On Black Friday there’s a range of products you might reasonably expect to see advertised at a discount price. A TV maybe, a cashmere jumper, or perhaps a set of saucepans. But I certainly didn’t expect to find the morning-after pill nestled among the savings promoted on the Boots website as I scrolled through their offerings last week. And yet there it was, at a 50% discount.
Emergency contraception is something that provides a safety net should things go wrong during sexual intercourse, though many women and people with wombs wouldn’t plan to use it as the first line of defence against pregnancy. Since its introduction to the UK in 1984, it has provided us with an effective plan B in the event that other contraceptive measures fail.
Although the morning-after pill is supposed to be widely available, pharmacies up and down the country sell it at a steep premium, creating an unnecessary barrier for many people who need it.
So along with the UK’s leading reproductive healthcare charity, the British Pregnancy Advisory Service (BPAS), I’m calling on Boots to make this essential medication available for the half-price cost it was willing to sell it for during Black Friday promotions. This call is supported by 27 MPs, including Stella Creasy, Dawn Butler and Diane Abbott, who have also written to the company. Boots has shown it can afford to cut its prices. It now has the opportunity to lead the way on making this medication much more accessible to those in need. If it does, it could have a huge public impact.
Access to the morning-after pill used to be exclusively in the hands of the NHS. But a change in legislation in 2001 – ostensibly to try to bring down the amount of unintended pregnancies, especially among teenagers – made it available over the counter and without prescription in pharmacies for the first time.
Since then, emergency contraception has been free through GPs, some A&E services and sexual health clinics – but as an all-party parliamentary group on sexual health and reproductive services found in 2020, many people are facing significant challenges in accessing these services. Diana Johnson recently called it a “chronic underinvestment in sexual and reproductive healthcare”. With 800 GPs closing since 2013 and an average waiting time of over 7 days, free access can often be hard to come by.
And so while making the morning-after pill available in pharmacies did improve overall access to emergency contraception – especially for people who wanted to prioritise discretion – it also moved this basic healthcare essential into the hands of the free market, making it subject to inflationary pressures and competitive pricing. Or even seeing it become part of a Black Friday sale.
In 2021 at Boots you can expect to pay £28.25 for Levonelle (levonorgestrel) and £34.95 for ellaOne (ulipristal acetate), the two leading brands of emergency contraception. If you weigh over 70kg (the average weight of a UK woman), a double dose of Levonelle is recommended, meaning the cost can double too. These prices are matched by other high-street pharmacies, like Superdrug. And yet there are online-only pharmacies, such as Dr Fox and Chemist 4 U, offering non-branded equivalents for under £4.
For many people, the inflated cost in places like Boots is simply out of reach. The BPAS told me that this high cost has dire consequences for some women. “We see women experiencing an unplanned pregnancy because they were unable to access emergency contraception,” says Katherine O’Brien, associate director of communications and campaigns, “including women who couldn’t afford to purchase it.”
These days, according to Boots’ website, 85% of people in the UK live within 10 minutes of a branch of their store, making it by far the easiest option for women seeking an emergency solution, particularly given that the efficacy of this drug hinges on how soon after sex it is taken. In offering the drug at a 50% discount this week, the pharmacy has proved that it can afford to sell it at a much-reduced cost, so why not do so for the rest of the year?
At the end of the day, many people – because of work schedules or childcare responsibilities – simply do not have the time to queue for hours in a clinic or wait to see a GP. We should be doing everything in our power to break down barriers to access and enable everyone to avoid the potential emotional and financial stress that an unplanned pregnancy can bring.
The idea that pharmacies are profiting excessively from what we know can be an incredibly stressful moment in any woman’s life is simply unconscionable. In 2017, Boots resisted similar pressure to drop the price of this essential drug because they didn’t want to “incentivise improper use”. That was wrong. Now the pharmacy has another chance to do the right thing. Let’s hope they take it.