Here’s Exactly Why The TGA Blocked A Proposal To Sell The Pill Over The Counter

Last week, the Therapeutic Goods Administration blocked two proposals to make the contraceptive birth control pill available over-the-counter in pharmacies. Today, the TGA deputy secretary John Skerritt has shed light on the decision.

In a Senate Estimates Hearing on Wednesday afternoon, Queensland Greens Senator Larissa Waters questioned the TGA on its decision to block OTC birth control pills from sale.

The TGA’s decision to block over-the-counter birth control cites the fact that “allowing people who run out of access to the pill without delay of booking a GP appointment can reduce the risk of unwanted pregnancies”, but also suggests that other alternatives such as longer scripts that are a more appropriate response.

When asked by Waters on what exactly the TGA was doing to progress these alternatives, Skerritt responded: “I should emphasise that already a 12 month prescription for the oral contraceptive pill can be written and indeed pharmacists have four continuing dispensing arrangements,” he said.

Specifically, he noted the higher risk of blood clotting when on contraceptive pills — an issue that has been thrust into the public spotlight amid the AstraZeneca vaccine rollout.

“One of the reasons behind the interim decision was that for a product like the oral contraceptive pill and we have talked so much about clotting after AstraZeneca vaccine, the rates of clotting with the oral contraceptive pill are orders of magnitude higher, several orders of magnitude higher,” he added. “So this is not a harmless set of products — one of the factors behind the decision is that it is not inappropriate to ask a woman, especially as she gets older and her risk of things like clotting increase, to see a doctor once a year.”

Additionally, he noted that the issue of writing longer prescriptions is actually far bigger than just the birth control pill, as there is a nationwide legal maximum for any script.

“There is another requirement generally under prescriptions in Australian state and territory law that they are generally valid for a 12-month period maximum,” he explained. “So writing two-year prescriptions would open up a separate legal can of worms. But we will review every application received and the decision-maker will make the decision with advice based on those submissions.”

It’s also worth noting that contraceptive pills are not the only option on the market for birth control, with IUDs, the contraceptive bar, and the quarterly Depo-Provera injection all available.

“For many women, in terms of convenience but potentially in terms of adverse events, LARC, or the long-term injections are preferred,” he explained when asked what was being done to improve awareness of these options. “They made the point that it isn’t an option that the pharmacist can offer, if someone comes with a script for the oral contraceptive pill.

“There are other alternatives such as IUDs which again, so if a woman, for example, has a previous history of clots, they may suggest an IUD as opposed to an oestrogen based substance or a progesterone-only pill, though the efficacy is lower.”

However, Skerritt neglected to note that women who have experienced the unfortunate side effects of birth control may opt for the contraceptive pill over a more invasive method such as the IUD or the bar as it gives them more control to stop taking the pill at their own discretion without medical intervention.

It’s important to note that the decision to block the proposals is only an interim decision, and is open for public consultation until November 1.