Nova Scotia health minister refuses ‘quick fix’ for abortion pill payment issue

HALIFAX — Nova Scotia’s health minister says he won’t step in to fix a payment issue that’s stopping doctors in the province from prescribing the abortion pill.

Randy Delorey said Thursday physicians have requested a new billing code to prescribe Mifegymiso, a publicly funded two-drug combination used to terminate an early pregnancy.

The province’s fee committee — made up of representatives of Doctors Nova Scotia, physicians and the department — has expedited the review of an application for a specific code for prescribing the abortion pill, he said.

“There has been a request for consideration of a mechanism to provide additional compensation … that’s being considered by the joint committee,” Delorey said. “The drug is available and can be prescribed.”

However, the abortion pill remains largely out of reach of most women in Nova Scotia.

Meaningful Mementos

Remembering Someone You've Lost at Christmas

Dec 03, 2024

Seasonal Sorrow

How Do You Get Through The Holidays When You're Grieving?

Nov 01, 2024

Upcoming Events at Oliver's

Grief & Loss and Estate Planning Seminars

Oct 02, 2024

Physicians have said the existing billing structure doesn’t adequately compensate them for the time involved with counselling patients, providing education about options, and ordering multiple tests before prescribing Mifegymiso.

The outcome is that most women in Nova Scotia currently cannot access the abortion pill, despite the provincial government’s decision to fund Mifegymiso last fall.

The situation has left women seeking to terminate unwanted pregnancies using pills scrambling to find one of the handful of doctors in the province rumoured to be willing to prescribe Mifegymiso.

However, most doctors and the province’s only abortion clinic are not offering the alternative to surgical abortion, according to Dr. Lianne Yoshida, medical co-director of the Termination of Pregnancy Unit at the QEII Health Sciences Centre in Halifax.

Although it’s unclear when the fee committee will review a new billing code for Mifegymiso, Delorey said he won’t bring in an interim billing code for overseeing an abortion using pills.

He said it’s more important to have sustainable solutions in health care rather than “quick fixes.”

“There’s a situation in health care … often we love to have quick fixes,” he said. “I think it’s more important to have sustainable and appropriate solutions.”

Delorey added that doctors can currently prescribe Mifegymiso and bill for it under an existing code that pays doctors for discussing the risks and benefits of any new drug with a patient.

Dr. Ken Wilson, medical consultant with Doctors Nova Scotia, said earlier this week that doctors’ fee for prescribing Mifegymiso doesn’t “adequately remunerate them for the time they spend and what’s involved, including counselling patients.”

Wilson, co-chair of the fee committee, said a new billing code for prescribing Mifegymiso is on a high priority list, but the committee is also in the midst of examining new fees for other critical issues including methadone management and medically assisted death.

The Department of Health has considered interim billing codes in the past, and Wilson said if it appears the delay will continue beyond six months he will push the government to usher in a temporary fee.

Meanwhile, Yoshida has said the province’s only abortion clinic still does not have an ultrasound machine, which could add to delays to accessing Mifegymiso.

The abortion pill is approved in Canada to terminate early pregnancies up to 63 days gestation, but an ultrasound is required first to rule out potential health risks and confirm gestational age.

But Delorey said it’s up to the Nova Scotia Health Authority (NSHA) to determine equipment needs.

“It’s important that in our health care system we make the optimal use of the equipment that is available,” he said. “I do rely on advice that comes from the NSHA in terms of identifying their priorities for equipment.”

The Nova Scotia government announced universal coverage of Mifegymiso last fall after The Canadian Press reported on issues with abortion access in the province.

The province also removed the requirement for a physician’s referral to obtain a surgical abortion, allowing women to “self-refer” to the abortion clinic.

The NSHA is in the midst of setting up a single phone line that women across the province can call to make appointments and seek advice, expected to be available in the coming months.

– With files from Keith Doucette

Brett Bundale, The Canadian Press