As a reminder, Mifegymiso is available through Health Canada’s Restricted Distribution and Administration Program. The product monograph references physician dispensing of the medication.
Both the College of Pharmacists of BC and the College of Physicians and Surgeons of BC have been advised by Health Canada that the normal distribution system for prescription medications (i.e. the physician prescribes the medication and the patient takes the prescription to a pharmacist for dispensing) is considered off-label. The product monograph is not a legally binding document, and physicians are allowed to use their professional judgment to determine what is in the best interest of each patient.
In BC, most physicians are not authorized to sell and dispense medication to their patients, and pharmacists are well positioned to dispense medications consistent with professional expectations for appropriate storage, labelling, instructions for use, etc.
There are three possible scenarios for Mifegymiso to be prescribed and dispensed to patients:
- Physicians can prescribe the medication to their patient, and have the medication dispensed by the pharmacist of the patient’s choice, and have the medication delivered to the physician’s office, consistent with the product monograph.
- Physicians can stock the medications, and sell and dispense directly to their patients. This requires the physician to be approved by the College Board to sell medications to their patients, and they must comply with the professional standard Sale and Dispensing of Drugs by Physicians.
- Physicians can prescribe the medication to their patients, and have that medication dispensed by the pharmacist of the patient’s choice, and the patient ingests the medication at home as directed.
It is important that the physician clearly indicates to the patient, and to the pharmacist on the prescription, what the directions are for dispensing and ingestion of the medication, as the product monograph may be at variance to the directions.