“Sorry this product isn’t covered by the Pharmaceutical Benefits Scheme, you’ll have to pay full price - is that okay?”
“Yes! Absolutely! Thank heavens I’m not paying a luxury goods and services tax on sanitary pads and tampons so I can afford to pay full price for the Pill. Oh wait…”
Last month when I went to fill a prescription for the Combined Oral Contraceptive Pill (the Pill), I didn’t realise it would elicit weeks of outrage and research. Surrounded by the usual gendered products - expensive pink razors, ibuprofen targeting period pain at three times the price of the identical product in generic packaging, and my personal favourite, Natio’s everyday facial moisturiser for men at half the price and twice the SPF as the one marketed at women -- I was informed that the Pill I had been prescribed wasn’t deemed ‘necessary’ and therefore was not government subsidised.
Why? Because I am not in a monogamous sexual relationship. The Pill isn’t the most logical nor complete contraceptive for me and, like many other women, my decision to go on the Pill was made largely for its positive side effects. Think: clear dewy skin all month-long and far fewer nice underwear ending up stained in the back of the drawer.
In 1961 Australia was the second country in the world to make the Pill legally available. It's hard to believe this nation was once progressive when just last year Tony Abbott was the Minister for Women. Despite 80% of Australian women taking the Pill at some point in their lives we’ve made very little progress on women’s sexual health (and let’s face it a whole pile of other things) in the last sixty-odd years. The Pill is only available for purchase with a prescription and only one new version of the Pill has been added to the PBS since 1996. Compare this with England where the Pill is available over the counter for free at all pharmacies and community and sexual health clinics. It is abundantly clear, Australia has a lot of catching up to do.
The only new Pill granted PBS status in the last two decades has been the Femme-Tab ED 20, a lower dose of the standard ethinylestradiol and levonorgestrel Pills (Femme Tab ED 30/50 and Levlen ED) already subsidised. Although Femme-Tab ED 20 is a welcome addition to the PBS as lower hormonal doses reduce the likelihood of negative side-effects including breast tenderness and nausea, it lacks the potential benefits of newer Pills containing drospirenone (Yaz, Yasmin) or cyproterone acetate (Brenda-35 ED, Diane 35-ED) instead of levonorgestrel. These ‘new generation’ Pills are far more likely to reduce hormonal acne and symptoms of premenstrual syndrome (PMS).
And yes, that is ‘syndrome’ not ‘stress’ as I was lead to believe, reducing the ‘S’ in PMS to stress has historically been used to dismiss and shame women suffering from a legitimate medical condition with symptoms ranging from mood swings, anxiety and depression to hot flushes and migraines.
All Pills have side effects and affect women in different ways. It is important to give women the opportunity to trial different types of the Pill to find one where the benefits outweigh adverse side effects. Expanding the coverage of PBS to bring the cost of newer versions of the Pill down from $120 a year to the subsidised cost of $20 would ensure women, especially those of lower socioeconomic status, are choosing a Pill based on performance not price.
This may seem like a minor issue but in our current political landscape, where rich white men are slashing public health in ways that disproportionately affect women (you can expect another month of ranting by yours truly when I am asked to pay for my next pap smear), we need to stand up and demand comprehensive and affordable women’s health care. We need more giant tampons dancing outside of Parliament and less dudebros inside it deciding they know what is best for women’s health.