Doctors support switch for contraceptive pills from POM to P medicine

Exclusive: The British Medical Association has said it is "in favour" of reclassifying the progestogen-only contraceptive pills Lovima and Hana, but issues around safeguarding and reduction in the use of long-acting reversible contraceptives would need to be addressed.
contraceptive pills

The British Medical Association (BMA) has backed proposals to permit the supply of two progestogen-only contraceptive pills in community pharmacies, but said “some issues” need to be addressed before the change is agreed.

In February 2021, the Medicines and Healthcare products Regulatory Agency (MHRA) launched consultations on the reclassification of two progestogen-only contraceptive pills — Lovima 75 microgram film-coated tablets and Hana 75 microgram film-coated tablets — from prescription-only medicines (POMs) to pharmacy (P) medicines.

It is the first time a switch to making the contraceptive products available from pharmacies without a prescription has been considered.

Responding to the consultation, which closed on 5 March 2021, the BMA said it was “in favour” of the change as it would seek to address some of the barriers and health inequalities [women face], and was likely to result in a reduction in unplanned pregnancies.

However, the association said it would be “pertinent” to address some issues relating to safeguarding and the potential for reduction of use of long-acting reversible contraceptives (LARCS).

“One concern about pharmacies that offer some contraceptives is that they do not offer either a whole range of contraceptive products or in-depth counselling about the risks and benefits of different choices,” the BMA response said.

“LARCs are more effective contraception than Lovima [and Hana], a contraceptive pill, which is usually due to user compliance, and we are concerned that without adequate information, sensitive counselling and signposting to the right services, the usage of LARCs could drop as a result of this change.

“Such a decrease in LARCs usage could have other unintended consequences relating to unplanned pregnancies, maternal health and beyond.”

The BMA added that Lovima and Hana are only effective as long as a user remembers to take them.

“In addition, an annual discussion with people receiving contraceptive services was considered sufficiently vital for it to have been included in the Quality and Outcomes Framework, and it should also be a requirement of Progestogen Only Pill (POP) supply from pharmacies.”

The Company Chemists’ Association also supported the reclassification proposals, but agreed that monitoring needed to be “factored in” to screen for adverse side effects.

“If the monitoring is to be undertaken by the pharmacist, then this also needs to be factored into the model under which contraceptive P medicines are delivered.”

It added: “Training for pharmacy teams will need to be provided prior to the launch of P med desogestrel contraceptives so that they can provide women with the information they need to make an informed choice.”

Commenting on the consultations, Sandra Gidley, president of the Royal Pharmaceutical Society, said: “We have welcomed this MHRA consultation, which could see a progestogen-only contraceptive pill become available without a prescription.

“The move will help to increase access to effective means of contraception through pharmacy and will give women more options to help them make informed choices on their medicines with the advice of a pharmacist.”

Last updated
Citation
The Pharmaceutical Journal, PJ, March 2021, Vol 306, No 7947;306(7947)::DOI:10.1211/PJ.2021.1.69828