Pfizer’s ‘gender-based’ decision to stop making Depo Provera confounds clinician

VANCOUVER (NEWS 1130) — The injectable contraceptive Depo-Provera will be in short supply by summer, something a sexual health nurse says will have a “huge impact” on her patients.

Pfizer has confirmed in an email to NEWS 1130 that it will stop manufacturing some drugs at its Kalamazoo production site until early in 2022 “as part of its efforts to prioritize manufacturing of the Pfizer-BioNTech COVID-19 vaccine to help meet the urgent needs of the pandemic.”

Nicole Pasquino, Clinical Practice Director at Options for Sexual Health, says switching methods will be challenging for her patients because this form of contraception is unique. While it’s the only injectable option, and it doesn’t have estrogen in it, one of the main reasons people use it is because it’s discreet.

“What that means is there’s no package to be found, there’s no device to be found. You can’t tell anybody’s on it,” she explains, noting a shot is only required once every three months.

“This impacts a large portion of our population. Youth who don’t want their parents or friends to know that they’re taking contraception, people who experience domestic violence, sometimes their partners don’t want them to be on contraception. They’ll come in and access this type of contraception so that no one’s aware.”

The organization will be making appointments with all patients who use Depo-Provera so they can counsel them about alternatives. However, Pasquino says telling people they need to forego something that works for them will be a challenge.

“There’s lots of great contraceptive options in the market, but we know from research that the best contraception that someone uses is the one that they choose to use,” she says.

“We’re going to have to switch people to other contraceptions that maybe aren’t their first choice, that maybe aren’t the best product for them. Then we have to work with them around side effects or issues that they’ll experience with their new contraception.”

‘It’s a gender-based decision’

Pasquino questions the decision to cut this drug, which an estimated 5,000 people in B.C. use, for which there is no substitute, and which is crucial for pregnancy and family planning.

“A complete stoppage of a product that is the only product on the market, it just seems like poor business to me. Ethically I’m not sure how they would come to this decision,” she says.

This is a medication that is being taken off the market that affects gender, it’s a gender-based decision. It doesn’t impact anyone else except for women.”

A spokesperson for Pfizer says clinicians should “reserve supplies” for “vulnerable populations” as production comes to a halt.

“We understand and regret the challenges this situation poses to patients. We are actively working to mitigate supply interruptions. Patients will need to consult with their healthcare professional to choose an alternate contraceptive option,” a statement reads.

Pasquino hopes Health Canada can intervene and either find a way to produce the medication locally, or at least secure a supply.

When it comes to Pfizer, she says she has not received a satisfying response to her inquiries.

“We did reach out to them and we got a generic email back saying that they are looking for solutions,” she says.

“But really, a discontinuation of a product for more than a year that many, many people rely on — it isn’t really a solution.”