DC Bill Could Move The Pill Over the Counter

D.C. is worth moving to just for the great chili, free museums and Stephen Strasburg. Add this to this list: the potential to get a birth control prescription WITHOUT waiting six months to go see an OB-GYN. The Washington Post reports that D.C. Council member David A. Catania (I-At Large) has introduced a bill that would open the door to women being able to purchase birth control pills directly from a pharmacist, without paying to see a doctor first.

Catania told the Post,

At this point, in this city, it’s already a challenge for many women in underserved communities to get the appointments and then find a pharmacy…I think it’s a way to expand access to contraception and to conserve valuable resources.

The bill would authorize the D.C. Board of Pharmacy and Board of Medicine to create a joint protocol allowing pharmacists to provide hormonal birth control without prescriptions. It would work like a physician’s standing order, which lets public health clinics give out, for instance, antibiotics for specific diseases. Ben Young, chief of staff to Councilman Catania, emphasizes that the bill “is not actually prescribing rules”: Details like age requirements would be left to the Boards of Pharmacy and Medicine.

Young believes that the bill will pass, though anti-abortion groups still have time to kick up a fuss. Planned Parenthood has already voiced its support. If passed, then the next hurdle for OTC birth control could be Food and Drug Administration approval, though it’s not clear whether it would be within FDA jurisdiction: An FDA spokeswoman says a birth control joint protocol by the Boards would fall into a “gray area” because the FDA regulates whether drugs can be prescribed but does not tend to regulate what “the practice of medicine.” The FDA approved the “behind-the-counter” sale of Plan B in 2006 but has always maintained that birth control should be given out by doctors in order to monitor side effects and medicinal interactions.

Because the birth control would be monitored by and discussed with pharmacists, Catania argues that it would not be violating FDA standards. He said to the Post,

This is not going to be the Wild West…Pharmacists are extraordinarily overeducated for what they do on a day-in and day-out basis. There is a lot of capacity for a pharmacist to do more than they do.

A program similar to what Catania has proposed took place in Seattle in 2003-2005 and more recently in Oregon, in which the “instant birth control” program let patients apply for contraception online, then speak with doctors or nurses over the phone before receiving the medication.

What makes this bill particularly important is that it takes place in D.C., where Congress has oversight. Since the passage of the 1973 Home Rule Act, D.C. has had a local government, consisting of a 13-member city council and a mayor. However, all legislation, including the city’s budget, is subject to the approval of Congress.

Assuming that the bill passes, the track record of the current Congress suggests that Speaker of the House John Boehner will knock it off the table. Young agrees that Congressional intervention “is always a possibility.” In the past, hot topic issues like local gun control laws have come under Congressional pressure. While the bill is at least a few months away from passage and even further away from implementation, keeping it out of John Boehner’s hands should stay high on the priority list.

Photo from Flickr user brains the head under Creative Commons 2.0.