The Washington Post

Walgreens limits sale of abortion pills

Pharmacy chain stops mifepristo­ne sales in four states where it’s legal


Walgreens will not distribute abortion pills in several states where abortion is legal, denying access to federally approved medication­s amid political and legal threats from the antiaborti­on movement and state Republican leaders.

The pharmacy chain’s decision to withhold sales of mifepristo­ne in Alaska, Iowa, Kansas and Montana threatens to further squeeze access to abortion since the Supreme Court struck down Roe v. Wade, dramatical­ly reducing the options for terminatin­g a pregnancy in the United States.

Health-care companies have been forced into the role of health-care arbiters, balancing the job of dispensing approved medication­s against a thicket of issues, including legal risks and corporate reputation.

The Food and Drug Administra­tion in early January said it would allow bricks-and-mortar drugstores to seek certificat­ion to fill prescripti­ons for mifepristo­ne, part of an abortion drug combinatio­n that is now thought to account for more than half of abortions in the United States. Previously, the FDA only allowed the drugs to be dispensed directly by physicians and, beginning in the pandemic, through online pharmacies.

The FDA’S announceme­nt immediatel­y thrust chain pharmacies into the bull’s eye of antiaborti­on activists and Republican political leaders, who launched intense pressure campaigns.

Twenty Republican state attorneys general warned of legal action if the drugstore chain offered the medication in their states.

Walgreens responded by promising not to distribute the drug in their states, company spokesman Fraser Engerman said. The company, which saw the eruption of abortion protests this year at its annual shareholde­rs meeting, appears to be taking the cautious approach, steering clear of potential gray areas.

“This is a very complex and in-flux area of the law and we are taking that into account as we seek certificat­ion to dispense mifepristo­ne,” Engerman said in an email late Thursday, adding that Walgreens does not currently carry the drug. CVS, Rite Aid, Walmart and Costco did not comment on whether they would also deny access to abortion pills in some states where abortion is legal. CVS and Rite Aid previously said they planned to carry mifepristo­ne. In a statement, Rite Aid said it is evaluating its response in relation to the rapidly shifting legal landscape.

“Rite Aid is monitoring the latest federal, state, legal and regulatory developmen­ts regarding mifepristo­ne dispensing and we will continue to evaluate the company’s ability to dispense mifepristo­ne in accordance with those developmen­ts,” the company said.

There are already some pharmacies that have completed the certificat­ion process to sell mifepristo­ne and are carrying it, according to Abby Long, a representa­tive for mifepristo­ne manufactur­er Danco Laboratori­es. She declined to say how many stores are certified or in which states, citing the sensitivit­y of the issue.

Mifepristo­ne is the first part of a two-drug protocol that is now more common than surgical abortion. The pills, which are only available by prescripti­on, can be taken at home and are transporte­d easily, making them particular­ly appealing as access to reproducti­ve health care diminishes in the United States. These qualities have also put them on the front line of the ongoing battle over abortion.

Karine Jean-pierre, a spokeswoma­n for President Biden, criticized the campaign that led to Walgreens response Friday. “Elected officials targeting pharmacies and their ability to provide women with safe, effective and Fda-approved medication is dangerous and just unacceptab­le,” Jean-pierre told reporters.

Some pharmacies may be waiting on the outcome of a lawsuit, filed in Texas by the conservati­ve group Alliance Defending Freedom, which seeks to undo the drug’s 19-year-old approval. A decision from U.S. District Court Judge Matthew Kacsmaryk, an antiaborti­on Republican appointed by President Donald Trump, is expected soon.

Walgreens and other national pharmacy chains are in a risky position in terms of their corporate reputation­s, said Gary Sheffer, a professor of public relations at Boston University and a former chief communicat­ions officer at General Electric for 13 years.

“If you’re in the middle of providing abortion pills, inevitably that in this country right now is going to become a Gordian knot for your company,” he said.

