Seattle, WA-Since the launch of the Washington State Emergency Contraception Pharmacist Pilot Project in late February of this year, women of Washington State have responded overwhelmingly to the new service, drawing national and international attention to the Project.

PATH (Program for Appropriate Technology in Health) initiated the Project with four other collaborating institutions in an effort to make emergency contraceptive pills (ECPs) more readily available to the women of Washington State. Collaborative drug therapy agreements between a pharmacist and prescribing clinician enable the pharmacist to prescribe ECPs directly to women in need. Thus women are able to go straight to the pharmacy without having to first arrange a visit to a doctor or clinic. Since ECPs must be taken within 72 hours of unprotected intercourse, easy access is critical to successful use. Washington is the first and only state in which pharmacists are dispensing ECPs directly to women. To date, more than 500 pharmacists have completed the training required by the Project to provide this service.

There are currently more than 100 pharmacies participating in the Project around the state, with more being added every day. These pharmacies wrote and filled more than 2,700 prescriptions for ECPs in the first 4 months of service. This represents a significant increase in the number of prescriptions being filled. Prior to the Project’s launch, one major pharmacy chain reported filling an average of one prescription for ECPs per week. Since the Project’s launch, that number has increased to an average of 61 per week.

One of the Project’s collaborators, the University of Washington, is surveying women who had ECPs prescribed by a pharmacist to evaluate their satisfaction with this service. In surveys collected and analyzed from the first two months of the Project, women rated their interaction with the pharmacist very highly. In addition, 50 percent reported that they obtained ECPs on a weekend or after 6 p.m. on a weeknight, times when they would not normally have been able to see their physicians. Also, 42 percent reported that if they had not received ECPs directly from a pharmacist they would have taken no action and would have waited to see if they were pregnant. An additional 16 percent of women didn’t know what they would have done if they could not have gone straight to the pharmacy.

The Project’s success has not gone unnoticed. Other states are looking to replicate the program. Even other countries are using the Project in Washington State as an example to help change public policy. In recent discussions with Parliament, physicians’ groups and Schering Health Care Ltd., a European ECP manufacturer, the Birth Control Trust of the United Kingdom presented the Washington State Project as a model approach to increase ECP access and reduce unintended pregnancy. As a result, Schering agreed to allow United Kingdom pharmacists to directly prescribe its ECP product, thus breaking a deadlock that had existed since 1994 when the company announced that it would withdraw its ECP product if it were designated for over the counter sale.

Washington State residents can access the five pharmacists and other health care providers nearest them that offer ECPs by calling the national Emergency Contraception Hotline,
1-888-NOT-2-LATE, or by accessing the Website at http://opr.princeton.edu/ec/. Since the Project’s launch in late February, the hotline has received 4,934 calls from Washington State, an average of 1,160 per month. Prior to the Project’s launch, the hotline averaged 110 calls per month from the state.

ECPs are ordinary birth control pills containing the hormones estrogen and progestin, taken in a higher dose up to 72 hours after unprotected sex. ECPs are at least 75 percent effective in preventing pregnancy. It is estimated that ECPs could prevent about half of the three million unintended pregnancies reported in the United States each year.

The Washington State Project, funded by the David and Lucile Packard Foundation, is a collaboration among PATH, Washington State Pharmacists Association, University of Washington Department of Pharmacy, Washington State Board of Pharmacy, and Elgin DDB. PATH has also established a Project Advisory Committee that includes legislators, physicians, and individuals from various Seattle-area health, pharmacy, insurance, and legal organizations.