USA- Exploring the feasibility of obtaining mifepristone and misoprostol from the internet

by Chloe Murtagh, Elisa Wells, Elizabeth G. Raymond, Francine Coeytaux, Beverly Winikoff

Contraception Accepted September 2017. DOI: 10.1016/j.contraception.2017.09.016

Objectives: We aimed to document the experience of buying abortion pills from online vendors that do not require a prescription and to evaluate the active ingredient content of the pills received.

Study design: We searched the internet to identify a convenience sample of websites that sold mifepristone and misoprostol to purchasers in the United States and attempted to order these products. We documented price, shipping time and other aspects of ordering. We sent the samples received to a testing laboratory that measured the amount of active ingredient in individual tablets.

Results: We identified 20 websites and ordered 22 products: 20 mifepristone-misoprostol combination products and two that contained only misoprostol. We received 18 combination products and the two misoprostol products from 16 different sites. No site required a prescription or any relevant medical information. The time between order and receipt of the 20 products ranged from 3-21 business days (median 9.5 days). The price for the 18 combination products ranged from $110 to $360, including shipping and fees; the products without mifepristone cost less. Chemical assays found that the 18 tablets labeled 200 mg mifepristone contained between 184.3 mg and 204.1 mg mifepristone, while the 20 tablets labeled 200 mcg misoprostol contained between 34.1 mcg and 201.4 mcg of the active ingredient.

Conclusions: Obtaining abortion medications from online pharmaceutical websites is feasible in the US. The mifepristone tablets received contained within 8% of the labeled amount of active agent. The misoprostol tablets all contained that compound but usually less than labeled.

Implications: Given our findings, we expect that some people for whom clinic-based abortion is not easily available or acceptable may consider self-sourcing pills from the internet to be a rational option.