Dear Premier Horgan,
On behalf of Action Canada for Sexual Health and Rights, West Coast LEAF, Options for Sexual Health and Island Sexual Health Society, congratulations on your newly formed government. Between us, we represent regional, provincial and national advocates for gender empowerment and rights-based sexual and reproductive health. We are looking forward to working productively with you and your team to promote health, justice and equality throughout British Columbia.
This letter is to discuss the importance of universal cost-coverage of the abortion drug Mifegymiso.
For more than a decade, our organizations have been advocating for Health Canada to approve the long-awaited abortion pill, Mifegymiso (a combination of Mifepristone and Misoprostol), referred to by the World Health Organization as the gold standard for medical abortion. Mifegymiso was originally approved in Canada in July 2015, although it was only made available in January 2017.
Reducing barriers to Mifegymiso will drastically improve access to abortion for British Columbians, particularly for people in rural communities. It can be prescribed by any physician or nurse practitioner and dispensed by a local pharmacist, but the pill’s $300-400 price tag remains a significant barrier to access. Over the past few months, several provinces, including Alberta, Ontario, Quebec and New Brunswick, have demonstrated that full cost-coverage for Mifegymiso is both necessary and possible.
Abortion is not only a medically necessary service, it is also commonly accessed. According to a 2011 Guttmacher Institute study, up to one third of women of reproductive age in North America will get an abortion in their lifetime. British Columbians, like all people in Canada, deserve the best possible sexual and reproductive healthcare. Yet, two years since Mifegymiso’s approval, access to this medication is still limited and compromised.
In British Columbia, there are significant inequities and gaps in access to abortion. Abortion providers are geographically concentrated in Vancouver and Victoria, with five dedicated clinics. Patients can also self-refer to the Cranbrook, Kelowna and Trail clinics, and abortions are accessible at some hospitals. This leaves most of the province completely unserved. Even for those living in communities where there is a local hospital provider, the limited number of appointments available can delay access to the point where a woman must travel outside of her community to find a provider that will offer services beyond a certain gestational limit. While Mifegymiso is freely available through BC’s Fair PharmaCare Program, Non-Insured Health Benefits Program for First Nations and Inuit, Pharmacare, and most private insurers, the amount covered and process of payment can be different, confusing and potentially onerous depending on the location and type of insurance. The cost is a major barrier to access. As service providers and sexual health advocates, we know first-hand, that people who want to have medical abortions are choosing surgical options because of the high costs for the medication. This contravenes the promise of equitable access to healthcare guaranteed by the Canada Health Act.
Whether a patient in BC can access abortion and whether they must pay for the care depends on where they live, which clinic they attend, and if they have the means to get there. No medically necessary procedure should be so inconsistently available and difficult to access.
We urge you to make cost-coverage of Mifegymiso an immediate priority to improve gender equality, and support the right to bodily autonomy, safety, and health.
Below are what we consider to be the highest standards for universal cost coverage. We hope and anticipate that your government, with its stated commitments to human rights and equality, will prioritise implementing a cost-coverage plan of this calibre:
- Mifegymiso should be free to anyone residing in British Columbia regardless of age, income, or medical needs;
- The provincial guidelines for cost- coverage should be consistent with the Society of Obstetricians and Gynecologists guidelines that say the drug is safe to use for up to 70 days
- People who reside in BC but do not yet have a BC Care Card should be able to present a pharmacist with proof of residence and receive the drug for free. This is necessary due to the time sensitive nature of abortion and the short gestational limit for Mifegymiso;
- BC should educate the medical community about the prescription, dispensing and usage of Mifegymiso’s cost-coverage plan by creating an implementation plan document and FAQ available to healthcare providers, pharmacists and patients;
- BC should publicly announce its decision to make Mifegymiso free and should work quickly to roll out the implementation. This will raise awareness and encourage health care practitioners and pharmacists to become providers, prescribers, and dispensers of Mifegymiso.
It is our position that all people in Canada should have the same access to health and rights, regardless of who they are and where they live in the country. Our organizations possess a vast scope of expertise on this issue. We would like to proactively support the government to meet this objective by supporting you with our knowledge on the issue. To that end we would like to request a meeting with you at your earliest convenience. Please contact Darrah Teitel, Public Affairs Officer at [email protected] (613) 241-4474 (5) to book this meeting.
Following the examples of other provinces, our hope is that the Government of BC will work to ensure that the people of this province have equal access to medical abortion.
Thank you in advance and we look forward to hearing back from you soon.
Public Affairs Officer
Action Canada for Sexual Health and Rights
West Coast LEAF
Options for Sexual Health
Island Sexual Health Society