Public consultation ARM 43: Request to reclassify azithromycin 500mg from POM (prescription only medicine) to P (Pharmacy)

Consultation ARM 43 (205Kb) sought  your views on the reclassification from POM to P of  azithromycin 500mg.  The reclassification summary and patient information leaflet included in the consultation document available to download below.

Outcome of consultation exercise ARM 43 - 6 August 2008
A total of 52 responses to the consultation were received, of which 37 supported the reclassification from POM to P, 6 did not support the reclassification, 7 raised issues but expressed no definitive views, and 2 had no comments.

Those in favour considered the reclassification would provide easier and effective access to treatment for patients, who may find difficulty in opening up about sensitive issues with GPs, especially teenagers. Early treatment of this prevalent infection may help reduce the chances of onward transmission and also help to reduce incidence of infertility in the long-term.

Pharmacy availability of azithromycin supports self care. Pharmacies are conveniently located and have more flexible opening hours including at weekends. Pharmacists are accustomed to dealing with patients who wish to discuss sensitive, confidential issues or symptoms, for example,  through the provision of emergency hormonal contraception. Some pharmacies are already involved in chlamydia services and have demonstated that provision through a community pharmacy is safe and effective.

Organisations supporting the reclassification
These included:

• Medical colleges - the Royal College of General Practitioners (RCGP), the Royal College of Physicians (RCP), the Royal College of Obstetricians (RCOG), Royal College of Physicians and Surgeons of Glasgow (RCPSG) 
• Pharmacy organisations - Royal Pharmaceutical Society of Great Britain, National Pharmacy Association, Company Chemists Association and other representative organisations, Chief Pharmaceutical Officer, Scotland
• NHS organisation representatives – PCTs, NHS Trusts, Sexual Health Departments, NHS Boards (Scotland)
• Other organisations including the British Association for Sexual Health and HIV, National Chlamydia Screening Programme, HPA Sexual Health Programme and Centre for Infections, Terrence Higgins Trust, Centre for Sexual Health and HIV Research, Independent Healthcare Advisory Service.

Organisations not supporting the reclassification
These included the British Medical Association, the Pharmaceutical Society of Northern Ireland and an NHS Trust. 

Organisations raising issues but not expressing a definitive view included the Advisory Committee on Antimicrobial Resistance and Healthcare Associated Infection (ARHAI) and the Royal College of Physicians of Edinburgh (RCPE).

A number of issues were raised by all respondents in relation to aspects of the pharmacy provision, including communication between pharmacy and local sexual health services, partner notification and treatment, suitability of IT systems for security/ patient confidentiality, and the emergence of antimicrobial resistance.

Copies of the responses (excluding those marked as "in confidence") are available below.

The following table broadly indicates how pharmaceutical bodies, medical bodies, and others responded to the consultation.

Professional Pharmaceutical Societies, Individual Pharmacists, Prescribing Advisers of PCTs etc and other pharmaceutical bodies
Yes to Reclassification Prescribing Advisor (1) (15Kb) Co-operative Pharmacy Association (9) (49Kb) Pharmacist NHS Borders (15) (60Kb) Boots Pharmacists’ Association (16) (42Kb) Association of Independent Multiple Pharmacies (AIMp) (18) (114Kb) Pharmaceutical Services Negotiating Committee (35) (196Kb) National Pharmacy Association (36) (386Kb)
Yes to reclassification but issues raised NHS Ayrshire and Arran Pharmacy and Prescribing Team (17) (158Kb) Royal Pharmaceutical Society of Great Britain (RPSGB) (31) (144Kb) Pharmacy & Prescribing Support Unit, Greater Glasgow & Clyde NHS Board and NHS Greater Glasgow and Clyde Area Pharmaceutical Committee (32) (136Kb) NHS Fife Area Drug and Therapeutics Committee (33) (100Kb) Lothian Area Pharmaceutical Committee (34) (61Kb) Chief Pharmaceutical Officer, Scotland (42) (61Kb) Principal Pharmacist Hounslow PCT and Primary and Community Care Network Colchester General Hospital (44) (139Kb) North East Lincolnshire PCT Prescribing Committee (25) (55Kb) UKCPA (30) (50Kb) Company Chemists Association (CCA) (37) (349Kb)
No to reclassification Pharmaceutical Society of Northern Ireland (19) (44Kb) Hospital pharmacist (20) (37Kb) Individual pharmacist (24) (28Kb)

Medical Colleges, Clinicians and other medical/professional bodies
Yes to reclassification Individual doctor (2) (51Kb) GUM consultant Centre for Sexual Health and HIV Research (7) (37Kb) Individual NHS University Hospital (5) (51Kb) Individual GUM specialist (21) (37Kb) Independent Healthcare Advisory Services (4) (36Kb) Royal College of Physicians and Surgeons of Glasgow (6) (44Kb) Family Planning Clinic (14) (37Kb) Consultant in Sexual and reproductive health (26) (34Kb) Paediatric Chief Pharmacists Group (39) (29Kb) Association of Medical Microbiologists (48) (23Kb) Royal College of Obstetricians and Gynaecologists (50) (171Kb) Individual (NHS hospital) (10) (52Kb)
No comment British Association of Dermatologists (51) (29Kb)
No definitive views on reclassification but issues raised Royal College of Physicians of Edinburgh (38) (197Kb) Nurse Practitioner Team, St Mary’s NHS Trust (41) (106Kb) Antimicrobial Resistance and Healthcare Associated Infection (ARHAI) (45) (401Kb) Health Protection Agency Sexual Health Programme (46) (132Kb) Confidential response (47) Confidential response (49)
Yes to reclassification but issues raised Head of Family Planning, West Hertfordshire Hospitals NHS Trust (8) (51Kb) Royal College of Physicians (11) (54Kb) Royal College of General Practitioners (12) (101Kb) National Chlamydia Screening Programme (27) (192Kb) Confidential response (29) Individual (13) (129Kb) Sexual Health Team County Durham and Darlington Public Health (43) (40Kb)
No to reclassification Individual doctor (22) – confidential response British Medical Association (28) (116Kb) Health Adviser, Chlamydia Screening Programme (23) (42Kb)

Industry
No comment Wyeth (52) (27Kb)

Patient Groups, Consumer Groups, Charities and Members of Public
Yes to reclassification Individual (3) – confidential response Terrence Higgins Trust (40) (105Kb)