Is Walgreens banned from selling the ‘abortion pill’? This is why the answer has been confusing

"Walgreen's Pharmacy" by JeepersMedia is licensed under CC BY 2.0.
“Walgreen’s Pharmacy” by JeepersMedia is licensed under CC BY 2.0.

If you have been feeling confused about Walgreens’s status since the uproar over the national pharmacy’s restrictions with Mifeprex, the drug commonly referred to as the “abortion pill,” you’re not alone.

The history behind the availability and obstacles to accessing to Mifeprex has been a long winding story that continues to develop, especially on the state level. This was perhaps confounded by more recent developments after the FDA’s risk evaluation and mitigation strategy (REMS) updated their protocol on Jan. 23 for use of Mifeprex, also known as Mifepristone. It is taken orally as part of a regimen that includes Misoprostol to end a pregnancy within 10 weeks of gestation. Mifepristone was subject to more regulatory red tape than Misoprostol because in the past, Mifepristone could only be dispensed to patients in person at a clinic, medical office, or hospital by a certified provider. Additional regulations affecting Mifepristone availability were patient’s requiring proof of counseling and signing an agreement acknowledging they understand the drug’s risk.

The second drug Misoprostol, which causes contractions that expel pregnancy tissue, and is usually taken 24 to 48 hours after Mifepristone. Because Misoprostol is commonly prescribed for various medical conditions, and is easily accessible at pharmacies (with a prescription) as opposed to certified medical facilities and hospitals, it was not as regulated. 

Here’s where the history of abortion drug restrictions, rulings, and reversals start to complicate the pharmacy’s status to date.

In July 2020, during the peak of the Covid pandemic, a federal judge suspended the requirement Mifepristone being dispensed, stemming from a lawsuit brought by the American College of Obstetricians and Gynecologists and other parties.

Just eight days before former President Donald Trump left office, the Trump Administration issued an appeal to enforce the rule of getting the abortion pill Mifepristone in person and in the presence of medical professionals. The ruling was reinstated on Jan. 12, 2021.

The Biden Administration temporarily lifted the abortion drug restriction that requires abortion pills to be dispensed in person after he took office and signed an executive order. In a statement, the White House explained its position on abortion drugs. The statement says, in part:

Protecting access to reproductive health care has been a priority since the beginning of the Biden-Harris Administration, made even more urgent by the Supreme Court’s decision to overturn Roe v. Wade.

Biden signed the executive order on July 8, 2022, reversing restrictions to access Mifepristone once again.

On Jan. 3, the new FDA ruling solidified the president’s executive order, approving the protocol for certification of pharmacies, allowing those that have been certified by the manufacturers of Mifeprex to dispense the pill directly to patients.

But, yet again women’s reproductive rights were put at jeopardy, this time after Missouri State Attorney General Andrew Bailey and 19 other conservative Republican attorney generals wrote a letter to several of the largest pharmaceutical companies that sell abortion pills like Mifeprex. The state officials threatened legal action against the companies, stating they could face consequences if they sell abortion drugs by mail.

The group of Republican attorneys general, who argue that the Biden Administration is misinterpreting the laws around mailing and dispensing abortion drugs, also wrote to CVS, Albertsons, Rite Aid, Costco, Walmart and Kroger. 

Walgreens found itself in controversy after the company wrote back to each of those attorney generals, stating in part:

Walgreens does not intend on dispense mifepristone in your state and does not intend to ship mifepristone to your state.

This sparked an uproar because some of the states belonging to those attorney generals were legally able to sell the abortion pill.

Going back to the new FDA ruling, people in states where abortion is protected by state laws now may be able to fill their abortion drug prescriptions at their qualified drug store or via a mail-order pharmacy like any other medication. Under the new FDA. 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 criteria, including certification, can dispense the pills in its stores and by mail order.

In my opinion, the problem was not that Walgreens “chose” not to sell the abortion pill, it was that the presumption that Walgreens will also not be selling the abortion pills in states where it is legal like Alaska, Iowa, Kansas and Montana. Unfortunately, Walgreens decisions appeared too political, like writing back to the attorney generals in the first place to offer reassurances. Other pharmaceutical companies have not following suit after the Republicans letter. It is also unclear if any of the other pharmacy companies responded to the attorney generals since then, but there has been no news on that front.

Leaders from several states, including California Governor Gavin Newsom, threatened to ban Walgreens from operating in the state and withdraw multi-million dollar agreementsThe state announced on March 8 that it would rescind renewal of a multi-million dollar contract with Walgreens and the Department of General Services (DGS), following Walgreen’s announcement it would not to dispense Mifepristone in 21 states, including states where abortion remains legal.

“California will not stand by as corporations cave to extremists and cut off critical access to reproductive care and freedom,” said Gov. Newsom. “California is on track to be the fourth largest economy in the world and we will leverage our market power to defend the right to choose.”

The contract allows the State to procure specialty pharmacy prescription drugs. The contract, which Walgreens has received $54 million from, was set to renew May 1.

Newsom’s response to Walgreens was one of the most aggressive compared to other states when he first announced via Twitter that California would stop doing business with Walgreens. But if a California Healthline report true, Gov. Newsom’s threat’s are shallow at best and wouldn’t significantly affect Walgreens’ ability to operate in California.

According to California Healthline on April 6, Walgreens can still rebid on that contract. The report also states California paid Walgreens $1.5 billion last year, and “is legally bound to continue doing business with Walgreens through the state’s massive Medicaid program.”

Walgreens has responded to the claims and accusations that the company does not plan to dispense Mifepristone in some states where abortion is legal. In a statement, the company explains several “facts vs myths” surrounding its handling of the abortion medication.

“We want to be very clear about what our position has always been: Walgreens plans to dispense mifepristone in any jurisdiction where it is legally permissible to do so. Once we are certified by the FDA, we will dispense this medication consistent with federal and state laws. Providing legally approved medications to patients is what pharmacies do, and is rooted in our commitment to the communities in which we operate.”

U.S. Congresswoman Ayanna Pressley speaks during an abortion rights event.
U.S. Congresswoman Ayanna Pressley speaks during an abortion rights event.

Taking abortion medication is a personal medical issue that only a woman has to deal with, and sadly, as seen with the letter sent to Walgreens, too many male politicians are trying to continue making decisions about a woman’s health and wellbeing. I’m hopeful Walgreens intends to stay true to its statements on dispensing Mifepristone. I know pharmacies are subject to a litany of regulations and scrutiny, but I also think we need to prioritize creating a health care system that isn’t swayed by political interference. Women’s health shouldn’t be political.


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