Pharmacies may offer morning-after pill

OLIVIA CARVILLE
Last updated 05:00 24/10/2013
ECP, morning-after pill
DANIEL TOBIN/Fairfax NZ

PHARMAC PRIORITY: Enabling pharmacies to offer the ECP free of charge would increase its availability to women and girls in need.

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Making the morning-after pill free to young Kiwi women is being considered to reduce teen pregnancies and abortions.

The move, to allow pharmacists to dish out the emergency contraceptive pill (ECP) free to women under the age of 25, has been hailed a success in other regions, but the Canterbury District Health Board (CDHB) is reluctant to back it after rejecting a similar proposal this year.

The board says the service will "not drop unplanned pregnancy rates" - a stance that puts it at odds with Christchurch pharmacists and youth health workers.

In April this year, the Canterbury Community Pharmacy Group (CCPG) put forward a proposal to the CDHB for women to have free access to the ECP, citing schoolgirls turned away from pharmacies unable to pay the $40 fee and reports of a rise in risk-taking behaviour, including unprotected sex, after the earthquakes.

The CDHB dismissed the proposal, but government drug-buying agency Pharmac is "actively working" on rolling out a nationwide scheme to allow pharmacies to offer the ECP free of charge.

The autonomous subsidy and provision of pharmaceuticals (ASAP) scheme was considered "high priority" to Pharmac and would grant pharmacies the right to prescribe, dispense and claim back the price of ECP and nicotine replacement therapies, Pharmac chief executive Steffan Crausaz said.

A major catalyst for the ASAP campaign was the Waikato DHB free ECP pilot programme that began in 2008. That service allowed accredited pharmacists to provide free morning-after pills and health advice to under-25s.

From July 1 to October 20 this year, 1138 free ECPs were dished out over the counter in the Waikato - 14 to children aged up to 14 years and 515 to those in the 15 to 19 age bracket, Midland Community Pharmacy Group figures show.

CDHB planning and funding general manager Carolyn Gullery questioned the programme's perceived success, saying any link to reducing unwanted pregnancies had "not been evaluated".

Research showed increased access to the ECP "does not drop unplanned pregnancy rates" as the ECP was mostly taken by those already using contraception rather than those at high risk, she said.

In Canterbury, all under 21-year-olds have free access to sexual health care, and the ECP, which can prevent pregnancy up to 72 hours after intercourse, is available by prescription from a GP, Family Planning or sexual health clinics for the pharmaceutical cost of $5. Some high schools offer a free ECP service.

Accredited pharmacists can supply the ECP through a private consultation and typically charge $35 to $45.

Some experts say there is a serious gap in the service for teenagers.

Christchurch medico Dr Sue Bagshaw, from the 298 Youth Health Centre, said not all of the city's high schools provided the free ECP service and they were closed on the weekends and during school holidays.

The city's one Family Planning clinic was often fully booked and not open on Sundays. Getting to a GP appointment could put up barriers for high school pupils.

Bagshaw endorsed the ASAP scheme and said women under 25 were often reliant on their parents for financial support or had low-paying casual jobs so could not afford a $40 fee.

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So far this year, the 298 Youth Health Centre has issued 24 free ECPs, and on Monday a woman was double-booked for an appointment at the centre to access the pill because she could not afford to pay for it elsewhere.

CCPG general manager Graeme Smith was disappointed the CDHB turned down the group's ECP proposal  this year, but he welcomed Pharmac's national plans.

"If this isn't progressed further you can be sure we will be submitting a revised business case to the CDHB," he said.

The CDHB said it would consider a free ECP proposal if it were part of a "wider strategy to increase access to those most at risk".

ABORTION FOR THE SAKE OF $40

Christchurch teenagers are ending up in abortion clinics because they cannot afford the $40 fee for the morning-after pill, a 15-year-old girl who needed the pill last month says.

While options to get the pill free were available, they were often inaccessible to young girls, the high school pupil said.

The 15-year-old, who did not want to be named, obtained the emergency contraceptive pill free at a medical practice after confiding in her school nurse that she had unprotected sex with her boyfriend at the weekend.

The nurse rang a GP and booked the appointment for her.

"If she hadn't organised it all for me and told me it was free, I personally would have just left it and hoped that I got my period," she said.

"I know some girls who have just left it because the pill is too hard to access. Forty dollars is hard to get at our age and it's not something you want to ask your parents for."

The 15-year-old was aware of friends who had wound up in abortion clinics because they couldn't afford to buy the ECP from the pharmacy and couldn't drive themselves to doctor appointments.

ECP

- Morning-after pill may be free in pharmacies nationwide.

- The CDHB rejected a similar proposal this year.

- The morning-after pill is available free from some clinics, but experts say these services are not reaching teenage girls.

- New Zealand's abortion rate has been on a downward trend since 2007.

- The trend is attributed to an increase in long-acting contraceptives, such as implants or IUDs.

- Last year, 277 women under  20 and 507 women between 20 and 24 had an abortion in Canterbury.

- © Fairfax NZ News

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