The Pharmacy Guild of New Zealand (the Guild) is extremely disappointed that the Medicines Classification Committee has chosen not to reclassify certain oral contraceptives from prescription medicine to restricted medicine. This reclassification would have enabled women to receive oral contraceptives from a pharmacist without having to visit a doctor.
The Guild strongly supported the proposed reclassification and believe it demonstrated a model of care for the supply of oral contraceptives that provided considerable safety, ensured all women spoke to a health professional, and provided an integrated approach with referral to a doctor at many steps.
The protocol for supply included a clear list of conditions that must be met before supply could be made by a pharmacist. This included measuring and recording the patient’s blood pressure, counselling on dosage, effectiveness, side effects, and safety, and notifying the patient’s regular doctor if supply was made.
Guild Chief Executive, Lee Hohaia says “This reclassification would have better utilised our pharmacist workforce and taken the pressure off general practitioners (GPs), while providing a convenient, front-line health service to New Zealand women.
“Pharmacists supplying the emergency contraceptive pill often see women who have no ‘medical home’. They are often healthy young women with no other medical conditions and therefore have not considered enrolling with a GP. It is more convenient for these women to receive an initial supply of oral contraceptives from a pharmacist than waiting to visit a doctor. This also means that patients receive a complete package of care in one place.”
The Guild is also disappointed, although not surprised, that nitrofurantoin was not reclassified from prescription medicine to restricted medicine, due to concerns raised regarding potential lung injury. The reclassification of nitrofurantoin would have allowed pharmacists to supply a patient presenting with a urinary tract infection (UTI) even if they had taken antibiotics in the last six months.
Mrs Hohaia says “Not being able to provide trimethoprim to patients suffering from a UTI who have taken antibiotics in the last six months typically results in treatment delays, due to a lack of GP appointments in many areas. The reclassification of nitrofurantoin would have given pharmacists an alternative medicine to supply.
“The Guild of course supports the Medsafe recommendation that the criteria for trimethoprim supply be revised to ensure these patients don’t face unnecessary treatment delays.”