Don't bypass GPs for contraceptive pill, warns Wollongong academic

Letting pharmacists prescribe the contraceptive pill, rather than GPs, could risk women's health according to a University of Wollongong academic and GP.

The Therapeutic Goods Administration (TGA) is investigating whether some prescription-only medicines, including the pill, should be reclassified so only a pharmacist must be consulted.

However Dr Mark Wilson said while there could be short-term cost savings to women - and the health system - it could prove more expensive in the long run.

Dr Wilson, of UOWs School of Medicine, said there were many advantages to requiring women to check in with their GP annually to get their pill prescription renewed.

"If the pill is given to women over the counter, they're not having that vital check-in with their GP," he said.

"An annual review with a GP means there's a process followed in selecting the most safe and appropriate contraceptive for each woman.

"GPs will measure a woman's blood pressure and weight; they will look at her past history with contraceptives; as well as her overall health and family history.

"It's about providing that follow-up, and that continuity of care over time that is so important."

This country doesn't invest very much in preventative health - it's just a small fraction of the health budget - so it's very undervalued.

Dr Wilson

Dr Wilson said there were countless different oral contraceptive pills on the market, and GPs could monitor the potential side effects on their patients.

"There's not just one stock standard pill - and all oral contraceptives have small risks of side effects," he said.

"The most common are the nuisance-type side effects which include irregular bleeding, nausea, breast discomfort and fluid retention.

"But there are also more severe - but far rarer - side effects like elevated blood pressure, blood clots, stroke or cardiovascular disease.

"That's why it's so vital for a GP to look at each individual woman, to determine what the risk factors might be."

As well, Dr Wilson said, the annual review enabled GPs to talk to women during their reproductive years about preventative health.

"It gives them a really great window of opportunity to talk about overall health as well as contraception," he said.

"They can talk to them about screening for conditions like breast and cervical cancer - preventative measures which can save the health system money in the long run.

"This country doesn't invest very much in preventative health - it's just a small fraction of the health budget - so it's very undervalued.

"That's why it's important to emphasise what GPs can offer."

This year the TGA held public consultations on whether to reclassify some schedule 4 (prescription only) medications like the pill to schedule 3 (pharmacist only).

The TGA heard from a number of stakeholders, including pharmacists who suggested reclassifying the pill would save time and lower costs for women.

Consultations closed at the end of April, with all submissions now under review.