Misoprostol in particular is regularly used for reproductive care procedures such as miscarriage, IUD insertion and
postpartum hemorrhage.
After the law took effect Oct. 1, city health officials received multiple reports that patients encountered obstacles attempting to fill prescriptions. Similarly, the Illuminator spoke with multiple doctors in October who
detailed issues their patients had with obtaining misoprostol from pharmacies.
“We were concerned from the beginning that changing the controlled substances law for misoprostol was going to cause significant barriers,” New Orleans health director Dr. Jennifer Avegno said.
After hearing about these challenges, Avegno said her team began calling all listed pharmacies in Orleans and Jefferson parishes, collecting information for patients and health care professionals so they would know where to fill prescriptions for procedures that are often time-sensitive.
City health workers reached out to 57 pharmacies in New Orleans and 107 in Jefferson Parish.
In New Orleans, 65% said they have the medication in stock and nearly 23% did not. Another 12% did not respond to the city survey.
Only 30% of Jefferson pharmacies reported keeping the drugs on hand, and 45% said they do not carry them. One-fourth of the businesses didn’t respond.
The new health department website provides a map of Orleans Parish searchable by address and location or pharmacy. Pharmacies where misoprostol is available are marked on the map, and there are links to a list for Orleans and Jefferson pharmacies.
Health care professionals and patients can use the new dashboard and map to find pharmacies that stock misoprostol nearby, and the information will be updated regularly based on information from providers, pharmacies and patients, according to Avegno.
In New Orleans, most national chain pharmacies, including CVS and Walgreens, reported having the medication in stock. Avegno said that if some pharmacists said they didn’t currently have it in their pharmacy but could get it if needed, the department counted it as a “yes.”
One of the questions posed to pharmacists was if they used to carry it and now don’t, why was there a change?
Avegno says “several pharmacists” said they stopped carrying the medication after misoprostol became a controlled substance. The respondents were provided anonymity to encourage disclosure.
“It’s too many restrictions, too many hoops to jump through,” Avegno said one pharmacist said.
Some pharmacies in Orleans and Jefferson Parish told city health workers they require additional information from the prescribing physician, even if the prescription is written out correctly with the diagnosis codes for a legally allowed medical use.
“The pharmacist could have it in stock, but there is either an official or unofficial internal policy in that pharmacy that says you better call the physician and make sure it’s not for an abortion or make sure that everything is OK,” Avegno said.
“That’s not part of the controlled substances law,” she added. “They don’t call your doctor every time you get a percocet or valium prescription. There’s this real unease and, I think, lack of trust, and I can’t blame a pharmacist for doing that. I think a lot of people are confused about what their liability might be, so they want to go above and beyond what is required.”
Avegno added that this means a patient going to fill a prescription might still encounter a delay, regardless of whether the medication is in stock. “The fear and confusion are creating barriers, which we’ve been saying all along,” she said.
The city health department plans to broaden its reach to look at what the misoprostol landscape looks like statewide, particularly in maternity care deserts where reproductive care is already challenging to access.
“We want to highlight that so decision makers, policy makers can help mitigate any barriers that may have been caused, intentionally or unintentionally, from the law,” Avegno said.
If you’ve experienced challenges seeking reproductive health care in Louisiana, particularly if you are in a rural area, we’d love to hear from you. Please fill out this secure form or contact our reporter at lorenaoneil.64 on Signal, an encrypted messaging app.
