Across Europe, different policies regarding access to emergency contraception (EC) are in place. This affects the legal status of EC generally as well as which type of emergency contraceptive pills (ECPs) are available and how they can be accessed.
Changes in access in the European Union zone
Until December 2014, there were varying degrees of access to EC methods. In Croatia, Germany, Hungary, Italy, and Poland women needed to visit a health care provider in order to obtain a prescription before purchasing levonorgestrel (LNG) ECPs. In most EU countries, women could only purchase LNG ECPs in pharmacies, but in some countries, such as the Netherlands; Norway or Sweden LNG ECPs could also be bought from drugstores and other types of convenient stores. In Malta, ECPs were not licensed and were therefore unavailable. Also, up until December 2014, in all EU countries except for Malta and Estonia, ulipristal acetate (UPA) ECPs (commercialized in the European market since 2009), were available only with prescription. Italy was the only EU country that, in addition to a prescription, required a mandatory pregnancy test before women could obtain UPA ECPs.
Upon request of the manufacturer, in November 2014 the European Medicines Agency’s (EMA) Committee for Medicinal Products for Human Use (CHMP) recommended a change in classification status from prescription to non-prescription for UPA ECPs. The marketing authorisation for UPA ECPs (centralised for all EU countries at the EMA) was amended. In January 2015 the European Commission issued an implementing decision which was the last step to allow the sale of UPA ECPs without prescription in all the EU territory.
Although the European Commission’s decision was not legally binding, most (but not all) countries automatically implemented it, and UPA ECPs are since then available directly in the pharmacies without prescription. One year after the Commission decision (November 2015), the situation regarding ECPs in the EU was the following:
- UPA ECPs were available directly from the pharmacy in Austria, Belgium, Bulgaria, Croatia, Cyprus, Czech Republic, Denmark, Finland, France, Germany, Greece, Ireland, Italy, Luxembourg, Poland, Portugal, Romania, Slovakia, Slovenia, Spain, Sweden, Netherlands, and the United Kingdom. Age restrictions were set in at least 3 countries: Croatia and Italy (for women younger than 18) and Poland (for women younger than 15).
- In the Baltic sub-region, the marketing authorization process took longer in Latvia, Lithuania, and Estonia, and UPA ECPs became available later than in the rest of the region.
- In Hungary, in January 2015, the government informed that, due to patient safety considerations, it would continue to require a prescription for all types of EC.
- Malta remained with no ECPs product registered nor available (until December 2016).
- LNG ECPs remained a prescription drug in Hungary and Poland. In Croatia, Germany and Italy since October 2015, at least one brand of LNG ECPs was switched to non-prescription status.
Other changes took place in specific countries in the following years:
- Malta: In June 2016 the Women’s Rights Foundation filled a judicial protest to request access to ECPs. After an intense debate, in October the Maltese Medicines Authority announced the approval of the sale of EC pills without mandatory prescription in order to ensure quality, safety and efficacy. By December 2016 both UPA and LNG ECPs could already be purchased at the local pharmacies without prescription.
- Poland: In June 2017 the Polish government restated mandatory prescription for UPA ECPs. This type of ECPs were directly available from pharmacies in Poland only between April 2015 and July 2017. Since July 2017 women, again, need to visit a doctor and get a prescription before obtaining any type of ECPs.
- Andorra: In June 2018, health authorities switched LNG and UPA ECPs status, making them available without prescription for women over 16.
- Italy: In October 2020, the Italian Medicines Agency (AIFA) removed age restrictions to UPA ECPs: a prescription is no longer necessary for women 18 and younger.
While differences in general EC access policies have progressively diminished in the past 10 years, important differences remain and make EC access uneven and unequal within the region (and sometimes, within countries). For further information read “Access to emergency contraception through community pharmacies in Europe: findings from a participatory survey” published by ECEC and YouAct in January 2021.
For more information on EC access in specific countries, please visit the Country-by-Country Information page on this website. See also:
- An update on access to emergency contraception in Europe – February2022.
- Access to emergency contraception in some countries of the Balkans, Eastern Europe and Central Asia. (2017)
- An update on access to emergency contraception in European Union countries. (April 2016)
The information on this page is based on expert surveys carried out by ECEC in 2012 and 2015, and later (again) for specific countries. We also monitor EC news and consult national experts to keep our database as up to date as possible. If any of the above information has changed or if you have more details to share about your country, please email us at ecec [at] eeirh [dot] org.
Last update: February 2022
Previous update: October 2018