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Why is the morning after pill so expensive?

UK women pay up to five times as much more for the morning after pill than Europeans – and the UK’s leading pharmacy is refusing to drop its price from £30 over fears of ‘inappropriate use’

“We would not want to be accused of incentivising inappropriate use, and provoking complaints, by significantly reducing the price of this product,” says Mark Donovan, chief pharmacist of Boots. The British chemist has refused to lower the price of the emergency contraceptive pill, touting fears that it would encourage ‘over-use’. Because for some reason, people want to make it more difficult than it already is to access safe, important aspects of healthcare.

Tesco and Superdrug recently halved the cost of the emergency contraception they sell, following an ongoing campaign by the British Pregnancy Advisory Service. The remarks on behalf of Boots – based more on the ideals of anti-choicers rather than even financial incentives – were in response to this campaign. According to the campaign by Bpas, women in the UK can pay up to five times as much as their European counterparts – with 4 percent of women at reproductive age using it each year, that’s a staggering amount. The same contraceptive method is available for as little as seven euros (about £5.50) in France.

According to Buzzfeed News, the cost of manufacturing the drug can cost around £2.

The morning-after pill can be bought in English pharmacies following a consultation with a pharmacist. At present, Boots charges £28.95 for the major emergency contraceptive brand, Levonelle, and £26.75 for its own brand. Superdrug’s version is £13.49, while Tesco’s costs £13.50. Boots is the largest high-street pharmacy in the UK, and 90 per cent of the population lives within 10 minutes of one of their shops, making it a major outlet for people wanting to access services like emergency contraception.

For many, emergency contraception is an important line of defence against becoming pregnant. While it can be accessed for free on the NHS following a visit to your GP, it must be taken within 72 hours of having unprotected sex, so time constraints can put pressure on anyone who needs it.

Bpas have called the price a “sexist surcharge”. As with many constraints put on women’s body autonomy when it comes to the likes of accessing abortion – particularly for Northern Irish, Irish and Manx women – and other sexual health services, it alienates poorer women the most.

Katherine O’Brien, head of media at Bpas, reiterated to Dazed that such surcharges penalise the financially strained: “£30 isn’t pocket change – it is a significant sum of money. At Bpas, we see women experiencing unplanned pregnancies who tell us that they simply could not afford to buy emergency contraception, so we know the impact that this extortionate price tag has on women’s lives and their health.”

“The fact that Superdrug and Tesco have both lowered the cost so significantly clearly demonstrates that it would be commercially possible for Boots to do so. There is no excuse,” she added. “Polling has shown that the public support women’s access to affordable emergency contraception. Women believe emergency contraception should only cost around £8.”

“It seems bizarre that in 2017 our leading high-street pharmacy would allow their policy on contraception to be shaped by those with such regressive, out-of-touch views”

What becomes apparent from Boots’ statement is that, rather than acting on issues of financial logistics, their reasoning is moralistic. The reference to ‘over-using’ what is a vital medicine is insulting to women who should have full control over their fertility, whatever their circumstance. It seems more concerned with uproar from the same camp of people who shun informed sexual education, who scream at women outside abortion providers, who seek to criminalise women exercising their right to choose. Boots, a corporation, has no right or place to judge what people choose to do with their bodies.

“Yes, there are some people who do not support women’s access to emergency, but they are a tiny minority,” says O’Brien. “It seems bizarre that in 2017 our leading high-street pharmacy would allow their policy on contraception to be shaped by those with such regressive, out-of-touch views.”

According to a recent study, 51.2 per cent of women who accessed abortion services at their clinics in 2016 reported using a method of contraception, with a quarter of those using the most effective methods: hormonal, or longer acting contraception. Contraception is never going to be 100 percent effective, and people don’t use it consistently or correctly always. Having other options to keep you safe is paramount.

Natika Halil, Chief Executive of sexual health charity FPA, also flagged that there should never be a cost barrier to reproductive healthcare.

“Pharmacies are often one of the most convenient places to get this type of contraception,” Halil tells Dazed. She points to a recent study that found many women prefer to access emergency contraception from pharmacies, but that cost ‘seems to be an important barrier,’ particularly among lower income demographics.

“We hope that other pharmacies, including Boots, can look at how they can help reduce costs following Superdrug introducing a more affordable emergency pill,” she adds. “Many pharmacies are part of schemes that offer free emergency contraception, and ultimately we would like to see emergency contraception available for free for all women through all pharmacies.”

Halil also told Dazed that FPA wants to see higher levels of awareness of emergency contraception and access, including the knowledge that the IUD option is also a method of EC. The Patient Group Directions lets nurses and pharmacists prescribe it to those in need.

According to the FPA, the emergency intrauterine device is the most effective form of EC, and can be fitted up to five days after unprotected sex. The emergency pill with ulipristal acetate can also be taken up to five days after. However, the quicker you access it, the more likely it is to work.

As Jessica Quinter of Bpas points out on the Huffington Post, Boots’ anti-women narrative is at odds with the image it presents in recent advertising campaigns, starring feminists like Chimamanda Ngozi Adichie. Instead, Boots exploit us and caters to ideologies of anti-choice and pro-birth, that puts women at risk of emotional, financial and medical stress.

Healthcare for people able to reproduce is already shocking enough – science finally confirmed what millions of women have been saying for a long time, that contraceptives can mess with our mental health. Boots’ decision to continue tacking up barriers to reproductive healthcare assumes women in the UK do not have the capability to make choices about their own bodies. It is unfair, alienating, and millions of us deserve better.