Retail pharmacies, like CVS and Walgreens, will be allowed to fill prescriptions for mifepristone—the first of two pills used for a medical or medication abortion—for the first time in the United States, according to a recent update provided by the Food and Drug Administration (FDA). The permanent regulatory change is expected to increase abortion access throughout the country following the Supreme Court’s decision to overturn Roe v. Wade last year; the landmark case guaranteed the federal right to abortion since 1973 and was officially reversed in June 2022.
Before this regulatory change, which was confirmed by the FDA on January 3, people who wanted or needed a medication abortion—which accounts for more than half of all abortions in the US—were only able to access mifepristone from doctors’ offices, clinics, or a few mail-order pharmacies. With the new change, you still need a prescription from a certified provider to get mifepristone, but retail pharmacies that agree to carry the drug and follow certain criteria can dispense the pills, either in person or via mail order. (Misoprostol, the second pill needed for a medication abortion that is also used for other conditions, hasn’t faced the same restrictions and can be picked up at pharmacies with a prescription.)
This change is a pretty big deal, according to Lauren Streicher, MD, a clinical professor of obstetrics and gynecology at Northwestern University Feinberg School of Medicine. “It’s all about telehealth,” she tells SELF. Prior to this, there was a requirement that mifepristone had to be dispensed in person; currently, in 18 states, the prescribing clinician also needs to be physically present when the medication is taken. One reason for that? There is a “ridiculous” concern that someone would be prescribed the medication and give it to someone else, Dr. Streicher says, noting that most other medications don’t have this type of restriction.
Requiring people to get or take abortion pills in person, typically in a doctor’s office or clinic, has always been problematic for various reasons, but it “was a huge barrier” if you were trying to get a prescription via telehealth in particular, Dr. Streicher says. Now, depending on where you live and your access to care, you can get the medication prescribed via telehealth, go to a certified pharmacy of your choice (or request a mailed order), and “take the pill in the privacy of your own home,” she says. Another perk: “This change also means that someone else can pick up the prescription for you,” Dr. Streicher adds. (Note: It’s always a good idea to read up on your state’s abortion stance to familiarize yourself with local legislation first.)
The research we have on medication abortions supports the FDA’s decision, Gopika Krishna, MD, an ob-gyn in New York and fellow with Physicians for Reproductive Health, tells SELF. “Despite years of medical research showing that medication abortion, and specifically mifepristone, is safe and effective, there have been medically unnecessary restrictions on how mifepristone can be prescribed,” she says. “The decision by the FDA follows the science by removing unnecessary barriers to safe and evidence-based medical care.” Remember: People will still receive prescriptions from certified prescribers, meaning their providers will discuss all the benefits and risks to be aware of, and the patient will still get to ask questions to ensure they feel comfortable and confident about their decision.
Morgan Hopkins, president of abortion care advocacy group All* Above All, echoes that point, noting wider access to abortion pills “is especially important for young people who can’t involve their parents in their decision to have an abortion, people who may be in abusive relationships, or anyone who needs a safe, private way to have an abortion.”
Still, Hopkins tells SELF plenty of people will face barriers to care. “Onerous state restrictions remain in place—including the 13 states where abortion is banned, 18 states that ban medication abortion care via telehealth, and in the 32 states that limit the type of provider that can prescribe medication abortion care to patients,” she says.
Mifepristone will still be dispensed under specific regulations. The FDA has what’s called a mifepristone risk evaluation and mitigation strategy (REMS) Program that lists specific requirements. For example, the prescriber must be certified under a specialized program and complete an agreement form; the patient must sign an agreement form; and mifepristone may only be dispensed by a certified pharmacy (meaning the pharmacy also needs to complete an agreement form and use shipping services that provide tracking information).
Those are only a few of the rules listed, and they do require time and effort for the pharmacy to complete compared to standard practice for other medications. Dr. Krishna also adds that the success of this change “is reliant on pharmacies making changes to stock mifepristone.” According to reporting from NPR, Walgreens said it will pursue certification to dispense mifepristone and CVS is reviewing the requirements in states without restrictions for medication abortions.
We’ll have to wait and see how everything unfolds as legislation evolves around this change, especially in states where abortion is banned or restricted, but many reproductive health experts and advocates consider this a step in the right direction. Timing is critical when it comes to getting a safe and effective abortion—and having access to the medication as soon as possible is key. “From my point of view,” Dr. Streicher says, “this change will facilitate more access to a medical abortion.”
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