Emergency contraception in the United Kingdom and the Netherlands

PIP: In both the UK and the Netherlands, emergency contraception is an established part of family planning practice and its cost is covered by the national health insurance systems. The experience in these two countries points to the needs both for education of providers and potential acceptors and for a comprehensive network of sources of method supply. In the UK, where the Department of Health has approved emergency treatment for up to 72 hours postcoitally, there is support for making PC4 (50 mcg of ethinyl estradiol and 0.5 mg of norgestrel) available from pharmacists without a physician's prescription. 2.5 million packets of PC4 have been sold since the regimen was licensed in 1984. A PC4 dose costs US$19-74 and saves the government health service $727-806 per unwanted pregnancy averted. Emergency contraception users in the Netherlands tend to be adolescents who have never been pregnant and seek the method from a family planning clinic. There are serious concerns about the strength of the hormonal dose required in the Yuzpe method and calls from the medical profession to make RU-486 available. In both the UK and the Netherlands, the success of postcoital contraception as a method of last resort is related to the overall high quality and accessibility of the national family planning programs.