CYTOTEC – First responses to the intended withdrawal from the market in France

Abortion providers in France are mobilising to retain Cytotec for abortion (or an affordable substitute). The decision to withdraw Cytotec from the market in France following complaints that it had caused problems for several women who had been given too high a dose to induce labour has led to an outcry among those who support universal access to safe abortion in France, such as the National Association of Clinics for Abortion and Contraception and the French National College of Obstetricians & Gynaecologists.

The group REIVOC, which consists of all the abortion providers in the Occitanie Region in France, including GPs, gynaecologists, midwives, and family planning advocates, called the decision hypocritical: “Cytotec is indispensible for inducing abortion. While there is an alternative, Gymiso, it is 40 times more expensive. Everyone knows Cytotec is used for abortion even if that is not one of its approved indications. Instead of withdrawing it, it is urgent that a generic substitute is found.”

The cost of abortion in France is controlled. The price of Cytotec is 30 centimes per pill; Gymiso is 12 Euros per pill. This will increase the cost of abortions. Véronique Sehier, vice-president of the Mouvement Français Planning Familial, said: ” If there are problems with the current dosage for inducing labour then a new preparation should be developed by Pfizer for that indication which is a lower, appropriate dosage. This medication has been around a long time; it should come into the public domain.”

Le Planning Familial and others  fear that the withdrawal of Cytotec will open the door for other companies to market new products at higher prices. Abortion providers are calling for an affordable equivalent to Cytotec for medical abortion. It is 40 years since Simone Veil’s abortion law was passed and yet abortion still seems to be a battlefield on a daily basis.

In South Africa, where (like everywhere else) Cytotec is used offlabel for abortion, when the National Department of Health learned Cytotec was to be withdrawn in France, their legal department advised no longer using it in South Africa either. The message about problems with its use for induction of labour at term vs. for induced abortion, for which there have been no problems, got lost in the process.

SOURCES: La Depeche, by Dominique Delpiroux, 14 November 2017 ; E-mail from Marion Stevens, South Africa, 30 November 2017 ; PHOTO