Two Major US Pharmacies Opening Doors To Abortion Pills Is Noteworthy

Two of the most prominent pharmacy chains in the United States, CVS and Walgreens, have announced plans to make the abortion pill mifepristone available by prescription at select locations across several states starting later this month. The decision, as reported by the New York Times on Friday, marks a pivotal moment in reproductive rights, garnering swift approval from President Joe Biden, who hailed it as an "important milestone" in ensuring access to essential healthcare services.

On April 21, 2023, the US Supreme Court temporarily also preserved access to the abortion pill mifepristone, a pill widely used in half of the abortions in the country. The apex court has also put a block on rulings by lower courts that may restrict the availability of the drug. However, two conservative Supreme Court Justices, Clarence Thomas and Samuel Alito, opposed the Supreme Court's decision previously. 

Presidential Support and Implications

President Joe Biden swiftly applauded this decision, considering it an "important milestone" in preserving access to the abortion pill. In a statement issued by the White House, he encouraged other pharmacies to follow suit. President Biden emphasised that with major retail pharmacy chains now certified to dispense medication abortion, women will soon have the option to conveniently pick up their prescription at local, certified pharmacies, akin to any other medication.

"The stakes could not be higher for women across America," he added, highlighting the significance of this move in the broader context of reproductive healthcare.

Biden issued a similar statement last year as well after Supreme Court verdict  calling on voters to take abortion access as a polling issue. He stated, “The stakes could not be higher for women across America promising to fight, politically driven attacks on women’s health. But let’s be clear: The American people must continue to use their vote as their voice, and elect a Congress who will pass a law restoring the protections of Roe v Wade."

The appeal came into the picture when US District Judge Matthew Kacsmaryk made a ruling earlier that would have banned access to the pill. However, Kacsmaryk’s decision offered seven days for the Biden administration to appeal. And that is how the case landed in New Orlean’s 5th Circuit  Court of Appeals.Coming back to the present, the Supreme Court is poised to hear this case later this month, following a federal appeals court ruling that upheld the legality of the pill but restricted its distribution through mail or telemedicine.Should the Supreme Court uphold the ruling, patients may face the prospect of obtaining the pill through in-person visits to clinics, doctors, or pharmacies, potentially reshaping the landscape of reproductive healthcare accessibility.

The decision by CVS and Walgreens to offer Mifepristone comes in the wake of a pivotal ruling by the US Food and Drug Administration (FDA) last year, permitting pharmacies to sell the abortion pill. 

CVS and Walgreens Rollout Plans

According to the New York Times, CVS will initiate the dispensing of prescriptions for the abortion medication mifepristone in Massachusetts and Rhode Island in the coming weeks. The pharmacy chain has received certification to dispense the medication in states where abortion remains legal and plans to add additional states to its distribution on a rolling basis, as confirmed by CVS spokeswoman Amy Thibault to The Associated Press.

Simultaneously, Walgreens is set to provide the pill in select pharmacies across California, New York, Massachusetts, Pennsylvania, and Illinois. Fraser Engerman, a spokesperson for Walgreens, stated, "We are beginning a phased rollout in select locations to allow us to ensure quality, safety, and privacy for our patients, providers, and team members."

Both pharmacy chains have expressed intentions to expand the dispensing of the medication to other states where it is legally permissible. However, they have refrained from extending access to areas where abortion bans are currently in place, as reported by the New York Times.

Context Amidst Legal Challenges

This development comes against the backdrop of Republican-led states imposing widespread restrictions on abortion access since the landmark 2022 US Supreme Court decision overturning the 1973 Roe v Wade ruling, which recognized access to abortion as a national right in the United States.

The Supreme Court's decision to hear oral arguments in a case related to abortion medication last December. The outcome of this case, expected this summer, holds the potential to impact access to mifepristone significantly.

Historical Perspective on Mifepristone

The FDA approved mifepristone in the year 2000 for terminating pregnancies of up to 10 weeks when used in conjunction with a second drug, misoprostol. However, for over 20 years, dispensing of mifepristone was restricted to a subset of specialty offices and clinics due to safety concerns outlined in FDA labeling.

Mifepristone operates by initially dilating the cervix and blocking the hormone progesterone, which is crucial for sustaining a pregnancy. Subsequently, misoprostol is administered 24 to 48 hours later, inducing uterine contractions to expel pregnancy tissue.

CVS, with nearly 9,400 stores in the US, and Walgreens, boasting around 8,700 stores, collectively represent a substantial expansion in the availability of mifepristone, marking a progressive stride in reproductive healthcare accessibility.

The impending Supreme Court decision and the evolving regulatory environment highlight the ongoing battle for reproductive rights and access to essential healthcare services. With nearly 9,400 CVS stores and approximately 8,700 Walgreens locations nationwide, the potential impact of this initiative on women's health cannot be overstated.