In June 2023, a law was enacted in Connecticut to allow pharmacists to prescribe hormonal birth control pills and patches directly to consumers. This new health care service has the promise of reducing common barriers associated with obtaining a prescription for contraception — taking time off from work, locating a nearby doctor or nurse practitioner who is in-network and has available appointments, paying for the cost of an office or clinic visit, and finding childcare or affordable transportation.  The ability to receive a prescription and have the medication dispensed in one location with extended business hours can alleviate some of these barriers and improve patient access to safe and effective care. There are 34 US states and the District of Columbia with pharmacist prescribing of hormonal contraception. As of 2022, a Kaiser Family Foundation survey reported that nine state Medicaid programs (CA, CO, ID, IL, MD, NV, OR, TN, WA, WV) and commercial health plans in six states (CO, DC, NM, OR, WA, WV) pay pharmacists for their hormonal contraception prescribing services. These pharmacist clinical services involve screening for patient eligibility or referral to another health care professional, assessing patient histories and prior contraception use, and prescribing safe and effective hormonal contraceptives based on patient-specific needs and therapeutic guidelines. Credit: Kaiser Family Foundation While Connecticut pharmacists can prescribe hormonal contraceptives, there is no health plan coverage and payment mechanism in Connecticut for pharmacist clinical services — including hormonal contraception prescribing services. If a Connecticut physician or nurse practitioner prescribes hormonal contraception, the health care provider receives payment for each patient care visit by the patient’s insurance – for example, Medicaid or commercial health plans. Yet, neither Medicaid nor commercial health plans will pay a pharmacist to provide the same clinical assessment and prescribe the same hormonal contraceptives. In April 2024, we surveyed Connecticut pharmacists to determine their perceived barriers to offering hormonal contraceptive prescribing services consistent with the new law. The major barriers identified by both pharmacy managers and staff pharmacists were the lack of payment for pharmacist clinical services, and lack of necessary pharmacist staffing to allow implementation of pharmacist-prescribing of hormonal contraception. If payment for pharmacist clinical services existed, managers would have sufficient resources to add pharmacists with dedicated time for patients seeking hormonal contraceptives. Previous experience in states who allowed hormonal contraceptive prescriptive authority, yet did not provide reimbursement mechanisms, had low uptake of pharmacist participation. Pharmacists at only 11% of California pharmacies offered the services. Other states, like Utah and Minnesota, did not formally address payment for hormonal contraceptive services provided by pharmacists.   The lack of reimbursement policies creates a disincentive for pharmacists and pharmacies to offer these services even if the state allows pharmacist prescribing. An unintended consequence may be that patients will be left with out-of-pocket costs for obtaining contraceptive care at pharmacies. Credit: Kaiser Family Foundation In the 2025 Connecticut legislative session, the Insurance Committee’s HB 7039 addresses the lack of payment for pharmacists prescribing services for hormonal contraceptives.  On March 13, the bill was voted out of committee as Joint Favorable Substitute to the floor. The promise of improved access to and consistent use of birth control with pharmacist prescribing services will not be fully realized and is not sustainable without a corresponding payment mechanism. We encourage legislators to support HB 7039 so that patients have the potential of over 600 new points of access at Connecticut pharmacies. Marie Smith, C. Michael White and Philip Hritcko are Pharmacists with the University of Connecticut School of Pharmacy. Kaylee Morosky is a fourth year pharmacy student there. Nathan Tinker is a member of the CT Pharmacists Association. ...read more read less