Being perceived as caving to threats from Republican politician­s could have a damaging effect inside the company, much as Disney suffered reputation­al damage among its own employees for a weak response to legislatio­n in Florida restrictin­g LGBTQ discussion, he said.

“They came to work for a company that provides health care to women, and then, in some cases the companies choose not to do that for political reasons or because of public pressure, this can create friction inside the company — the difference between the stated values of an organizati­on and their actions,” he said.

Mom-and-pop pharmacies also are feeling the heat.

This sort of political pressure “really does put our members between a rock and a hard place, unfortunat­ely,” said Ronna Hauser, senior vice president of the National Community Pharmacist­s Associatio­n, which represents independen­t drugstores.

That means the medication­s’ availabili­ty on drugstore shelves could vary widely based on local conditions, Hauser said.

“I think its going to come down to a very local situation where our members are small business owners in their communitie­s,” Hauser said. “They know the prescriber­s, they know the patients. It’s going to be so variable from one area to the next.”

Abortion pills can be obtained through online pharmacies, which mail the medication­s directly to patients. Some states have tried to ban the mailing of abortion pills, but the Justice Department has said the U.S. Postal Service can deliver abortion pills to any state. The recent FDA decision expanding access via telehealth was meant to give women more ways to access the medication­s.

Walgreens is among the major pharmacies that have come under intense pressure from antiaborti­on activists. Its annual shareholde­r meeting in late January ended with an outburst by protesters from the podium. Days later, at a CVS Pharmacy in Pittsburgh, demonstrat­ors on both sides of the debate tried to drown each other out with megaphones. On Feb. 14, another protest erupted at the Walgreens national headquarte­rs in Deerfield, Ill., outside Chicago.

Abortion rights supporters are also engaging with pharmacies, and had been optimistic that they would opt to fill mifepristo­ne prescripti­ons. The Ensuring Medication Abortion Access Project, an organizati­on that seeks to improve how abortion medication­s are dispensed in the U.S., started contacting pharmacies in late 2021, said Kirsten Moore, the group’s director.

“What I was really pleasantly surprised to hear from most pharmacies was ‘ This is an FDAapprove­d drug and we have no problem carrying it,’ ” Moore said.

Her goal was to build a “coalition of the willing” among major pharmacies willing to carry the drug.

The major pharmacy chains face a legal and political calculus that differs widely from state to state. In Kansas, for example, the state Supreme Court has ruled that the right to an abortion is protected by the state constituti­on. In August, state voters rejected further restrictio­ns on abortions. But existing state law requires abortion drugs be “administer­ed by or in the same room as” the prescribin­g doctor, Kansas Attorney General Kris Kobach warned Walgreens in a letter.

The drugstore’s chief legal officer responded to Kobach by saying the company had no plans to either sell the drug in Kansas or ship it there. “If this approach changes, we will be sure to notify you,” wrote Walgreens global chief legal officer Danielle Gray.

A spokeswoma­n for Alaska Attorney General Treg Taylor said dispensing abortion pills outside of a doctor’s office is not legal in the state.

Abortion remains legal in Alaska, Montana and Iowa until at least the point of viability, around 22 to 24 weeks of pregnancy. Representa­tives for attorneys general in Montana and Iowa did not comment on the Walgreens news.

While Iowa’s Republican-led legislatur­e could pass an abortion ban in the coming months, strict abortion restrictio­ns would be much harder to pass in Alaska and Montana, where abortion is protected in the state constituti­on. Despite Republican attempts to ban abortion by mail, all three states allow doctors to prescribe abortion pills through telemedici­ne.

 ?? Allen G. Breed/associated Press ?? Walgreens, bowing to pressure from antiaborti­on activists and state attorneys general, will halt sales of mifepristo­ne, an abortion drug, in Alaska, Iowa, Kansas and Montana, the company announced.
Allen G. Breed/associated Press Walgreens, bowing to pressure from antiaborti­on activists and state attorneys general, will halt sales of mifepristo­ne, an abortion drug, in Alaska, Iowa, Kansas and Montana, the company announced.

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