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Pharmacists can feasibly dispense mifepristone for abortions

The United States Food and Drug Administration (FDA) currently prohibits pharmacists from dispensing the abortion drug mifepristone. But ANSIRH researchers found that most pharmacists were willing to be trained on how to dispense mifepristone and did so with few challenges when given the opportunity—supporting a removal of FDA restrictions.

Key Findings

Among 72 pharmacists invited to participate in a mifepristone dispensing study, 78% received a one-hour training on how to do so.
83% of respondents to a follow-up survey after the study were very or somewhat satisfied with mifepristone dispensing, while more than half reported experiencing no challenges dispensing the medication. Nearly all said the training was “very” or “somewhat” sufficient.
Four of 72 pharmacists, or 6%, declined to participate in mifepristone dispensing.
At the end of the study, pharmacists demonstrated a higher level of medication abortion knowledge, particularly on topics most relevant for dispensing, such as dosing, contraindications, efficacy, and safety.

Study Design 

Researchers administered surveys to pharmacists before and after a study on mifepristone dispensing that included training for pharmacists. The surveys measured medication abortion knowledge, along with perceptions about benefits and challenges of the model. The team administered follow-up surveys in the study’s final month that re-assessed knowledge and perceptions, as well as pharmacists’ satisfaction and experiences with mifepristone dispensing.

Implications

At a time when abortion access in some states is extremely limited, the FDA’s in-facility dispensing requirement for mifepristone further constrains patients’ ability to obtain care. This study suggests that it would be feasible for pharmacists to dispense mifepristone if the agency’s restrictions are lifted. However, if pharmacists are allowed to dispense mifepristone, training materials and opportunities will be important to ensure successful implementation.

“If pharmacist dispensing becomes possible, it will be important to address as a part of training relevant legal statutes and pharmacists’ obligation to refer to a willing dispenser in the case of pharmacist refusals. There is also a potential role for mail-order pharmacies to dispense the medication in settings where few pharmacies or pharmacists agree to stock or fill prescriptions for mifepristone.”

The article, Pharmacists’ knowledge, perspectives, and experiences with mifepristone dispensing for medication abortion, is available in Journal of the American Pharmacists Association.

Additional Resources