Action Canada for Sexual Health and Rights congratulates Nova Scotia for making great strides in addressing barriers to abortion access for its residents. On 22 September, Nova Scotia Premier Stephen McNeil announced the government’s plan to implement universal cost coverage for the medical abortion drug Mifegymiso and to support people’s right to self-refer for an abortion.

Until this practice changes, Nova Scotia remains the only province in Canada where a doctor’s referral is necessary to access surgical abortion. The province had come under fire this past summer when local activists and reproductive rights organizations, including Action Canada, brought media attention to the fact that Nova Scotia was the only province still requiring a physician’s referral and that this practice conflicts with the international laws and Canadian charter rights upheld in 1988 with the Morgentaler decision.

Action Canada consistently advocates against all unnecessary administrative policies and regulations that impede reasonable and timely access to abortion services. Barriers to abortion disproportionately affect young people and marginalized people, especially those who are low-income, people of color, migrants or refugees, people with precarious immigration status and those who do not speak English or French. These barriers are compounded for those living in rural or remote areas. We applaud Nova Scotia’s decision to listen to the longstanding concerns expressed by individuals and promptly adopt the advice of activist organizations.

Nova Scotia becomes the fifth province to pledge universal access to the medical abortion pill after New Brunswick, Alberta, Ontario and Quebec. Regrettably, British Columbia along with Manitoba and Saskatchewan have opted for partial and/or localized coverage, leaving many of their residents with compromised access to an important service. The same is true for residents of Newfoundland and Labrador and Prince Edward Island as they await an announcement by their governments. This leaves many with two-tiered access to an essential medical service.

Mifegymiso was approved by Health Canada in 2015 after having been used in over sixty countries for close to three decades with an outstanding safety and efficacy record. Not only did this decision ensure more choice for people facing unintended pregnancies, this approval presented Canada with an outstanding opportunity to address the enduring problem of unequitable access to abortion services across the country by making it possible for more health care providers to offer abortion services in their communities.

Universal cost coverage for a medication that retails between $300 and $450 is a first step as we continue to work towards achieving comprehensive reproductive health services across Canada, regardless of postal code or income bracket.

All people in Canada deserve equal access to reproductive health care. Real choice requires real access. #RealAccessNow


Action Canada congratulates Ontario for announcing its cost coverage plan. Joining Alberta and New Brunswick, Ontario will implement universal cost coverage for anyone with a Health Card beginning  August 10, 2017. Quebec has also committed to universal cost coverage of the abortion pill.

In its overview documents of the drug reimbursement program for Mifegymiso, the ministry has clearly articulated eligibility requirements and procedures for dispensing and billing . The document also acknowledges that “Mifegymiso is recognized as a positive step in supporting autonomy for women’s reproductive health, provides an alternative to surgical abortions, and expands access to care.” And we agree. This is a ground-breaking step towards achieving comprehensive reproductive health services in Ontario.

Ontario’s overview document also points to the College of Nurses of Ontario regulation, which legally authorizes Nurse Practitioners to prescribe the medication. As more Nurse Practitioners and physicians become prescribers of Mifegymiso, we expect abortion access to increase significantly in Ontario. Currently, abortions are mostly provided in major urban centers within 150KM of the U.S. border.

While we commend Ontario on its Mifegymiso roll-out programme, we note with caution that individuals without a valid Ontario Health Card will not be able to access the medication. We urge Ontario to implement a plan similar to Alberta’s, which allows individuals to show proof of residence in place of a Health Card in order to receive the medication. This is an especially necessary step given the time sensitive nature of abortion.  

All people in Canada deserve equal access to reproductive health care. Real choice requires real access. #RealAccessNow


Two weeks ago, without a public announcement, Manitoba added the abortion medication, Mifegymiso, to their provincial drug formulary. Unlike Alberta, New Brunswick, Quebec and Ontario, where universal cost coverage will be offered for anyone with a provincial health card, Manitoba will only cover those with extended drug benefits through “Manitoba Pharmacare.”

Manitoba is reinforcing and sustaining a system of two-tier access to abortion, and gaps remain.

The pill will also be covered by the province in one or two, possibly three clinics, that already offer surgical abortion. While this will expand options available within these clinics, the move will not address the most common barriers to access in Manitoba.

The province is one of the most difficult in which to access abortion. Many seeking the service are required to travel upwards of 20 hours to the two southern cities where it is offered: Winnipeg and Brandon, or leave the province altogether. Mifegymiso’s $350-$450 price tag is only one of the many costs associated with access. Travel, accommodation, child or family care cost and lost wages make it difficult for many to access abortion services that are limited to urban centres. People need access to abortion services within their own community or as close as possible. Universal cost coverage is one step closer to achieving this.

