Coronavirus Exposes Birth Control Access Flaws
To prevent the United States from going the way of Italy — where there are simply too many patients and too few ventilators for everyone to receive adequate care — the Centers for Disease Control and Prevention has issued guidelines that encourage all Americans to do their part to control the spread of disease.
The CDC’s recommendations — which include avoiding sick people, staying away from crowds and maintaining a distance of at least six feet from others — are commonsense pieces of advice. However, because of inexplicable government regulations, they may actually work at odds with other medical necessities.
Many Americans rely on maintenance medications — drugs that they use long-term. These include a host of medications, including hormonal contraception, which are used to maintain daily quality of life. In the case of contraception, hormonal birth control can be used for family planning and treating the symptoms of illnesses like polycystic ovarian syndrome.
The problem is that getting a new or renewed birth control prescription can require an in-person doctor’s visit, during which a physician takes the patient’s blood pressure, listens to her self-reported medical history and discusses birth control options. Only after this visit can a woman receive her prescription, which a pharmacist can then fill.
This paradigm creates unnecessary barriers and puts undue strain on our healthcare system in a time of crisis. Not only is a doctor’s office one of the last places you want to go during a pandemic, but it’s nearly impossible for women to follow the CDC’s social distancing guidelines if they have to be at a medical facility.
Given this reality, the current regulations leave women with difficult choices.
Fortunately, there are both short-term and long-term actions that the federal government and many states can take to alleviate the pressures on women that will simultaneously benefit society as a whole.
To date, 11 states and the District of Columbia have enacted what’s known as a “pharmacy access model” for birth control, and others are currently considering the same paradigm. This model allows women to bypass doctor’s visits and obtain a hormonal birth control prescription directly from a pharmacist, who completes a blood pressure check and screens for contraindications.
And why not? Pharmacists, who are trained experts in medications, are imminently qualified to fulfill this role. If more states adopted this model, that would free up more medical professionals to focus on the COVID-19 outbreak and encourage more women to avoid germ-ridden doctors’ offices.
The pharmacy access model can be adopted safely, too. In fact, leading medical groups like the American College of Obstetricians and Gynecologists and the American Medical Association believe that hormonal contraception can be deregulated even further and offered over-the-counter with no prescription.
The United States is actually outside the norm in its regulatory approach: In more than half of countries across the globe, birth control is available over-the-counter.
Moving to over-the-counter status will likely take considerable time, because it requires manufacturers to file an application with the Food and Drug Administration for each product on the market and go through the FDA review process.
In the meantime, Congress can help incentivize manufacturers to apply by passing legislation like the bill proposed by Sens. Cory Gardner (R-Colorado) and Joni Ernst (R-Iowa), Allowing Greater Access to Safe and Effective Contraception Act.
The measure incentivizes drug manufacturers to apply for OTC status by waiving some fees and encourages FDA to fast-track applications. Of course, pharmacy access laws across the states can serve as a short-term fix until full OTC status is granted.
The state and federal models won’t just provide relief during times of emergency, but in everyday situations, too. By increasing access to birth control, more women will be able to obtain contraception, which will reduce maternal mortality, unplanned pregnancies and the associated public expenditures that fund the latter.
In fact, Oregon was the first state to implement the pharmacy access model, and the preliminary results have been promising. Unplanned pregnancies, abortions, and public spending all dropped.
Reorienting the birth control access paradigm simply makes sense. And as hospitals prepare for a massive influx of COVID-19 patients, it provides a simple, time-tested pathway to reduce some unnecessary doctors’ visits and free up medical resources for those truly in need.
Americans across the country are making extraordinary sacrifices to follow the CDC’s guidance and do their part to “flatten the curve.”
It’s time we enact common-sense regulatory reforms to make it easier for Americans to stay healthy and alleviate the massive burden that will soon be placed on our healthcare system.