Emergency contraceptive pill hits Ontario market

A 1-year pilot study is allowing women in Toronto to receive emergency contraceptive pills (ECPs) directly from their pharmacists without a prescription.

Participating pharmacists are trained to screen women, using special forms to ensure they meet criteria to use the drug. The forms are then sent to a collaborating physician, who supplies “retrospective authorization.”

In British Columbia, where pharmacies also provide ECPs, pharmacists have “delegated authority” to prescribe the drug.> It is also available directly from pharmacists in Britain and France and in the states of Oregon and California.

Dr. Sheila Dunn, the coprincipal investigator of the Toronto pilot, said demand was much higher than anticipated during the Ontario project's first month. Interim data, which Dunn hopes to have ready by November, may determine whether the program receives ongoing funding. When the study is completed in 2003, the group funding it, the Ontario Women's Health Council, will make recommendations to the provincial government. The council was created by the Ministry of Health 3 years ago “to create a legacy of lasting systemic change in improving women's health care in Ontario.”

If taken within 72 hours of unprotected sex, ECPs reduce the risk of pregnancy by about 80%. Dunn says improved access to them may prevent abortions and unwanted pregnancies in Ontario, where about 43 000 therapeutic abortions are performed annually.

“Emergency contraception is currently underused because of a general lack of awareness about its availability and the difficulty in accessing treatment within the appropriate time frame,” says Dunn. Outside the pilot project, emergency contraception in Ontario is available only by prescription; the only exceptions are at some emergency units, sexual assault centres and public health units, where nurses distribute ECPs through protocols set up by local physicians.

The Ontario project, which began June 4, will eventually include some 50 Toronto-area pharmacies. It includes a consumer hotline (1-866-ECP-1ECP) and other consumer information, plus training for pharmacists and physicians.