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Three quarters of pharmacists oppose growing calls to reclassify EHC

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Royal College of Obstetricians and Gynaecologists is latest body to call for reclassification
Royal College of Obstetricians and Gynaecologists is latest body to call for reclassification

Three quarters of C+D readers are opposed to growing calls to reclassify emergency hormonal contraception (EHC) as a general sale list (GSL) product, a C+D poll has suggested.

Of 106 readers who participated in the poll – which ran on the C+D website from November 29 to December 18 – 73% were against the proposal, with the remainder in support.

C+D commissioned the poll after charity the British Pregnancy Advisory Service (BPAS) called last month for progestogen-based EHC to be reclassified from a pharmacy (P) to a GSL product, “so it can be sold directly from the shelf without a consultation, at a more affordable price”.

Since then, the Royal College of Obstetricians and Gynaecologists (RCOG) has urged that these contraceptives should be available over the counter without the need for a pharmacist consultation.

In its report, ‘Better for women: improving the health and wellbeing of girls and women, published on December 2, the organisation called on the Medicines and Healthcare products Regulatory Agency to reclassify oral EHC to GSL to “enable it to be sold straight off the shelf without consultation”.

Oral EHC should be made free of charge, continued the RCOG, which also called for prescription-only progestogen-only oral contraceptives to be reclassified as P products.

Although, unlike in England, EHC is already available free of charge in Scotland and Wales, the requirement in all three countries for a mandatory consultation with a pharmacist “adds a further barrier to access”, the RCOG said, “since many girls and women report that this consultation leaves them feeling uncomfortable, embarrassed or judged”.

“Many pharmacies display no information about EHC and do not have any dummy packets on their shelves,” the RCOG alleged, “yet they do display pregnancy tests, a wide range of condoms and even information about Viagra”.

C+D poll shows “strength of feeling”

Royal Pharmaceutical Society president Sandra Gidley said: “C+D’s findings reflect the strength of feeling pharmacists have about the reclassification of EHC as GSL.

“Having a consultation with a pharmacist is focused on helping women who need emergency contraception. This would be absent if the product was bought off the shelf,” Ms Gidley said.

“As well as supporting the choice of emergency contraception that’s best for each woman, pharmacists can advise on future use of contraception and the risk of sexually transmitted infections.

“What we’d really like to see across the country are schemes to provide free emergency contraception through community pharmacy,” she added. “These already exist in Scotland and Wales and so should be extended to England too.

“Cost is a barrier to accessing medicines and it’s unacceptable that women in England still have to pay for emergency contraception.”

In October, the Company Chemists’ Association and the Association of Independent Multiple Pharmacies called on the government to commission a national EHC service in pharmacies.

9 Comments
Question: 
Do you think EHC should be reclassified?

Jenny Etches, Community pharmacist

What about if they take it at one of the non-optimal times or take EllaOne because they missed a Cerazette two days previous? How are they signposted for emergency IUDs if necessary? How will STIs be discussed? What about safeguarding issues? 
I have had patients who were unaware that EHC doesn't work at certain times in their cycles, that Ellaone isn't always appropriate if on the pill or have taken Levonelle in the previous 5 days, that have been raped and needed help as well as a pill, who were on rifampicin - the list is endless. But then again this applies to many otc meds - the patient who'd been self medicating with gaviscon and ranitidine who had stage 3 stomach cancer, the anorexic taking too many laxatives, the list is endless. Making medicines conveniently available in supermarkets isn't always appropriate. They're not the same as oranges and carrots. 

Uma Patel, Community pharmacist

The above are exceptions, these should not over rule the convenience of the majority

Uma Patel, Community pharmacist

We should stop being a nanny state. If people want our advice they can always ask. They should not be forced to have a consultation which is a deterent for the most vulnerable. Most have 'googled' before they come in.

When an adult buys a pack of cigarettes no questions are asked, yet when they ask for a pack of ibuprofen we are obliged to quiz them

Personally I think regulation in all aspects of life has gone too far !!

 

Dominic Smith, Locum pharmacist

EHC is much higher risk for treatment failure or innapropriate selection than Ramipril. Maybe we should make ACEI and CCB GSL too, seeing a doctor AND a pharmacist is BEYOND inconvenient!

Adam Hall, Community pharmacist

I have no problem with reclassifying any medicine from PMO to P to GSL if that is what people want. HOWEVER - Who 'carries the can' when it is misused or has unfortunate affects (such as touched on by Kat S)? I bet it won't be the purchaser!

Sunil Patel, Pharmacy owner/ Proprietor

Yes agree. This could be very risky when you take the professional advice out of the equation 

Adam Hall, Community pharmacist

BTW It's nice to know all that training I did to ensure the safe,  effective and appropriate supply of EHC looks to turn out to be a COMPLETE WASTE OF MY TIME!

Kat S, Community pharmacist

This is very misguided, if children and men could buy this product it could lead to abuse and misuse. I really don't think making everything GSL is the answer, especially when we are looking at such high levels of a hormone. What if it is used repeatedly instead of an actual form of contraception, could that lead to increasing levels of uterine cancers? Has anyone thought about long term effects of it at all, instead of accepting drug companies saying its safe as they do with all drugs they want to flog to the mass market. GSL means a petrol station could sell it with no questions at all! Absolutely irresponsible.

Dominic Smith, Locum pharmacist

This is just the same idiocracy that led to the diclofenac saga. Underestimation of peoples need for convenience and people in huge medical ivory towers not really understanding that the average punter really knows very little about medication

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