Free Access to the Emergency Contraceptive Pill

Pharmacists have joined the call for the emergency contraceptive pill (ECP) to be made freely available to young women after three DHBs found that subsidising the ECP resulted in a drop in both the number of abortions and in the teen pregnancy rate. 

Currently two DHBs are still funding free access to the ECP for women under the age of 25.
 

Waikato DHB

Waikato DHB has subsidised access to the ECP for almost four years, after pharmacists in the area reported that young women were coming into their pharmacy requesting the ECP and then leaving without it when told that it would cost $35. Around 400 women a month are accessing the ECP and the DHB has noted a reduction in the number of teen pregnancies and in the number of abortions. There is no restriction on the number of ECPs as Waikato DHB funds the service on a as needs basis.

Mid Central DHB

Mid Central DHB is reaching the end of a two-year trial of subsidising free access to the ECP and have reported a 7.5% drop in the number of abortions at the end of the first year. The current funding for the trial is due to end at the end of June 2011 and costs the DHB $98,000 a year. Around 170 women a month are provided with free access to the ECP. A Board spokesperson described the service as a fence at the top of the cliff instead of an ambulance at the bottom. 

Auckland DHB

The Auckland DHB ran a 5-month trial of providing free access to the ECP from October 2008 to March 2009 at a cost of $300,000. Pharmacists were reimbursed at a cost of $47+GST per ECP which included the cost of the drug, the dispensing fee, the cost of condoms, and the cost of the pamphlet detailing how the ECP should be taken. Around 1700 women per month were provided with free access to the ECP. A subsequent report to the Auckland DHB Community & Public Health Advisory Committee on 16 June 2010 stated that the busiest pharmacies were those situated in malls or in high pedestrian zones. There was a 13% drop in the abortion rate but this was regarded as not statistically significant because of the short period of the trial and the relatively low numbers.

It was noted that “the ‘other’ ethnic category utilised the service most (65%), followed by Asian (21%), Pacific (8%) and Maori (6%). This parallels with the ADHB population which consists of 59% ‘other’, 22% Asian, 12% Pacific and 7% Maori.”

The report pointed out that the price of a first trimester termination of pregnancy at Epsom Day Unit is $994, and that termination of pregnancy rates for Maori and Pacific women are considerably higher than for European and Asian women.

Despite that fact that one of the key findings was the clear downward trend in terminations rates in Asian and European ethnic groups, and that “the positive trend observed provides confidence that this type of service will be of benefit to ADHB financially and the population on a psychological and social level,” Auckland DHB has no plans to extend the ECP pilot at this stage. 

Women in the Auckland DHB area are still able to obtain the ECP free from family planning, and are able to purchase it over the counter from a pharmacy, or by visiting a GP and obtaining a prescription – and some funding is directed towards making this service free with Procare Network Auckland for under 18-year-olds.

West Coast DHB

The West Coast DHB provides access to the ECP to under 22-year-old young women at a cost of $3.

Other DHBs have different schemes in place regarding access to the ECP. 

Family Planning Support

Jackie Edmond, the CEO of the Family Planning Association (FPA), appeared on Radio NZ Checkpoint on 3 February saying FPA would like to see the ECP subsidised across all pharmacies.

It would certainly be extremely beneficial for women. And for cash-strapped DHBs is makes good economic sense – a $35 pill compared to nearly $1,000 for an abortion is a no-brainer.

Sources

• Radio NZ Checkpoint. 3 Feb 2011

• ADHB CPHAC Agenda papers 16 June 2010