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Ministry OKs proposal for online morning-after pill prescription in exceptional cases

The contraceptive pill "Norlevo," left, which is accepted for distribution in Japan, is seen alongside an imported foreign brand, Ella, said to be effective for a longer period of time, in this undated photo. (Mainichi/Toshiyasu Kawachi)

TOKYO -- The emergency contraceptive morning-after pill could soon be available for prescription via online consultation only in limited circumstances, after a Ministry of Health, Labor and Welfare review panel accepted drafted revisions to guidelines June 10.

In the event that a patient cannot receive face-to-face consultations with medical professionals due to difficulty obtaining an appointment quickly or for mental health reasons, a prescription would be delivered by post without a physically present discussion. Because of set criteria in the accepted proposal, challenges remain in creating a framework to help people who need the medication.

Revisions to the medical payment system in fiscal 2018 first introduced the possibility of online consultation. But as a general rule, it forbids first-time diagnoses and prescription of medication by medical professionals online, meaning they must be done face-to-face.

Under the review panel's proposed changes, the drugs, which can reduce the chances of pregnancy by around 80% if taken within 72 hours after sexual intercourse, could be dispensed after online consultation beginning with the first time in exceptional circumstances. Acceptable circumstances cited by the panel include geographical factors, or if professionals at a consultation center for issues such as sexual abuse decide a patient would be mentally distressed by direct discussion with a doctor.

Only obstetricians and gynecologists, and doctors who have received specialized training would be authorized to distribute the contraceptives. To avoid the possibility of the drugs being resold, just one pill can be included in a prescription, which must be taken in front of a pharmacist. Additionally, doctors would seek an in-person follow-up appointment three weeks later to check if the pregnancy was successfully avoided.

Other first-time consultations that can be carried out solely online due to exceptional circumstances include smoking cessation services.

The health ministry intends to implement the amended guidelines as early as July, following a public comment procedure in which opinions from ordinary citizens will be canvassed on the proposed changes.

(Japanese original by Hiroyuki Harada, Lifestyle and Medical News Department)

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