Abortion pills in Canada not covered by most provincial drug plans

Reports further added that already there had been a delay in the sale of Mifegymiso - that terminates pregnancy -  in Canada for more than one year due to the company’s manufacturing problems. Added to this was the fact that this drug could not be distributed by pharmacists.

The requiring physicians who were permitted to distribute Mifegymiso were restricted by the advocacy warnings. As a result, few physicians outside existing abortion clinics were able to offer Mifegymiso in their offices.

According to reports the company that manufactured Mifegymiso had decided not to include these drugs in the list of publicly funded drugs. The reason for this, added reports was the huge price of $72, 000 that the company had to pay for a for a standard review of the medication’s cost effectiveness.

This meant that most provincial drug plans won’t cover abortion pills in Canada and that women needing this drug would either buy these from their own pockets or rely on private insurance.

All the provinces, except Quebec felt that this decision by the company prevented them from adding the two-drug abortion regimen to their list of publicly funded drugs, added reports.

“It’s going to be a huge, significant barrier,” warned Dawn Fowler, the Canadian director of the National Abortion Federation (NAF), which represents abortion providers in North America, reports added.

Celopharma Ltd., the Canadian distributor for Mifegymiso had tried and failed to persuade the Canadian Agency for Drugs and Technologies in Health (CADTH), the independent body that oversees the Common Drug Review, to either drop or defer the fee. But the plea was declined.

Ellen Wiebe, the medical director of the Willow Women’s Clinic in Vancouver, said paying $300 for Mifegymiso would be a challenge, especially for women who are young or poor or both.

According to reports Mifegymiso was originally known as RU-486, and had been approved in more than sixty countries, including the United States, where it had been available since 2000. The funding problems had not only restricted Canadian women in the use of this pill, but also impeded its access in rural and small-towns in Canada, where even free surgical abortion clinics were not available.

“Taken together, these regulations are onerous, create administrative and practical barriers for women to access medical abortion and do not contribute to patient safety,” B.C. Health Minister Terry Lake wrote in a July letter to Dr. Philpott, added reports

Lake had already asked federal Health Minister Jane Philpott to look into the pricing options of Mifegymiso before it became available in early November, reports said.

Celopharma Ltd. had hoped to make the drug available earlier this year but the supplier of the second drug misoprostol failed an inspection and consequently the switch to a supplier in Britain, reports confirmed.

The reports added that women will not be able to have access to this drug even after the drug was available in November because doctors who were authorized to distribute these would have to take an online course that was still being finalized. This fact meant that women would have to wait until early next year to access the drug, reports said.

Reports added that Mifegymiso was made up of two medications, sold together in a combination pack. The first, mifepristone, blocked the hormone progesterone, causing the lining of the uterus to break down. The second drug, misoprostol, was to be taken twenty-four to forty-eight hours later, and induced contractions similar to a natural miscarriage.

According to reports, bringing the drug to Canada had been a long and strenuous process. Linepharma International Ltd., a small European drug company, first applied to Health Canada to sell mifepristone here in December of 2011.

It was only in July 2015 that Health Canada finally approved the drug. This approval was accompanied with a list of conditions which the company proposed. These included the distribution of the pills to patients only by doctors. The doctors were also required to perform an ultrasound beforehand to make sure that pregnancy was not ectopic (outside the uterus) and the pregnancy less than forty-nine days, said the report.

The rules, according to reports, also required women to make a return visit to their doctor to ensure the abortion was complete. In the rare instances where pregnancy continued even after taking the pills, there was a risk of birth defects in the baby reports said and added that there had been rare cases of sepsis, or blood poisoning, following use of mifepristone.

On the whole, mifepristone was considered extremely safe. According to a review of forty-five thousand medical abortions published in 2013 in the journal Contraception serious complications occurred only in 0.4 per cent of cases.

Health Canada stated that it had no role in deciding which drugs are covered by the provinces. But the federal department stated that was open to changing some of the rules around the drug, only if the risks to women could be minimized, said the reports.

“In almost every other country, because of the potential risks associated with [mifepristone], there is some sort of constraints and restraints on how to access that,” said Supriya Sharma, chief medical officer for Health Canada. “We’re always open to making changes. [But] if I can underscore one thing, it has to be supported by appropriate science and evidence.”, reports said.

(Reporting by Asha Bajaj)