Approved but Unavailable: A Mystery-Caller Survey of Mifepristone Access in a Large Ontario City

• DOI: 10.1016/j.jogc.2023.06.009
• Publication Date: 2023-06-29T01:18:34Z
• Authors: Giuliana Guarna; Maryam Kotait; Rachel Blair; Nancy Vu; Donika Yakoub; Rhianna Davis; Dustin Costescu
• Keywords: Stock (firearms)

Mifepristone/misoprostol (mife/miso) has been approved in Canada since 2017, and is available since 2018. Mife/miso does not require witnessed administration in Canada, and therefore most patients obtain a prescription for home use. We sought to determine the proportion of pharmacies in Hamilton, Ontario, Canada, a city of over 500 000, that had combination mife/miso in stock at any given time.A mystery-caller approach was used to survey all pharmacies (n = 218) in Hamilton, Ontario, Canada between June 2022 and September 2022.Of the 208 pharmacies that were successfully contacted, only 13 (6%) pharmacies had mife/miso in stock. The most commonly cited reasons for the medication being unavailable were low patient demand (38%), cost (22%), lack of familiarity with medication (13%), supplier issues (9%), training requirements (8%), and medication expiry (7%).These findings suggest that while mife/miso has been available in Canada since 2017, significant barriers remain to patients accessing this medication. This study clearly demonstrates a need for further advocacy and clinician education to ensure mife/miso is accessible to the patients who require it.