Jones Rachel K
Guttmacher Institute, 125 Maiden Lane, New York, New York, 10038.
Contracept X. 2020;2:100042. doi: 10.1016/j.conx.2020.100042. Epub 2020 Oct 13.
The objective was to examine trends in the number of low-volume and nonmetropolitan mifepristone purchasers and their role in the expansion of medication abortion.
We use deidentified data from Danco Laboratories, the sole distributor of mifepristone during the study period, to examine trends in mifepristone distribution. We focus on customers who purchased < 100 doses a year and a subset of those who purchased < 10 doses for the periods of 2008-2011 and 2014-2017. We use data from the Guttmacher Institute Abortion Provider Census (APC) studies in 2008 and 2017 to examine the extent to which some facilities that purchased mifepristone may be missing from Guttmacher's APC.
Between 2008 and 2017, the number of medication abortions increased 73%, though the number of mifepristone purchasers only increased 15%. The number of low-volume mifepristone customers, or those who purchased < 100 tablets of mifepristone per year, decreased 8% over the study period, while the number purchasing < 10 tablets per year decreased 14%. However, in recent years, low-volume customers were more likely to have purchased mifepristone in multiple years. In nonmetropolitan areas, the number of sites purchasing mifepristone increased slightly but the amount of mifepristone that was purchased more than doubled between 2008 and 2017.
While reliance on medication abortion increased substantially between 2008 and 2017, there is no evidence that this was due to an increase in the number of facilities that purchased low volumes of mifepristone.
While their numbers declined, abortion providers purchasing low volumes of mifepristone likely played an important role for the individuals they cared for. Access to abortion could increase if a wider network of health care practitioners, especially those in settings that do not currently provide abortions, was able to offer medication abortion.
本研究旨在探讨小剂量米非司酮购买者及非大城市地区购买者数量的变化趋势，以及他们在药物流产推广中的作用。
我们使用研究期间米非司酮唯一经销商丹科实验室提供的匿名数据，来研究米非司酮的分发趋势。我们重点关注2008 - 2011年以及2014 - 2017年期间每年购买量少于100剂的客户，以及购买量少于10剂的部分客户。我们使用古特马赫研究所2008年和2017年堕胎服务提供者普查（APC）研究的数据，来考察一些购买米非司酮的机构未被古特马赫研究所的APC涵盖的程度。
2008年至2017年期间，药物流产数量增加了73%，而米非司酮购买者数量仅增加了15%。在研究期间，小剂量米非司酮购买者，即每年购买少于100片米非司酮的客户数量减少了8%，而每年购买少于10片的客户数量减少了14%。然而，近年来，小剂量购买者更有可能多年购买米非司酮。在非大城市地区，购买米非司酮的机构数量略有增加，但2008年至2017年期间购买的米非司酮量增加了一倍多。
虽然2008年至2017年期间对药物流产的依赖大幅增加，但没有证据表明这是由于购买少量米非司酮的机构数量增加所致。
虽然购买少量米非司酮的堕胎服务提供者数量有所下降，但他们可能对其所照顾的个体发挥了重要作用。如果更广泛的医疗从业者网络，尤其是那些目前不提供堕胎服务的机构，能够提供药物流产，那么堕胎服务的可及性可能会提高。
