CVS Walgreens Selling Abortion Pill.

Article by: Pam Belluck

The New York Times original article.

Last updated: March 1, 2024

CVS & Walgreens: Mifepristone will be available with a prescription at pharmacy counters in a few states.

The two largest pharmacy chains in the United States will start dispensing the abortion pill mifepristone this month, a step that could make access easier for some patients.

Officials at CVS and Walgreens said in interviews on Friday that they had received certification to dispense Mifepristone under guidelines that the Food and Drug Administration issued last year. The chain’s first plan was to make the medication available in stores in several states. They will not be providing the medication by mail.

CVS and Walgreens: Major Players in Abortion Landscape

Both chains said they would gradually expand to all other states where abortion was legal and where pharmacies were legally able to dispense abortion pills — about half of the states.

Walgreens Abortion Pill

Walgreens will start providing the pill within the next week in a small number of its pharmacies in New York, Pennsylvania, Massachusetts, California, and Illinois, said Fraser Engerman, a spokesman for the chain.

“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,” he said.

CVS Abortion Pill

CVS will begin dispensing in all of its pharmacies in Massachusetts and Rhode Island “in the weeks ahead,” Amy Thibault, a spokeswoman for the company, said.

CVS States with Abortion Limitations

The chains will be monitoring the prospects in a few states, including Kansas, Montana, and Wyoming, where abortion bans or strict limitations have been enacted but are forbidden because of legal challenges.

Mr. Engerman said that Walgreens was “not going to dispense in states where the laws are unclear” to protect its pharmacists and staff members.

“We continually monitor and evaluate changes in state laws and will dispense mifepristone in any state where it is or becomes legally permissible to do so,” Ms. Thibault said. In some states where abortion is legal, she said, pharmacists are prohibited from dispensing mifepristone because laws require that to be done by doctors or in a hospital or clinic.

It is uncertain how much initial demand will be for the service at brick-and-mortar pharmacies. In the states where the chains will begin dispensing, abortion pills are already available in clinics or easily prescribed through telemedicine and sent through the mail. However, some women prefer to visit doctors, many of whom do not have the medication on hand. The new development will allow doctors and other eligible providers to send a prescription to a pharmacy for the patient to pick up.

As the availability in retail pharmacies expands, they may become a more popular alternative, and depending on the outcome of a case the Supreme Court will hear later this month, the pharmacy option could take on more importance.

In that case, abortion opponents have sued the F.D.A., seeking to remove Mifepristone from the market in the United States. An appeals court ruling in that case did not go that far but effectively banned the mailing of Mifepristone and required in-person doctor visits. If the Supreme Court upholds that ruling, it could mean that patients would have to obtain Mifepristone by visiting a clinic, doctor, or pharmacy.

Walgreens and CVS Pharmacy Certification for Selling the Abortion Pill

To obtain certification, the pharmacy chains had to take specific steps, including ensuring that their computerized systems protected the privacy of prescribers, who are certified under a particular program that the F.D.A. applies to mifepristone and several dozen other medications.

Manufacturers of mifepristone grant pharmacy certification. Walgreens was certified by the brand name manufacturer Danco Laboratories and is seeking accreditation from the generic manufacturer GenBioPro, Mr. Engerman said. CVS was certified by GenBioPro.

The Abortion Pill: How it Works

Medication abortion is a two-drug regimen that is now the most common method of terminating pregnancies in the United States and is typically used through 11 weeks of pregnancy. Mifepristone, which blocks a hormone necessary for pregnancy development, is taken first, followed 24 to 48 hours later by Misoprostol, which causes contractions that expel the pregnancy tissue.

The same regimen is also used for miscarriages, and those patients can now also obtain Mifepristone from the pharmacy chains.

The F.D.A. has tightly regulated Mifepristone since its approval in 2000, and doctors and other health providers must obtain special certification to prescribe it. It has previously been available primarily from the prescribers or from clinics or telemedicine abortion services, in which the pills were generally shipped from one of two mail-order pharmacies that were authorized. Misoprostol has never been as tightly restricted as Mifepristone and is used for many medical conditions. It is easily obtained at pharmacies through a typical prescription process.

The American Pharmacists Association urged the F.D.A. to allow retail pharmacies to distribute Mifepristone, even though the medication is unlikely to generate significant revenue. In a statement last year, the association said it wanted the agency “to level the playing field by permitting any pharmacy that chooses to dispense this product to become certified.”

Shortly after the F.D.A. policy change was announced in January 2023, Walgreens and CVS said they planned to become certified and offer Mifepristone in states where laws would allow pharmacies to dispense it.

Walgreens later became the focus of a consumer and political firestorm after it responded to threatening letters from Republican attorneys general in 21 states, confirming that it would not dispense the medication in those states.

Both chains have had protests outside their stores, primarily from anti-abortion advocates, and similar protesters interrupted a meeting of shareholders at Walgreens Boots Alliance, the chain’s parent company.

CVS is the nation’s largest chain, with over 9,000 stores in all 50 states. Walgreens has about 8,500 stores in all states except North Dakota.

A handful of small independent pharmacies began dispensing Mifepristone last year.

Pam Belluck is a health and science reporter covering a range of subjects, including reproductive health, long Covid, brain science, neurological disorders, mental health, and genetics. More about Pam Belluck