GPs cleared to give latest birth Pill

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The Independent Online
FAMILY DOCTORS are to be allowed to prescribe newer brands of the Pill after a policy U-turn by the Department of Health on advice that caused a scare over the contraceptives four years ago and sent abortion levels soaring.

In 1995, the Committee on Safety of Medicines (CSM) sparked a health scare by advising GPs not to give out "third-generation" brands. But yesterday it effectively rescinded its own advice. The department said it wanted to reassure women that the Pill was safe, but family-planning groups said the move proved the scare was a "disaster that never should have happened".

Abortion levels soared after the CSM said research showed that newer brands of the Pill increased the risk of blood clots. The third-generation drugs, which were taken by 1.5 million women, contained gestodene or desogestel and included such names as Femodene, Marvelon, Mercilon and Minulet. As women stopped taking the Pill, the number of abortions rose by 29,000, and has since failed to drop to pre-scare levels.

Dr Jeremy Metters, the government's deputy chief medical officer, declared yesterday that the increased danger of clotting was extremely small. The risk of contracting venous thromboembolic disease (VTE), which clots the blood in legs, stood at 25 cases per 100,000 women per year of use of third-generation contraceptives.

However, to offer clear advice to patients, all packets of these brands will now carry leaflets showing that the risk of clots is nearly twice as high as for older drugs.

Dr Metters also announced that he was sending new advice to all GPs to allow them to prescribe the newer drugs as a first choice, as long as they discuss the risks with the patient first. In 1995, the CSM recommended that GPs should not prescribe these Pills for women at risk of VTE and should use them only in those who were intolerant of older brands and were prepared to accept the risk.

"It is important to remember that the risk of thromboembolism is very small and that the Pill is a very effective form of contraception," he said.

Dr Metters dismissed suggestions that the advisers had made a grave mistake in 1995. "They gave the advice that they thought was right at the time," he said. "We are still talking about tiny risks. Women should not think that this is any great risk, but they have a right to be aware of the data. We would have been criticised if we had sat on the data."

Asked if he regretted that the scare led to a surge in the abortion rate, Dr Metters said: "Of course I regret unnecessary abortions. Any abortion and any unwanted pregnancy is a matter of regret."

Professor Walter Spitzer, author of one of the pieces of research that prompted the original warning and a subsequent critic of the CSM for its "overreaction", said: "It's three or four years overdue. I never saw the need to change the regulations in the first place."

The British Pregnancy Advisory Service, Britain's biggest provider of abortion services, said it welcomed the return to first-line use of the brands. Its spokeswoman, Ann Furedi, said it had warned in 1995 that the advice given by the CSM was unnecessary and alarmist.

"It was a disaster that should never have happened. It caused a massive hike in the rate of unwanted pregnancies, it undermined confidence in the Pill. We still see women requesting abortion who wrongly believe the Pill is dangerous."

A spokeswoman for the British Medical Association said: "GPs were critical in 1995 of the way this whole issue was handled and it was a nightmare, with increased abortions and unwanted pregnancies. We now seem to be getting back to a situation where doctors can prescribe the contraception that they feel is best for their patients on the basis of their medical history and discussing it with women... we welcome it."

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