Gretchen Whitmer wants more Michigan pharmacists to prescribe birth control

• Whitmer’s action is intended to make it easier for pharmacists to prescribe birth control without a doctor’s visit
• The action isn’t a rule change, but may ease the paperwork necessary for pharmacists willing to prescribe birth control
• 20 states and Washington, D.C., allow pharmacists to provide contraceptive care without such doctor agreements

Birth control pills, patches and vaginal rings could soon be available through more Michigan pharmacists, bypassing a doctor’s appointment.

Under “long-standing” authority in Michigan, pharmacists have been able to enter into collaborative practice agreements with doctors to obtain prescribing rights, said Mary Beth O'Connell, a professor of pharmacy practice at Wayne State University. 

But most community-based pharmacists do not have such collaborative practice agreements in place to cover birth control, she said. 

Gov. Gretchen Whitmer is seeking to change that by publicizing the ability of pharmacists to directly prescribe birth control if they take the needed steps. Whitmer said the need to provide more reproductive health options to women is greater now that a federal right to abortion no longer exists.  

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“It is time to come into the moment and acknowledge that women need access to birth control,” Whitmer told Bridge Michigan on Monday.

The Michigan Department of Licensing and Regulatory Affairs (LARA) sent an email to pharmacists emphasizing their ability to enter into collaborative agreements — authority they already have under Michigan’s public health code. The state also issued a two-page “interpretive statement” reaffirming such authority and a two-page template for the agreements, easing paperwork hurdles.

It’s a request only. Pharmacists are not required to prescribe hormonal contraception, according to the administration. 

“We wanted to go out of our way to ensure that the rule is very clear and that our pharmacists understand that, from the department that regulates them, that this is a permissible activity,” Whitmer said.

According to the announcement by Whitmer’s office, hormonal birth control includes oral contraceptives, patches or the ring — small, flexible devices that release hormones once inserted into the vagina. (The rules do not cover IUDs and implants, which still require a doctor.) 

In May, when a leaked U.S. Supreme Court memo indicated the imminent fall of Roe v. Wade, Whitmer directed state departments and agencies to identify ways to “increase protections for reproductive health care.”  Monday’s rule clarification is part of that effort.

Pharmacists’ prescribing authority varies from state to state. Twenty states and the District of Columbia allow pharmacists to provide contraception without collaborative agreements with doctors, according to the National Alliance of State Pharmacy Associations.

O’Connell, of Wayne State, said that, ideally, the Michigan Pharmacists Association wants a law change that would give pharmacists prescribing authority for birth control without collaborative agreements. Democrats introduced bills in December that would have given pharmacists the standalone authority to prescribe birth control and enable insurance reimbursements. Both bills stalled in committee.

Right to Life Michigan doesn’t take a position on contraception and had no comment Tuesday on Whitmer’s move, according to the organization’s legislative director, Genevieve Marnon. She drew a sharp distinction between a state’s contraception policy and abortion. 

“There’s a big difference between preventing ovulation and preventing the creation of a human life and destroying an already created human life,” she said.

For the Pharmacists Association, changing Michigan law would be preferable to the Whitmer rule clarification because it would be less vulnerable to politics and changing administrations, O’Connell said.

Such prescriptions are essential sexual health care that shouldn’t require a doctor’s visit, she said. A person on vacation or away at college, for example, may not have easy access to their family doctor or gynecologist, she said.

“Bottom line, we want this as a service that can be provided at all community pharmacies,” said Wayne’s O’Connell.

Still, until lawmakers do away with doctor collaborative agreements, Whitmer’s efforts — and Monday’s clarification from LARA — “makes it easier and encourages collaborative practice agreements. Now, we at least have a template, so that is forward progress,” O’Connell said.