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Pharmacist Provision of Hormonal Contraception in the Oregon Medicaid Population

Anderson, Lorinda PharmD; Hartung, Daniel M. PharmD, MPH; Middleton, Luke BS; Rodriguez, Maria I. MD, MPH

doi: 10.1097/AOG.0000000000003286
Contents: Contraception: Original Research
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OBJECTIVE: To describe early utilization of pharmacist prescription of contraception in Oregon's Medicaid program.

METHODS: Using Oregon Medicaid claims data, we conducted a retrospective analysis and quantified overall and monthly trends in pharmacist-prescribed contraceptives from January 1, 2016, to December 31, 2017. Our population was restricted to patients obtaining a new prescription for oral and transdermal methods and who had continuous Medicaid coverage during the study period. We summarized demographic and utilization characteristics, including whether patients were continuing or switching methods or initiating contraception. New prescriptions were those written to patients who did not have one for hormonal contraception in the prior 30 days. To assess program safety, we examined rates of prescriptions to patients with medical contraindications to contraceptive use.

RESULTS: Among the 3,614 patients receiving a new prescription for oral or transdermal contraceptives in the Oregon Medicaid program from all health care providers, 367 (10%) received their prescription from a pharmacist. Five months after implementation, pharmacists filled an average of 61 prescriptions per month as the prescriber. Most claims originated from retail chain pharmacies (94%) in urban locations (71%). The majority of patients who were prescribed contraception by pharmacists (73.8%) had no history of contraceptive prescriptions in the preceding 30 days (n=252). Ages ranged from 13 to 49 years, fewer patients lived in a rural location (35.7%), most received a combined hormonal pill (90.5%), and the average day's supply dispensed was 65 (range of 21–364 days). Fewer than 5% (12) of patients had a diagnostic code indicating a possible contraindicating comorbidity.

CONCLUSION: Among Medicaid enrollees, we found that 10% of all new oral and transdermal contraceptive prescriptions were written by pharmacists.

Among Oregon Medicaid enrollees, 10% of all new oral and transdermal contraceptive prescriptions were written by pharmacists.

Oregon State University, College of Pharmacy, Corvallis, the Oregon State University, College of Pharmacy, Portland, and the Oregon Health & Science University, Obstetrics and Gynecology, Portland, Oregon.

Corresponding author: Lorinda Anderson, PharmD, 1601 SW Jefferson St, 203 Pharm Bldg, Corvallis, OR 97331; email: lorinda.anderson@oregonstate.edu.

Financial Disclosure Daniel Hartung has received money paid to his institution (grant funding) from NIH, CDC, AHRQ, National MS Society, and AbbVie Pharmaceuticals. He has a consulting contract with MedSavvy. Maria Rodriguez received money paid to her institution from the Laura and John Arnold Foundation and World Health Organization. She was on a medical advisory board for Cooper Surgical and has been a contraceptive implant trainer for Merck. She was also a WRHR Scholar with NICHD funding in the past (which didn't support this work). The other authors did not report any potential conflicts of interest.

Each author has confirmed compliance with the journal's requirements for authorship.

Peer reviews are available at http://links.lww.com/AOG/B377.

© 2019 by the American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.