Mifegymiso in the Northwest Territories


What is Mifegymiso?

Mifegymiso is a prescription drug used in a medical abortion, which is an alternative to a surgical abortion. It can be only used to terminate pregnancies up to nine weeks gestation. The prescription contains two pills, Mifepristone and Misoprostol, which are to be taken over a number of days.

What is the Northern Options for Women Program?

The Northern Options for Women (NOW) Program at Northwest Territories Health and Social Services Authority is dedicated to making reproductive choice and abortion services available to women. Mifegymiso may be administered through this program.

What happens when I go to the NOW program and ask for Mifegymiso?

You will first need to consult with a doctor at the NOW program to see if Mifegymiso is a safe option for you. The doctor needs to ensure that national guidelines are met before prescribing it.  For example, you will be assessed to make sure that the pregnancy is less than 9 weeks along.

What is the cost of Mifegymiso?

A prescription for Mifegymiso costs approximately $486.00 in the Northwest Territories.

In November 2018, the Minister of Health and Social Services committed to implementation coverage for the cost of Mifegymiso for clients who do not have access to government or employer-sponsored health benefits.

How will the cost for the prescription be covered?

The pharmacist will fill the prescription and bill your government/employer insurance (if applicable). The Department will be sent an invoice for any outstanding amount that your insurance plan does not cover or will invoice the entire amount if you do not have any insurance coverage at all.

Is the NOW program available in all communities?

Not currently. Since the requirements of Health Canada and the National Abortion Federation cannot be met in all communities, the NOW program is only available in Yellowknife and Inuvik at this time. The requirements are:

  • Accessing counseling prior to receiving Mifegymiso;
  • Being assessed to determine the date of the pregnancy;
  • Ensuring there is access to emergency medical care in the two weeks after the second Mifegymiso pill has been taken; and
  • Receiving an ultrasound or blood test at the end of two weeks to confirm that the pregnancy has been terminated.

Will the option be more accessible to residents that live in smaller communities in the future?

Work is being done to develop clear territorial processes and clinical protocols to determine if it will be possible to provide NWT residents, who live in smaller communities, with a range of safe options for them to choose from. Best practices for providing access to Mifegymiso to women in smaller communities are currently being discussed at a national level. The NWT is participating in these discussions and this will inform the work going forward.

Will medical travel cover the costs of residents in communities travelling to Yellowknife or Inuvik?

Yes, the Department of Health and Social Services will cover the medical travel costs for residents that live outside of Yellowknife and Inuvik who choose treatment options using Mifegymiso, and are referred by a practitioner.

How did Health Canada update Mifegymiso prescribing information?

Health Canada recently removed the requirement for an ultrasound prior to Mifegymiso being prescribed. This does not eliminate the need for accurate dating information to ensure the gestational age is within applicable guidelines.

How does Health Canada’s update affect NWT processes?

Health Canada’s relaxation of the requirement for an ultrasound makes it possible to begin considering administering Mifegymiso outside of Yellowknife and Inuvik. Work that is necessary to be able to expand access to the service in smaller communities is being done.

What if I am under my parent or spouse’s insurance plan and I want my prescription to remain confidential from them?

A process is being developed to ensure the privacy of the individual being prescribed Mifegymiso is protected.

Are other jurisdictions covering the costs of Mifegymiso as well?

Some provinces have announced that they will cover the entire cost of a Mifegymiso prescription, but not all.