| In Australia, the oral contraceptive pill (OCP) is only available by prescription. Moving this option over the counter (OTC) could expand accessibility and potentially reduce unintended pregnancies by offering a more convenient pathway for women to obtain the most popular form of contraception. Yet, do Australian consumers even want that? A recent study indicates that making the pill available without a prescription would likely encourage more women to use it, particularly those who currently use less effective contraceptives or nothing at all.
Unintended pregnancy poses significant public health, societal, and economic challenges in Australia, creating financial pressures for women and families. The study from the Macquarie University Centre for the Health Economy highlights the potential for non-prescription access to reduce healthcare costs by lowering GP visits for repeat prescriptions and decreasing costs associated with abortion and related healthcare needs.
To understand preferences around contraceptive access, the researchers conducted a discrete choice experiment (DCE), a method often used to analyse consumer choices by presenting various hypothetical scenarios. The DCE considered factors such as method of access, annual costs, provider training, opportunity for broader health discussions, and consultation time. In total, 902 Australian women of reproductive age participated, with 386 current OCP users seeing a “status quo” option that mirrored their usual access method and 516 non-users given an “opt-out” option to express a preference for no contraceptive access.
The study’s results indicate clear trends: non-users were generally receptive to OTC access if it was available both in-person and online but placed high importance on privacy, expressing strong reservations towards settings with limited confidentiality. For cases where a prescription was necessary, telehealth was the preferred option due to its convenience.
For women who already use OCPs, traditional GP visits were favoured, likely due to the opportunity for private, in-depth consultations. Both groups rated lower costs and provider training as highly important, with non-users willing to pay an extra $77 annually for privacy in OTC settings and current OCP users willing to pay up to $165 for similar privacy assurances.
Variations in preferences were influenced by factors like education, empowerment, and relationship status, underscoring the need for tailored options to meet diverse consumer needs. Policymakers could consider expanding the role of pharmacists in providing OCPs, especially for repeat prescriptions. This expansion should include measures to maintain privacy during consultations and ensure that pharmacists are adequately trained to provide counselling on contraception. Such a policy could improve access to contraception, particularly for non-OCP users who are more open to using pharmacies. To encourage uptake, this service must also be affordable and cost-effective. |
