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bigstock-149237591Women in California and Oregon can now legally walk into a pharmacy and purchase birth control over the counter from pharmacists with special training – a move that many feminist groups and lawmakers have been calling a no-brainer for years.

But with only two states forging ahead with pharmacy access birth control laws so far, it’s likely that state trackers will continue to see this issue being debated in numerous statehouses.

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Eleven states introduced pharmacy access bills in the 2016 legislative session. If statistics surface in either California or Oregon showing a reduction in unplanned pregnancies as a result of the new laws, many more states are expected to follow suit. Even without statistics available, Public Affairs Vice-President Brit Wahlin of Ibis Reproductive Health said she’s seen the over-the-counter birth control movement gaining major ground lately.

“Ibis Reproductive Health has led the Oral Contraceptives Over-the-Counter Working Group since 2004, and over the last few years we have seen interest in and support for moving oral contraceptives over the counter soar,” she said, adding that more than 50 organizations working in women’s reproductive health have signed on to the group’s statement of purpose.

Major medical societies like the American Congress of Obstetricians and Gynecologists can be found on that list, and there’s also been bipartisan support in the U.S. Congress for moving birth control to an over-the-counter format. The bill on the Democrat’s side of the aisle aims to provide insurance coverage for over-the-counter birth control, while the Republican bill would provide incentives for pharmaceutical companies to submit applications to the U.S. Food and Drug Administration (FDA) for an over-the-counter product.

Only the FDA has the power to decide if a medicine can truly be available everywhere on an over-the-counter basis. All the states can do is increase access to birth control by allowing medical providers like pharmacists to provide it, instead of restricting it to doctors. In California and Oregon, the pharmacists are required to undergo training and communicate with a primary care physician.

Wahlin said Ibis Reproductive Health considers California’s law the model for the states, as the Oregon law (along with some other states’ bills in legislature) contains restrictions for minors.

In Oregon, those younger than 18 must demonstrate they’ve previously been prescribed an oral contraceptive by a doctor, although that part of the statute is scheduled to sunset in two years.

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Some have argued that the pharmacy access movement for birth control could get in the way of more progressive over-the-counter measures, but Wahlin said Ibis doesn’t see it that way. Over-the-counter and pharmacy access happens through very different mechanisms, she said.

“State legislatures can define the scope of practice for pharmacists, while approval of a medication for over-the-counter use happens at the federal level by the FDA,” said Wahlin. “Approval of an over-the-counter birth control pill would have immediate and sweeping effects for women across the country, while pharmacy access laws leave out those who live in states that do not have them.”

In addition, it’s noteworthy that pharmacy access programs include a range of hormonal birth control methods like the patch, ring, and many formulations of the pill. Approval of an over-the-counter pill will happen one formulation at a time through the FDA.

“Pharmacy access programs are a big step forward for contraceptive access, and we support efforts to expand these programs to more states, even as we push to make a birth control pill available over the counter in the United States,” said Wahlin.

Another argument some are voicing against this type of legislation is that pharmacists may not be qualified to determine the correct dosage and follow-up procedures for women seeking hormonal birth control. Although these issues will be at the crux of the debate for many states in future legislative sessions, Wahlin discredited the idea that pharmacists are under-qualified.

“Pharmacists are under utilized in the health care delivery system,” she said. “They’re well qualified and well positioned to help more people access common medications that should not require the expense and trouble of a doctor’s visit. I do not see merit in the argument that pharmacists are not qualified to provide contraception, nor in the argument that pharmacy access laws will get in the way of efforts to move a birth control pill over the counter.”

The prediction that state bill trackers will be seeing more of this topic is evidenced by the progress that Ibis Reproductive Health and the Oral Contraceptives Over-the-Counter Working Group has made in recent months. The group secured a $12 million grant last December from the Dave and Lucile Packard Foundation to support its work toward removing the prescription requirement from birth control.

Part of that funding has been set aside for advocacy work in the states, and the group also plans to work with a pharmaceutical company to submit an application for an over-the-counter oral contraceptive product to the FDA.

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