“In those states, there are still access issues and those pharmacies are still caught between a rock and a hard place, between state and federal law, in what they can do,” said Dr. Bernstein.
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When asked if pharmacies are willing to get swept up in the polarized abortion debate, she said, “Each pharmacy will have to make their own decision based on political, as well as religious and ethical considerations.”
The steps for pharmacies to become certified to dispense mifepristone aren’t difficult, but there are some administrative requirements that go beyond the process pharmacies use with most other medications, such as appointing a staff member to monitor compliance. to guarantee.
For chains like CVS and Walgreens, the most logistically complex step is requiring pharmacies to keep confidential the names of the certified healthcare providers who prescribe mifepristone to protect their privacy and safety.
To meet that requirement, a chain like CVS, for example, wouldn’t be able to list a doctor’s name in a company-wide database, and that information would have to be limited to the store that fills that doctor’s prescriptions, according to a report. officer of Danco Laboratories. , one of two makers of mifepristone, who spoke on condition of anonymity due to the company’s concern over threats from abortion opponents.
Mifepristone, which blocks a hormone necessary for pregnancy to develop, is FDA-approved for use in the first 10 weeks of pregnancy, although many clinics and telemedicine providers have pushed it to 12 or 13 weeks into pregnancy offer. This is a step they can legally take, as most states allow doctors to use medical discretion to prescribe a drug for a particular “off-label” use if there is scientific evidence that it is safe and effective is for that use. The World Health Organization supports drug-induced abortion through 12 weeks of pregnancy, and studies suggest it is safe and effective during that time.
The second drug in the regimen, misoprostol, has never been more severely restricted than mifepristone and is used for many different medical conditions. It is readily available from pharmacies through a typical prescription process. Misoprostol, which causes contractions that expel pregnancy tissue, is taken 24 to 48 hours after mifepristone.
Mifepristone is currently only approved for abortion. But it is also used in the treatment of some miscarriages, and pharmacies may be pressured to dispense it for that purpose as well. Recently, dozens of groups, including the American College of Obstetricians and Gynecologists and the American Medical Association, filed a citizens’ petition asking the FDA to take action to make it easier to use mifepristone in miscarriages.
