Pharmacists can effectively dispense mifepristone for abortions

Published March 11, 2021

Current FDA requirements mandate that mifepristone be dispensed by certified healthcare providers in clinics, medical offices, or hospitals. In this study patients were prescribed mifepristone and misoprostol by a clinician and received the medications from trained pharmacists at a nearby pharmacy. This research demonstrates that pharmacists can safely and effectively dispense mifepristone for medication abortion, and most patients are satisfied with this model of care.

Key Findings

Over 90% of patients in this study indicated their support for pharmacists dispensing of mifepristone. The vast majority reported that they were satisfied with this model of care and that they had received adequate information, either from the clinician or pharmacist.
Among participants with follow-up data, 93% had a complete abortion, and none had an ongoing pregnancy. These outcome proportions are similar to those where the medications are dispensed by a clinician.
Patients had no adverse events related to pharmacist dispensing. Only 1.5% of patients had adverse events possibly related to the abortion.
One-third of participants who had had a prior medication abortion reported that the experience of getting the medications at the pharmacy was better than clinician-dispensed mifepristone.

Study Design

For this study, after evaluating patients for eligibility for medication abortion, clinicians transmitted an electronic prescription for mifepristone and misoprostol to a nearby pharmacy. Patients went to the pharmacy, where they received the medications from trained pharmacists. Patients took the medications at home and had standard follow-up with the clinic.

Researchers enrolled 266 patients at eight study sites in California and Washington State, each of which was paired with a nearby pharmacy that agreed to dispense mifepristone. Participants were sent web-based surveys about their experience and outcomes on Day 2 and 14 after enrollment. Researchers also obtained clinical information from patient health records.

This study demonstrates that medication abortion may be offered with a high level of effectiveness and patient satisfaction, and low prevalence of adverse events, without requiring mifepristone to be dispensed in the clinic or medical office. However, there is potential for improvement, with some patients citing pharmacy wait times and confusion on the part of pharmacists as reasons for being less than very satisfied with the pharmacy experience. Another possible concern is refusal on the part of individual pharmacists or pharmacies to dispense or stock the medication, which could limit the feasibility of the model.

“Participants wrote they appreciated the ability to schedule when they would take the medications, which improved convenience and allowed them to have more control over when the abortion would take place.”

The article, Medication abortion with pharmacist dispensing of mifepristone, is available in Obstetrics and Gynecology.

Additional Resources

Allowing pharmacists to dispense medication abortion on prescription could improve access to early abortion care
The FDA’s REMS effect on access to medication abortion

Areas of Research