The purpose of the database is to improve access to comprehensive country-level information on the availability of different brands of mifepristone, misoprostol and combipacks that can be used by a range of organizations including governments, private sector pharmaceutical distributors and NGOs that are either currently providing or planning to offer safe abortion services in line with their national law and policies. IPPF has worked closely with Gynuity Health Projects and Concept Foundation to develop this database.
Inclusion of commodities
The Medical Abortion Commodities Database includes information on brands of mifepristone, misoprostol or combipacks of mifepristone and misoprostol that are registered and available in a country and, for misoprostol and combipacks, have sufficient evidence to indicate they are of good quality. If there is a product not listed for a particular country, it is because either a) the product is misoprostol or a combipack and does not have sufficient evidence to indicate it is of good quality; b) the product is not registered in that country; or c) it was not identified during the extensive data collection exercise.
Intended users
The primary audience for the database includes organizations and procurement managers seeking information on the quality and availability of different medical abortion commodities to inform policy and use in programmes. These include public health and service delivery managers, staff involved in safe abortion programmes, donors funding projects on safe abortion and maternal health, policy analysts, clinical service providers and supply chain logisticians. The database does not provide counselling, clinical assessments, dosing regimens or other information that is essential for a quality medical abortion service as defined and implemented by IPPF. However, more information can be found in the External Resources section.
How misoprostol quality was determined
Given the wide body of evidence in published literature documenting the challenges with degradation of misoprostol, this database includes information on the quality of misoprostol in misoprostol-only tablets and within co-packaged brands of mifepristone and misoprostol (combipacks). Both the manufacturing process and handling of the finished pharmaceutical product can affect the overall quality of misoprostol. In addition to the quality of active pharmaceutical ingredient used, the manufacturing process and packaging used, there are a number of factors along the supply chain and at the point of use that can affect the clinical efficacy of misoprostol; in particular, its quality is susceptible to degradation if exposed to moisture or humidity. This database, therefore, only includes misoprostol products with sufficient and objective evidence of quality, including as to appropriate handling through the supply chain to ensure clinical efficacy. Inclusion on this website is not, however, a guarantee that such medicines are safe, as no medicine is risk-free and there always remains the potential for side effects. The database includes misoprostol products that have been internationally quality assured, and those with evidence on stability and content of the products. Criteria for inclusion are as follows:
- Products that have been approved by a Stringent Regulatory Authority (SRA)
Products that have met requirements and standards by the WHO prequalification of medicines programme and are
WHO prequalifiedProducts that have a current positive risk-based assessment recommendation of category 1 or 2 from the UNFPA Expert Review Panel (ERP) process.
Products that have other evidence on stability, content and clinical effectiveness from at least two of the following:
Stability testing data from manufacturers
Independent product testing for content of misoprostol in finished pharmaceutical products
Review of outcome data on clinical effectiveness as identified from clinical trials included in a Cochrane review or WHO evidence base for guidelines on induced abortion or post-partum haemorrhage.
The quality status of combipacks listed on the database only relates to the misoprostol component of the combipack.
How availability was determined
IPPF and its partners on this project employed a structured and standardized data collection process that involved a data collector visiting a minimum of at least two locations in each country and collecting information on available brands of misoprostol, mifepristone and combipacks from up to 20 pharmacies and health facilities. Information was also sourced from social marketing organizations, and distributors and stockists of such medicines in select countries.
Updates
IPPF will strive to undertake regular updates to ensure that the information on the database is as up to date as possible. While all reasonable efforts will be undertaken by IPPF, updates will also depend on information provided by others, which will be verified before being included on the website. Availability of drugs and medicines is an ever-changing field in many countries in accordance with local laws and regulations. It is possible that since the launch or most recent update, changes may have occurred resulting in either availability of new products or withdrawal of listed products. If you notice such a discrepancy on the website, please provide us with accurate information by clicking on 'Contact us' below.
Contact us – If you have information to share on availability of misoprostol, mifepristone or the combipack, or if you have any feedback about this site, please complete this form.
