affordable Care Act, which requires insurance to cover, without copay, birth control medications for women.
A pharmacist checklist will highlight risk factors for women who have health conditions treated with birth control medications, such as endometriosis. If a medical risk factor is identified, the pharmacist will suggest going to a physician. But the bill says women can be served regardless of whether they had a prior prescription and there’s no language preventing a woman with a medical condition from getting a prescription, according to Inouye’s office.
Teshima said a bill also was submitted this legislative session that would have given prescriptive authority to pharmacists for smoking-cessation products, an opioid antagonist and public-health drugs such as the hepatitis A vaccine. But that bill failed.
Physicians are in short supply and finding new ways to serve the needs of patients has become a priority nationwide. The bill to let physicians prescribe birth control might be a first step toward expansion of the pharmacists’ role in Hawaii, Teshima said.
“If Senate Bill 513 is a foot in the door for pharmacists, to allow pharmacists to prescribe and dispense prescription drugs, maybe,” she said.
Pharmacists aren’t looking to do assessments and diagnosis, which is the role of physicians. Rather, the idea is that they’d have the ability to prescribe certain medications with standardized criteria.
Ma said the pharmacy college “would be more than willing, and prepared, to provide the certification.” Or, she said, the college would also be supportive if pharmacists in the state prefer another accreditation organization.
Email Jeff Hansel at jhansel@hawaiitribune-herald.com.