The two largest drugstore chains in the United States will begin distributing the abortion pill mifepristone this month, a step that could make access easier for some patients.
CVS and Walgreens officials said in interviews Friday that they had received certification to dispense mifepristone under guidelines issued by the Food and Drug Administration last year. The chains plan to initially make the drug available in stores in a few states. They will not provide the drug by mail.
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 the states.
President Biden said in a statement Friday that the pill’s availability in pharmacies was “an important milestone in ensuring access to mifepristone, a drug that has been approved by the Food and Drug Administration as safe and effective for more than 20 years.”
“I encourage all pharmacies that want to pursue this option to seek certification,” he added.
Walgreens will begin providing the pill within the next week at 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 will begin distributing to all of its Massachusetts and Rhode Island pharmacies “in the coming weeks,” said Amy Thibault, a company spokeswoman.
The chains will be watching the outlook in a handful of states, including Kansas, Montana and Wyoming, where abortion bans or strict restrictions have been enacted but are being held up by legal challenges.
Mr. Engerman said Walgreens “was not going to distribute in states where the laws are unclear” to protect its pharmacists and staff members.
As for CVS, “we are constantly monitoring and evaluating changes in state laws and will administer mifepristone in any state where it is or becomes legally permissible to do so,” Ms. Thibault said. In some states where abortion is legal, he said, pharmacists are prohibited from dispensing mifepristone because the laws require it to be done by doctors or in a hospital or clinic.
It is uncertain how much initial demand there will be for the service in pharmacies. In states where the chains will begin distribution, abortion pills are already available in clinics or easily prescribed via telemedicine and sent by mail. But some women prefer to see doctors, many of whom do not have the drug on hand. The new development will allow doctors and other qualified providers to send a prescription to a pharmacy for the patient to pick up.
“Now that doctors no longer have to store the drug themselves and administer it, it increases the likelihood that a patient will go to their own doctor, the person they already have a relationship with, and say, ‘I’m pregnant. I don’t want to be,” said Kirsten Moore, the director of the Expanding Medication Abortion Access Project.
He said it may also prompt more doctors and other health care providers to obtain the special certification the FDA requires for mifepristone prescribers. The steps to becoming a certified prescriber are simple, but some doctors have been put off by the paperwork and logistics involved in ordering and storing pills.
As availability in retail pharmacies expands, they may become a more popular alternative, and depending on the outcome of a Supreme Court case later this month, pharmacy choice could become more important.
In that case, abortion opponents have sued the FDA, seeking to remove mifepristone from the market in the United States. An appeals court ruling in that case didn’t go that far, but it effectively banned mifepristone from being mailed and required in-person doctor visits. If the Supreme Court upholds this ruling, it could mean that patients will have to get mifepristone by visiting a clinic or doctor. If such a decision allowed pharmacies to continue dispensing, more patients could get the drug there.
Opponents of abortion criticized the pharmacy chain’s decision. “As two of the largest, most trusted ‘health’ brands in the world, the decision by CVS and Walgreens to sell dangerous abortion drugs is shameful and the harm to unborn babies and their mothers immeasurable,” said Katie Daniel, Susan’s state policy director. B. Anthony Pro-Life America, said in a statement.
To get certified, drugstore chains had to take specific steps, including making sure their electronic systems protect the privacy of prescribers, who are certified under a special program that the FDA applies to mifepristone and several dozen other drugs.
Pharmacy certification is granted by mifepristone manufacturers. Walgreens was certified by brand-name manufacturer Danco Laboratories and is seeking certification from generic manufacturer GenBioPro, Mr. Engerman said. CVS was certified by GenBioPro.
Medical abortion is a two-drug regimen that is now the most common method of terminating a pregnancy in the United States and is usually used up to the 12th week of pregnancy. Mifepristone, which blocks a hormone necessary for pregnancy to develop, 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 these patients can now get mifepristone from chain pharmacies.
Mifepristone has been tightly regulated by the FDA since its approval in 2000. Previously, it was available primarily from prescriptions or from telemedicine abortion clinics or services, to which the pills were generally shipped from one of two licensed mail-order pharmacies. Misoprostol has never been as tightly restricted as mifepristone and is used for many different medical conditions. You can get it easily at pharmacies through a standard prescription process.
The American Pharmacists Association has urged the FDA to allow retail pharmacies to dispense mifepristone, even though the drug is unlikely to generate significant revenue. In a statement last year, the association said it wanted the agency to “level the playing field by allowing any pharmacy that chooses to dispense this product to be certified.”
Shortly after the FDA’s January 2023 policy change was announced, 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 drug in those states.
Both chains had protests outside their stores, mostly by anti-abortion advocates, and similar protesters disrupted a shareholder meeting of 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 every state except North Dakota. Neither chain would discuss the drug’s price, but both noted that some insurance policies would cover it in some states.
A handful of small independent pharmacies began dispensing mifepristone last year.
