National Partnership for Women & Families

In the News

Legal medication abortion drug unavailable to women in Canada

Although Canadian regulators approved a medication abortion drug last year, the drug is still not available, and women's health specialists have expressed concerns that dispensation regulations will limit access once it comes to market this fall, CBC News reports (Lunn, CBC News, 7/6).

Background

Canada's public health ministry, Health Canada, in July 2015 approved mifepristone, one of the drugs involved in a medication abortion, for use in the country. The approval aligned Canada with roughly 60 other countries where mifepristone has been legal for some time.

Mifepristone in Canada is also referred to by the brand name Mifegymiso (Women's Health Policy Report, 8/3/15).

Access barriers

While the drug was scheduled to be available via physician prescription as of July 1, the drug will not be available in Canada until this November, CBC News reports. Celopharma, the company that distributes the drug in Canada, did not give a reason for the delay.

Meanwhile, women's health specialists have flagged concerns about how the rules regarding dispensation of the drug could restrict access to medication abortion when Mifegymiso comes to the market. To prescribe the drug in Canada, doctors must complete an online training course. Further, doctors authorized to prescribe the drug must dispense it themselves, rather than referring a patient to a pharmacy.

Women's health specialists have said the dispensation protocol could keep family doctors in remote areas from distributing the drug, as they do not have training in drug dispensation or maintenance. Wendy Norman of the Society of Obstetricians and Gynaecologists of Canada stated, "Most family physicians we've spoken to don't have any mechanism to sell drugs to their patients." She noted, "You also need to buy, stock, store and maintain a stock," which "is outside the expertise of physicians."

Given the rules, Norman said she expects only large practices in urban areas will be able to provide medication abortion. Meanwhile, in "[a]ll of these communities where abortion is not currently available, and where women are having to travel long distances and leave their families, and leave their jobs, the situation won't change," she said.

In addition, CBC News reports that some provincial colleges of physicians and surgeons do not permit physicians to dispense drugs, which means that doctors in certain regions would have to obtain special permission to dispense the medication abortion drug.

In a May letter to Health Canada, Fleur-Ange Lefebvre, executive director and CEO of the Federation of Medical Regulatory Authorities of Canada, wrote, "Dispensing by physicians is not normal practice (and could be a conflict of interest) and has the potential to create additional barriers for patient access."

Potential for change

Federal Health Minister Jane Philpott acknowledged the concerns regarding medication abortion and said there is potential for changing the distribution protocol. "They can always be adjusted along the way with appropriate evidence and reassurance that the system is functioning appropriately," she said.

Separately, Paula Tenenbaum, a spokesperson for Celopharma, said the company "is working very hard along with providers across the country and leading advocates to open the restrictive distribution of Mifegymiso in Canada" (CBC News, 7/6).