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Mifepristone Access Through Community Pharmacies When Regulated as a Routine Prescription Medication.
Elizabeth Nethery1, Catherine Xu1,2, Carissa S Y Chan1
1Collaboration for Outcomes Research and Evaluation, Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, British Columbia, Canada.
JAMA Network Open
|November 6, 2025
Summary
Mifepristone-misoprostol abortion access in British Columbia shows 99% geographic coverage, but 23% of pharmacies failed to dispense or refer, impacting timely access for reproductive-aged females.
Area of Science:
- Reproductive Health
- Pharmaceutical Access
- Public Health Policy
Background:
- Mifepristone-misoprostol medication abortion became available in Canada in 2017 without restrictions.
- Despite widespread availability, patients report challenges in accessing this time-sensitive medication.
Purpose of the Study:
- To assess the availability of mifepristone within three calendar days at community pharmacies in British Columbia (BC).
- To evaluate the proportion of pharmacies dispensing mifepristone or providing valid referrals.
Main Methods:
- A population-based, cross-sectional study utilizing a mystery caller survey.
- Conducted in BC community pharmacies from July to August 2024.
- Surveyors posed as patients requesting mifepristone pickup within 3 days, assessing dispensing or referral capabilities.
Main Results:
- 66% of pharmacies could dispense mifepristone within 3 days; 12% provided a valid referral.
- 23% of pharmacies neither dispensed nor referred, placing the burden on patients.
- 99% of reproductive-aged females in BC lived within a 15-minute drive of a dispensing pharmacy.
- Urban pharmacies and those in areas with high residential instability or ethnocultural diversity showed poorer availability.
Conclusions:
- While geographic coverage for mifepristone dispensing is high, significant barriers to timely access persist due to pharmacy dispensing and referral failures.
- Findings suggest a need for policy interventions to strengthen pharmacist referral networks and improve medication abortion access.
- Results offer insights for international contexts considering similar medication abortion frameworks.
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