Pharmacy Daily | No need for OTC pill push: RACGP

ARGUMENTS supporting calls for the oral contraceptive pill (OCP) to be down-scheduled to Pharmacy Only (Appendix M) no longer stand, the Royal Australian College of General Practitioners (RACGP) believes.

In a submission to the Therapeutic Goods Administration (TGA) the RACGP said the development of telehealth services and the rollout of electronic prescriptions had negated "any argument that access to general practice is a barrier" for patients seeking the pill.

The RACGP's submission said proposed moves to make the pill available over-the-counter (OTC) would restrict GPs' abilities to offer "important preventative interventions such as cervical screening and make sure there have been no relevant changes to lifestyle factors such as smoking status or sexual activity".

The College noted that "at a time when the community has an enhanced awareness of the risk of thrombosis, and the Prime Minister has publicly stated that women are at greater risk of this life-threatening condition from taking the OCP (particularly proposal A's cyproterone) than after receiving the COVID-19 AstraZeneca vaccine, reducing clinical oversight of OCP prescribing is not prudent".

The RACGP also warned that the move to down-schedule the pill posed a number of questions about where legal responsibility would lie for any patient harm arising from reduced clinical oversight.

"The RACGP receives numerous examples each year from our members where adverse outcomes appear to have occurred due to pharmacist advice," the RACGP said.

"One such example is a patient who sought emergency supply of the OCP and was dispensed a discontinued prescription for the mini pill they had once purchased at that pharmacy.

"Their GP had since prescribed a different type of OCP, which they had been purchasing from a different pharmacy.

"The mistake resulted in an unwanted pregnancy."

Should the TGA approve the move to down-schedule the pill, the RACGP said, "pharmacies that participate in dispensing Appendix M drugs should be required to declare all commercial (financial and non-financial) arrangements with drug companies which supply the drugs in question".