Formularies are not a substitute for universal cost coverage. Under Manitoba’s program, a 30-year-old single woman with no dependents and a salary of $45,000 per year would have to reach a $2,400 deductible before the medication would be covered – a cost most people won’t reach. Manitoba’s drug benefits also fail to cover those who have not signed up for the program in advance.

While the “Manitoba Pharmacare” program offers some compensation, this program is intended for those whose income would be most severely impacted by high prescription drug costs. It does not always match the diverse needs of someone seeking an abortion. Complicated and patchwork programs fail to meet the needs of all people.

Everyone in Canada deserves equal access to healthcare. Alberta, New Brunswick, Ontario and Quebec have already demonstrated that universal cost coverage is both necessary and possible. It’s time Manitoba and the rest of Canada follow their lead.

Real access shouldn’t depend on your postal code, or your income bracket! #RealAccessNow


Action Canada for Sexual Health and Rights is thrilled that Alberta has implemented its cost coverage plan for the abortion pill, Mifegymiso. The announcement comes in the week following Action Canada’s abortion access panel with Alberta Health Minister Sarah Hoffman. The event that took place during the Council of the Federation, an annual meeting of the premiers of Canada. 

Mifegymiso, the Canadian name-brand for the combination of Mifepristone and Misoprostol, is the World Health Organization’s gold standard for medical abortion and has been on its list of essential drugs for over a decade. The combination has been used for over 30 years with an outstanding safety and efficacy record and is available in over 60 countries around the world.

Last April, Alberta became the second of now four provinces to commit to cost coverage of Mifegymiso, which retails between $300-$450. Too many people in Canada still experience major barriers when needing to access abortion services. Alberta has shown exemplary leadership in implementing a program that recognizes the potential for Mifegymiso to address ongoing barriers and to increase health equality. The province has demonstrated that cost coverage is both necessary and possible. We expect all provincial and territorial governments to commit to cost coverage programs of at least the same calibre before the Health Ministers’ meeting this fall. This is a question of avoiding a two-tiered system of abortion access in Canada. We need universal cost coverage. 

A future where all people in Canada can choose the highest quality medical services for free, must also include a push for a diversity of medical practitioners to become prescribers of Mifegymiso, including Nurse Practitioners. We need provinces like Alberta to continue to step up and remove barriers to choice. Because access to abortion shouldn’t depend on your postal code, or your income bracket.

Real choice requires real access! #RealAccessNow
 


Action Canada for Sexual Health and Rights is thrilled that the Quebec government announcement will guarantee universal cost coverage of the abortion pill, Mifegymiso. In early July, the province’s government announced that Quebeckers will have access to Mifegymiso at no charge in the fall.  

Mifegymiso, the Canadian name for the combination of Mifepristone and Misoprostol, is the World Health Organization’s gold standard for medical abortion and has been on its list of essential medicines for over a decade. The combination is available in more than 60 countries and has been used for over 30 years with an exceptional safety and efficacy record.

To date, four provinces and a federal program have agreed to cover the cost of Mifegymiso, which ranges from $300 to $450. In promising that the abortion pill will be available to all its health card holders, Quebec is following in New Brunswick, Alberta and Ontario’s footsteps. So far, New Brunswick is the only province to have launched its program.

Action Canada calls on all provincial and territorial governments that have not yet promised free access, to guarantee equal access to medical abortion by ensuring universal cost coverage of the pill. Access to abortion shouldn’t depend on your postal code.

Real choice requires real access! #RealAccessNow


Action Canada for Sexual Health and Rights welcomes the CADTH Canadian Drug Expert Committee’s final recommendation on the newly approved abortion pill known as Mifegymiso in Canada (a combination of Mifepristone and Misoprostol). The expert committee recommends provincial and territorial cost reimbursement of Mifegymiso. 

After the recommendation was made public, Alberta and Ontario joined New Brunswick in becoming the second and third Canadian provinces to commit to universal cost coverage of Mifegymiso through provincial health care. Mifegymiso is the World Health Organization’s gold standard for medical abortion and has been on its list of essential drugs for over a decade. Mifegymiso has been used for over 30 years with an outstanding safety and efficacy record and is available in over 60 countries around the world.
 
Patient populations in the studies undertaken for the CADTH review had a gestational age of up to 56 to 63 days (8 to 9 weeks) rather than the 49 days (7 weeks) limitation set by Health Canada. Mifegymiso is available up to 9-weeks gestation in the US, UK, and Scotland, among other countries, and up to 12-weeks in Norway.
 
Action Canada calls once again on all provincial and territorial governments to promptly ensure that the cost of medication abortion is covered under public health care. We also recognize the number of individuals who require abortion between 7 and 9 weeks and call on Health  Canada to increase the 7-week gestational limit restrictions to 9 weeks, as reviewed by the expert committee.
 
Real choice requires real access! #RealAccessNow