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Should two desogestrel contraceptive pills switch from POM to P?

CCA: Women shouldn't face cost or local availability barriers to sexual health services
CCA: Women shouldn't face cost or local availability barriers to sexual health services

The MHRA is seeking views on whether to make desogestrel contraceptive pills Lovima and Hana available to women directly from pharmacists, without a prescription.

The consultations on reclassifying Hana 75 microgram film-coated tablets and Lovima 75 microgram film-coated tablets from prescription-only medicines (POM) to pharmacy (P) medicines closes on March 5.

While the two consultations are separate, the Medicines and Healthcare products Regulatory Agency (MHRA) “will consider responses that relate to the active ingredient (desogestrel) as applying to both products, even if views are only submitted for one”, the regulator said launching the consultations last month.

“If these two products are reclassified, pharmacists will have access to training materials and a checklist to enable them to identify women who can be supplied this medicine safely,” it added.

“Contraceptive pills containing desogestrel will still be available on prescription from GPs and sexual health clinics,” the MHRA explained, and women “may opt to switch between methods of supply”.

“Strong support” from stakeholders

In initial consultations with stakeholders, the MHRA said there was “strong support from all…for making [desogestrel] available to purchase from pharmacies in addition to being available through sexual health clinics and GPs on prescription”.

The Company Chemists’ Association (CCA) Professional Practice Group – which is responding to the consultations on behalf the large multiples and supermarket pharmacies – told C+D it is supportive of plans to make more sexual health services available through community pharmacy and repeated its call for a nationally commissioned service.

Should the pills be reclassified, as well as training for pharmacy teams, “there may be a role for the General Pharmaceutical Council to reissue their guidance on personal values and beliefs to support this”, the group suggested.

“We would not like to see women face any unintended barriers to access, whether that be through cost or local availability,” it said.

The Royal Pharmaceutical Society (RPS) also welcomed the MHRA consultations, with president Sandra Gidley stating: “This move will increase access to an effective method of contraception and enable women to make an informed choice about their needs after discussion with a pharmacist.”

The RPS also called for a nationally commissioned pharmacy contraceptive service, “so many more people can benefit from another point of access to contraception and advice”, Ms Gidley added.

Result

Should desogestrel contraceptive pills Hana and Lovima switch from POM to P?
Yes
49%
No
45%
I am undecided
7%
Total votes: 107
4 Comments
Question: 
Should Hana and Lovima desogestrel pills switch from POM to P?

TC PA, Community pharmacist

I'd love to see a national pharmacy service introduced for all contraception services. However, there are potentially a few problems which have resulted in this POM to P switch proposal as opposed to an NHS funded service:

It would have to be an essential service to make it worthwhile. There is no point it being a postcode lottery service, it would need to be available in every pharmacy. Some pharmacies may not be able to cope with the extra workload.

Pharmacy owners would introduce targets for managers/pharmacists.

PCNs would most likely oppose the service as it would be taking money away from the invidual GP surgeries through loss of QOF payments.

It is easier to simply go for the POM to P switch. It would be interesting to know what the GPHC's guidance will say on safe sale. Would we have to do all of the stuff a nurse currently does in regards to BP, weight, counselling? If so the selling price will have to reflect the cost of the consultation and drug. I dare say superdrug or whoever will swoop in with an absurd price of £9.99 making it impossible for the independants to compete.

Naresh Chauhan, Community pharmacist

With robust protocols in place, all contraceptives ought to be available as P meds. After a couple of years, majority of Pharmacists will have gained enough experience for it to become just "second nature" - as has the EHC services.

Richard MacLeavy, Dispenser Manager/ Dispensing Assistant

I am in favour of improving access to this category of medicines, particulary as the key demographic of patients using this are working age and GP's opening hours is a key barrier to access currently. However there is a couple of concerns I feel would need to be considered. If the medicine becomes a P, there is a risk that in line with current prescribing guidelines that patients are encouraged, coerced or instructed to purchase the medicine over the counter rather than on prescription as part of the drive to not prescribe over the counter medication. If this happend the barrier to access would increase as patients would need to pay for what is currently a free prescription item. This would also then be a regressive policy in terms of equality. Secondly if it was to become a P then presumably we may need to monitor blood pressure. There is then the question of how this should be funded. If its added to the retail price of the drug then we could face similar criticisms to the EHC service where the cost of consultation is included in the retail price but condemed by media outlets as "pharmacies ripping of patients". It would be much better in my view to commission a national contraception service so that pharmacies can offer all contraception services (including EHC) free of charge which would improve access to contraception and reduce GP workload. This should be adequately renumerated to include funding for consultation and any monitoring requiremets

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