Beginning as early as Thursday, July 6, Arizona women will be able to buy birth control pills and other hormonal contraceptives from pharmacies without prescriptions, if the pharmacist is willing and thinks they are healthy enough to use them.
The Governor’s Regulatory Review Council gave final approval Wednesday to allowing pharmacists to dispense hormonal contraceptives without the specific annual prescription from a doctor that has been required until now. A standing order by the Arizona Department of Health Services will authorize that.
All the state was waiting on late Wednesday was a formal blessing from the American College of Obstetricians and Gynecologists, which was already on record in support of the change. Once Arizona has its formal OK, expected on Thursday, pharmacies will immediately be authorized to dispense the items without seeing prescriptions.
Still, women won’t be able to grab a box of pills or other hormonal birth control, such as vaginal rings or patches with hormones, right off the shelf.
They will first have to fill out a questionnaire asking about certain personal habits and health conditions. The pharmacist can refuse to sell the items if they believe the pills could cause health problems, said Kam Gandhi, executive director of the Arizona Board of Pharmacy.
Also, Arizona has a “right of conscience’’ law that permits pharmacists to refuse to dispense a drug if to do so would violate their religious or moral beliefs. But Gandhi said most pharmacists would refer customers to another pharmacy where they could get the pills.
The new law applies only to adults. Anyone younger than 18 still needs an actual prescription from their doctor.
This is the culmination of a three-year effort by former state senator Michelle Ugenti-Rita to remove some of the barriers to access contraceptives.
“Women can make that decision for themselves,’’ she told Capitol Media Services on Wednesday. The Scottsdale Republican pushed the measure through the GOP-controlled Legislature over some arguments that women do not understand all of the risk factors involved.
“Do guys understand all the risk factors when they take Viagra?’’ Ugenti-Rita responded. While Viagra does require a prescription under Arizona law, it is widely available online without providing a prescription.
That shows a double standard, she said.
“I find these questions insulting to women’s intelligence,’’ Ugenti-Rita said. “I find it just offensive that in 2023 women still have to justify and explain why they’re perfectly capable of making meaningful and rational health and well-being choices that are aligned with who they are, their goals, their objectives.’’
Under the questionnaire they will have to fill out at pharmacies, some answers might eliminate their chances of getting birth control outright. These include that they are currently pregnant, already currently use a hormonal birth control, or are nursing a newborn.
Other questions are designed to determine risk factors.
Women will be asked, for example, if they smoke, which is generally considered a risk factor for blood clots in women who take hormonal contraceptives.
They’ll also be asked if they have been told by a medical professional they are at high risk of developing a blood clot in a leg or lung.
“A pharmacist still hast to make a clinical judgment,’’ Gandhi said. And there are conditions he said are likely to cause someone to turn away a customer.
“If someone hasn’t seen their primary care physician in five years, it doesn’t make sense to give them something,’’ Gandhi said. “They need to go to their family practice person, get a physical, make sure they’re in good health.’’
Ugenti-Rita, for her part, said, “If it was up to me, we wouldn’t need the questionnaire.”
“Women are perfectly capable of making health choices for themselves when it comes to whether they want to take hormonal birth control or not,’’ she said. “It’s their choice, they’re armed with information, they’re empowered with doing whatever they feel comfortable doing.’’
Ugenti-Rita suggested there has been paternalism in handling of the issue. “It blows my mind and it’s sad that we still struggle with the concept of women being in charge of their own health care,’’ she said.
But she said including the questionnaire requirement was the only way to get the measure through the Legislature.
Ugenti-Rita also took issue with those who have said that, absent being required to go to a doctor once a year to get a birth control prescription refilled, some women won’t go in for preventative care and screening.
One of those expressing such concern was Will Humble, executive director of the Arizona Public Health Association. While Humble said that, on balance, he supports the liberalized access to birth control, he feared there is “a good chance that some women will skip that routine care, Pap smears (tests that can detect cervical cancer), and things like that.”
“That’s ridiculous,’’ Ugenti-Rita countered. “Women are capable of managing multiple priorities. And this isn’t going to take away from their ability to go to the doctor in other capacities.’’
She noted that the U.S. Food and Drug Administration approved the first oral contraceptive in 1960.
“It’s been highly studied,’’ she said. “It’s been one of the most prolifically taken drugs in the world.’’
She got the measure approved and signed by then-Gov Doug Ducey in 2021, but it has taken until now for the Board of Pharmacy to craft the rules and get them through the regulatory process.
US Food and Drug Administration advisers voted in favor of making the birth-control pill, Opill, available over the counter.
