Priority 13 from the Contraception PSP

UNCERTAINTY: If the progestogen-only pill was available over the counter would this be acceptable and safe?  (JLA PSP Priority 13)
Overall ranking 13
JLA question ID 0049/13
Explanatory note The responsibility for commissioning contraceptive services moved to local councils in 2013.  The Advisory Group on Contraception (AGC), details that half the councils had cut their budgets  and - 1 in 3 councils has closed services since 2015. The majority of individual who use community sexual health clinics are women (9 out of 10), the majority of visits are about contraception (3 out of 4). Oral contraception is the most commonly prescribed method (47%),  of which about 1 in 3 women is prescribed a Progesterone only pill (POP). Against a background of reduced funding and difficulty accessing services women and healthcare providers are keen to look at cost effective ways for women to continue to access free contraception.  Internationally contraception can be bought over the counter, in the UK emergency contraception is available at pharmacies and is free to young women,  but there is concern about the high price for charged by pharmacies, so the impact on accessibility is unclear. There is overlap between this and priority 6 about pharmacy provision of SRH service.

Pharmacy provision of sexual and reproductive health commodities to young people: a systematic literature review and synthesis of the evidence, Lianne Gonsalves, Michelle J. Hindin, Contraception, Vol. 95, Issue 4, p339–363  Published online: December 23, 2016. (Indirect as not specifically POP- general SRH)

Health Research Classification System category Reproductive Health and Childbirth
Extra information provided by this PSP
Original uncertainty examples

“Why is the contraceptive pill not available as an over the counter medication?” (Patient)

“What are the blocks to making the progestogen only pill available over the counter? Especially the new drosperinone one” (HCP)

Submitted by Healthcare Professionals x 1~Patients x 3~Both x 0
PSP information
PSP unique ID 0049
PSP name Contraception
Total number of uncertainties identified by this PSP. 57  (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop 21 April 2017