The results of a recent study support allowing pharmacists to dispense mifepristone directly to people — like any other medication.1
“Our study found that pharmacists were easily able to provide mifepristone to people who needed it,” says Shelly Kaller, MPH, lead study author and project director at Advancing New Standards in Reproductive Health at the University of California, San Francisco. “This means we could provide this essential care to more people so they could not only get the medication from their abortion provider, but also from a pharmacist. People who are not able to go into a clinic could get their medication through telemedicine and by mail.”
Researchers trained pharmacists at six pharmacies in California and Washington to dispense the abortion medication to patients after the patients visited a medical provider in person. The standard practice was for mifepristone to be dispensed in person by a certified provider directly from their clinic or office.
“We got permission from the FDA to conduct this study where they’re still seeing a provider in person to assess their eligibility, but instead of getting medication directly from the provider, they have the option to be in this study and pick up mifepristone from their local pharmacy, along with other medication,” Kaller explains.
Kaller and colleagues wanted to know if this was feasible for pharmacists, and they wanted to learn more about pharmacists’ experiences with that process. “We interviewed 22 pharmacists before their pharmacies dispensed mifepristone, and 15 pharmacists after their pharmacies had dispensed it,” she adds.
The pharmacists were employed by community pharmacies, including hospital-affiliated and independent locations. “We asked them before and after their pharmacies had dispensed how supportive they personally felt, how comfortable they were with it, and what kind of concerns they had,” Kaller says. “The pharmacists were overwhelmingly supportive and felt comfortable — especially after receiving training on the medication. The process of dispensing it went really smoothly for them.”
The study concluded before the FDA announced in December 2021 that it would permanently lift the in-person dispensing requirement on mifepristone.2
“In 2020, the FDA, because of the COVID-19 health emergency, had stopped dispensing with the in-person requirement,” Kaller says. “As of December 2021, they removed the in-person requirement altogether, but they’re still working with manufacturers to implement the change.”
One or two pharmacists included in the study might have expressed concerns about the legality or liability for pharmacists. But once their pharmacies dispensed the medication, they no longer had those concerns. “With the right kind of training and structure in the pharmacy, hopefully some of those concerns would be allayed,” Kaller says.
The West Coast pharmacists also wondered how pharmacy dispensing of mifepristone could work in conservative Southern and Midwestern states or in smaller pharmacies. If a patient’s small-town pharmacy did not stock the drug or refused to dispense it, then the patient may not have another local option for obtaining it.
“It may not be completely black and white. There may be some states that allow abortion, but in a restrictive way,” Kaller adds. “People can get creative.”
The findings could be good news for states that will not ban abortions. It also is good news for women in those states because it offers easier access to abortion medication.
“Some people will always need or prefer a surgical abortion, but the medication abortion has the advantage of less person-to-person contact, and it’s provided more easily in places where surgical abortion is not available,” Kaller says. “If pharmacists can be part of that process, it allows more people to access that essential care and allows for abortion resources to be more available to others. I am hopeful that California would implement this quickly.”
Since California is experiencing high volumes of people traveling from other states to obtain abortion care, more legal abortion access options are needed.
“This option for pharmacists to provide the abortion pill could allow people to walk down the street to their local pharmacies if they need it, or to have it mailed to their homes by the local pharmacy,” Kaller explains.
REFERENCE
- Kaller S, Ma M, Gurazada T, et al. “No big deal”: A qualitative study of pharmacists’ perspectives on dispensing mifepristone for medication abortion. Womens Health Issues 2022 Jul 30;S1049-3867(22)00075-5.
- Reproductive Health Access Project. Update: FDA’s decision on mifepristone REMS. Feb. 2, 2022.
The results of a recent study support allowing pharmacists to dispense mifepristone directly to people — like any other medication.
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