Last week, the Government announced that women in England would be able to purchase two types of contraceptive pills from pharmacies.
Before this, the two desogestrel (DSG) progestogen-only pills, Lovima and Hana tablets, were only available on prescription following a medical consultation.
The MHRA’s decision to reclassify the contraceptive DSG pills follows both a safety review by the MHRA’s Commission on Human Medicines committee and a public consultation.
This landmark ruling has been welcomed by health bodies and pharmacists alike, as a well-timed ‘step in the right direction’ as health services are busier than ever dealing with a backlog of patients.
Reena Bari, who runs a community pharmacy in Sutton, London, told The Pharmacist that she was ‘really excited’ about the decision and ‘couldn’t wait’ to get the tablets on [her] shelf.’
She also said the move was ‘definitely a step in the right direction,’ but she would like to see the Government go further in the future.
‘I would love the government to subsidise the availability of the contraceptive pills from pharmacies directly, but until that happens, this presents an option for women who are willing to pay for it and know they will be getting the right advice from a pharmacist when they purchase a product,’ she explained.
Dr Asha Kasliwal, president of the Faculty of Sexual and Reproductive Healthcare (FSRH), also called for the pills to be subsidised.
‘Reclassification of some brands is only the first step and buying contraception should not be the only solution. We are calling for these pills to be available to everyone for free in community pharmacies, as well as the reclassification of other contraceptives moving forward.’
Robbie Turner, director of pharmacy at the Royal Pharmaceutical Society (RPS),
also echoed Ms Bari's thoughts and said ‘whilst this reclassification is a positive move, there will be an affordability issue for some women.
‘Ultimately we’d like to see contraception provided for free through NHS community pharmacy services across GB so that many more people can benefit from another point of access to contraception and advice.
‘We are encouraged that a Patient Group Direction is currently being developed in Scotland and free to access prescribing clinics are available in Wales which will enable women to access desogestrel for free from community pharmacies,' he said.
Many pharmacies in Birmingham already offer free contraception services — which includes providing women with free progesterone only and combined contraceptive pills — under Umbrella, the sexual health service provider in the city.
Struggling for an appointment
Amarachi Inechi, a pharmacist at Attwood Green Pharmacy — one of the pharmacies commissioned by Umbrella — also welcomed the move after he has seen first-hand how impactful offering women the pill in pharmacies can be.
‘Since the service was launched over 4 years ago, I’ve started more than 200 people on contraceptive pills,’ he said.
‘Most people come in asking for the morning-after pill, I then ask them if they are considering going on contraception and a lot of people who have been considering it but haven’t been able to start because they haven’t managed to get a GP appointment they end up starting it with me.
The issue of women struggling to get GP appointments easily to get a prescription for their pill has only been exacerbated in recent months due to Covid-19.
‘During the pandemic, I have seen many women struggle to get hold of contraception and to have the option for it to be made available over the counter in a pharmacy is a really good move,’ Ms Bhari also said.
Back in September, an inquiry by the All-Party Parliamentary Group on sexual and reproductive health (APPG SRH) who backed the consultation, heard that difficulties accessing contraception were leaving women at risk of unplanned pregnancies, a situation made worse by the Covid-19 outbreak.
However, Dr Edward Morris, president of the Royal College of Obstetricians and Gynaecologists (RCOG) pointed out that many women struggled to get hold of contraception even before the pandemic began.
‘This announcement is a huge win for women and girls who will no longer face unnecessary barriers when accessing this type of contraception,’ he said.
‘Too many women and girls were struggling to access basic women's health services. The consequences of this include an increase in the number of unplanned pregnancies, which can result in poorer outcomes for women and their babies. Enabling women and girls to access POP more easily and conveniently will give them more control over their reproductive health, which can only be a good thing,’ he added.
Batul Roowal, a pharmacist at Zenith Pharmacy in Birmingham said it was ‘right’ for pharmacies to offer the pills over the counter and she was ‘very positive about it.’
She added that she was not worried about offering the pill to her patients: ‘It is only desogestrel so we don’t have to worry about patients having a history of breast cancer and it doesn’t affect your blood pressure.’
Clare Murphy, chief executive of the British Pregnancy Advisory Service (BPAS), said the move was ‘uncontroversial’ and ‘safe’.
‘We welcome the reclassification of the progestogen-only pill so it can be sold directly to women without a prescription by a pharmacist. It’s an uncontroversial move that should improve access to this method of contraception, and give women another option if they cannot access their GP, or prefer a walk-in service.
‘This is an extremely safe method of contraception which does not require a blood pressure check so we expect any consultation at the counter to be swift and straightforward.
'We should learn the lessons from the transition of emergency contraception to a pharmacy medication in the early 2000s, which was burdened with a needlessly intrusive consultation, and ensure this method can easily be bought by the women who need it,’ she added.