More pharmacies are stocking mifepristone-misoprostol since the TGA lifted prescribing restrictions, but researchers say the biggest gains were in major cities.
The number of Australian pharmacies stocking medication abortion increased by almost 50% when “unnecessary barriers” were relaxed, but new research has found there’s more to be done to improve regional abortion access.
Published in JAMA Network Open last week, the study examined how the TGA’s 2023 MS-2 Step changes – which allowed GPs without specialist training to prescribe it and registered pharmacists to fill prescriptions – affected pharmacy stocking of medical abortion.
The study examined the number of unique pharmacies ordering at least one unit of MS-2 Step each month, covering 24 months before and 24 months after the TGA relaxed its prescribing restrictions. It also examined the proportion of postcodes with at least one ordering pharmacy each month.
There were 2228 pharmacies stocking the medication before the policy change, rising to 4107 by mid-2025 – a 48.6% increase.
The number of postcodes with at least one pharmacy stocking MS-2 Step rose from 915 to 1292 – totalling 48% of all Australian postcodes – two years after the changes.
The researchers estimated that by July 2025, there were 446 more pharmacies ordering the medication each month than would have been expected had the restrictions remained.
Increases were greatest in major cities and least disadvantaged areas but were observed across all remoteness and socioeconomic categories.
Regional coverage in the most remote regions with 12 or more pharmacies quadrupled over the study period, rising from 35 to 140.
Choice of method remained limited, though. By 2020, women in regional and remote areas were nearly four times as likely to use medication abortion as procedural abortion, an earlier study found.
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The study’s lead author, Professor Kristina Edvardsson from La Trobe University’s School of Nursing and Midwifery, told The Medical Republic that while greater uptake in regional and remote areas would be desirable, the results were “a very positive change”.
While accessing care closer to home was a “great benefit”, especially for women who were disadvantaged or unable to travel to metropolitan services, women being able to choose their preferred abortion method remained essential, she said.
“Even though the share of medication abortions seems to be steadily increasing, it’s important that [surgical abortion] still also exists.”
It was also important for participating GPs to openly advertise whether they provide medication abortion, she told TMR.
“For women, it can be difficult to know if their local GP will support this type of care,” she said.
Professor Edvardsson said the next steps would be to better understand whether the increase was due to the expansion of telehealth services or to increased provision of local GPs prescribing MS-2 Step.
“This is just the first piece of the puzzle to obtain an understanding of the effects of this regulatory change,” she said.
Study co-author Professor Danielle Mazza, head of the Department of General Practice at Monash University and a clinical researcher in women’s sexual and reproductive health, said the results were a “fantastic outcome”, but remained only one step in further increasing abortion access.
“There are other issues still in the way, and one of those is around affordability for women, and the other one is supporting the workforce to continue to, or to take up prescribing of medical abortion,” she said.
MS Health applied to the TGA to extend the gestational limit from nine to 10 weeks and add MS-2 Step for the management of miscarriage up to 70 days.
The PBAC recommended the 10-week extension to the PBS listing in July and will consider the miscarriage listing in November.
Passing these recommendations would help destigmatise mifepristone-misoprostol and make more GPs feel comfortable prescribing the medication, Professor Mazza said.
MS-2 Step was the only abortion pill available at the time of the study, but in February this year the TGA approved the generic brand Arzestra, which can be taken up to 63 days of gestation.
Read the full study here.
