ArticleJAMA network open2025
Mifepristone Access Through Community Pharmacies When Regulated as a Routine Prescription Medication.
Article in JAMA network open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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13 authors.
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Abstract
Importance: The mifepristone-misoprostol medication abortion regimen became available in Canada as a normally prescribed medication, without restrictions, in 2017. Despite rapid uptake, patients have reported difficulty accessing this time-sensitive medication. Objective: To quantify mifepristone availability within 3 calendar days at community pharmacies. Design, Setting, and Participants: This population-based, cross-sectional study using a mystery caller survey was conducted from July to August 2024 at community pharmacies in British Columbia (BC), Canada. Exposure: Surveyor posing as a patient with a prescription for mifepristone who requests to pick up the medication within 3 calendar days. For nondispensing pharmacies (ie, unable to dispense within 3 days), surveyors requested a referral to a dispensing pharmacy. Main Outcomes and Measures: Proportion of pharmacies that could dispense mifepristone or provide a valid referral to a dispensing pharmacy; proportion of reproductive-aged (15-49 years) female population residing within 15-minute walking and 15-, 30-, and 60-minute driving times of a dispensing pharmacy, and proportion of the population with poor local availability (<50% of available pharmacies dispense mifepristone). Results: Among 1460 of 1482 community pharmacies, 962 (66%) could dispense mifepristone within 3 days and 169 (12%) provided a valid referral. Only one-third of nondispensing pharmacies (169 of 498 pharmacies [34%]) provided a valid referral to a dispensing pharmacy; 329 pharmacies (23%) neither dispensed within 3 days nor provided a valid referral. Almost all reproductive-aged females (1 095 915 of 1 110 218 females [99%]) in BC lived within a 15-minute drive of a mifepristone-dispensing pharmacy. Urban pharmacies were more likely to be nondispensing and nonreferring (relative risk [RR], 1.78; 95% CI, 1.19-2.80) and less likely to offer same-day dispensing (RR, 0.39; 95% CI, 0.30-0.51) compared with rural pharmacies. Populations in areas with the most residential instability (RR, 1.41; 95% CI, 1.19-1.67) or greater ethnocultural diversity (RR, 1.36; 95% CI, 1.15-1.61) had poorer local availability of mifepristone-dispensing pharmacies. Conclusions and Relevance: This cross-sectional study found 99% of reproductive-aged BC females lived within a 15-minute drive of a mifepristone-dispensing pharmacy; however, despite relatively good geographic coverage and mifepristone being available as a routine prescription, 23% of pharmacies neither dispensed within 3 days nor provided a valid referral, putting the onus on patients to identify a dispensing pharmacy. These findings may inform policy and initiatives to enhance pharmacist referral networks and improve mifepristone access, as well as service planning for international jurisdictions considering a similar medication abortion framework.
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