The availability of the abortion medication MS-2 Step in Australian pharmacies increased by nearly 50% following the relaxation of prescribing and dispensing restrictions in 2023, according to a study published in JAMA Network Open. The research, led by La Trobe University, evaluated the impact of regulatory changes made by the Therapeutic Goods Administration (TGA) that expanded the pool of healthcare professionals authorized to prescribe the medication and removed the need for special registration for pharmacists.
Before these reforms, only GPs with additional training could prescribe MS-2 Step, and pharmacists also had to be registered to dispense it. The 2023 changes allowed any general practitioner, appropriately trained nurse practitioners, and endorsed midwives to prescribe the medication, while pharmacists no longer needed registration to dispense it. Administrative barriers were relaxed to facilitate easier access.
By mid-2025, 4,107 pharmacies were stocking MS-2 Step, up from 2,228 prior to the policy shift—a 49% increase. The number of postcodes with a pharmacy supplying the medication rose from 915 to 1,292, covering nearly half of all Australian postal areas. Accessibility in regional locations improved from 23% to 35% of postcodes, and availability in remote areas nearly doubled, increasing from 12.5% to 22%.
Lead author Professor Kristina Edvardsson, from La Trobe University’s School of Nursing and Midwifery, noted the significance of the expanded availability for women living outside metropolitan centers. “Australian women who need access to this medication can access it closer to home,” she said, emphasizing how reduced travel requirements alleviate barriers, particularly for disadvantaged women and those in rural or remote communities. Edvardsson highlighted that faster local access leads to quicker care.
The study also supports previous findings that increased availability of medical abortion reduces reliance on surgical procedures. She referenced examples from Europe where medical abortion accounts for over 90% of all abortions, suggesting Australia is following a similar trend. MS-2 Step, subsidized under the Pharmaceutical Benefits Scheme, combines mifepristone and misoprostol and is approved for use up to 63 days of gestation. In February, the TGA approved a second medication containing the same active ingredients, Arzatra.
Dr. Anna Noonan, a postdoctoral research fellow at the University of Technology Sydney, called the findings “an important signal” for countries retaining tighter prescribing controls, such as the United States. She cautioned that unnecessary regulatory barriers still impede access in many places. Noonan also pointed out the significant but often unrecognized efforts by local healthcare providers and advocates to facilitate confidential access to abortion care, including arranging pharmacies to stock the medication in advance.
“Noonan stressed that overregulation imposes additional burdens on providers and hinders timely care delivery, noting that a more deregulated environment would ease access, especially for individuals with fewer resources,” she said.
The study underscores how regulatory reforms in Australia have contributed to safer and more timely access to medical abortion through greater pharmacy participation nationwide.