Mail order abortion pills are safe and effective
May 30, 2024
Source: Grossman, et al JAMA Int Med May 13, 2024
Only a minority of abortions in the US are surgical procedures, and restrictions on abortion access in much of the country have increased attention on medication abortion. Medication abortions require prescriptions for mifepristone, which causes the abortion, and misoprostol, which leads to uterine contractions that help complete the procedure. The Supreme Court is expected to rule next month on a lawsuit that could limit access to mifepristone. Misoprostol could be prescribed without mifepristone but has a lower success rate.
Researchers reported this week in JAMA Internal Medicine on medical outcomes and satisfaction with abortion medication prescribed by five family planning clinics and six primary care clinics in seven states where the medication was delivered “next day” by a mail order pharmacy. Few provider offices carry these medications, so delivery via mail order allowed prescription by providers that otherwise did not provide abortion care.
Patients were enrolled when they sought medication abortions at less than nine weeks (63 days) of pregnancy. Medication abortion terminated pregnancy in 97.8% of recipients. About 1 in 20 (5.3%) required an additional dose of misoprostol. Of 510 abortions, there were five incomplete abortions and there were six ongoing pregnancies. There were 10 emergency department visits and one blood transfusion for bleeding and one infection treated with antibiotics. Patient satisfaction with medication abortion was 90%, and patient satisfaction with mail order delivery for abortion pills was 94% (see chart above).
Implications for employers:
Mail order delivery of abortion pills can make abortion more accessible and less expensive for plan members in states where abortion is legal.
Employers that have chosen to provide benefits to cover abortions can instruct their pharmacy benefit manager to provide coverage for mifepristone in states where this is legally available.
Human Resources and carriers should be prepared to answer employee and member queries about abortion coverage.
Here’s a link to a post from March when Walgreens and CVS announced they would dispense abortion medications in states where this is legal.