The 3rd and 4th generation pill crisis last year pushed 20% of French women to change oral contraception. According to the ANSM, sales of 3rd and 4th generation pills have fallen by 26% this year. The patients abandoned these pills in favor of those of the 1st and especially of the 2nd generation. Indeed, the risks of vein thrombosis (phlebitis, pulmonary embolism) in women using a 3rd generation combined oral contraceptive (COC) (containing desogestrel or gestodene) or a pill containing drospirenone are twice as high as in women using a 2nd generation pill containing levonorgestrel. Due to the risk of thrombosis, France withdrew from the market on May 21 the anti-acne treatment Diane 35 (and its generics) too prescribed as a contraceptive. And the French health authorities had also decided in January to no longer reimburse the 3rd and 4th generation pills. This decision has been effective since March 31, 2013.
“Over a million women have changed contraception. There has been no increase in abortions, ”said Mahmoud Zureik, director of“ strategy and international affairs ”at the ANSM. There was just “a small increase in the sale of morning-after pills of 5% at the end of August”, compared to the previous period, he reports.
Ansm recommendations
The National Medicines Safety Agency (Ansm) reminds prescribers to always look for risk factors, especially thrombosis, when prescribing a pill to a new patient.
For this, it is necessary to proceed to a complete examination of the personal and family medical history in order to identify possible risk factors, in particular of venous thrombosis, to identify smoking, to carry out a clinical examination in order to detect in particular a eventual arterial hypertension, and perform a lipid balance and a blood glucose test.
