Medical abortion access grows after prescribing rules changed
08 Oct 2026
The changes affected access to mifepristone and misoprostol, known as MS-2 Step, which is used for medical abortion.
Before August 2023, doctors needed to complete specific training and registration requirements to prescribe MS-2 Step. The medicine also had to be dispensed by a registered pharmacist.
In 2023, the Therapeutic Goods Administration (TGA) removed several of these requirements. Pharmacies were allowed to stock and dispense MS-2 Step, while appropriately qualified health professionals, including nurse practitioners, could prescribe it.
Researchers from Australia examined whether the changes affected access to the medicine. The study, published in JAMA Network Open, analysed monthly pharmacy orders using sales data from Australia's only mifepristone distributor.
The researchers compared pharmacy orders over the 24 months before and after the changes.
They found that both the number of pharmacies stocking MS-2 Step and their geographic spread increased after the restrictions were removed.
Before August 2023, 2,228 pharmacies had ordered MS-2 Step at least once. After the changes, this increased to 4,107 pharmacies.
The researchers described the increase as immediate and continuing over time.
Professor Danielle Mazza, Chair of General Practice at Monash University and a co-author of the study, said the findings showed how changes to prescribing rules could improve access.
She said having more pharmacies stock the medicine was important because prescribing access alone does not help patients if they cannot obtain the medication.
The study also found that pharmacies stocking MS-2 Step became more widely distributed across Australia.
Professor Mazza said the researchers plan to further examine the number and location of GPs prescribing medical abortion.
However, not all GPs prescribe MS-2 Step, and some barriers to prescribing remain.
Professor Mazza said some older GPs had not been trained to include abortion care as part of women's healthcare during their medical education. Medical abortion has been available in Australia since around 2013.
She also said some GPs may not yet be aware that the previous restrictions have been removed.
Medical abortion is now included in the RACGP curriculum for general practice. There is also greater awareness of the medicine's safety and effectiveness and its use within general practice.
Training and support are available for GPs through AusCAPPS, the Australian Contraception and Abortion Primary Care Practitioner Support Network.
Further changes are also being considered by the TGA and the Pharmaceutical Benefits Advisory Committee.
These include an application to extend the gestational limit for medical abortion from nine to 10 weeks, in line with current Australian abortion guidelines.
An application has also been made to expand the use of mifepristone for the management of miscarriage.
Professor Mazza said these changes, if approved, could further increase the use of mifepristone in general practice.
Medical abortion access grows after prescribing rules changed
Source: RACGP newsGP; JAMA Network Open; Therapeutic Goods Administration (TGA).