By Randall K. O’Bannon, Ph.D., NRL Director of Education & Research
Editor’s note. This appears in the March issue of National Right to Life News, the “pro-life newspaper of record.” Please share the contents of this great issue with your pro-life family and friends.
After threatening for over a year, Walgreens and CVS, two of the nation’s top pharmacy chains, are slated to begin filling prescriptions for mifepristone at selected stores in selected states sometime in the next few weeks, the chains announced Friday, March 1st.
Walgreens said it would start dispensing abortion pills from stores in New York, Pennsylvania, Massachusetts, California, and Illinois within a week. CVS said its stores in Massachusetts and Rhode Island would be selling the pills before the end of March.
Eventually, the chains say they plan to extend sales to other states where abortion pills are legal, though which states meet this qualification for CVS and Walgreens is unclear at this point.
It is clearly not legal in some states where full protections are in place for unborn children. But what about states where there is a heartbeat law or some law which limits abortion to a certain number of weeks? What about states where mifepristone—the “abortion pill”–is legal, but prescription is limited to physicians and pills must be picked up in person?
Finally, what about states where abortion may be legal under certain circumstances, but state Attorneys General have declared that the shipping and delivery of such pills in the state is prohibited by the federal Comstock Law which forbids the mailing or transport of abortifacients?
Clearly, they are going forward in those states where abortion has been welcomed or encouraged.
Still, some other details are still working themselves out. Some confusion exists as to whether or when these chains will begin offering mifepristone at all or just some of its stores.
According to the Wall Street Journal (3/1/24) both chains said that they intended to offer the pills at all company pharmacies in states where it is allowed. CVS said it means to offer mifepristone at all its stores where legal within the next 45 days. Walgreens made a similar commitment as to availability but did not give a hard time frame.
Other statements by the retailers seem to imply that the pills will only be distributed from certain chain stores in a given area. A statement from Walgreens on the company website speaks as if those stores will be limited and their locations will not be generally identified.
Certified medical providers will be able to direct patients to locations to pick up their prescriptions. But in the interests of pharmacist and patient safety, we will not disclose the number of sites per state nor identify the pharmacies that are dispensing.
(If “all” company stores in a given state were dispensing these pills, identifying the involved stores would simply be a matter of seeing the company sign over the door.)
From a purely economic standpoint, it might not make much sense to have to set up a special prescriber database and train pharmacists at every location in order to be able to meet full FDA certification standards. The difficulty and expense involved there is believed to be one of the reasons it took both CVS and Walgreens so long to qualify for the necessary certification.
In addition to filling out a “Pharmacy Agreement Form,” pharmacists handing mifepristone prescriptions have to review prescribing information, verify prescriptions come from certified prescribers whose “Prescriber Agreement Forms” are on file, and confirm with the prescriber that the drug is appropriate for the patient.
Essentially this means that the pharmacist needs to certify that he or she understands how the pills work, that they are given to women who are no more than 10 weeks past their last menstrual period (LMP) and have been checked for ectopic pregnancy (mifepristone’s effective drops and complications increase the farther along a woman’s pregnancy; the pills do not work in circumstances of ectopic pregnancy) and has no other conditions that could make the pills dangerous for her.
It would appear that this also would entail assuring that the woman has access to emergency help in situations where the pills do not work or might bring about uncontrolled bleeding. Only after all these conditions are met is the pharmacist allowed to dispense mifepristone.
Unless they have been hired and trained specifically and exclusively to handle mifepristone orders – which seems extremely unlikely given the relatively small numbers of patients per store1 this is in addition to whatever other tasks the pharmacist has. Both Walgreens and CVS have recently been in the news lately over labor troubles involving stressed, overworked employees.
What is interesting is what both pharmacy chains said they would not be doing. Though allowed by the current Food & Drug Administration (FDA) regulations, neither Walgreens nor CVS said its certified pharmacies would be shipping abortion pills by mail. No reason was given, though perhaps the chains found FDA shipping and tracking requirements (on top of the obligations mentioned above) too onerous or cumbersome. Or that maybe they considered the legal risk of lawsuits from injured or unhappy patients too great.
More than two dozen mifepristone patients have died in the U.S. since the drug went on the market, and thousands have suffered serious “adverse events” like hemorrhage, infection, or ruptured ectopic pregnancy.
The abortion industry has tried to convince the FDA otherwise, but there is both belief and evidence that the FDA’s allowing this new distribution scheme — dropping the requirement… ectopic pregnancy and other contraindications — will put the health and lives of many more women at risk.
This latest news is evidence that the abortion industry is plowing ahead, ignoring the dangers in order to open a new market for mifepristone. Caught up in the cause and perhaps blinded by the lure of new profits, CVS and Walgreens have gotten themselves enmeshed in a new controversy that will inevitably rachet up turmoil at the already troubled pharmacy chains and expose them to significant legal and moral liability.
The friendly neighborhood pharmacy where folks went to pick up drugs to treat or cure disease or illness is now well on its way to becoming a cold, corporate apothecary of death.
1. Even if half a million chemical abortion patients all got their pills from a CVS or Walgreens pharmacy, and patients were evenly distributed among all 18,100 locations, that would give each store less than 28 patients per year, or just over two a month, hardly enough to justify a special hire.