By Myles Starr
Following a February summit, “Accessible Consumer Choices: Shaping the Future of Contraceptive Care at Pharmacies,” co-convened by the American Pharmacists Association (APhA) and Contraceptive Access Initiative (CAI), both groupsreleased a joint report in September outlining ways to create accessible pathways for consumers to receive contraception.
The call for uniform insurance coverage for over-the-counter (OTC) contraceptives “was at the top of the impact list, and for good reason. If uniform coverage is implemented, 60 million women of reproductive age could gain affordable access to contraception,” said Dana Singiser, the co-founder of the CAI.
The recommendations in the report are not dictates from the two organizations. Rather, they reflect consensuses reached during the summit on a wide array of recommendations that fell into four distinct categories:
1. pharmacy and retail store operations;
2. health plans;
3. the pharmacy profession; and
4. public policy and advocacy.
An extensive post-summit survey and analysis revealed 18 recommendations that enjoyed broad and deep support among a diverse range of private and public sector stakeholders—including representatives from the White House Gender Policy Council, the Department of Health and Human Services, pharmacy businesses, pharmacists, and patient advocates.
These 18 recommendations were included in the report and ranked by feasibility (those most easily attainable), impact (those with the most powerful potential effect) and overall score. The recommendation that achieved the highest overall score was “work with partners (e.g., trusted community members and leaders, community health workers, faith-based organizations, media outlets, and providers of comprehensive school-based sex education) to educate key populations about expanded access to contraception through pharmacies and pharmacists.”
This was followed by two recommendations that achieved the highest impact scores but were regarded as being less feasible:
• Securing a uniform federal requirement to cover OTC contraceptives. One commentor suggested this could be achieved through requiring coverage of OTC contraceptives through the Affordable Care Act with no out-of-pocket costs and no prescription required.
• Creating a mechanism for coverage of OTC hormonal contraception at non-pharmacy counterpoint of sales. Respondents offered the idea that patients could be provided with insurance-issued debit cards or other electronic payment forms to increase access to OTC hormonal contraception at non-pharmacy counterpoint of sales.
The fourth and fifth top-scoring recommendations would, respectively, have pharmacies publish signage, materials and resources for consumers in multiple languages and formats to accommodate people with varying reading levels; and ensure that the process for obtaining hormonal contraception is transparent to youth.
Although the report is aimed at pharmacists, “for the recommendations in the report to be successful, we need all stakeholders to work together: advocates, industry, pharmacists and federal officials, to name a few,” Ms. Singiser explained. She further noted that this collaborative approach was already reaping rewards, concluding that “part of the success of the report was bringing those stakeholders together behind a unified set of recommendations.”
On Nov. 19, the CAI released another report indicating that governors and state officials are taking the lead on enacting initiatives to make contraception more affordable and accessible. “Amid an increasingly hostile federal landscape, states are taking the lead to not only secure but expand access to critical reproductive healthcare, including over-the-counter contraception,” Reproductive Freedom Alliance executive director Christina Chang commented in a CAI press release.
