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Changes to mifepristone

Since 1 November 2022 mifepristone (Mifegyne) for early medical abortion (EMA) became available as a subsidised medicine on a prescription. Prior to 1 November 2022, subsidies for mifepristone were limited to authorised prescribers through a practitioner’s supply order (PSO).

Why was there a change?

Providing funded access to EMA medicines in the community supports the intent of the 2020 reform of the Contraception, Sterilisation and Abortion Act 1977 to provide equitable and timely access to abortion services. Having EMA medicines available on prescription to pick up from a pharmacy, instead of the person having to travel to a hospital or clinic to pick up medicines, improves availability, choice, and removes a potential access barrier.

What this means for pharmacies

This change means that some people may choose to fill their prescription for EMA at a community pharmacy that stocks these medicines.

What pharmacists need to know

The pharmacist education package, developed by the Goodfellow Unit, is now available for pharmacists:

 

The course provides the knowledge necessary to dispense EMA medicines, understand what to expect, and how best to support a person receiving EMA medicines safely and sensitively.

No requirement for pharmacies to supply EMA medicines

There is no requirement for a pharmacy to provide medicines used for medical abortion. A pharmacist may hold a conscientious objection to supplying these medicines and a pharmacy business may decide not to supply these medicines.

Pharmacists are reminded of their obligations under the Pharmacy Council’s Code of Ethics 2018- that acknowledges a pharmacist’s right to hold a conscientious objection, and for the pharmacist who holds such an objection, their requirement to ‘refer patients to alternative providers if personal moral or religious beliefs prevent the pharmacist from providing a professional service, and appropriately facilitates continuity of care’ (Principle 2: H).

Pharmacists who choose to supply EMA medicines

If a pharmacy chooses to supply medicines for EMA, under the legislation the pharmacy meets the legal (but not clinical) definition of an abortion provider and so must appear on a list held by the Ministry of Health, and is also able to apply for a Safe Area.

Please note that pharmacists dispensing EMA medicines are not required to submit reporting to the Ministry. It is the EMA prescriber's overall responsibility, (ie, the health practitioner who provided the abortion consultation and prescription), who is responsible for the reporting.