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The Pill: make it easy, make it free?

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There are moves afoot to have the contraceptive pill (and some pharmaceuticals that lower cholesterol) made available over the counter at the chemist. Walk in and top up. No doctor, no worries!

But not so fast. Not everyone’s happy with the proposed new arrangements. While the bill still travels through Parliament, doctors and pharmacists are duking it out over the arrangements.

First, the details.

Pharmacists would theoretically not be allowed to ‘diagnose’ but would be allowed to dispense the pill without a script if it has been lost, or at times when a patient cannot get into see a GP. ie: you can get a repeat without a new script but you can’t get an entirely new pill or go on it for the first time.

And there’s the the desire among many to see it made free. As News Ltd journalist Lucy Kippist wrote in The Punch:

“Now it’s time for the next one: make the contraceptive pill free. And throw in free sanitary products while you’re at it. Because when it comes to health, it’s about time women had the full support of the state.

Take the United States, though it seems strange to say it. Not the first place you think of when you think about good public health policy, but the US has recently taken some pretty big steps in the right direction when it comes to women’s health.

Back in July, the Obama Administration commissioned non-partisan recommendations for women’s health iniatives for affordable health care. Free contraceptives made the top of their wish-list. And they’re about to be delivered; beginning August 1, 2012.”

Mamamia spoke to Australian Medical Association President Dr Steve Hambleton to ask his views on both issues:

“Pharmacists are not trained to diagnose and to prescribe. Our health system works best when people do what they are trained to do. The pill can be prescribed in one year lots so this legislation is trying to solve a problem that doesn’t exist. There is a huge conflict of interest when the pharmacists are both prescribing and then dispensing the medication. They’re very good chemists, but they’re not doctors. And when we encourage people to miss doctor appointments then we are missing a very good opportunity at health promotion and getting people in for check-ups, blood pressure checks and so on.

“As for whether the pill should be free, it almost is. A three-month script for one costs $16.99. Some people can’t tolerate some pills, so there is a range of prices but we’re still talking just dollars a month.”

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President of the Pharmaceutical Society of Australia Grant Kardachi told the Daily Telegraph:

“Pharmacists will not be able to diagnose a patient, it is not replacing a doctor, just continuing the same medication. People won’t be able to come back every month. It will only help out if there’s a lost script, misplaced or if someone can’t get to the GP. It’s not intended to be a regular way of accessing the medication.”

He told Mamamia:

“We are not looking to usurp the role of the GP. This is just a sensible mechanism that allows continuity of care. It only applies to previously prescribed medication for the patient and usually only in exceptional circumstances anyway, for example if they cannot get in to see their GP but the script has run out. There is a previous history file to check at the chemists for patient history, or a phone call can be made to a GP to check the particulars of a patient history.”

A spokesman for Health Minister Nicola Roxon said the legislation didn’t allow pharmacists to prescribe. “This change is about helping everyday Australians get access to two low-risk groups of medicines — cholesterol-lowering statins and contraceptive pills — with strict protocols in place for pharmacists to follow.”

But no word on making the pill – or hey, even condoms – free for all.

What do you think? Are contraceptives cheap enough? Would buying the pill over the counter be helpful? Is there a downside?