Women in the UK can now buy the morning-after pill from an online pharmacy for as little as £4.99.
A nonbranded version of levonorgestrel 1500mcg, an oral emergency contraceptive pill, can be purchased from Chemist-4-U for £4.99 and Levonelle, the branded version of the same drug, which is most commonly sold by pharmacies, can be bought for £9.99.
Both drugs, which contain the same active ingredients, can be taken to prevent pregnancy up to 72 hours after having unprotected sex. EllaOne, another one-step emergency contraceptive pill, which can be taken 120 hours after unprotected sex, is on sale at Chemist-4-U for £19.99.
While other online pharmacies have previously offered emergency contraception, and it can be purchased in a pharmacy shop without a prescription, it usually costs up to £30. Emergency contraception is available for free if a prescription is obtained from a GP or sexual health clinic.
The British Pregnancy Advisory Service (BPAS) is actively campaigning to reduce the cost of emergency contraception, as well as do away with the consultation process that is required when purchasing it from a pharmacy, because it is believed that both of these things inhibit women's ability to access the drug.
"There is no financial justification for the high price of this pill, nor clinical reason for a consultation before it can be sold," Ann Furedi, the founder of BPAS, said during the launch of the "Just Say Non" campaign, which looks to bring the price of emergency contraception more in line with the rest of Europe, where it is much cheaper.
“People are trusted to use a wide variety of medications sold on the shelves of pharmacies in a sensible and appropriate way," Furedi added.
James O'Loan, the pharmacist superintendent for Chemist-4-U, told BuzzFeed News the company was keen to support BPAS's efforts to lower the cost of emergency contraception.
"The higher price point can exclude people of lower incomes and therefore potentially lead to unwanted or unplanned pregnancy," O'Loan said. "Studies have shown that women feel the price is too high, and also that it is not easily accessible."
A spokesperson for the Faculty of Sexual and Reproductive Healthcare (FSRH) of the Royal College of Obstetricians and Gynaecologists told BuzzFeed News it believed "the cost of levonorgestrel emergency contraception in
pharmacies, for those who have to pay, is unjustifiably high in the UK".
The generic morning-after pill medication levonorgestrel can be manufactured by numerous drug companies, resulting in competitive pricing. O'Loan said that Chemist-4-U is able to offer it at such a low price because the consultation is completed in the form of an online questionnaire: It therefore requires fewer staff than a pharmacy shop and can be bought in advance.
"If an advanced supply is in place it can help to prevent unplanned pregnancy in individuals whose barrier methods have failed. We want to promote safe sex always but accidents happen, and it’s always best to be prepared," O'Loan said.
FSRH's spokesperson said the organisation would "support the advance provision of emergency contraception in line with current NICE [National Institute for Health and Care Excellence] guidance where the regular contraceptive method being used is subject to 'user failure'".
A spokesperson for BPAS agreed that purchasing the pill in advance was a good option. "We think it makes absolute sense for women to have a pill at home in case accidents occur. Emergency contraception is extremely safe, and the earlier it’s taken, the more effective it is. It totally belongs in the bathroom cupboard."
After BuzzFeed News recently reported on campaigns to make it easier to buy emergency contraception cheaply and without consultation, we were contacted by a handful of people who believed the removal of these barriers could actually be detrimental to women.
One pharmacist told us they felt that selling the drug without consultation could mask situations where the woman intending to take it was being sexually abused.
A spokesperson for End Violence Against Women (EVAW), a charity supporting women who have been abused, worried that restricting access to emergency contraception for this reason was problematic.
"On the one hand, we don’t think limiting women’s access to whatever type of contraception is helpful," the spokesperson said. "It’s really important that women have access to contraception and that’s a really important part of their freedom and their ability to have control over their bodies.
"Free reproductive rights are an important part of women’s freedom."
But on the other hand, the spokesperson added, "controlling fertility is a key aspect of coercive relationships. Some women might get very little contact with people who can help them, so keeping those doors open is very important". With the right training, the charity said, the consultation process could be hugely important in spotting signs of abuse.
BPAS believed the consultation process could actually have the opposite effect and make women less likely to open up about sexual assault.
"A mandatory consultation is, if anything, a deterrent to women seeking help and in our experience women who have suffered sexual assault can find the questioning, which can take place on the shop floor, extremely inappropriate and upsetting," its spokesperson said.
They added that when they had asked people for feedback on their experiences buying emergency contraception, one woman had responded with the following: “The pharmacist just gave me a lecture in the middle of the shop floor, in front of the condom shelves, about how I needed to be more careful and use condoms.
"I was raped. I felt ashamed and it's one of the things that happened after being raped that helped to retraumatise me.”
O'Loan said that this was an issue Chemist-4-U took very seriously, and that there were processes in place to try to spot unusual activity even with an online consultation.
"If a woman was ordering emergency contraception from us constantly, it would flag immediately to the pharmacist, who would then look to reach out to the patient to ascertain the reasons for multiple purchases," he told us.
"It could be that the patient is using it as [a] regular method, which we would advise against and promote other methods such as barrier or daily hormonal contraception, or as you rightly point out it could be that that patient is being subjected to abuse.
"If we suspected this to be the case after a discussion with the patient herself we would look to forward our concerns to the relevant local authority."
He added that most of the company's transactions for the drug so far had been “one-off purchases".
EVAW's spokesperson said the charity did not take a specific stance on the purchase of emergency contraception online, but reiterated that "women need the freedom to be able to have access to contraception".
"Controlling fertility is a key aspect of coercive relationships, but limiting access to contraception feels like a bit of a sledgehammer for that."
Laura Silver is a reporter for BuzzFeed News and is based in London.
Contact Laura Silver at firstname.lastname@example.org.
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