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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14 Comments

  1. vixeyv
    02/02/2017

    This is a refreshing contrast to Trumps recent gag rule. Bless Australia.

    • Ronky
      03/02/2017

      The so-called “Trump’s gag rule” (merely a reinstatement of the previous rule which Obama reversed) prevents US taxpayers’ money being used to promote or perform late-term abortions (it doesn’t “gag” anyone). It doesn’t apply to morning after pills such as levonorgestrel and ulipristal (which weren’t invented when the rule was created in 1984), which although you are correct that they are early-term abortifacients, the sponsors and the TGA insist on calling them “contraceptives”.

      • Sahar Khalili
        03/02/2017

        Enjoy the moment Ronky

      • dirk
        04/02/2017

        How are they abortifacients? What scientific background do you have Ronky?

        • Ronky
          06/02/2017

          Read the PI and Martindale. I’m a pharmacist with a science degree, how about you?

          • dirk
            09/02/2017

            Interesting interpretation of the mechanism of action.

          • Ronky
            09/02/2017

            No ‘interpretation” required. “mode of action… cause endometrial changes that discourage implantation.”

          • dirk
            10/02/2017

            No point debating this. Take care.

  2. David Haworth
    02/02/2017

    While it may have advantages in effectiveness it has a barrier in time and cost to see a Doctor first. The article does not mention this. Some areas you cannot just breeze in and see a doctor. Some people will find the cost of seeing a GP a barrier as well.

    • dirk
      02/02/2017

      Read the first sentence carefully. “As of Wednesday 1 February, pharmacists will be able to supply EllaOne (ulipristal acetate 30mg tablets) to women as a Pharmacist Only medicine.”

  3. Helen Calabretto
    02/02/2017

    Plan B is a misleading title although I assume it has been included as a play on words. Plan B is actually a brand name of levonorgestrel (LNG) emergency contraception available in the USA, not in Australia. The LNG brands in Australia include Postinor-1, NorLevo-1, Levonelle-1, Postella-1, Postrell-1 (there are other generic brands as well).

  4. Nicholas Logan
    02/02/2017

    Can I add the words “when appropriate” at the end of my last quote “Consumers have a right to the product and we should be making it as comfortable as possible for them to access it.”

  5. Owner
    02/02/2017

    What is so hard about reporting source literature? And where is the confidence intervals and P-values… Seriously!!

  6. John Guy
    03/02/2017

    For a price premium, I would think an even slightly more efficacious product would be would be worth it for peace of mind.

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