Testimony from: Courtney Joslin, Commercial Freedom Fellow, R Street Institute Kristen Nyman, Government Affairs Specialist, R Street Institute
Regarding S 845 “AN ACT concerning contraceptives, supplementing P.L.2003, c.280 2 (C.45:14-40 et seq.), and amending P.L.2005, c.251”
May 13, 2019
Senate Health, Human Services and Senior Citizens Committee
Chairman Joseph F. Vitale and Members of the Committee:
Thank you for considering this educational testimony on the issue of pharmacists dispensing contraception to patients in New Jersey. Our mission at R Street is to engage in policy research and outreach to offer resources to stakeholders on free markets and limited, effective government in many areas, including contraception access. We appreciate the opportunity to offer insight and outline best practices for contraception access.
Currently in New Jersey and 39 other states, women seeking oral hormonal contraceptives must schedule doctors’ appointments during which they answer a medical questionnaire and submit to a blood pressure test in order to receive a prescription, which a pharmacist subsequently fills.
But such doctors’ visits seem unnecessary when pharmacists are well-equipped to check patients’ blood pressures, check for contraindications and dispense hormonal birth control. To date, 10 states and the District of Columbia have adopted a pharmacy access model—allowing women to bypass doctors in order to safely obtain birth control.
Roughly 25 percent of women who use contraceptives use self-administered oral contraceptives like birth control pills as their primary method.[1] As a result of the high threshold to access these contraceptives, many women turn to other, less effective methods. Lowering the barriers to obtaining oral contraceptives would certainly increase their use and benefits. Indeed, an estimated 39 percent of women nationally would reportedly be interested in taking administered contraceptives if they were more readily available.[2]
The unintended pregnancy rate in the United States is appallingly high—and New Jersey is no exception. In New Jersey, 53 percent of all pregnancies are unintended. For women aged 19 years and younger, over 80 percent of pregnancies are unintended.[3] These pregnancies not only bring personal costs, but costs for taxpayers as well. The federal government and the state of New Jersey spent $477.1 million on healthcare costs associated with unintended pregnancies in the state over just one year, in 2010.[4] The unintended pregnancy rate in the state has fortunately seen a small but steady decrease in subsequent years—due largely to increased use of effective contraceptives like self-administered hormonal contraceptives.
Any model of birth control access must prioritize the safety of patients who seek contraceptives, and the pharmacy access model passes that litmus test. The pharmacy access model requires patients to complete a self-assessment to identify any contraindications or risk factors of taking birth control. This is the same assessment developed by the Centers for Disease Control and Prevention that doctors use to determine whether a birth control prescription is viable. Many physician groups also support loosening the restrictions on birth control access. In fact, the American College of Obstetricians and Gynecologists issued a committee opinion that advocates for complete over-the-counter access to birth control.[5]
The bottom line is that women and government alike benefit from unintended pregnancy prevention. We thank the committee for the opportunity to present this testimony on increasing access to self-administered hormonal contraceptives.
Thank you for your time,
Courtney Joslin Commercial Freedom Fellow 202-900-9736 R Street Institute cmjoslin@rstreet.org
Kristen Nyman Government Affairs Specialist 305-979-1056 R Street Institute knyman@rstreet.org
[1] “Fact Sheet: Contraceptive Use in the United States,” Guttmacher Institute, July 2018. http://bit.ly/2J9qVs5
[2] Kate Grindlay, MSPH and Daniel Grossman, MD, “Interest in Over-the-Counter Access to a Progestin-Only Pill among Women in the United States,” Jacob’s Institute of Women’s Health, April 2018 http://bit.ly/2VbLsOu
[3] Kristen Nyman and Courtney Joslin, “R Street Supports the Allow Women Greater Access to Safe and Effective Contraception Act,” The R Street Institute, April 2019. http://bit.ly/2V2jRix.
[4] “Fact Sheet: Unintended Pregnancy in the United States,” Guttmacher Institute, January 2019. http://bit.ly/2JmOzRq.
[5] The Committee on Healthcare for Underserved Women, “Opinion: Access to Contraceptives,” The American College of Obstetricians and Gynecologists, issued January 2015, reaffirmed 2017 http://bit.ly/2vUwt1j
