Hartford ― Supporters of a bill that would allow pharmacists to prescribe birth control medication stressed the importance Monday of increasing access to contraception in under-served or rural areas, while others raised concerns and said a doctor should evaluate patients.

Their comments came during a public hearing before the General Assembly’s Public Health Committee.

Sens. Heather Somers, R-Groton, a ranking member of the committee, and Ryan Fazio, R-Greenwich, introduced the bill, S.B. 171, for the purpose of increasing access to birth control. The bill has both Democratic and Republican co-sponsors including representatives Devin Carney, R-Old Lyme, and Holly Cheeseman, R-East Lyme.

The bill, which Gov. Ned Lamont, Lt. Gov. Susan Bysiewicz and Department of Consumer Protection Commissioner Michelle Seagull’s support, is similar to reforms implemented in more than 20 states that have increased access to birth control and improved health outcomes, Fazio said.

He said reducing barriers to birth control is widely supported by the medical community and giving women a choice to either go to their physician or a pharmacist for birth control prescriptions will improve outcomes, especially for women with lower incomes or who live in rural areas. For example, many people on Medicaid have trouble finding physicians who will accept their insurance.

Support for improving access, concerns

Sally Grossman, a board member of Planned Parenthood Votes! Connecticut, spoke on her own behalf in support of a number of bills, including S.B. 171.

“Connecticut has become a leader in the country in regards to reproductive rights, and we should be enhancing protections and access for residents of Connecticut and for anyone who is forced to leave their state and come here to exercise their right to bodily autonomy,” Grossman said. “Any unnecessary barriers to access for both abortion and for birth control should be eliminated.”

“Birth control is a human right, and it is imperative that all women have equal access to it,” said Pia Baldwin Edwards of New Haven. Edwards said about 180,000 Connecticut women live in contraceptive deserts, which “means that they don’t have access to a health center that provides contraceptive services.”

Nathan Tinker, CEO of the Connecticut Pharmacists Association, supports the bill.

In his written testimony he cited a study in California, where pharmacists can prescribe birth control, found that 74% of patients “sought a contraception prescription at a pharmacy because it would be faster than waiting for a doctor’s appointment.

The study found that 46% of patients said it was because the location and hours were more convenient while one in four said they did not have a regular doctor.

In written testimony, Liz Gustafson, state director for Pro-Choice Connecticut, supported the bill and explained that “difficulties getting birth control fall harder on people of color and Indigenous people, immigrants, LGBTQ+ folks, those working to make ends meet, and people with disabilities.” Gustafson also supported other bills, including a bill that would allow emergency contraception to be dispensed in medical vending machines.

However, some people raised concerns.

“The American College of Physicians opposes independent pharmacist prescriptive privileges and initiation of drug therapy outside of a collective practice agreement, physician standing order or supervision, or similar arrangement,” wrote Anthony Yoder, a board-certified internal medicine specialist who is the co-chairperson of the Health & Public Policy Committee for the Connecticut chapter of the American College of Physicians. “While the premise of the bill is to expand availability of contraception by making it more available at the pharmacy, we are concerned that this bypasses many safeguards in place in a primary care office or by a practitioner with access to the full scope of a patient’s medical history.”

Yoder said the decision to start contraception “is best done by a healthcare practitioner with a license to prescribe, familiar with an individual patient’s sociodemographic and medical history and the nuances, which make any one of many modalities preferable for that individual.”

Christina Mukon, the chair of health policy for the Connecticut APRN Society, wrote that prescribing contraceptive medication “can contain certain risks for which training to evaluate those risks is necessary in order to provide safe care.”

Because the bill would allow pharmacists to provide a service they are not not currently providing, she said the matter should be reviewed “so that the training and appropriateness of this service by pharmacists can be thoroughly explored and vetted.”

Legislators weigh in

State Rep. Aundré Bumgardner, D-Groton, said allowing pharmacists to prescribe birth control medication can improve access to care, convenience, bodily autonomy, healthcare outcomes and cost effectiveness for individuals seeking birth control medication.

Several members of the Public Health Committee spoke in support of the bill’s intent, but raised questions and offered ideas of how to refine the bill so it had the appropriate safety “guardrails.”

They discussed concerns about women missing out on cervical and ovarian cancer screenings if they went to a pharmacist rather than a doctor, not having discussions with a doctor about potential health risks, or not having follow-up care from their doctor. There were also concerns about the impact the proposed legislation would have on small pharmacies that already are overburdened.

However, some legislators said an interaction with a pharmacist could serve as a first point of contact with the medical system and the women could still go to a doctor. They also talked about the importance of access to birth control for women who face barriers, such as co-pays and travel issues.

Some floated ideas for how to craft the bill to address concerns, such as requiring patients to sign a form about possible risks for some people, such as people with a risk of stroke or transient ischemic attack and encouraging people to go to their doctors.

When asked about whether there would be an age limit, Fazio said there should be a conversation about that.

Fazio said there should be an added layer of training for pharmacists prescribing birth control and screening with the patients. He said language can be developed to address the concerns, including the higher health risks for certain women. He said the bill would not force pharmacies to prescribe birth control medication.

k.drelich@theday.com