Kiwi call for oral contraceptive downschedule rejected


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New Zealand pharmacies won’t be able to supply the oral contraceptive pill over the counter, following the Medicines Classification Committee’s decision not to reclassify them from prescription to restricted medicine.

The reclassification would have enabled women to receive oral contraceptives from a pharmacist without having to visit a doctor.

The Pharmacy Guild of New Zealand, which had strongly supported the proposed reclassification, says it is extremely disappointed, as the proposal had demonstrated a model of care for the supply of oral contraceptives that provided considerable safety, ensured all women spoke to a health professional, and provided an integrated approach with referral to a doctor at many steps.

The protocol for supply included a clear list of conditions that must be met before supply could be made by a pharmacist, it says.

This included measuring and recording the patient’s blood pressure, counselling on dosage, effectiveness, side effects, and safety, and notifying the patient’s regular doctor if supply was made.

“This reclassification would have better utilised our pharmacist workforce and taken the pressure off general practitioners, while providing a convenient, front-line health service to New Zealand women,” says Guild Chief Executive, Lee Hohaia.

“Pharmacists supplying the emergency contraceptive pill often see women who have no ‘medical home’.

“They are often healthy young women with no other medical conditions and therefore have not considered enrolling with a GP,” she says.

“It is more convenient for these women to receive an initial supply of oral contraceptives from a pharmacist than waiting to visit a doctor. This also means that patients receive a complete package of care in one place.”

In considering the proposal, the Committee discussed concerns regarding the amount of pharmacist time required for consultation and that not all pharmacies would be resourced to provide such a service.

“The concern was also raised that pharmacists do not have access to patient’s medical records in order to provide appropriate advice,” it noted.

“Although recent innovations in electronic data sharing between health providers (such as HealthOne in Canterbury) would assist in this regard, the Committee noted national adoption of such data sharing was still some way off.

“Formal consent would be required before the pharmacist could inform the woman’s general practitioner that an oral contraceptive had been supplied, potentially resulting in incomplete or disjointed medical records.

“The Committee acknowledged this is the current situation with existing providers of contraception such as Family Planning and there is no evidence of harm from this.

“The Committee also noted from the pre-meeting comments that there were a number of possible alternates to this submission that could improve patient access to oral contraceptives including prescribing by practice nurses rather than direct supply by pharmacists, and pharmacist supply by way of standing orders issued by medical practitioners.”

However the Committee noted that while consultation with some primary healthcare practitioners had occurred, it did not consider this consultation to be sufficient, and had not met the requirement for resubmission. In the absence of support from the major medical representative bodies it decided not to support the request for reclassification.

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