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▼ Japan Panel Approves Nation's First Abortion Pill
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A health ministry panel on Friday approved the country’s first abortion pill, which would provide an alternative to a surgical procedure amid calls for progress in women’s reproductive rights and gender equality.
The ministry announced the move after a secondary panel reviewed 12,000 public comments collected online. Final approval from the health minister is expected to follow, but the timing remains unclear.
For around 30 years, abortion pills have been used overseas, with over 80 nations having them available. Japan has been criticized for lagging behind other nations.
British drug manufacturer Linepharma filed for approval of the Mefeego pill pack in December 2021.
Although the expected final approval may signal progress, discussions over pricing and controversial rules about consent are still being debated as factors that limit access to safe abortion.
Kumi Tsukahara, director of the Reproductive Health Rights Literacy Institute, said the decision was positive in terms of putting a spotlight on these issues, but she cautioned that the drug could be inaccessible to some.
On Friday, the Pharmaceutical Affairs Council discussed whether to approve manufacturing and sales of the drug. The pill pack, to be administered at medical institutions, includes two types of drugs, mifepristone and misoprostol, and is intended to be taken orally within the first nine weeks of pregnancy.
The government will also work to create guidelines for physicians and offer the public information on the drug.
Tsukahara says the government should establish a separate system to train medical practitioners on ways to communicate about abortion without stigma as well as to assess the risks.
“It’s important that they help patients understand what is safe and what is not, enabling them to make their own decision,” Tsukahara said.
Friday’s decision comes after an initial advisory panel at the health ministry approved the production and sale of the drug in January.
In early April, the health ministry said it was considering plans to make it mandatory for patients to wait for up to a day at hospitals until the abortion is confirmed, after the administration of the second pill.
This also applies to outpatients, with the decision expected to be in effect for an indefinite period after approval for the pill pack.
In clinical trials, 60% of medical abortions using the Mefeego pill pack were confirmed at four hours after the second dose, with the figure reaching 90% after eight hours. In less than 10% of cases, abortion was unsuccessful even after 24 hours.
Currently, surgical procedures, allowed at the early stages of pregnancy, are the only options available for an abortion in Japan, despite the World Health Organization having endorsed the pill as one of the safest methods.
The approval of the pill in Japan would mark progress for women’s reproductive rights, but debates over pricing and consent have cast a shadow over the decision.
Mefeego will not be covered by Japan’s national health insurance, and with women being required to take the drugs under medical supervision, costs may be greater than if one were to get a surgical abortion, even if the average wholesale price of abortion pills globally is estimated to be around ¥780 to ¥1,400.
Surgical procedures for abortion in Japan cost ¥100,000 to ¥200,000 (around $730 to $1,500).
The cost of the drug could make it inaccessible for some, but its approval can be seen as a first step, Tsukuhara said.
Another factor is Japan’s Maternal Health Act, which requires spousal consent for an abortion — a policy that prevents access in some cases.
The health ministry says the law will be applicable to abortion pills.
Exceptions to the consent policy are granted for situations where the spouse is unknown or is unable to express intention.
While a partner’s consent is not legally needed for unmarried women, many doctors require a man’s consent due to a lack of understanding and fear of legal consequences.
The law includes no provision for unmarried mothers. However, the health ministry has said a partner’s consent is not required for unmarried women or those impregnated through rape.
Such cases have led to tragic incidents, such as when a 21-year-old former nursing school student was handed a suspended prison sentence for abandoning her newborn in a public restroom at a park.
In court, the woman said the hospital required male consent, which she was unable to acquire, highlighting the limitations to reproductive rights in Japan.
“Being able to control one’s own pregnancy is already the minimum requirement for gender equality,” said Tsukahara. “Although this discussion is on medicine, we must not lose sight of how this is a human rights issue.”
The ministry announced the move after a secondary panel reviewed 12,000 public comments collected online. Final approval from the health minister is expected to follow, but the timing remains unclear.
For around 30 years, abortion pills have been used overseas, with over 80 nations having them available. Japan has been criticized for lagging behind other nations.
British drug manufacturer Linepharma filed for approval of the Mefeego pill pack in December 2021.
Although the expected final approval may signal progress, discussions over pricing and controversial rules about consent are still being debated as factors that limit access to safe abortion.
Kumi Tsukahara, director of the Reproductive Health Rights Literacy Institute, said the decision was positive in terms of putting a spotlight on these issues, but she cautioned that the drug could be inaccessible to some.
On Friday, the Pharmaceutical Affairs Council discussed whether to approve manufacturing and sales of the drug. The pill pack, to be administered at medical institutions, includes two types of drugs, mifepristone and misoprostol, and is intended to be taken orally within the first nine weeks of pregnancy.
The government will also work to create guidelines for physicians and offer the public information on the drug.
Tsukahara says the government should establish a separate system to train medical practitioners on ways to communicate about abortion without stigma as well as to assess the risks.
“It’s important that they help patients understand what is safe and what is not, enabling them to make their own decision,” Tsukahara said.
Friday’s decision comes after an initial advisory panel at the health ministry approved the production and sale of the drug in January.
In early April, the health ministry said it was considering plans to make it mandatory for patients to wait for up to a day at hospitals until the abortion is confirmed, after the administration of the second pill.
This also applies to outpatients, with the decision expected to be in effect for an indefinite period after approval for the pill pack.
In clinical trials, 60% of medical abortions using the Mefeego pill pack were confirmed at four hours after the second dose, with the figure reaching 90% after eight hours. In less than 10% of cases, abortion was unsuccessful even after 24 hours.
Currently, surgical procedures, allowed at the early stages of pregnancy, are the only options available for an abortion in Japan, despite the World Health Organization having endorsed the pill as one of the safest methods.
The approval of the pill in Japan would mark progress for women’s reproductive rights, but debates over pricing and consent have cast a shadow over the decision.
Mefeego will not be covered by Japan’s national health insurance, and with women being required to take the drugs under medical supervision, costs may be greater than if one were to get a surgical abortion, even if the average wholesale price of abortion pills globally is estimated to be around ¥780 to ¥1,400.
Surgical procedures for abortion in Japan cost ¥100,000 to ¥200,000 (around $730 to $1,500).
The cost of the drug could make it inaccessible for some, but its approval can be seen as a first step, Tsukuhara said.
Another factor is Japan’s Maternal Health Act, which requires spousal consent for an abortion — a policy that prevents access in some cases.
The health ministry says the law will be applicable to abortion pills.
Exceptions to the consent policy are granted for situations where the spouse is unknown or is unable to express intention.
While a partner’s consent is not legally needed for unmarried women, many doctors require a man’s consent due to a lack of understanding and fear of legal consequences.
The law includes no provision for unmarried mothers. However, the health ministry has said a partner’s consent is not required for unmarried women or those impregnated through rape.
Such cases have led to tragic incidents, such as when a 21-year-old former nursing school student was handed a suspended prison sentence for abandoning her newborn in a public restroom at a park.
In court, the woman said the hospital required male consent, which she was unable to acquire, highlighting the limitations to reproductive rights in Japan.
“Being able to control one’s own pregnancy is already the minimum requirement for gender equality,” said Tsukahara. “Although this discussion is on medicine, we must not lose sight of how this is a human rights issue.”
- April 23, 2023
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