Contraceptive pill will become available without a script in Victoria

Victorian women will be able to access contraceptive pills from the chemist without a script under a new Allan government plan that has sparked concern from doctors who say it puts patients at risk.

Premier Jacinta Allan and Health Minister Mary-Anne Thomas on Friday announced the expansion of Victoria’s Chemist Care Now program, which allows people to get treated at local pharmacies, rather than a GP, for conditions such as shingles and urinary tract infections.

Under the current arrangement, women can refill their prescription for the pill at participating chemists but must see a GP for the first consultation.

The changes mean that from July, the 850 chemists who are already part of the scheme will be able to provide the oral contraceptive pill to adult women without a script.

The move puts the state government at odds with Australia’s medicine watchdog, the Therapeutic Goods Administration (TGA), which has consistently ruled that the pill should only be prescribed by doctors who can manage the risk of serious complications.

“The use of oral contraceptive pills can cause significant adverse effects that are not consistent with over the counter medicines,” the watchdog concluded in a landmark 2021 review.

“These effects include weight gain, emotional anxiety, heavy bleeding and thromboembolism, particularly with increasing age.”

A free consultation will be required before any medication is dispensed for the first time, where pharmacists will explain any risks and give advice about other options, including alternatives like long-acting reversible contraception.

Pharmacists who want to provide this service will also have to undertake new training.

“Since Chemist Care Now has been up and running, it’s delivered something like 75,000 services to the Victorian community,” Allan said.

“Having the hassle of having to shop around, get a bulk billing GP appointment [and] reorganising your whole day around that appointment. That takes time out of women’s days.”

Allan said the policy could be life changing for young women and would particularly benefit outer suburban, regional and rural communities who travel further for healthcare.

Royal Australian College of General Practitioners Victoria chair Dr Anita Munoz labelled the change a dangerous rejection of clinical safety that “sells women short”.

“This causes me deep concern because the TGA — the authority on the safe use of medicine in our country — did an extensive review on the safe prescribing of the contraceptive pill and made it explicit that the oral contraceptive pill should only be initiated by a medical practitioner,” Munoz said.

“What disturbs me is that a politician with no medical training feels comfortable overriding the learned wisdom and experience of the TGA.”

Munoz said pharmacists were not trained to undertake all the complex medical checks that are required to safely prescribe the pill.

The RACGP also raised these concerns when a similar scheme was introduced in Queensland.

Dr Nisha Khot, president of the Royal Australian and New Zealand College of Obstetricians and Gynaecologists, said the new arrangement created a conflict of interest as pharmacists stood to financially benefit from prescribing the pill.

“I think it will put women’s choices at risk,” she said.

Allan said these complaints did not recognise that pharmacists were already highly trained and skilled healthcare professionals, and the changes would free up GPs under huge pressure in the primary care sector.

Grace Chong, a committee member of the Pharmacy Guild of Australia, said pharmacists would now be able to discuss options for contraception with women who come into the chemist.

She said pharmacists would be trained to address red flags that may mean patients cannot use oral contraception and would collaborate with patients and GPs to find the best treatment options.

The TGA has been contacted for comment.