Insights: Primary Care Clinicians Can Partner with Pharmacies for Medication Abortion Care
Written by Sally Rafie, PharmD, BCPS, APh, FCCP, FCPhA
Primary care clinicians can prescribe mifepristone and misoprostol to be dispensed by a pharmacy as a means to increase access to medication abortion. Patients can fill the prescriptions at a certified brick-and-mortar or mail-order pharmacy of their choice. In January 2023, pharmacies were granted the ability to dispense mifepristone with the modification of the Risk Evaluation and Mitigation Strategy (REMS). There is not widespread availability yet, though the number of certified pharmacies is slowly growing.^1-2 Pharmacy dispensing of mifepristone and misoprostol enables expanded access to medication abortion care via telehealth and by clinicians who cannot stock and dispense the medications in their practices.
Dispensing mifepristone at pharmacies may be advantageous for some patients. Most notably, it allows patients to pick up their medication at a location that is convenient for them. This can be especially beneficial for individuals who face transportation barriers or live in rural areas with limited access to health care facilities. Many pharmacies have extended hours of operation in the evenings and weekends. Additionally, pharmacy dispensing can help destigmatize medication abortion by allowing people to access mifepristone the way most other medications are accessed.
Pharmacists can counsel patients when picking up their prescriptions, ensuring they understand how to take the medications, what to expect, and how to follow up. This interdisciplinary approach provides patients access to comprehensive information that is reinforced by multiple health care team members.
While most pharmacies routinely stock misoprostol, mifepristone is new for them. The mifepristone REMS requires pharmacies to become certified before they can stock and dispense the drug. The pharmacy certification process involves completing a pharmacy agreement form, confirming the ability to ship mifepristone with tracking information, and ensuring dispensing of mifepristone in a timely manner to patients.^3 Pharmacies are more likely to pursue this if they are aware that local providers will be sending prescriptions for it. If you are planning to prescribe these medications, consider contacting your local pharmacies to collaborate in meeting patient needs. Pharmacies providing direct contraception care will likely be willing partners.
Expanding access to medication abortion is a critical step towards ensuring reproductive autonomy and health care equity for all individuals. With collaboration and commitment from primary care and pharmacy team members, we can overcome barriers to access for patients seeking abortion services.
To find a certified pharmacy, view the lists of certified pharmacies available on the Danco and GenBioPro websites. You can also email Danco (info@earlyoptionpill.com) or GenBioPro (info@genbiopro.com) for help finding your nearest certified pharmacy, as not all pharmacies participate in the public directories.
RHAP Resources:
Telehealth Care for Medication Abortion Protocol
Telehealth Care for Medication Abortion Workflow
Abortion Pill Info to Read Prior to Phone Visit
Partner Resources:
- Clinic and Pharmacy Collaboration for Medication Abortion
- Birth Control Pharmacist
- Medication Abortion Care Resources
- Birth Control Pharmacies
Sources:
Pharma-free: The Reproductive Health Access Project does not accept funding from pharmaceutical companies. We do not promote specific brands of medication or products. The information in the Insights is unbiased, based on science alone.
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