By Andrea Woo, The Globe and Mail, 29 July, 2015

RU-486, or mifepristone, already available in 57 other countries, has been approved

After a series of delays, Health Canada has approved the use of the medical-abortion drug mifepristone.

The approval brings Canada into line with nearly 60 countries where the drug, also known as RU-486, has long been legal, including the United States, Australia and most of Europe.

It will be sold under the brand name Mifegymiso.

Vicki Saporta, president of the National Abortion Federation (NAF), said in an interview late Wednesday that the approval means women in Canada will now have access to what is considered the gold-standard of medical abortion care.

The NAF, which represents about 80 per cent of Canada’s abortion providers, has long heard from women seeking access to the drug.

“Some have even crossed the border to obtain a medical abortion in the United States,” Ms. Saporta said. “There was absolutely no reason, given the outstanding safety record of mifepristone throughout the world, that it was not available in Canada.”

Mifepristone, when combined with misoprostol, is generally used to terminate a pregnancy at between seven and nine weeks. NAF and other organizations that support bringing the medical abortion drug to Canada say it will make ending a pregnancy more discreet and widely available, especially in areas where services are scarce.

Ms. Saporta is hopeful the drug will be available by the first quarter of 2016.

Health Canada, which had been reviewing the decision since December, 2012, did not make anyone available for an interview late Wednesday. In a statement, the department said the drug’s manufacturer, Linepharma International Limited, was notified of the approval on Wednesday afternoon.

There are about 100,000 abortions in Canada every year, most of them performed surgically in clinics or hospitals.

PIC COMMENT:  Federal approval of RU-486 should help to reduce the irrationality and inequity regarding abortion in Canada where access to surgical abortions varies widely by region.  However, while welcome, approval still does not guarantee that women wishing to end pregnancies will be able to obtain the medication in all parts of the country.

RU-486 will be available for use in early pregnancy by prescription only.  Therefore, since national ethics rules allow doctors to refuse to perform abortions or to refer patients for them (providing they connect the patient with further services), it will remain impossible to predict how many doctors will opt to prescribe RU-486 or indeed how easily patients will be able to find doctors willing to treat them. Also, some pharmacists may refuse to fill prescriptions on conscientious grounds, as is their right, according to the Canadian Pharmacists Association.

Historically, abortion has been least accessible in PEI, in the three northern territories, in New Brunswick and, more generally, to women living in remote regions of all provinces and territories. The latter has had a particularly negative  impact on First Nations’ women in terms of access and treatment.

Nevertheless, the availability of RU-486 will mean that for many women taking a highly effective, safe drug at home will offer a choice requiring no – often lengthy – travel to have an abortion, and will be greatly preferred  to surgery.  Also, the availability of mifepristone – RU-486 – will, based on experience in other user countries, likely result in abortions occurring earlier in gestation, when they are safer, and in reduced waiting times for surgical abortions.