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Mail-Order Pharmacy Dispensing of Mifepristone for Medication Abortion After In-Person Screening
Daniel Grossman1, Sarah Raifman1, Natalie Morris1
1Advancing New Standards in Reproductive Health, Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Francisco, Oakland, California.
Mail-order pharmacy dispensing of mifepristone for medication abortion is effective and feasible. This approach improves patient access to essential reproductive healthcare services, demonstrating high satisfaction and safety.
Area of Science:
- Reproductive Health
- Pharmacology
- Public Health
Background:
- The US Food and Drug Administration previously mandated in-person dispensing of mifepristone, creating barriers to medication abortion access.
- Mail-order pharmacy services offer a potential solution to enhance accessibility for patients seeking medication abortion.
Purpose of the Study:
- To evaluate the effectiveness, patient acceptability, and feasibility of using a mail-order pharmacy for dispensing mifepristone for medication abortion.
- To compare outcomes with traditional in-person dispensing models.
Main Methods:
- A prospective cohort study involving 11 clinics across 7 states from January 2020 to May 2022.
- Included participants seeking medication abortion up to 63 days' gestation, receiving mifepristone and misoprostol via mail-order pharmacy after in-person screening.
- Data collected via medical records and patient surveys at 3 and 14 days post-enrollment.
Main Results:
- Medication abortion was effective in 97.8% of cases, with 85.5% of participants receiving medications within 3 days.
- Patient satisfaction was high (91.2%), with 90.4% willing to use mail-order dispensing again.
- Serious adverse events were rare (0.6%) and not associated with mail-order dispensing.
Conclusions:
- Mail-order pharmacy dispensing of mifepristone is an effective, acceptable, and feasible method for medication abortion.
- This model demonstrates a low rate of serious adverse events and can significantly improve access to care.
- Expansion of this care model is recommended to broaden access to medication abortion services.
