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Research and analysis

This page presents findings of analyses we have conducted of secondary information that was collected to populate this database.

Availability of medical abortion commodities, by income status

Availability of medical abortion commodities, by type and income status*, based on data in MedAb.org

* Income status is based on the World Bank 2021 classification

Availability of medical abortion products in 66 countries

Between 2017-2018, IPPF, Gynuity Health Projects and Concept Foundation conducted data collection in 46 countries to populate an inventory of medical abortion products available around the world. IPPF and Gynuity completed a similar exercise in 20 additional countries in 2019-2020. In total, we visited 597 outlets in 66 countries. We analysed data on availability and quality of misoprostol, mifepristone and combipacks. In the prescription graph below, n = the number of products that we identified.

Prescription required

(n=653)

Unique brands found, by quality assurance status

* Quality assured products are those that have been approved by an SRA or are WHO Prequalified

Price of medical abortion commodities at point-of-purchase in 61 countries

These graphs present information collected from 61 countries between 2017-2020

Key

  • n= number of price points.
  • LAC = Latin America and the Caribbean
  • EE/CA = Eastern Europe and Central Asia
  • NA/ME = North Africa and the Middle East

Price range and median

Median prices (USD) by quality assurance status

Quality-assured misoprostol, 1 pill (n=247) $0.66
Non quality-assured misoprostol, 1 pill (n=156) $0.54
Quality-assured combipack (n=18) $9.76
Non quality-assured combipack (n=37) $9.00

Price per misoprostol pill, by region

Price per combipack, by region

Price per mifepristone pill, by region

Access to medical abortion

Each of these quotes from data collectors is from a different country, and together they highlight the range of issues surrounding access to quality medical abortion around the world.

Lack of stock or information

"The pharmacist threw out the carton cover and insert, they kept strip only."
"They sell [Brand x] but it was out of stock that day. There were 2 boxes of [Brand y] and one contained only 1 tablet out of 10."
“The product [misoprostol] is registered in their system, but there are none in stock.”

Quality compromised

“The medicines were sold by a street vendor of disinfectants and rat poison in a market in the capital city. The dealer asked for the approximate time of pregnancy to determine the number of tablets that are effective. There was no manufacturing data and no expiry date on the packaging, which was damaged.”
“The misoprostol that I bought was expired.”

Evidence of wasted mifepristone

“Providers in some facilities told us that if they want to use misoprostol only, they take that from the combipack and dispose of the mifepristone.”
“The mifepristone is widely wasted because they use the misoprostol more commonly.”

Fear and stigma

“The pharmacist indicated never seeing such products because gynecologists are usually old fashioned and do not approve of abortion or give prescriptions. It is possible to order misoprostol, but there were no stocks.”
“Despite asking for a signed prescription from the doctor, the pharmacy staff are always afraid to sell the medicine; they think the buyer may be a policeman and there is fear of getting into trouble."

Bribes in lieu of prescriptions

“Without a prescription you can still get the drug [misoprostol], but you pay an extra fee to the health worker.”
“In the absence of a prescription, clients often negotiate with providers, particularly those in the maternity ward, to obtain misoprostol for a tip.”

Published literature

IPPF and Gynuity Health Projects analysed medical abortion package inserts in 2017 and data on price and availability in 2020. These findings were published in peer-reviewed journals.

Medical abortion package inserts

Overall, the results show that there is significant need to improve inserts for medical abortion products in low- and middle-income countries. 

Read the full article: A cross-sectional analysis of mifepristone, misoprostol, and combination mifepristone-misoprostol package inserts obtained in 20 countries.

Medical abortion prices and availability in 44 countries

We found wide variation in product pricing and availability across settings, with infrequent availability of mifepristone and combipacks, and limited availability of quality-assured medicines.

Read the full article: A descriptive analysis of medical abortion commodity availability and pricing at retail outlets in 44 countries across four regions globally.