The Therapeutic Goods Administration’s Advisory Committee on Medicines Scheduling has opted to leave the oral contraceptives as a Schedule 4 prescription-only medicine rather than making it available over the counter with pharmacists’ advice, management and monitoring (Schedule 3).
Pharmacy Guild of Australia National Councillor, Natalie Willis, says failure to make oral contraceptive pills available over the counter at community pharmacies flew in the face of reason and good health practice.
“It’s a sad moment for women in Australia,” says Ms Willis.
“Allowing pharmacies to sell the pill in certain situations would take the pressure off GPs and increase its accessibility for women.
“It’s merely improving convenience for women to the same level as men, who can pop down to the shops and take care of their contraceptive needs very easily, whereas women have to jump through all these hoops.
“Rather than making a sensible and progressive decision in the interests of women, this interim decision is a retreat into the safety of the status quo. This has simply shelved an issue of great importance for women’s health.”
In 1961, Australia was the second country in the world to legalise the oral contraceptive pill, giving Australian women greater control over their own reproductive health.
Ms Willis says with an ageing population the burden of disease was increasing yearly and doctors were having their time taken up by patients with a growing number of chronic health conditions.
“There is a two-to-three week wait to see a GP in most areas. The rescheduling of oral contraceptives would provide recognition of women’s right to access contraception in a safe and convenient manner, is backed by global evidence on safety and quality service delivery and would free up GP time to focus on patients with more complex health needs,” says Ms Willis.
“Failure to recognise the expertise of pharmacists as the custodians of safe medicine delivery by not allowing them to provide medications such as oral contraception without a prescription is holding back the entire health system in this country, creating unnecessary costs to the taxpayer, placing an undue burden on GPs who are already struggling to cope with demand and inconveniencing patients by denying them easier access to quality healthcare.”
Ms Willis says unplanned pregnancy was a public health concern and the benefits of preventing such pregnancies by making the contraceptive available over the counter outweighed the risks associated with their use – risks which pharmacist were trained to identify and act upon.
Pharmacists are highly trained health professionals, having completed a minimum of four years of university education and an additional 12 months of supervised practice prior to obtaining general registration. They then undertake mandatory continuing professional development throughout their careers to maintain currency and competency in contemporary pharmacy practice as it evolves.
“It is recognised as being within a pharmacist’s scope of practice to be able to assess a patient’s suitability for treatment and provide counselling on medicines, including indication, correct use, dosage, adverse effects, contraindications, precautions, and when to seek further medical advice.
“Pharmacists have demonstrated this ability in relation to oral contraceptives with the supply of levonorgestrel for emergency post-coital contraception (emergency contraception), which was rescheduled by the TGA as a Schedule 3 medicine in 2004,” says Ms Willis.
“We now have a situation where the morning after pill can be purchased over the counter, but a contraceptive pill will continue to require a prescription.
“Women in New Zealand and many other countries can readily access the contraceptive pill over the counter at their community pharmacies but in Australia women are being denied the same right.
“The oral contraceptive has been available in Australia for a long time; however our scheduling of these medicines is lagging in comparison to other countries. Rescheduling of these substances would harmonise Australia’s scheduling with New Zealand and provide patients with increased access to effective contraception for continuing treatment.
“Data collected for a study looking at the prescription requirements and over the counter access of oral contraceptives globally, found that oral contraceptives were available over the counter without a prescription in 70% of the 147 countries included in the study.”
