BILL ANALYSIS
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|SENATE RULES COMMITTEE | SB 1169|
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THIRD READING
Bill No: SB 1169
Author: Alpert (D)
Amended: 5/30/01
Vote: 21
SENATE HEALTH & HUMAN SERV. COMMITTEE : 7-1, 5/23/01
AYES: Ortiz, Chesbro, Figueroa, Kuehl, Romero,
Vasconcellos, Vincent
NOES: Haynes
SUBJECT : Pharmacy
SOURCE : Public Health Institute
DIGEST : This bill authorizes pharmacists to initiate
emergency contraception drug therapy in certain
circumstances.
ANALYSIS : Under existing law, a pharmacist may not, in
general, furnish a dangerous drug except upon the
prescription of a physician, dentist, podiatrist,
optometrist, or veterinarian. However, existing law
provides for certain exemptions.
This bill authorizes a pharmacist to initiate emergency
contraception drug therapy in accordance with written
guidelines or protocols previously established and approved
for his or her practice by a practitioner authorized to
prescribe drugs.
The bill requires the pharmacist to provide the recipient
CONTINUED
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of the emergency contraception drugs with a standardized
fact sheet that includes, but is not limited to, the
indications for use of the drug, the appropriate method for
using the drug, the need for medical follow-up, and other
appropriate information. Requires the Board of Pharmacy to
develop this form in consultation with the American College
of Obstetricians and Gynecologists, a state pharmacy
association, and other health care organizations.
Comments
Emergency contraception (EC) drug therapy, commonly
referred to as the "morning after pill" are hormone pills
that when taken within 72 hours of unprotected intercourse,
reduce the chance of a woman becoming pregnant by about 75
percent. The hormones are regular birth control pills
containing estrogen and progestin, taken in two doses. In
California and Washington, there is also available an EC
pill known as "Plan B" made from synthetic progestin. The
EC pills provide a short, high burst of hormone exposure
that disrupts the hormone patterns essential for pregnancy.
The EC pills reduce the hormone release from the ovary and
the development of the uterine lining is disturbed, the
disruptions are temporary, however, lasting only a few
days. Depending on the time during the menstrual cycle
when the EC pills are taken, they prevent pregnancy by
inhibiting or delaying ovulation, or altering the lining of
the uterus thereby inhibiting implantation of a fertilized
egg. The EC pills can also prevent sperm from fertilizing
an egg. EC pills do not cause an abortion. Because
implantation occurs five to seven days after fertilization,
EC pills work before implantation and not after a woman is
already pregnant.
The U.S. Food and Drug Administration (FDA) has ruled that
birth control pills require a prescription and therefore
cannot be sold over the counter. In 1996, the FDA ruled
that an oral contraceptive regimen is safe and effective
for emergency use. Following that issuance, the American
College of Gynecologists and Obstetricians (ACOG) issued a
Practice Pattern on EC discussing the risk and benefits,
administering pills, and identifying women who are
candidates for EC. In December, 2000, the American Medical
Association approved a resolution asking the government to
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consider making EC pills available over the counter. The
AMA's Report on the Council on Medical Service, calls for
physicians and other health professionals to play a more
active role in providing education about access to
emergency contraception.
Legislative History
AB 261 (Lempert), Chapter 375 of 1999, expanded the duties
of pharmacists to include adjusting the drug regimen of a
patient pursuant to a specific written order or
authorization made by the patient's physician. Previously,
pharmacists were authorized to do this by the patient's
prescriber for the individual patient, in accordance with
the policies, procedures, or protocols of a health care
facility, home health agency, licensed clinic, or health
plan.
This change has allowed the operation of the Pharmacy
Access Partnership. The Partnership, funded by a $2.2
million grant from the David and Lucile Packard Foundation,
operates in approximately 40 pharmacies and clinics in
California. The program matches neighborhood pharmacies
and clinics and sets up the proper authorizations for
patients to purchase the EC pills from the participating
pharmacies whenever they need it. The project is modeled
after one in Washington state where over 30,000 women have
received EC pills direct from local pharmacies. In
California, the participating pharmacies set aside a
private area where the druggists counsel women and the
pharmacists are required to notify the woman's clinic when
she receives the pills.
FISCAL EFFECT : Appropriation: No Fiscal Com.: No
Local: No
SUPPORT : (Verified 5/23/01) (Unable to reverify support
and opposition at time of this writing)
Public Health Institute (source)
California Medical Association
Planned Parenthood
ARGUMENTS IN SUPPORT : The Public Health Institute, the
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bill's sponsor, writes that there are over three million
unplanned pregnancies each year in the U.S. and that the
American College of Gynecologists and Obstetricians
estimates that readily available emergency contraception
could help eliminate over half of the abortions performed.
They also write that the American Medical Association, the
American College of Gynecologists, and the California
Medical Association have approved resolutions supporting
these products be made available on an over-the-counter
basis. Planned Parenthood additionally notes that for
several decades, EC pills have been prescribed to women and
millions of women around the world have used EC safely and
effectively.
CP:sl 5/30/01 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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