Changes to mifepristone
From 1 November 2022 mifepristone (Mifegyne) for early medical abortion (EMA) will become available as a subsided medicine on a prescription. Up until 1 November, subsidies for mifepristone have been limited to authorised prescribers through a practitioner’s supply order (PSO).
Why has there been 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 local 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 local 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 safely and sensitively dispense EMA medicines, understand what to expect, and how best to support a pregnant person receiving EMA medicines.
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 which acknowledges a pharmacist’s right to hold a conscientious objections, and the pharmacist who holds such an objection, their requirement to ‘refers 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 are also able to apply for a Safe Area.
Please note that pharmacists dispensing EMA medicines are not required to submit abortion reporting to the Ministry. It is the person with overall responsibility, ie, the health practitioner who provided the abortion consultation and wrote the prescription, who is responsible for the reporting.