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Health Care—Insurers weigh options in abortion pill coverage

Health Care: Blue Shield, Kaiser to Insure When Product Is Available

Now that the Food and Drug Administration has approved the hotly debated abortion pill RU-486, health insurers are evaluating guidelines to cover the drug.

“All California health plans will be required (under the Knox-Keene license) to cover RU-486 to the extent that they cover abortions,” said Michelle Naiditch, spokeswoman for Blue Shield of California.

The Knox-Keene Health Care Service Plan Act of 1975 regulates health care service plans and providers of health care. The lawful execution of California state laws is overseen by the California Department of Managed Health Care.

Blue Shield and Kaiser Permanente, however, were the only two health plans surveyed to concede they will cover the pill as soon as it becomes commercially available.

Brad Kiefer, a spokesman from Health Net, said the health plan won’t make a decision on coverage for the pill until January 2001 , at the earliest.

Cheryl Randolph, a spokeswoman for PacifiCare Health, said the health plan is in the process of evaluating coverage for the pill.

Susan Pisano, vice president of communications at the American Association of Health Plans in Washington, D.C., anticipates most health plans will offer the pill, but pointed out that a few employers may choose to exclude RU-486 under their benefits plans.

“Most employers provide a broad range of reproductive services , including pregnancy services, contraceptives, infertility and surgical procedures,” Pisano said.

A small New York firm, Danco Laboratories, is expected to market RU-486, known by its chemical name mifepristone, by the end of this month. It will be sold under the brand name Mifeprex. Danco has not released a price for the pill, said a Planned Parenthood official.

Marc Salo, president and CEO of Planned Parenthood in San Diego, said the approval marks a major victory for proponents of the pill.

“We knew it was a safe drug and good drug back in 1995,” Salo said.

Planned Parenthood was one of 12 groups in the United States to test mifepristone for safety and efficacy as required by the FDA.

The trials dating back to 1995 showed the drug was “safe and effective” 95 percent of the time, a Planned Parenthood spokeswoman said.

The pill had been used by millions of women in Europe, but anti-abortion organizations have fought to keep mifepristone out of the United States since it debuted in France in 1988.

Salo said Planned Parenthood will offer the pill to women as one of several abortion methods as soon as it becomes available.

He declined to speculate on the cost of the drug. Salo predicts most women will prefer surgery as the preferred method of abortion.

“The surgical method is a one-time procedure most women want to get it behind them quickly,” he explained.

Mifepristone can be used only within 49 days of the beginning of a woman’s last menstrual period. The woman takes two mifepristone pills. Two days later, the woman needs to return to the clinic and take a second drug, misoprostol, that causes uterine contractions and to expel the embryo.

Within the next two weeks, the woman returns for a follow-up visit to make sure the abortion is complete. Studies have shown mifepristone is 92 percent to 95 percent effective in causing early abortion, according to published reports.

Salo said Planned Parenthood contracts with several managed care organizations, including Kaiser Permanente in San Diego, to provide reproductive services.

He expects local gynecologists and family-practice doctors will also offer mifepristone.

He said it will change the politics of abortion, making it a private and anonymous decision matter between a woman and her personal doctor.

Salo anticipates the drug will not be made available in local emergency rooms as an emergency abortion method, because it isn’t intended to be used that way.

Doctors have been providing an abortion-inducing drug, methotrexate, for rape victims and women seeking an emergency abortion for years, he said. Mifepristone, by contrast, is an early abortion drug to be used after the pregnancy begins, he said.


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