The mini pill is finally available without a prescription, but at a cost

In a landmark ruling, women in the UK will finally be able to access the contraceptive pill over the counter from the end of this month. The progesterone-only pill, also known as the mini pill, will be available in pharmacies without a prescription – but it will cost you.

Women wanting to access the mini pill over the counter will face a charge of up to £7.50 a month, and will have to have a brief consultation with the pharmacist. Those who want their contraception for free will still have to get a prescription from a doctor.

Lovima and Hana are the two brands of pills that will be available to buy. Both contain 75 micrograms of desogestrel, a synthetic progesterone, and are considered safe for most women to take.

Dr Asha Kasliwal, the president of the Faculty of Sexual and Reproductive Healthcare (FSRH), said in a statement that she “fully supports the reclassification of progestogen-only pills to a pharmacy medicine”, which is something the FSRH has “recommended for many years”.

“Progestogen-only contraceptive pills are safe, reliable, easy to use, and are an incredibly popular contraceptive method,” she continued. “Availability over the counter will make it easier for women to access essential contraception to avoid unplanned pregnancies during and beyond COVID-19. The fragmented sexual and reproductive healthcare system is notoriously difficult for women to navigate, and successive cuts to public health budgets have made it harder for women to get the contraception they need. Reclassification may also reduce unnecessary pressures on GPs, who will not need to see patients for repeat prescriptions.”

However, Kasliwal did criticise the decision to make the mini pill available only at a cost, adding: “We are calling for these pills to be available for free in community pharmacies, as well as for the reclassification of other contraceptives moving forward.”

Speaking to Dazed, Kasliwal expands on this. “There is a charge as with any other product or medicine sold in pharmacies,” she says. “For instance, you can buy emergency contraception (branded and generic preparations) in pharmacies despite it also being available for free on the NHS. This increases choice for those able to pay, but it should by no means be the default option.”

“To date, the progestogen-only pill has been available for free on prescription in contraception clinics, sexual and reproductive health clinics and GP surgeries,” Kasliwal explains. “Community pharmacies would need to be funded to provide this new NHS service for free to patients. Free and universal contraception is something that the Faculty of Sexual and Reproductive Healthcare will continue to strongly advocate for, and we hope to see the progestogen-only pill available for free in community pharmacies soon.”

In September, a report revealed that many women in England struggle to access contraception as a result of underfunding and cuts to services. The pandemic has only served to exacerbate these problems, with a number of women saying they’ve been unable to access their regular form of contraception during lockdown. Sales of the morning after pill dropped by half between March and April last year, after stay-at-home orders were imposed, proving that it’s too difficult to access and should be available without a consultation.

Though it’s not just access to contraception that’s difficult for women. Last month, social media was filled with testimonies of people in extreme agony during the procedure of having an intrauterine device (IUD) fitted, highlighting the fact that there still isn’t a pain or side-effect free contraception option for women.

“This increases choice for those able to pay, but it should by no means be the default option” – Dr Asha Kasliwal

One potentially fatal side effect of the combined pill hit the headlines recently, after the roll-out of the AstraZeneca COVID vaccine was paused due to its possible link to blood clots. In a feature for Dazed, writer Jessica Rawnsley said: “For many women, the debate sharply reinforced another one: gendered healthcare bias. Let’s put the peril in some perspective. Of the 18 million people who have received the vaccine in the UK, there were 30 reports of blood clots. In some estimates, the risk of blood clots when taking the combined pill is 1 in 1,000. Research has found the pill triples the risk of blood clots; in others it was found to increase it 7.5 times.” Meanwhile, the male contraceptive pill is still a decade away. 

Last year, a study explored the impact of a government scheme which offered financial incentives to GP surgeries that told patients about long-acting reversible contraceptives (Larcs) – including the coil, implant, and contraceptive injection. The scheme was introduced in 2009, but was scrapped last year.

Speaking to Dazed in September, Katherine O’Brien, the associate director of communications and campaigns at the British Pregnancy Advisory Service (BPAS), was critical of the scheme. “The aim of a contraceptive consultation should be to provide information that enables women to decide which is the right method for her. There is no ‘right’ method of contraception, yet sadly women have told us that they have felt pressured by their GP to choose a particular method. This damages the relationship between women and their healthcare professionals.”

Look back at women’s stories of IUD trauma and medical misogyny here.