CT closer to Plan B, Narcan in vending machines

Connecticut residents are one step closer to seeing emergency contraception in vending machines and pharmacist-prescribed birth control after House lawmakers overwhelmingly passed a bill that would expand health care access throughout the state. 

The bill, which makes several changes to Connecticut pharmaceutical law, now goes to the state Senate after securing a 125 to 21 vote in the House Wednesday. 

If passed, the legislation would allow pharmacists to prescribe hormonal and emergency contraception, increase the availability of Narcan and other opioid harm-reduction resources, and permit the sale of over-the-counter medications — including the morning-after pill Plan B — in vending machines. 

“We are the only state in the union that doesn’t allow the sale of non-prescription drugs in vending machines,” General Law Committee Chair Michael D’Agostino said as he introduced the bill to the floor. 

“We are obviously not talking about vending machines that you see chips and candy and gum in,” he added. “They are robust machines and in this bill, we’ve got an equally robust set of statutory requirements for these machines.”

D’Agostino said that the bill would only permit machines to sell over-the-counter medication that is not age or ID restricted and are currently available to anyone for purchase on store shelves. 

The vending machines can only dispense a 5-day supply of the medication, excluding emergency contraception, which comes in a single-pill package. 

The Department of Consumer Protection must approve the location, licensee and maintenance person for each machine application. They must be powered, temperature controlled, and have plans in place for power outages or drug expirations. The vending machines cannot reside in K-12 schools or be exposed to the elements. 

The bill also allows pharmacists to prescribe hormonal birth control and the emergency contraceptive pill Ella — a proposal supported by the Connecticut Hospital Association and pharmacists across the state as a key expansion of reproductive health care. 

Nearly 10% of Connecticut women live in “contraceptive deserts,” according to testimony submitted by Nathan Tinker, the CEO of the Connecticut Pharmacists Association. 

Since 2016, 20 states and the District of Columbia have authorized pharmacists to prescribe birth control and emergency contraception.

“The reason for this is very simple: pharmacist-prescribed contraception increases access and decreases barriers to health care for women,” Tinker said. “In a recent study in California, 74% of patients said they sought a contraception prescription at a pharmacy because it would be faster than waiting for a doctor’s appointment; 46% said it was because the location and hours were more convenient. Perhaps most importantly, more than one in four said they sought contraception at a pharmacy because they did not have a regular doctor.”

Under the legislation, Connecticut pharmacists would have the option to undergo a separate training and certification program to prescribe hormonal and emergency contraception. Before prescribing the medication, D’Agostino said pharmacists would need to complete a DCP-approved form and intake process to gather health information, such as blood pressure. The pharmacist would be required to consult with the patient about the potential side effects of the medication and send a notification of the prescription to the patient’s primary care physician.  

During the debate of the bill, Rep. Anne Dauphinais objected to Plan B sales in vending machines and Rep. Robyn Porter raised concerns over the emergency contraceptive Ella and the prescription process.

“It’s a pharmacy and not a doctor’s office. There’s an issue of privacy, asking questions in this vetting process or whatever it is they’re going to be doing to screen someone that wants to be on birth control,” Porter said. “What happens if the person does not have a primary care physician? Because pharmacists have expressed to me that they don’t have access to people’s medical history, to their blood work, to certain things that a doctor would look at when basing a decision on whether to prescribe and what kind of birth control to prescribe.”

In the final vote, four Democrats, including Porter, joined Dauphinais and 17 Republicans in voting no on the proposal. 

In addition to non-prescription vending machines, the bill also allows pharmacists and practitioners to partner with local health organizations, emergency service providers, boards of education, and government and law enforcement agencies to distribute opioid antagonists such as Narcan in separate vending machines or secured boxes. 

“It is very obvious but maybe not always stated that you can’t rehab someone that is not alive,” said Rep. Tracy Marra, a pharmacist and co-sponsor of the bill. “We’re losing people in our state … [ And] there are areas across the state that do not have as much access to Narcan.”

Marra said that the legislation would expand overdose prevention methods in areas that do not have easy access to harm-reduction centers concentrated in the state’s cities. 

In conjunction with Narcan, General Law Committee Ranking Member Rep. David Rutigliano said the vending machines would include narcotic test strips that could detect the presence of fentanyl.

“We’re trying to be compassionate, we’re trying to save lives,” Rutigliano said. 

In 2022, approximately 1,467 people died of a drug overdose in Connecticut. 

Alison Cross can be reached at across@courant.com.