The federal government has pledged to run pharmacist-led prescribing trials that will see some contraceptives essentially become “over-the-counter” for women on low incomes.
Pharmacist-led prescribing is going national, but only for women with concession cards.
As part of the big-ticket $500 million funding package for women’s health announced earlier this month, the Department of Health and Aged Care promised $100 million to support two national pharmacist prescribing trials – one for uncomplicated urinary tract infections and one for “over-the-counter contraceptives”.
It’s set to begin in early 2026, and patients treated under the scheme will only have to pay “the usual medicine cost” for any medication that is prescribed as part of the consult.
Patients will not pay out-of-pocket for the consult component of the service.
It will only be open to the 250,000 women with Commonwealth concession cards.
This is the extent of the information published on DoHAC’s fact sheet about the funding package.
It does not specify which contraceptives are included under the “over-the-counter” banner, but the reference has been interpreted by multiple industry sources as a reference to the oral contraceptive pill.
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The TGA rejected applications to down-schedule oral contraceptives as recently as December 2021, citing “the adverse effects of oral contraceptive substances, and the potential for evolving risks over time” as being significant enough to require management by a medical practitioner.
According to the Australasian College of Pharmacy, existing clinical protocols and guidelines will be rolled out nationally “to ensure harmonisation and consistency”, with community pharmacists potentially ready to commence services from July 2025.
All jurisdictions are currently running trials and pilot programs that allow pharmacists to prescribe or resupply the oral contraceptive to women under certain conditions, under a private prescription model.
In a recent piece published by The Conversation, Gold Coast GP Dr Natasha Yates was the only health expert out of five interviewed who categorically did not endorse the federal government’s move to launch a nationwide trial.
“If this really is about supporting the people who are most vulnerable – and the people on the healthcare card are the most vulnerable – if anything, they should be the ones who are supported to get a proper consultation,” Dr Yates told The Medical Republic.
“[They need] somebody who can take a proper history, examine them and talk about all the other things to do with women’s health, not just ‘here’s a pill to stop you from getting pregnant’.”
The analogy that comes to mind, Dr Yates said, would be if the government were to provide tents and say it has fixed the housing problem; it does not address the underlying social determinants of health.
“It’s just not an okay way of resolving a problem with healthcare access for women,” Dr Yates said.
“And the problem is, if the general public doesn’t understand that women are getting a second-best deal, they’re going to let this just all happen, because it’s being sold to them as being improving access.
“What they don’t understand is that the longer-term consequences to women can be quite devastating.”
Dr Yates also said that, financially, the best value contraception for women on a healthcare card would likely be a long-acting reversible contraceptive like an IUD or bar.
“Pharmacists can’t install an Implanon or put in a Mirena,” she said.
“All they can offer people is a shorter-acting [solution] which they make money out of … they’re not giving women everything that they should be offering them, and it’s not their fault.
“I think the government’s great at turning these conversations into pharmacist-versus-GP, but it’s not; we are all members of the community.
“We all want the best options for our women, and I don’t believe this is the best option.”
