Walgreens said it would not begin selling an abortion pill in 20 states warning of legal consequences if it did so.
The pharmacy chain’s announcement on Thursday indicated that access to mifepristone may not expand as much as federal regulators wanted in January, when they finalized a rule change that allowed more pharmacies to provide of the pill.
Here’s a closer look at the issue.
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 maintain pregnancy. Misoprostol is taken a day or two later, causing contractions to empty the uterus.
More than half of abortions in the US are now done with the pill instead of the procedure, according to the Guttmacher Institute, a research group that supports abortion rights. In rare cases, the drug combination can cause excessive bleeding, which requires emergency care.
SENDING ACCESS
For more than 20 years, the FDA has limited the distribution of mifepristone to a subset of specialty offices and clinics due to safety concerns.
The agency has repeatedly eased restrictions and expanded access, increasing demand even as state laws make the pills harder to get for many women.
In late 2021, the agency eliminated a personal requirement for taking the pill, saying a new scientific review showed no increase in safety complications when the drug is taken at home. . That change also allows the pill to be prescribed via telehealth and sent to mail-order pharmacies.
Earlier this year, the FDA further loosened restrictions by allowing pharmacies such as Walgreens to begin distributing the drug after they undergo certification. That includes meeting standards for shipping, tracking and confidential storage of prescription information.
STATE STEPS TO
Generally, 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 — after the Supreme Court’s decision last year overturned federal abortion rights.
Last month, the attorneys general of 20 conservative states Warned CVS and Walgreens in a letter that they could face legal consequences if they sell abortion pills by mail in their states.
In addition to state laws, attorneys general from conservative states argued that the shipments of mifepristone violated a 19th-century law that prohibited sending abortion products through the mail. .
REACTION TO WALGREENS
A spokeswoman said the company has told attorneys general it will not provide mifepristone in their states and plans to ship the drug to them as well.
But Walgreens is working to qualify through the FDA certification process. It plans to distribute the pills where they can be legal.
The company does not currently distribute the pills anywhere.
OTHER DRUGSTORES
Aid to the Rite The Corp. said it is “monitoring the latest federal, state, legal and regulatory developments” and will continue to evaluate its policies. The Associated Press also sought comment from CVS Health Corp., retail giant Walmart and the grocery chain Hooks.
Some independent pharmacists want to be certified to dispense pills, said Andrea Pivarunas, a spokeswoman for the National Community Pharmacists Association. He added that it was a “personal business decision,” based in part on state laws. The association did not have details on how many will do so.
OTHER LEGAL ISSUES
In November, an anti-abortion group filed a federal case of Texas is seeking to revoke the approval of mifepristone, claiming that the FDA approved the drug 23 years ago without sufficient evidence of safety.
A federal judge may rule soon. If he sides with abortion opponents, mifepristone could potentially be taken off the US market.
In January, abortion rights supporters filed separate lawsuits challenging abortion pill restrictions imposed in North Carolina and West Virginia.
Legal experts have seen years of court battles over access to the pills.
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