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 Projectwith four other collaborating institutions in an effort to make emergencycontraceptive pills (ECPs) more readily available to the women of WashingtonState. Collaborative drug therapy agreements between a pharmacist andprescribing clinician enable the pharmacist to prescribe ECPs directly towomen in need. Thus women are able to go straight to the pharmacy withouthaving to first arrange a visit to a doctor or clinic. Since ECPs must betaken within 72 hours of unprotected intercourse, easy access is critical tosuccessful use. Washington is the first and only state in which pharmacistsare dispensing ECPs directly to women. To date, more than 500 pharmacistshave completed the training required by the Project to provide thisservice.

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

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

The Project’s success has not gone unnoticed. Other states are looking toreplicate the program. Even other countries are using the Project inWashington State as an example to help change public policy. In recentdiscussions with Parliament, physicians’ groups and Schering Health CareLtd., a European ECP manufacturer, the Birth Control Trust of the UnitedKingdom presented the Washington State Project as a model approach toincrease ECP access and reduce unintended pregnancy. As a result, Scheringagreed to allow United Kingdom pharmacists to directly prescribe its ECPproduct, thus breaking a deadlock that had existed since 1994 when thecompany announced that it would withdraw its ECP product if it weredesignated for over the counter sale.

Washington State residents can access the five pharmacists and otherhealth care providers nearest them that offer ECPs by calling the nationalEmergency 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 controlpills containing the hormones estrogen and progestin, taken in a higher doseup to 72 hours after unprotected sex. ECPs are at least 75 percent effectivein preventing pregnancy. It is estimated that ECPs could prevent about halfof the three million unintended pregnancies reported in the United Stateseach year.

The Washington State Project, funded by the David and Lucile PackardFoundation, is a collaboration among PATH, Washington State PharmacistsAssociation, University of Washington Department of Pharmacy, WashingtonState Board of Pharmacy, and Elgin DDB. PATH has also established a ProjectAdvisory Committee that includes legislators, physicians, and individualsfrom various Seattle-area health, pharmacy, insurance, and legalorganizations.

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