Clarifying Gov. Whitmer’s expansion of birth control access

The governor and LARA announce that pharmacists may prescribe birth control

On Sept. 19th, Gov. Gretchen Whitmer released a statement publicizing pharmacists’ ability to prescribe self-administered, hormonal birth control.

While this is not new, Whitmer aims to expand access to birth control in the state of Michigan by clarifying and emphasizing the option. This action comes from a reinterpretation of the Public Health Code by the Michigan Department of Licensing and Regulatory Affairs.

LARA summarizes the statement to say that “a physician licensed in the state of Michigan may delegate limited prescriptive authority to a Michigan-licensed pharmacist to prescribe self- administered, hormonal contraceptives.”

“Basically, the provider delegates their authority to the pharmacist,” associate professor of pharmacy practice Michelle Sahr said. “So, this is not commonly [used] in Michigan for pharmacists to prescribe birth control, but we’ve never had any laws stopping us from doing it.”

Pharmacies, including CVS, have been providing this service for years, Sahr explained. She and other pharmacists were confused by the relevance and wording of the initial announcement, which was soon revised.

“[Pharmacists] had some concerns because the interpretation at first actually limited us more than what we normally do,” Sahr said. “So, when they came out with the proclamation or the announcement, it said PharmDs could receive this authority from a physician, which actually restricted what we’ve been able to do for years.”

Brian Sapita, the director of government affairs for the Michigan Pharmacists Association, explains that the MPA presented their concerns with the initial statement to LARA. Last Friday, LARA released a revised statement saying that any licensed pharmacist with a bachelors or a doctorate degree can receive prescribing rights.

Whitmer released the statement on the state of Michigan’s website following an executive directive from May. This instructed Michigan departments and agencies to identify opportunities to protect reproductive health care in preparation for the overturning of Roe v. Wade.

With the 2022 midterm elections only five weeks away, and since both the governor and statewide constitutional reproductive rights are on the ballot, Whitmer, a democrat elected in 2018, has heavily promoted her stance on birth control access and abortion rights.

“As reproductive freedom is under attack across the nation, we are using every tool in our toolbox here in Michigan to protect women,” the executive directive reads. “We are taking action to guarantee that Michigan women have the right to easily make reproductive health care decisions that are best for them.”

Sahr supports the initiative to expand access to birth control and other prescriptions through pharmacists. There are new pieces of state legislation being introduced that could expedite and make the process easier.

Rep. Abraham Aiyash introduced HB 5654. This bill, currently in the House insurance committee, would require insurers to cover hormonal contraceptives prescribed by a pharmacist. Rep. Kara Hope introduced HB 5655, a bill in the House health policy committee that would allow pharmacists to consult and prescribe contraceptives independently.

Both bills were introduced in 2021 and have not been passed by the Michigan House of Representatives.

“A lot of times the holdup is, you know, physicians don’t necessarily want to give up patients [and] appointments,” Sahr said. “So, sometimes [physicians] see this more of stepping on toes.”

In Big Rapids, many residents do not have a primary care doctor. Passing this legislation would offer people an easier route to obtaining prescriptions with more documentation than in telemedicine.

The cost of visiting a physician’s office can be a barrier to health care. Sapita explained that receiving prescriptions from a pharmacy would reduce costs by 60%.

“Pharmacists are not trying to replace a physician, and we believe a patient should see their primary care physician at least once a year,” Sapita said. “We are just trying to ensure our patients have access to safe and affordable healthcare.”

Sapita is confident in pharmacists’ capacity to prescribe oral contraceptives. Pharmacy students are trained to identify preexisting conditions that would complicate the use of hormonal birth control, and additional training is offered throughout the field. This ensures that pharmacists are kept up to date on the prescription of contraceptives.