Medication abortion: Potential for improved patient access through pharmacies
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Figure 1
Medication abortion as a percentage of total nonhospital abortions and abortion rate in the United States, 2005-2014.6-9 The left y-axis and corresponding bar graph (blue) show the proportion of all nonhospital abortions that were medication abortions by year. The right y-axis and corresponding line graph (red) show the annual abortion rate per 1000 women 15-44 years of age.
Abstract
Objectives
To discuss the potential for improving access to early abortion care through pharmacies in the United States.
Summary
Despite the growing use of medications to induce termination of early pregnancy, pharmacist involvement in abortion care is currently limited. The Food and Drug Administration's Risk Evaluation and Mitigation Strategy (REMS) for Mifeprex® (mifepristone 200 mg), the principal drug used in early medication abortion, prohibits the dispensing of the drug by prescription at pharmacies. This commentary reviews the pharmacology of medication abortion with the use of mifepristone and misoprostol, as well as aspects of service delivery and data on safety, efficacy, and acceptability. Given its safety record, mifepristone no longer fits the profile of a drug that requires an REMS. The recent implementation of pharmacy dispensing of mifepristone in community pharmacies in Australia and some provinces of Canada has improved access to medication abortion by increasing the number of medication abortion providers, particularly in rural areas.
Conclusion
Provision of mifepristone in pharmacies, which involves dispensing and patient counseling, would likely improve access to early abortion in the United States without increasing risks to women.
Disclosure: The authors have no conflicts of interest to disclose.
Funding: This work was supported by a grant from Fidelity Charitable.
