Fifteen months after the much-acclaimed conscience vote in both Houses of Parliament rid the Therapeutic Goods Administration of the Harradine Amendment preventing Australian women from accessing RU-486, approval to prescribe the drug for medical abortion is still confined to just two doctors, Cairns gynaecologist Caroline de Costa and a colleague.

Applications have been returned to four other practitioners who sought approval as ‘Authorised Prescribers’ of the drug – de Costa’s category, which limits her to using it for women with “life-threatening or otherwise serious” medical conditions that would be worsened by continuing a pregnancy. In each case, the TGA has asked for further information before considering the application.

A peek into Hansard shows that in the past year the TGA has been under close scrutiny from Senate Estimates Committee member Guy Barnett, the ‘pro-life’ senator from Tasmania who headed the original Senate inquiry into RU-486 — which may explain the TGA’s hesitation.

Strangely, no Australian-based drug company has yet shown any interest in applying to manufacture or market the drug, now out of patent. Drug companies, normally not backwards about coming forward in pursuit of new markets, are tripping over their feet to distance themselves from RU-486. Could rumours in the industry of heavy pressure from the federal Department of Health, under Minister Tony Abbott, not to involve themselves in making the drug available here, be true?

New Zealand solved this problem when five doctors founded a not-for-profit company, Istar, to import the drug there. RU-486 is steadily gaining ground across the Tasman. This may turn out to be the way to go for Australia, too.

That Australian women would welcome the drug is shown by the large number of requests flooding in to the Cairns docs – estimated at 12-15 each week from across the country. Marie Stopes International in Sydney has just given the green light to its NSW clinics to provide medical abortion using methotrexate/misoprostol, having run a pilot project with this drug combination late last year that was welcomed by women in NSW.

But the announcement from the organisation makes clear that this option is second best. Extensive overseas studies have shown that mifepristone (RU-486) is more effective than methotrexate, as well as safe and highly acceptable to the women who have used it. Marie Stopes would clearly prefer it, too.

Peter Fray

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