BILL ANALYSIS
SENATE HEALTH AND HUMAN SERVICES
COMMITTEE ANALYSIS
Senator Deborah V. Ortiz, Chair
BILL NO: SB 490
S
AUTHOR: Alpert
B
AMENDED: March 27, 2003
HEARING DATE: April 2, 2003
4
FISCAL: Business and Professions / Appropriations
9
0
CONSULTANT:
Hansel / ak
SUBJECT
Pharmacists: Emergency contraception drug therapy.
SUMMARY
This bill authorizes a licensed pharmacist to initiate
emergency contraception drug therapy in accordance with a
standardized procedure approved by the Board of Pharmacy
and the Medical Board.
ABSTRACT
Existing law:
1.Regulates the practice of pharmacy by the California
State Board of Pharmacy.
2.Prohibits a pharmacist from furnishing a dangerous drug
except upon the prescription of a physician, dentist,
podiatrist, optometrist, or veterinarian.
3.Allows a pharmacist to administer, orally or topically,
drugs and biologicals pursuant to a prescriber's order.
4.Authorizes a pharmacist to initiate emergency
contraception drug therapy in accordance with
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standardized protocols developed by the pharmacist and an
authorized prescriber acting within his or her scope of
practice.
This bill:
1.Authorizes a pharmacist to initiate emergency
contraception drug therapy in accordance with a
standardized procedure or protocol approved by the
Medical Board of California and Board of Pharmacy, in
consultation with the American College of Obstetricians
and Gynecologists and other appropriate entities.
2.Requires the Medical Board, for purposes of the procedure
or protocol to be developed, to designate an authorized
prescriber.
3.Requires a pharmacist, prior to furnishing emergency
contraception, to receive training regarding the
appropriate use and indications for emergency
contraception.
FISCAL IMPACT
Unknown, probably minor costs for the Medical Board and the
Pharmacy Board to develop a protocol for pharmacists to
administer emergency contraception.
BACKGROUND AND DISCUSSION
SB 1169 (Alpert, Chapter 900, Statutes of 2001) created
authority for a pharmacist to initiate emergency
contraception drug therapy in accordance with standardized
procedures or protocols developed by the pharmacist and an
authorized prescriber acting within their scope of
practice. Emergency contraception therapy is a drug
regimen that reduces the chance of pregnancy significantly
if administered within 72 hours of unprotected intercourse.
SB 1169 requires a pharmacist, prior to initiating
emergency contraception drug therapy, to complete a
training program on emergency contraception, covering the
conduct of sensitive communications, quality assurance,
referral to additional services, and documentation. For
each therapy regimen initiated by the pharmacist, the
pharmacist must provide the recipient of the emergency
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contraception services with a standardized fact sheet,
developed by the Board of Pharmacy, that includes the
indications for the drug, the appropriate method for using
the drug, the need for medical follow-up, and other
information.
SB 490 adds a second process under which pharmacists can
provide emergency contraception therapy that is
standardized and does not require pharmacists to develop
their own protocol in conjunction with authorized
prescribers.
The American Medical Association and the American College
of Obstetricians and Gynecologists have recommended that
emergency contraception be granted over-the-counter status
by the Food and Drug Administration.
Arguments in Support
According to proponents, SB 490 will further expand access
to emergency contraception, thereby reducing unintended
pregnancies in California.
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According to the author and proponents, although SB 1169 of
2001 allows pharmacists to provide emergency contraception
to patients under a protocol developed by the pharmacist
and an authorized prescriber, the current system is
cumbersome and presents significant barriers to
pharmacists. In addition, few physicians have participated
in the development of protocols for pharmacist
administration of emergency contraception due to
malpractice concerns. As a result, only about 14 percent
of all retail pharmacies in the state provide emergency
contraception. This bill would address these problems by
establishing a standard protocol under which pharmacists
may provide emergency contraception to patients.
According to the author, New Mexico currently permits its
Board of Pharmacy to develop a standard protocol for
emergency contraception.
Comments
The California Academy of Family Physicians opposed the
provision of the bill as introduced which made the Board of
Pharmacy principally responsible for developing the
alternative protocol for pharmacists to follow in
administering emergency contraception. With the most
recent amendments to the bill, which require the protocol
to be developed by the Board of Pharmacy and the Medical
Board, in consultation with the American College of
Obstetricians and Gynecologists and other appropriate
entities, the Academy has removed their opposition.
Related Bills
SB 545 (Speier), currently in the Senate Business and
Professions Committee and scheduled to be referred to
Senate Health and Human Services Committee, would remove
the training requirement for pharmacists who wish to
provide emergency contraception. The bill would also
prohibit pharmacists from charging a separate consultation
fee if they provide emergency contraception and limit the
dispensing fee charged for emergency contraception drugs to
the Medi-Cal dispensing fee.
Prior Legislation
SB 1169 (Alpert), Chapter 900, Statutes of 2001
AB 261 (Lempert) Chapter 375, Statutes of 1999
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POSITIONS
Support: Public Health Institute (sponsor)
American College of Obstetricians and
Gynecologists
California Abortion and Reproductive Rights
Action League
California Commission on the Status of Women
California Family Health Council
California Medical Association
California Women Lawyers
Institute for Health Policy Studies
Planned Parenthood, Los Angeles
Planned Parenthood Affiliates of California
San Francisco Health Plan
Six Rivers Planned Parenthood
Three individual
Oppose: None received.
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