Access to abortion drug could be hampered by lack of coverage

Exclusion from most provincial plans will restrict Canadian women’s access to the ‘gold standard’ drug

Access to abortion drugs has been a hot-button topic among Canadian women, with many voicing concerns over prohibitive pricing. This is evident in the case of Mifegymiso, otherwise known as RU-486, which is widely known as the gold standard in medical abortion drugs.

According to a report on the Globe and Mail, Mifegymiso is made up of two drugs, bundled together in a single pack. The first, mifepristone, is a hormone blocker that causes the uterine lining to break down; the second, misoprostol, is taken 24 to 48 hours later to induce contractions that mimic a natural miscarriage.

The drug has already been approved in more than 60 countries, including the United States. Health Canada approved it in July 2015, but with several conditions. These include stipulations that doctors distribute the pills directly to patients, and that they perform an ultrasound beforehand to ensure that the pregnancy is neither ectopic nor further along than 49 days.

Women are also required to revisit their doctor to ascertain that the abortion was successful. While mifepristone is considered extremely safe, with one study by Contraception finding complications in 0.4% of cases, there have been rare instances of blood poisoning following use of the drug.

The newest hurdle is the revelation that the pills, which cost $300, will not be covered by most provincial drug plans. This is because of the manufacturing company’s July decision to opt out of a standard review of the medication’s cost-effectiveness – a review that comes with a $72,000 price tag.

The evaluation is a critical step on the path to obtaining eligibility for public reimbursements for new drugs, meaning that once the product becomes available in Canada later this year, women will have to purchase it with their own money. While surgical abortions are available for free across the country, they are nearly impossible to avail of outside of major cities.

British Colombia Health Minister Terry Lake has already asked federal Health Minister Jane Philpott to step in on the price issue and to relax the stipulations Health Canada has imposed for Mifegymiso before it enters the market as early as November.

“Taken together, these regulations are onerous, create administrative and practical barriers for women to access medical abortion and do not contribute to patient safety,” he said in a July letter to Dr. Philpott.

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