Why British Women Are Forced to Pay More for the Morning-After Pill

British women pay more for emergency contraception than almost anyone else in Europe, apart from the Republic of Ireland, according to new research from the European Consortium for Emergency Contraception.

In the UK, women obtaining Levonelle—the most popular progesterone-based morning-after pill—without a National Health Service prescription will pay up to £33 ($48). Those purchasing alternative ellaOne (also progesterone-based, but effective for longer) will pay up to £45 ($65). This prohibitive pricing makes the UK the most expensive country in Europe when it comes to accessing emergency contraception with the exception of Ireland, which is itself hardly a shining example of women's access to basic reproductive rights. By comparison, women in Belgium over the age of 21 will pay £6.80, or around $10. In France, the morning-after pill is about five times cheaper than it is in the UK.

While emergency contraception is available on the NHS free of charge, it needs to be prescribed by a doctor. Getting an appointment within the three-day window in which Levonelle is effective is often near impossible, given the unprecedented pressures currently faced by the public health care system. One 2015 study from the NHS regulator found that a third of patients had difficulties getting GP appointments, most of which aren't open at weekends or in the evenings anyway

None of the alternatives are great for women, many of whom may be balancing work and childcare commitments. Take time off work to spend hours waiting in a NHS walk-in centre, bite the bullet and purchase the pill at a pharmacy, or risk it and hope that everything will be okay? If you don't have accommodating employers or can't afford to just pay, it's easy to understand why many women leave it to chance.

Clare Murphy from the British Pregnancy Advisory Service is campaigning to make emergency contraception more affordable. "Levonelle has been around for donkey's years and it's extremely safe. But women are paying over £30 to access it, which is considerably more than they pay in almost every European country with the exception of Ireland. It's really hard to understand why it's being priced at this level, but the intention seems to be to deter women from using it."

The morning-after pill is still subject to a huge amount of stigma. A study from sexual health charity FPA found more than half of under 24 year olds thought asking for it was "embarrassing," and 46 percent didn't know where they could get it if they needed. Meanwhile, the British right-wing tabloid press runs thundering headlines about "promiscuity pills" that apparently allow morally questionable young women to engage in reckless behaviour because of the "existence of a perceived safety net." The implication that women who access emergency contraception are promiscuous has the effect of deterring many women, with predictably grim consequences.

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In Murphy's view, pricing the morning-after pill with the intention of deterring widespread use actually interferes with women's basic reproductive rights. "There are all sorts of reasons why women may need the emergency contraceptive pill—condoms may fail or pills may be forgotten. It's really important that women can access emergency contraception, and there's no clinical need for women to be made to have medical consultations. It's an extremely safe medication; safer than many you can buy on the shelves of pharmacies without prescriptions."

I ask Murphy whether making emergency contraception available off the shelves at pharmacies might encourage women to use it as a regular contraceptive option. "What we need in this country is a new discussion around contraception, so that we can make it absolutely clear that the emergency contraceptive pill is a safe option and something women should feel relaxed about using." According to official WHO data, repeated use of the emergency contraceptive pill poses "no known health risks," although it may decrease in efficiency if used repeatedly.

It's important to point out that the British government doesn't actually have the power to lower the price of the morning-after pill as it's currently stocked in pharmacies, because individual retailers set the price. However, the government could reclassify the pill—meaning that pharmacists didn't have to consult with patients before prescribing it—in effect lowering the cost to consumers. BPAS recommends making it available at £10 to £15 on pharmacy shelves without the need for a pharmacist's consultation, like cough syrup or painkillers.

In Murphy's view, we need to have a revolution in how we view emergency contraception. "It's safe, it's effective, and it should be accessible at a price women can afford. There's no need for all the shame and stigma that currently accompanies it, the fact that it's seen as a sort of 'slut's charter'. We feel profoundly that this is an issue of a woman's basic reproductive rights, and not something we should shame or deter women from using."