More About the Campaign
It is now 15 years since the progestogen-only emergency contraceptive Levonelle was first made available for women to purchase. The price was set high, and a mandatory consultation with a pharmacist introduced, to prevent women from using it as a regular method of contraception. In essence, UK women are obligated to discuss their sex lives in order to avoid an unwanted pregnancy. This is neither right nor fair.
Until recently, British women were paying up to £30 for a pill which costs a fraction of that to produce. In France, women can buy emergency contraception for just €7. After the first stage of the Just Say Non! campaign, several major retailers including Tesco and Superdrug reduced the price to around £13. Having initially refused to cut the price, Boots eventually began offering it for £16.
While EC is available for free from GPs and sexual health clinics, appointments can be hard to obtain in the timeframe needed, particularly as services become more restricted. This leaves many women with no choice but to purchase it from a pharmacy, sometimes with a hefty price tag, and always with a clinically unnecessary consultation, which can be embarrassing and is often conducted on the shop floor.
Most women in the UK rely on pills and condoms, and need swift access to emergency contraception when their method fails or is forgotten.
The consultation causes stigma and embarrassment, which can prevent women from accessing emergency contraception when they need it. It is no surprise that use of EC has barely changed in this country since pharmacy access was introduced: the cost and consultation have acted as significant barriers to its use. Around a third of British women have had an episode of unprotected sex in the last 12 months, but in the vast majority of cases have not used EC afterwards.
We calling on all those involved in the supply and sale of EC in the UK to act in good conscience and give women better access to this important second chance to avoid an unwanted pregnancy.
How does this compare with other countries?
It is completely out of step with other comparable countries that women must endure a consultation in order to purchase EC. Progestogen-only emergency contraception is very safe, and available without a consultation in the USA, Canada, and many European countries.
In France, EC costs in the region of 7 Euros to buy without a consultation or prescription. In Sweden, Norway and the Netherlands, it is available on the pharmacy shelf for women to self-select. Even in the USA, where issues surrounding women’s reproductive health are far more politicised, EC is available on the shelf, without a consultation.
We need to ask ourselves why in other countries in North America and Europe – where drug safety protocols are no less rigorous than our own – women are sufficiently trusted to pick this product off the shelf and use it safely and sensibly without a mandatory discussion with a healthcare professional.
How safe is emergency contraception?
There are no known health risks associated with the use of progestogen-based EC. No deaths or serious complications have been causally linked to this product, and the World Health Organisation classifies it as a Level One medication – indicating there should be no restrictions on its use. There are no women for whom EC is not safe, including women who are breastfeeding. EC cannot disrupt an existing pregnancy and there is no evidence it causes any congenital malformations or any other pregnancy complications, so it can be taken by a woman who does not know she is pregnant.
EC is considerably safer than many medications currently available to purchase from the shelf without consultation, including Nicotine Replacement Therapies, which can be fatal if ingested by young children, and enzyme inhibitors such as Nexium, which can mask serious underlying gastric conditions such as cancer, and which with long-term use is associated with the sometimes fatal C.difficile infection.
Indeed, emergency contraception meets all the criteria to be classified as a medication that can be sold directly off the shelf without a consultation, as it is in other countries.
Placing products on the shelf does not mean people cannot consult with their pharmacist about the most appropriate product for them and how to use it; it simply means that this consultation is not mandatory. There is nothing that a pharmacist asks a woman requesting emergency contraception which would preclude her from taking it. The only relevant drug interactions relate to liver enzyme inducing drugs, and the issue here is one of reduced efficacy of EC. This could be clearly stated in the Patient Information Leaflet.
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