Walgreens’ decision to stop selling abortion pills in 20 states is a major blow to federal government plans
Walgreens says it won’t start selling an abortion pill in 20 states that have warned of legal ramifications if it does.
The drugstore chain’s announcement on Thursday signals that access to mifepristone may not become as widespread as federal authorities intended in January when they finalized a rule change that allowed more pharmacies to offer the pill.
Here’s a closer look at the problem.
ABOUT THE ABORTION PILL
The US Food and Drug Administration approved mifepristone in 2000 to terminate pregnancy when used in combination with a second drug, misoprostol. The combination is approved for use up to the 10th week of pregnancy.
Mifepristone is first taken to dilate the cervix and block a hormone needed to sustain a pregnancy. Misoprostol is taken a day or two later, which causes contractions that empty the uterus.
More than half of abortions in the United States are now performed with pills rather than a procedure, according to the Guttmacher Institute, a research group that advocates for abortion rights. In rare cases, the drug combination can cause excessive bleeding that requires emergency care.
EXPANDED ACCESS
For over 20 years, the FDA restricted the sale of mifepristone to a subset of specialty practices and clinics due to safety concerns.
The agency has repeatedly eased restrictions and expanded access, driving demand even as state laws make it harder for many women to get the pills.
In late 2021, the agency eliminated an in-person requirement to take the pill and said a new scientific review showed no increase in safety complications when the drug was taken at home. This change also made it possible to prescribe the pill via telemedicine and have it shipped from mail-order pharmacies.
Earlier this year, the FDA further relaxed restrictions by allowing pharmacies like Walgreens to start dispensing the drug after undergoing certification. This includes adhering to standards for mailing, tracking and storing prescription information confidentially.
STATES STEPPED IN
Typically, the FDA’s authority to regulate access to prescription drugs has gone unchallenged. But more than a dozen states now have laws restricting abortion in general — and the pill in particular — following last year’s Supreme Court decision overturning federal abortion rights.
Last month, attorneys general in 20 conservative-run states warned CVS and Walgreens in a letter that they could face legal action if they sell abortion pills through the mail in their states.
In addition to state statutes, attorneys general from conservative states have argued that shipments of mifepristone violated a 19th-century law that banned items used in abortions from being mailed.
THE WALGREENS RESPONSE
A spokesman said the company has told attorneys general it will not be distributing mifepristone in their states and plans to ship the drug to them as well.
But Walgreens is working to get approved through the FDA’s certification process. It plans to dispense the pills where legally possible.
The company is not currently distributing the pills anywhere.
OTHER DRUG STORE
Rite Aid Corp. said it is monitoring “the latest federal, state, legal and regulatory developments” and will continue to evaluate its policies. The Associated Press also solicited comment from CVS Health Corp., retail giant Walmart and grocery chain Kroger.
Some independent pharmacists would like to be certified to dispense the pills, said Andrea Pivarunas, a spokeswoman for the National Community Pharmacists Association. She added that this is a “personal business decision” based in part on state law. The club has no specifics on how many will do so.
OTHER LEGAL MATTERS
In November, an anti-abortion group filed a federal lawsuit in Texas to revoke the approval of mifepristone, claiming the FDA approved the drug 23 years ago without sufficient evidence of its safety.
A federal judge could soon decide. If he side with the anti-abortion side, mifepristone could potentially be taken off the US market.
In January, pro-choice advocates filed separate lawsuits challenging abortion pill restrictions in North Carolina and West Virginia.
Legal experts assume years of court battles over access to the pills.
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