E-drug: OCs OTC (cont)
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In the US, OCs remain on prescription after two national meetings on the
issue in 92 and 93, the first sponsored by the Alan Guttmacher Institute
and the second by the Henry J. Kaiser Family Foundation, both attended by
govt officials, medical experts, women's advocacy organizations and other
research and provider organizations. Here the requirement for a
prescription is quite strictly enforced. However, the FDA no longer
considers a full physical exam necessary to initiate OC use. The
arguments for OTC focus on general safety and access, the arguments
against focus on specific contraindications and the importance of
counseling and followup re side effects and correct use. The Kaiser
Family Foundation has published a monograph on the issue. Any requests
should be sent to them at 2400 Sand Hills Road, Menlo Park, CA 94025, fax
415-854-4800 (no email).
Pills are distributed OTC in most developing countries, although in some
of those countries written gov't policy states otherwise. In those
countries, pregnancy is far more dangerous than the pill and access to
medical care is poor, making OTC the safest option. Family Health
International and the Population Council among others have done extensive
research on distribution of OCs, and the safety and effectiveness of use in
developing countries. Community based distribution systems (with
non-medical providers) and social marketing programs (with distrib
primarily by pharmacies) are sanctioned by many of those countries and
often supported by intl donor organizations.
Note: WHO recently issued new guidelines for contraindications for all
contraceptive methods, using a 1-4 scale for level of medical oversight
required.