Walgreens’ decision against selling abortion pills in 20 states is a huge blow to federal government’s plans

Walgreens says it will no longer sell abortion pills in 20 states that have warned of legal consequences for doing so.

The pharmacy chain’s announcement on Thursday signaled that access to mifepristone may not expand as much as federal regulators had hoped in January, when it finalized a rule change that would allow more pharmacies to stock the pill.

Here’s a closer look at the problem.

About the Abortion Bill

The US Food and Drug Administration approved mifepristone in 2000 to terminate pregnancy, when used in combination with another drug, misoprostol. The combination is approved for use up to 10 weeks of pregnancy.

Mifepristone is taken first to dilate the cervix and block the hormones needed to maintain the pregnancy. Misoprostol is taken for a day or two, causing contractions to empty the uterus.

More than half of US abortions are now done with the pill rather than with the procedure, according to the Guttmacher Institute, a research group that supports abortion rights. In rare cases, the combination of drugs can cause excessive bleeding, which requires emergency treatment.

WIDENING ACCESS

For more than 20 years, the FDA limited the dispensing of mifepristone to a subset of offices and specialty clinics due to safety concerns.

The agency has repeatedly eased restrictions and increased access, increasing demand even as state laws make the pill more difficult for many women to obtain.

By the end of 2021, the agency is eliminating the personal requirement to take the pill, saying a new scientific review has not shown any safety complications if the drug is taken at home. The change also allows the pill to be prescribed via telehealth and delivered by a mail-order pharmacy.

Earlier this year, the FDA further loosened restrictions by allowing pharmacies like Walgreens to begin distributing the drug after undergoing certification. That includes meeting standards for shipping, tracking and confidentially storing prescription information.

STEP IN

Typically, the FDA’s authority to regulate access to prescription drugs has been unenforceable. But more than a dozen states now have laws that broadly restrict abortion — and the pill specifically — after a Supreme Court decision last year overturned the federal right to abortion.

Last month, attorneys general in 20 conservative-led states warned CVS and Walgreens in a letter that they could face legal consequences if they sell abortion pills by mail in their states.

In addition to the state law, attorneys general from conservative states have argued that shipping mifepristone was done under a 19th-century law that prohibited sending items used for abortions through the mail.

WALGREENS REACTION

A spokesman said the company had told the attorney general that it would no longer offer mifepristone in his country and that it also planned to ship the drug to him.

But Walgreens is working to qualify through the FDA certification process. It plans to dispense pills where it can legally.

The company does not currently distribute these pills anywhere.

OTHER DRUG STORES

Rite Aid Corp said it is “monitoring the latest federal, state, legal and regulatory developments” and will continue to evaluate its policies. The Associated Press also sought comment from CVS Health Corp., retail giant Walmart and grocery chain Kroger.

Some independent pharmacists want to become certified to dispense the pills, said Andrea Pivarunas, spokeswoman for the National Association of Community Pharmacists. He added that it would be a “personal business decision,” based on state law. The association did not have specifics on how much it would cost.