Pros, Cons to Making the Pill Available Over the Counter
Are prescriptions for oral contraceptive pills out of date and paternalistic, or do they benefit women?
WEDNESDAY, Dec. 24 (HealthDay News) -- Two Head to Head articles published online Dec. 23 in BMJ highlight the pros and cons of making oral contraception available over the counter (OTC) rather than as a prescription drug.
Sarah Jarvis, G.P., of the Royal College of General Practitioners in London, U.K., states that the "low use of long-acting reversible contraception (intrauterine contraceptive devices, intrauterine system, progestogen-only subdermal implants, and progestogen-only injectable contraceptives) compared with user-dependent methods such as the contraceptive pill [is] one of the reasons for high rates of unwanted pregnancy" and may contribute to the United Kingdom's high rate of teenage pregnancies. Making oral contraception available OTC would make it even harder for physicians to choose the most appropriate contraception for their patients, she argues.
However, Daniel Grossman, M.D., of the University of California San Francisco, argues that the prescription presents barriers to women's use of oral contraception, either to starting or to compliance, in the case of travel away from home and forgetting to carry their pills, for example. Women would still have the access they needed without requiring a prescription for oral contraception, he states.
"The prescription requirement is an out-of-date, paternalistic barrier to contraceptive use that is not evidence-based," Grossman writes. "If governments are committed to addressing the challenge of unintended pregnancy -- and the related problem of maternal mortality in the developing world -- health systems must create mechanisms to allow freer access to hormonal contraception for all women at low or no cost."
Sarah Jarvis reports a financial relationship with Bayer.