Abstract

background

Following the OTC switch of oral emergency contraceptives in Germany the question arises whether oral hormonal contraceptives should also be available without prescription.

objectives

The aim of this evaluation of eight surveys within pharmacies, physicians, patients and stakeholders, was to find out whether oral hormonal contraceptives would be accepted as an OTC (pharmacy-only) drug within the healthcare professional community and whether there is a visible need for such an Rx-to-OTC switch. At the same time, reasons for or against such a switch were evaluated.

methods

Several quantitative surveys were initiated, using different methodologies. A total of eight large-scale surveys and one stakeholder survey were conducted. The pharmacist surveys were conducted exclusively on-line. The physicians’ survey was made available online and additionally as a paper sheet for return by fax. The respective questionnaires contained between five and 17 questions on the topic Switch and could all be answered in about five to ten minutes. The BAH Health Monitor hosted the patient survey and included telephone interviews. The qualitative stakeholder survey included personal interviews.

results

940 pharmacists and pharmaceutical technical assistants took part in the initial pharmacist survey. In the subsequent pharmacist surveys, the number of participants was high at almost 4,000. Within the physicians’ survey 540 responses were received and within the BAH Health Monitor 1,000 telephone interviews were conducted. In the stakeholder survey, 24 interviews were conducted with 32 participants from a wide-range of professional backgrounds; most of them involved in aspects of the German switch process. 61% of the participating physicians younger than 50 years see oral contraceptives as possible switch candidates. On the question of how practical implementation should take place, 40% of all 3,854 participants of a pharmacy survey voted for an initial diagnosis and prescription setting by the physician and subsequent OTC delivery.

conclusion

Most pharmacists have a conservative attitude to a switch of oral contraceptives even though most feel that that the work could be done in pharmacies. Doctors and patients participating in the various surveys are partly open to a switch of oral contraceptives. Stakeholders, however, anticipate opposition from German gynaecologists.