Researchers, physicians, and feminist advocates from China, France, Sweden, Great Britain, Norway, and the United States heralded the use of RU 486 (mifepristone) as a method of early abortion and called for increased availability of the compound worldwide at a Feminist Majority Foundation-sponsored panel during the recent Fourth World Conference for Women NGO Forum in China."The results are in: women have responded favorably to RU 486 in every country in which the drug has been made available. Politics--in terms of obstacles to distribution and introduction of RU 486--is all that stands in the way of giving women access to this medical breakthrough," said Eleanor Smeal, President, Feminist Majority Foundation.
China Produces Own "RU 486"
A Chinese version of RU 486, which is comparable in safety and efficacy to the Roussel Uclaf product, has gained increasing popularity among Chinese women, reported Dr. Xiao Bilian of the National Research Institute for Family Planning in Beijing. Dr. Xiao predicts that soon 90% of all women in China seeking early abortions will use mifepristone.
Three Chinese manufacturing plants now produce mifepristone. China first synthesized the drug in 1990.
China also has been the site of new innovations in the administration of mifepristone. Chinese trials provide evidence that lower and incremental doses of RU 486 are as effective as the single, higher dose regimen used in France, Great Britain, Sweden, and the United States.
Dr. Xiao believes mifepristone will be useful in developing countries where surgical procedures are difficult and often entail the risk of pelvic infection.
Popular in France, Obstacles to Use in U.K.
RU 486 continues to be used by women successfully in France, Great Britain, and Sweden. In all three countries, the compound is distributed by Roussel Uclaf.
In France, one-half of all abortions are performed with the RU 486 procedure. RU 486 can be used by French women up to 49 days of pregnancy.
While RU 486 has been available in the United Kingdom for women until the 63rd day of pregnancy since 1991, only 5% of abortions in the U.K. are performed with the RU 486 procedure, according to Karen Newman of International Planned Parenthood Federation. Newman referred to RU 486 as "the most under-marketed drug in the world."
RU 486 has not gained as much popularity in the U.K. as in France because the health care system works against early abortion. For example, women are required to obtain approval for an abortion from two doctors. A slow referral system and waiting lists at clinics provide another obstacle to early abortion. In addition, clinics are required to provide an over-night bed for every woman, increasing the cost of the procedure for clinics and patients.
U.S. Trials Conclude, Demand for Product High
Population Council President Margaret Catley-Carlson during the panel re ported that her organization successfully had concluded mifepristone trials involving 2100 women in the U.S. While data from the trials are still being analyzed, women in the U.S. trials as well as in trials in Cuba, India, China and Vietnam found the RU 486 procedure to be highly acceptable to women.
The Population Council, which has received patent rights on mifepristone from Roussel Uclaf, will submit an application for U.S. Food and Drug Administration approval by the end of 1995. Once mifepristone receives FDA approval, the Population Council and its chosen distributor will evaluate marketing the compound in other countries, according to Catley-Carlson.
A recently released study by the Kaiser Foundation showed that one-third of ob/gyns who do not currently provide abortions would be willing to prescribe RU 486 when it becomes available in the U.S.