The price of EHC hit the national headlines recently, opening up a heated debate

Boots caused a furore recently when it commented about not wanting to lower the price of emergency hormonal contraception (EHC) available over the counter because it didn’t want to be accused of “incentivising inappropriate use”. The statement led to a storm of criticism, including threats by women’s groups to boycott the country’s largest pharmacy chain.

The company apologised over the comments, saying it was “truly sorry” for causing “offence and misunderstanding” over remarks made to the British Pregnancy Advisory Service. Boots defended the price of EHC sold over the counter, saying it reflected the consultation its pharmacists carry out with women asking for the medication. “This is necessary to understand the patient’s individual circumstances and ensure we provide an appropriate, safe and effective medicine,” the company said in a statement.
However, Boots also confirmed it was looking for cheaper EHC alternatives after Tesco and Superdrug slashed the retail price of Levonelle and a generic equivalent.

Misleading coverage

LloydsPharmacy superintendent pharmacist Steve Howard criticised the media coverage writing to The Times calling for “more clinically appropriate and accurate coverage”. In his letter, Mr Howard said he was concerned that readers “could have been misled” by an article that appeared in the 27 July edition. “[Pharmacists’] priority is to ensure that women have access to the most appropriate and effective EHC products,” he wrote. “This article missed an opportunity to explain that the cheapest products aren’t necessarily always the most appropriate. Pricing of the pill, whilst important, should be the secondary issue.”

Mr Howard highlighted the complexities of having a retail price that incorporates a service and reflects professional input, arguing that pricing is only one element and that this was not reflected in the article. “Our most important consideration…is doing what is right for the patient, regardless of price. Through a consultation with [a] pharmacist, they can offer advice and guidance that best meets the needs of the patient, which could be referral to a doctor,” he said.

Pharmacists are also ideally placed to talk to patients about contraception and sexually transmitted infections, both of which are important associated topics, he added.

Cost is a barrier

The Royal Pharmaceutical Society’s view is that a consultation with the pharmacist is central to providing EHC. However, the consultation is free and unconnected to the cost of the product.

Sandra Gidley, chair of the English Pharmacy Board, said the Society supports improved access to emergency contraception and sexual health advice for women. “Cost is a barrier to access medicines, and for that reason we would like to see all community pharmacies in England able to supply emergency contraception free through the NHS.”

She pointed out that emergency contraception is already provided free via the NHS in pharmacies in Scotland and Wales and the RPS would like to see this rolled out across the rest of the UK, “to ensure women can access contraception regardless of their ability to pay”.