Pharmacists should prepare for Plan B alternative


Woman looking unhappy and showing a pill

EllaOne has been found to be more effective than levonorgestrel but also more expensive – and pharmacists should be prepared to explain the benefits to customers

As of Wednesday 1 February, pharmacists will be able to supply EllaOne (ulipristal acetate 30mg tablets) to women as a Pharmacist Only medicine.

Prior to EllaOne becoming available in mid-2016, the levonorgestrel 1.5mg tablet was the only oral emergency contraption available in Australia.

While levonorgestrel (Plan B) tablets cost $15-$25, EllaOne will cost about twice the amount.

“It’s really significantly expensive, that’s going to be the biggest setback – that it costs almost twice as much as the original [levonorgestrel],” Sydney pharmacy owner Nick Logan tells AJP.

“If you’re offering that choice, pharmacists will have to simply and concisely describe the benefits of the new one. I think it would even be worthwhile rehearsing.”

According to the results of two independent randomised controlled trials, EllaOne works better than levonorgestrel for the first 24 and 72 hours after unprotected sex, and reasonably well up to 120 hours.

For example, the risk of pregnancy for levonorgestrel within the first 24 hours is 2.3%, while for EllaOne is 0.9%.

At 72 hours this becomes 2.2% for levonorgestrel and 1.4% for EllaOne.

And even at the 120-hour mark, the pregnancy risk for levonorgestrel is 2.2% while for EllaOne is 1.3% – a “really significant” difference, says Mr Logan.

He refers to recent findings that oral emergency contraceptives are safer and more effective than previously thought.

“I think people should develop a process in their store so that accessing emergency contraception is destigmatised,” Mr Logan argues.

“It should be less like a gateway and it should be you adding to their safe and appropriate use without it being stigmatised.

“Consumers have a right to the product and we should be making it as comfortable as possible for them to access it when appropriate.”

For more information, the Guild Pharmacy Academy offers a CPD-accredited EllaOne online course.

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