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IC Program Background
Since the inception of the Health Step demonstration program in spring 2003, 27 pharmacists, practicing in 26 pharmacies partnered with 19 clinics and offices in eight geographic areas around California. As of September 2006, the funding stream for the demonstration program ended and re-injection reimbursement is no longer available. Some pharmacists and clinicians who successfully integrated this service into their practices continue to offer the pharmacy re-injection option to their clients.
The Injectable Contraception (IC) Program allows pharmacists to partner with physicians and clinics to better meet the needs of contracepting women. In this innovative program, established patients on injectable contraceptives (Depo-Provera) are given the choice of obtaining re-injection at their regular provider or at a participating pharmacy. The idea behind this effort is simple: why not afford patients on injectable contraceptives the same convenience as oral contraceptive (OC) users?
Why Have an IC Program?
A significant number of women rely on injectable contraceptives to prevent pregnancy. One of the largest surveys ever conducted in California on contraceptive method use (the Family PACT Program Evaluation) suggests that about a quarter of women using hormonal methods select contraceptive injections to prevent pregnancy.
Program Benefits
Convenience is important for many women, particularly working women. By offering women several access options, providers are recognizing this need. Enhanced access may also make it easier for patients to maintain contraceptive adherence and thus avoid unintentional pregnancy.
The medical indications and contraindications for progestin-only or combined estrogen and progestin contraceptives are very similar, whether administered orally or by injection. While oral contraceptive users may receive a supply or prescription for up to a year, women on injectable contraceptives are not given the same convenience. This clinician visit limitation for injectable contraceptives is not medically indicated.
Pharmacists Provide Injections
Increasingly, pharmacists are routinely providing injections and many schools of pharmacy now require that graduates be trained to administer injections. Pharmacies are open in the evening and weekends, and can offer highly convenient and accessible services. These changes are starting to make pharmacies a viable option to perform a “re-supply” function for women on injectable contraceptives in much the same way that they re-supply women on oral contraceptives.
Partnership
For busy physicians, partnering with a local pharmacy can frequently help with office management. Some providers, for example, may not want to stock injectable contraceptive products or may find injection visits an inefficient use of staff time.
Increased Access
Through the addition of pharmacies as extra service sites for injection, patients will have increased access to this important service and greater convenience in maintaining contraceptive compliance.
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