Abortion pill coverage won’t lead to increase in terminations: province
Mifegymiso available to Albertans only through doctor’s prescription
Alberta’s decision to begin covering the cost of a medical abortion pill is not expected to increase the number of terminated pregnancies in the province, the government says.
In a set of written statements to the Journal this week, Alberta Health officials said their belief is largely based on data from the United States, where the drug Mifegymiso has been available since 2000.
“Experience from the United States shows that while the percentage of completed abortions reported as early medical abortions has increased, the abortion rate has been in decline,” the statement said.
The reasons for this decline are a matter of debate, though better access to birth control may be playing a role. Other observers have suggested the trend may be tied to some states making it more difficult for women to terminate a pregnancy.
Statistics from the Canadian Institute of Health Information indicate the abortion rate in Alberta also has been declining in recent years.
The province recorded 13,358 abortions in 2015, a number that has remained relatively stable for close to decade despite a substantial increase in Alberta’s population.
The province said it estimates about 30 per cent of the abortions currently performed in Alberta may meet the criteria for using Mifegymiso. As such, it is believed roughly 4,000 prescriptions for the drug could be filled in the province each year.
One of the government’s main reasons for covering the drug is to provide women a more convenient method of terminating a pregnancy, especially women in rural areas who currently have to travel to a major city to get a surgical abortion.
It might be expected the improved accessibility offered by the pill would lead to an increase in abortions, but the government said it doesn’t believe that will come about if Alberta follows the U.S. trend.
New Brunswick and Alberta are the first two provinces in Canada to introduce universal coverage for Mifegymiso. Ontario and Quebec have also announced plans to cover the pill.
Q How can women obtain the drug in Alberta?
A Mifegymiso is available only through a doctor’s prescription. An ultrasound is also required to determine the age of the pregnancy and to rule out an ectopic (tubal) pregnancy. If a patient meets the criteria, she can then get the prescription filled by a pharmacist at no cost. No upfront payments are required.
Q What are the restrictions?
A The drug is approved by Health Canada to terminate pregnancies of up to 49 days. The manufacturer is seeking to extend the limit to 63 days.
Q How many pharmacies are currently stocking the drug?
A The number is unknown. Pharmacies are not required to keep a stockpile of any drug, but most can usually get any medication delivered within a day or two.
Q How difficult is it to get an ultrasound? Is there a long wait list?
A Health officials did not provide an average wait time, but indicated waits are likely to be in hours rather than days or weeks. Alberta Health said there is adequate capacity in community imaging clinics, where most of the ultrasounds will take place. In places that don’t have a clinic, patients can go to an Alberta Health Services facility.
AHS said there are approximately 200 ultrasound units in its facilities, and at least double that number in private clinics. For women approaching the 49-day deadline for the drug, physicians can ask that their ultrasounds be prioritized.
Q Will universal coverage of Mifegymiso create any extra costs or savings for the government?
A If Alberta Health is correct in its prediction that the drug won’t prompt an increase in overall abortions, then costs should be relatively unchanged.
The Canadian Agency for Drugs and Technology in Health reports the average cost of a medical abortion using Mifegymiso is about $610, which includes the cost of the drug itself ($300) plus the ultrasound and visit to the doctor. That’s $89 more than a surgical abortion performed in a clinic, where most terminations are performed in Alberta. An abortion performed in a hospital is $916 more expensive than a termination done using Mifegymiso.
Q For physicians prescribing Mifegymiso, do they need any special training?
A An education course is recommended by Health Canada, but it is not mandatory.
The training is available online. Physicians can take a one-hour, non-accredited course or a sixhour version that counts toward their continuing medical education credits. It is not known how many Alberta doctors have received the training.