Sunday, December 16, 2007

OTC Birth Control Pills In The UK

UK health minister Lord Darzi has introduced a Pilot Scheme, due to start in 2008, that would allow women to purchase the Pill from pharmacies without a doctor's prescription.

Sort of.

If you look at the fine print, it appears this initiative isn't so much about making the Pill OTC as it is about shifting the gatekeeper job from doctors to pharmacists. According to the BBC (emphasis mine):

A spokesperson for the Department of Health said pharmacies could play an increased role in the provision of contraception and other sexual health services, because of their accessibility and convenient opening hours.

There is no firm commitment to roll out the scheme nationally but any women receiving the contraceptive pill from a pharmacist would have to go through the same process if they were to receive it through a prescription issued by a GP, they said.

"We will work with the pharmacy profession to ensure robust standard setting and appropriate training to ensure pharmacists are competent to safely provide this service."

Having OTC access to the Pill means you walk into a pharmacy and are able to buy the Pill, no questions asked.

Having to "go through the same process [as] if [you] were to receive it through a prescription issued by a GP" means you have to go over your gyn history (and, maybe, undergo a physical exam) right there at the pharmacy counter. The middle of a store is not the proper place to have a medical exam. [Sure, the store could set aside a private area to conduct screenings for Pill eligibility, but that would defeat the purpose of the undertaking. If you're still required to undergo an exam to obtain the Pill, there's no advantage to having the screening done by a stranger, in a store vs. by your own Ob/Gyn in his/her office.]

True OTC access to the Pill means you trust that women are capable of making their own medical decisions. And since this is science we're talking about, we can look at the evidence to support the proposition that women have, you know, the ability to make decisions that are in their best interest.

For example, when researchers looked at the ability of women to self-screen for contraindications to Pill use, they found that 6.7% of women incorrectly thought they could use the Pill when, in fact, they couldn't. Compare that with the ~6% of Pill users who, despite undergoing screening by an MD, are still contraindicated for use. There's basically no difference.

So, the UK's Pilot Scheme is somewhat of a first step, but it's not yet clear if it will lead to OTC Pill availability. Meanwhile, here in the US, we're still proudly and prudently protecting women from themselves, only allowing them to obtain the Pill with a prescription.

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At 7:37 PM, Blogger Bardiac said...

I've long wondered if it's really necessary to make birth control pills prescription, so it's interesting to see this.

What about the hoop jumping of pap smears and such? (I can imagine some women would get the pill and never go--me, for example--but is that a reason to make the pill hostage?)

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