Mifepristone can now be offered at retail pharmacies

Good news, for at least some of the country.

For the first time, retail pharmacies, from corner drugstores to major chains like CVS and Walgreens, will be allowed to offer abortion pills in the United States under a regulatory change made Tuesday by the Food and Drug Administration. The action could significantly expand access to abortion through medication.

Until now, mifepristone — the first pill used in the two-drug medication abortion regimen — could be dispensed only by a few mail-order pharmacies or by specially certified doctors or clinics. Under the new F.D.A. rules, patients will still need a prescription from a certified health care provider, but any pharmacy that agrees to accept those prescriptions and abide by certain other criteria can dispense the pills in its stores and by mail order.

The change comes as abortion pills, already used in more than half of pregnancy terminations in the U.S., are becoming even more sought after in the aftermath of last year’s Supreme Court decision overturning the federal right to abortion. With conservative states banning or sharply restricting abortion, the pills have increasingly become the focus of political and legal battles, which may influence a pharmacy’s decision about whether or not to dispense the medication.

The F.D.A. did not issue an announcement but planned to update its website to reflect the decision. The two makers of the pill, Danco Laboratories and GenBioPro, released statements saying the agency had informed them of the action.

The action is the latest step taken by the federal government to expand access to abortion pills by easing some of the restrictions that have applied to mifepristone since it was approved in 2000.

In December 2021, the F.D.A. said it would permanently lift the requirement that patients obtain mifepristone in person from a health provider, a step that paved the way for telemedicine abortion services which conduct medical consultations with patients by video, phone or online questionnaires and then arrange for them to receive the prescribed pills by mail.

On Tuesday, the F.D.A. officially removed the in-person requirement from its regulatory rule book for mifepristone, leaving in place the remaining two requirements: that health providers be certified to show they have the knowledge and ability to treat abortion patients and that patients complete a consent form.

See here for some background. My understanding of the action taken in 2021 was that it allowed mifepristone to be prescribed via telehealth. I’m a little fuzzy on how much of a difference-maker this announcement is, but whatever it is, every little bit helps. Just, you know, not everywhere.

Whether large pharmacy chains and local drugstores would opt to make the pills available was not immediately clear Tuesday. The steps for pharmacies to become certified to dispense mifepristone are not difficult, but they involve some administrative requirements that go beyond the process pharmacies use with most other medications, such as designating an employee to ensure compliance. Given the time and resources required by those steps, some pharmacies may not consider it worthwhile to offer a medication that only a small percentage of their customers may use.

But while abortion pills may constitute a small percentage of a pharmacy’s sales, they could have a big impact on its public profile. Calculations about public perception and the highly polarized political landscape are also likely to influence a pharmacy’s decision.

In about half the states, abortion bans or restrictions would make it illegal or very difficult for pharmacies to provide abortion pills.

In states where abortion remains legal, pharmacies may face customer demand for the medication or public pressure from abortion rights advocates and health providers. National chains could decide to offer the medication in those states while not providing it in their stores in restrictive states.

I can say with 100% certainty that you won’t be able to walk into your local CVS here in Texas and find any mifepristone. The real question is what the Lege will try to do to prevent people from going out of state to get any kind of abortion care, or to punish people not in Texas who provide that care; the corollary questions will be about what the courts will do with the resulting litigation. We’re still a few months out from that, but it’s coming. In the meantime, at least some people will get to benefit from this.

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