A recent study reveals that while many pharmacies in British Columbia can provide the abortion pill mifepristone quickly, significant barriers remain for some women needing this crucial medication. Published on November 6, 2023, in JAMA Network Open, the research offers an important overview of pharmacy-level access to mifepristone across the province.
Mifepristone is a medication used for medical abortions and can be prescribed by any physician or nurse practitioner in Canada. Following regulations in 2017, Health Canada lifted previous requirements for pharmacists to complete specific training or for pharmacies to register with the manufacturer, aiming to improve access to abortion care. The study indicates that while access has improved notably, gaps persist.
Dr. Elizabeth Nethery, the lead author and a postdoctoral research fellow at the University of British Columbia’s faculty of pharmaceutical sciences, emphasized the importance of timely access. “In abortion care, every day matters,” she stated. “The medication is approved for use up to the ninth week of pregnancy, but people usually become aware they’re pregnant at around six to seven weeks, so timely access is important to maintain and respect a person’s choice to have an abortion.”
Access Patterns Revealed
The research team conducted a “mystery shopper” survey in the summer of 2024, contacting more than 1,400 pharmacies across British Columbia while posing as patients seeking mifepristone. The results showed that two-thirds, or 67 percent, of pharmacies could fill the prescription within three days, a timeframe considered acceptable for urgent care.
Interestingly, rural pharmacies performed slightly better than their urban counterparts. Researchers speculate that in smaller communities, pharmacists are more familiar with local medication stock and can coordinate better. In contrast, urban pharmacies, despite being more numerous, often directed callers to “try somewhere else” without offering assistance.
The study found no significant link between pharmacy chain affiliation and access levels. Independent, franchise, and large-brand pharmacies exhibited similar availability, indicating that corporate structure does not necessarily predict access.
Challenges and Recommendations
Among the pharmacies that could not fill prescriptions within the three-day window, only one in three provided a valid referral to another pharmacy that could. This lack of robust referral practices creates additional stress for patients, particularly those in marginalized or lower-income communities. For example, a patient in Vancouver may need to contact five or six pharmacies just to find one that has mifepristone available, wasting valuable time and increasing anxiety.
Dr. Laura Schummers, a senior author and assistant professor at UBC’s faculty of pharmaceutical sciences, highlighted the impact of these challenges. “It should be straightforward,” she noted, expressing concern over the unnecessary hurdles faced by patients.
To address these issues, researchers advocate for better communication among pharmacies, clearer referral systems, and ongoing training for pharmacists. Dr. Schummers remarked, “In many ways, what we found is a success story. When mifepristone is treated like a routine prescription, B.C. pharmacies are, for the most part, supporting local access to this important health care service.”
The findings of this study underscore the need for continued efforts to bridge gaps in access to mifepristone in British Columbia, ensuring that all individuals can receive timely and equitable care.
