CVS and Walgreens to begin dispensing the abortion pill mifepristone

CVS and Walgreens announced on March 1 that they would begin dispensing the abortion pill mifepristone, also known under its brand name, Mifeprex. Walgreens, a pharmacy giant with about 8,600 locations, completed the process of certification to sell mifepristone with the U.S. Food and Drug Administration in January 2023 and plans to begin selling the drug this week, and plans to expand sales to stores in other states. “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,” the Walgreens website reads.

Phased Rollout and State Availability

Walgreens said it would start selling the pills in five states, including Pennsylvania, then roll them out to others. The Walgreens website lists New York, Pennsylvania, Massachusetts, California, and Illinois as the first states where the pills will be dispensed. Mifepristone will be dispensed at CVS pharmacies in Massachusetts and Rhode Island, and the company intends to expand the offering to more states as the law allows, according to CNN. CVS operates over 9,000 pharmacies nationwide.

Regarding the initial availability across the two major chains:

• Walgreens: New York, Pennsylvania, Massachusetts, California, and Illinois.
• CVS: Massachusetts and Rhode Island.

Dispensing Requirements and Presidential Statement

The pharmacies will dispense the medication on the basis of a prescription from a certified medical professional, but they will not be able to send it by mail, the New York Times reports. “With major retail pharmacy chains newly certified to dispense medication abortion, many women will soon have the option to pick up their prescription at a local, certified pharmacy—just as they would for any other medication,” President Joe Biden said in a statement. “I encourage all pharmacies that want to pursue this option to seek certification.”

Clinical Significance and Judicial Context

The FDA approved mifepristone in 2000 as the first part of a two-step nonsurgical abortion regimen, along with a second drug, misoprostol, which both CVS and Walgreens already dispense. The two-step regimen is also used in miscarriage care. Medication abortions account for over half of all U.S. abortions. Since the Supreme Court overturned Roe, 21 states have banned or restricted abortion.

Legal challenges to the drug's availability continue to move through the courts. The U.S. Court of Appeals for the 5th Circuit in New Orleans, Louisiana, ruled in August 2023 that mifepristone should not be prescribed after seven weeks of pregnancy or be available via telehealth. In September 2023, the U.S. Department of Justice asked the U.S. Supreme Court to review the lower court’s ruling. In December 2023, it agreed to do so. The court will hear oral arguments in the case on March 26.

Impact on Patient Access

Rabia Muqaddam, a senior staff attorney for the Center for Reproductive Rights, told CBS News the announcement by CVS and Walgreens was “absolutely a game-changer.” “This type of dispensing is going to be huge for patients who struggle to travel. We’re going to see much better health outcomes,” Muqaddam added. “Planned Parenthood of Western Pennsylvania celebrates the expansion of access to abortion care, which is critical following the decision to overturn Roe v. Wade in 2022,” Sydney Etheredge, president and CEO of Planned Parenthood of Western Pennsylvania, said.

Regional Considerations: Pennsylvania

Abortion is legal in Pennsylvania up to 23 weeks of pregnancy. However, Planned Parenthood notes, the state’s Abortion Control Act includes restrictions such as a 24-hour waiting period, informed consent counseling that includes information “designed to discourage” a patient, and consent from a parent or guardian for minors. “Although Mifepristone is safe and effective, these state regulations, along with the upcoming Supreme Court case challenging the legitimacy of the FDA’s approval, put this type of expansion into question,” Etheredge said.