P.E.I. pharmacists say doctors shouldn't be dispensing abortion drug

P.E.I. College of Pharmacists says Health Canada rules could make it harder to access drug

Image | Abortion Pill

Caption: The drug can be used to terminate a pregnancy up to 49 days after conception. (Charlie Neibergall/Associated Press)

The Prince Edward Island College of Pharmacists is questioning the rules attached to an abortion drug recently approved for use in Canada.
Health Canada is allowing Canadian doctors to prescribe the drug Mifegymiso, more commonly known RU-486, as of July 1. The drug can be used to terminate a pregnancy up to 49 days after conception.
But the agency has placed an unusual restriction on how the drug can be dispensed: it's requiring prescribing doctors to dispense the drug themselves, rather than write up a prescription and send the patient to see a pharmacist.
"It was really interesting from a college perspective to hear Health Canada went in that direction," said Michelle Wyand, registrar with the P.E.I. College of Pharmacists.
"Pharmacists have been dispensing medications for many years, and are really probably the best-suited as far as infrastructure to be able to dispense medications … and have many standards of practice in place around dispensing medications."

'Ideal scenario'

Wyand said having a physician write a prescription which would then be filled by a pharmacist would have been "the ideal scenario" when it comes to RU-486. She said she's not aware of any other drugs on which similar restrictions have been placed, and she noted doctors' offices on P.E.I. are not set up to be able to dispense drugs.
Pharmacists have been dispensing medications for many years, and are really probably the best-suited as far as infrastructure to be able to dispense medications. -Michelle Wyand, P.E.I. College of Pharmacists
"The prescribing doctor is going to have to have access to that medication. They're going to have to have systems in place to be able to order and maintain inventory of that particular medication," said Wyand.
"They're also going to have to be able to ensure that the products are in date, so if they're going to maintain an inventory they're going to have to ensure that somebody is overseeing expiry dates."
Wyand also questions how patients would pay for the drug at a doctor's office.
"Physicians really don't have an infrastructure in place to be able to bill a patient for a medication," she said.
"It'd be very challenging for them, I believe, to bill a patient if there's private insurance, even to be able to exchange monies, it would be really difficult to be able to do that for a physician."

Image | RAMQ pharmacy

Caption: The P.E.I. College of Pharmacists says having a physician write a prescription which would then be filled by a pharmacist would have been 'the ideal scenario.' (Radio-Canada)

Rules could change

Wyand said the requirement for physicians to dispense the drug could make it harder to access on P.E.I., although she said there are still many questions about how RU-486 will be provided in the province, including whether the provincial government will pay for the drug.
If that's the case, she noted doctors could simply bill the province and physicians wouldn't have to be set up to accept payments.
Federal Health Minister Jane Philpott has said rules around dispensing Mifegymuso could change. Health Canada has also stipulated that doctors prescribing the drug are required to take an online training course on the drug.
While doctors can now legally prescribe the drug, it's not expected any supplies of the drug will be available in the country until the fall.