JAMA Intern Med
Can patients self-screen for OTC medication abortion?
Clinical Takeaway: Most patients seeking medication abortion were able to accurately self-determine eligibility using only a prototype over‑the‑counter (OTC) package and Drug Facts Label—supporting the feasibility of OTC access.
In a diagnostic study published in JAMA Internal Medicine, researchers evaluated whether people seeking medication abortion could accurately self‑select eligibility using a prototype OTC package for mifepristone–misoprostol, without clinician input.
The study enrolled 168 patients at five abortion facilities in Illinois, Minnesota, and Colorado between July and December 2024. After reviewing the prototype label, participants assessed whether the product was appropriate for them to use at that time, and their responses were compared with clinician determinations.
Overall, 88% of participants showed concordance between self‑selection and clinician‑determined eligibility. Nearly all participants (94%) believed the product was appropriate for them, and 93% said they would be interested in purchasing medication abortion OTC if available. Only ~9% were clinically ineligible—most commonly due to gestational age, miscarriage, or an intrauterine device.
“We found that people did a really good job at self‑assessing their eligibility,” Daniel Grossman, MD, said in an interview with NPR, noting that the findings add to evidence supporting FDA criteria for potential OTC consideration.
The authors note that while the sample size was modest and limited to English‑speaking clinic patients, the results strengthen the growing evidence base for patient‑directed, OTC medication abortion access.
Source: Ralph LJ, et al. (April 6, 2026). JAMA Intern Med. Accuracy of Self-Selection for Medication Abortion Using a Prototype Drug Facts Label