Arizona pharmacists' perspectives on prescribing hormonal contraception

Unintended pregnancy remains a significant public health challenge in the United States. In 2021, Arizona passed Senate Bill 1082 authorizing pharmacists to prescribe self-administered hormonal contraceptives, including oral contraceptive pills, the transdermal patch, and the vaginal ring. Successful implementation of such policies depends on pharmacists' willingness and ability to provide these services.

The objectives of this study were to understand Arizona pharmacists' perceived benefits and barriers of providing direct pharmacy access to self-administered hormonal contraception, and to gauge their interest in receiving training on prescribing contraception at their practice.

We conducted a cross-sectional survey of licensed Arizona pharmacists (n = 7972) in June 2022 through the Arizona Board of Pharmacy's electronic listserv. The survey assessed awareness of Senate Bill 1082, interest in prescribing and receiving training, and perceived benefits and barriers to providing contraceptive services. Chi-square analyses evaluated associations between demographic and practice characteristics and interest in prescribing.

The study sample included 295 pharmacists (response rate 3.7%). A majority were aware of Senate Bill 1082 (61.9%) and expressed interest in prescribing hormonal contraception (57.2%), though only 40.3% agreed prescribing was currently feasible in their practice. Female pharmacists showed significantly greater interest than male pharmacists (62.5% vs. 47.6%, P = 0.02). Top perceived benefits included increased contraceptive access (90.2%), reduction of unintended pregnancy (90.6%), and expanded scope of practice (84.4%). Top barriers were shortage of pharmacy technician staff (86.4%), liability concerns (88.7%), and lack of reimbursement (87.8%).

Arizona pharmacists recognize the potential for pharmacist-prescribed hormonal contraception to improve access and reduce unintended pregnancy. However, substantial implementation barriers exist, particularly workforce shortages, liability concerns, and lack of reimbursement. Addressing systemic challenges through workforce development, clear liability guidance, and payment reform will be essential to translating legislative authorization into meaningful patient access.