Exploring the Regulatory Journey of Progestin-only Emergency Contraceptive Pills in Canada: A Multi-methods Study

Abstract

The journey of emergency contraception in Canada serves as a noteworthy example of drug deregulation in the sexual and reproductive health field. Over less than two decades, progestin-only emergency contraceptive pills transitioned from being a Schedule I drug requiring a prescription from a physician to being available over-the-counter as a Schedule III drug. Through a scoping review and a mystery client study in Greater Ottawa, this thesis aims to explore the regulatory reform pathway of progestin-only emergency contraceptive pills and evaluate the current availability and accessibility of both the progestin-only and ulipristal acetate forms of emergency contraception. The findings from the scoping review shed light on the process of reproductive health drug deregulation in Canada and provide a model for how a change in regulatory status might be successful for other medications with similar safety and efficacy profiles. The results from the mystery client study showcase the implementation challenges once deregulation has gone into effect. The findings highlight the need for continued education of and engagement with pharmacists and pharmacy staff. The journey of progestin-only emergency contraception offers important lessons for what the deregulation of medication abortion drugs might entail.