Since the Minor Ailments and Contraception Service (MACS) launched in British Columbia in 2023, the most likely type of patient to come through the doors of a pharmacy seeking this service is a young woman, between the ages of 20 to 34, accessing the service for a contraception prescription.
The insight was revealed in the one-year overview of the program published by the British Columbia Ministry of Health in the November 2024 edition of its PharmaCare newsletter.
The data showed that pharmacists performed 431,100 MACS claims between June 1, 2023 and May 31, 2024, and that one-in-five claims were for contraception. Overall, 73 per cent of patients who use the MACS program are women, with the largest group being those between the ages of 20 to 34.
Christina Kolios, pharmacist at Aaronson’s Pharmacy in Victoria, is within this age group herself. She said that even more than a year later, there are still patients who are surprised to learn that pharmacists can prescribe contraception, and that the products are publicly funded in B.C.
“This program has redefined access to care,” she said. “I’ve seen patients who were hesitant or overwhelmed by the process of obtaining contraception now feel relieved because of how straightforward and supportive this model is.”
Christina Kolios, a pharmacist in Victoria, said many of her patients are young women, including some who are from the city’s vulnerable, transient population.
Given her pharmacy’s location in downtown Victoria, many of her patients are young women, including some who are from the city’s vulnerable, transient population. For many of these patients, being able to access contraception at a place like a pharmacy can also mean an opportunity to talk to a health provider about sexual health in general.“
By having this service in pharmacies, we are creating safe and inclusive spaces where women can access care and feel comfortable asking questions about their options,” Kolios said.
“During their appointments, I ask patients if they have been vaccinated for HPV. When needed, I can prescribe and administer the vaccine during the same appointment. I also discuss routine STI testing and provide guidance on how to use our in-store telemedicine services for same-day requisitions.”
Parmida Nafezi, co-chair of the University of British Columbia’s Pharmacy Women’s Health Club, said most patients she sees for contraception are shocked at how efficient pharmacies can be.
“Some patients cannot even believe this is happening. They’ll come to me and ask if we can really prescribe. And then they’ll ask it again because they’re just so shocked that the health care system is changing that quickly,” she said. “Often, they will have had a friend who received a prescription from a pharmacy and they want to know if it’s true.”
MACS by sex and age
The third-year pharmacy student has been working once a week at a Vancouver pharmacy, where she regularly consults with patients during contraception assessments.
“I had a patient who told me that they were waiting two weeks to see a family doctor. But at a pharmacy they only have to wait half an hour before seeing the pharmacist for a prescription,” she said.
“As a female, I know how frustrating it can be to wait for a refill for birth control. As a pharmacist, it has been really rewarding seeing how happy patients are to be able to access women’s health care when they need it.”
Teale Phelps Bondaroff, chair and co-founder of AccessBC, an advocacy group that seeks to remove barriers to accessing prescription contraception, said that British Columbia has been a leader in reproductive justice.
“There are so many barriers that prevent people from accessing prescription contraception, and these barriers compound, making it harder for people to access medicine and to exercise reproductive autonomy,” he said.
AccessBC Chair and co-founder Teale Phelps Bondaroff poses in front of the Canadian Parliament Building in Ottawa with a giant intrauterine device prop. His group seeks to remove barriers to accessing prescription contraception.
“Our campaign was absolutely delighted when B.C. became the first province in Canada to make prescription contraception free, as this removed a significant barrier, but the province has done even more. We were so happy to see the province allow pharmacists to prescribe many forms of prescription contraception, as not only not only does this remove additional barriers that individuals face when trying to access life-saving and life-changing medicine, but it also helps remove pressure from our health care system.”
Kolios, the pharmacist in Victoria, said there is still room for the program to grow by providing coverage for additional contraceptive options that currently aren’t funded, and possibly looking at expanded scope for pharmacists to be trained to insert implant devices.
“Additionally, compensation for virtual prescribing when a pharmacist deems it is appropriate, such as a simple continuation of therapy that can be assessed over the phone, can further simplify the process for patients,” she said.