On the abortion pill, Walgreens says its hands are tied. Experts disagree – Rolling Stone

The governor of California, Gavin Newsom, made this week what could be considered a bold commitment or a shameless stand: he announced that the state was reevaluating the expected renewal of a contract with Walgreens, after the pharmacy chain secured to 20 Republican attorneys general who would not. dispenses Mifepristone in its states, including some states where abortion remains legal.

“California will not stand by as corporations pander to extremists and cut off critical access to reproductive care and freedom,” California’s governor said in a statement. Walgreens had received about $54 million dollars under the contract to date, to provide prescription drugs for California prisons.

As calls to boycott the pharmacy chain have grown, Newsom is not the first or last Democratic heavyweight to express disappointment with the company for its capitulation to GOP AGs. A few days earlier, the CEO of Illinois-based Walgreens was summoned to the office of Governor JB Pritzker to discuss his plans, and on Thursday, Governor Kathy Hochul of New York sent a letter d proper warning.

Privately, Walgreens representatives complained that by simply promising to comply with state and federal laws, they were unfairly bearing the brunt of public outrage over the substance of those laws. And in a statement responding to the California decision (which Walgreens said was based on “false and misleading information”), the company sniped: “Walgreens faced the same circumstances as all retail pharmacies, and no other retail pharmacy has said that it will approach this situation differently, so it is not clear where this contract will now be moved.”

But experts challenge Walgreens’ position, saying the company’s interpretation of state and federal law is wrong — and that the company is being unnecessarily restrictive with a medication that’s critical not only for abortion, but also for the treatment of abortions.

Walgreens is the second largest drugstore chain in the country. The largest, CVS, remained quiet as the outrage continued to build. CVS did not respond to multiple requests for comment Rolling Stone, nor Walmart and Costco. (The country’s third largest pharmacy group, Health Mart, a franchise program, said Rolling Stone that each owner-operator chooses to dispense mifepristone by himself. “Health Mart’s independent community pharmacy operators make their own independent business decisions.”)

If these companies are still evaluating how they will respond to threats from Republican attorneys general, Elizabeth Nash of the Guttmacher Institute, a leading expert on state abortion laws, says they are likely to find they have more leeway than they thought. Walgreens says it has.

The 21 states where Walgreens said it won’t dispense mifepristone fall into several different categories, he explains. Some have banned abortion completely, some have laws that require a doctor to dispense the drug in person, some have onerous requirements that will simply make it impractical for a pharmacy to dispense. And then there are many states, she says, that don’t have any of the above, where Walgreens also says it won’t dispense Mifepristone.

Alaska, Nash says, is an example: it has no ban on telemedicine, no requirement that the abortion pill be dispensed in person, no waiting period and no gestational limit. Montana, she says, is another. A Walgreens representative, reached for comment, pointed to language in statutes in Alaska and Montana that say an abortion can only be provided by a licensed physician, but Nash says that doesn’t create a significant barrier, since a doctor would be the one writing a prescription for the drug anyway.

The details, she says, matter a lot. “Alaska, Montana — they’re both rural states where access to pharmacy could be very important,” Nash says. Both states, he also notes, have higher courts that have consistently protected access to abortion. With future struggles over access to birth control and gender-affirming care looming in the near future, he adds, the decision sets a troubling precedent.

“They needed to take more time to think,” says Nash. “There were definitely places where they could provide Mifepristone, and now they won’t.”

A maker of mifepristone — GenBioPro — and its lawyers, meanwhile, argue that the state restrictions that Walgreens cited are functionally irrelevant because courts have consistently ruled that only the federal government has the power to regulate drugs. “Was the letter meant to intimidate the pharmacies? Yes. Did it do its job? It looks like it,” says Skye Perryman, president of Democracy Forward and legal counsel for GenBioPro. “But the theory is wrong on the law.”

GenBioPro is currently suing the state of West Virginia over this issue, arguing that states cannot ban or regulate a drug in a manner inconsistent with federal policy. Courts reaffirmed that finding until 2014, when Massachusetts tried to ban a powerful opioid, only to be firmly rebuked by a federal judge, who said doing so “would undermine the FDA’s ability to make drugs available to promote and protect public health.”

GenBioPro is now considering whether it could use a similar argument in legal action against AG Republicans who are working to prevent the distribution of mifepristone in their states. In a statement to Rolling StoneCEO Evan Masingill said the company is “reviewing the state AG’s actions and will continue to use the legal process to vindicate access to this evidence-based medication.”

The fight between the Biden administration, pharma, the GOP AG, Democratic governors and drug companies is especially frustrating for people in states like Kansas who, just months ago, went to the polls and voted in size to protect access to abortion – just to see. their elected officials who work to close that access.

“The message in August was very clear — 19 clear points,” Ashley All, who helped lead the campaign against the Kansas abortion ban with the group Kansans for Constitutional Freedom, said in a statement. “Kansans voted ‘No’ to give politicians more power to regulate abortion. Yet, at every turn, politicians have ignored the will of the voters and meddled in the private medical decisions of citizens of Kansas”.

Kansas Attorney General Kris Kobach, who has been at the forefront of the crusade against pharmacies, “interferes in Kansans’ private medical care, decides what legal prescriptions can be sent to Kansans, and threatens pharmacists.” All said. “Last time I checked, he’s not a doctor or a pharmacist.”


And that comes exactly to the problem, says Ushma Upadhyay, professor in the Department of Obstetrics, Gynecology and Reproductive Sciences at UCSF, and the co-director of the UCSF. UCGHI Center for Gender and Health Justice: None of the state or federal restrictions on abortion — including the rules around pharmacy certification to dispense Mifepristone that will be instituted under the renewed policy of the Biden administration — is rooted in science. “Mifepristone is extremely safe – it has a safety rating of over 99 percent,” says Upadhyay. “We looked at 11,000 medication abortions and found a serious complication rate of less than a third of 1 percent.”

While she welcomes the Biden administration’s expansion of mifepristone to retail pharmacies, she says the additional certification pharmacies must obtain to dispense the drug is an unnecessary burden for a drug that is not only used for abortion. , but “very commonly prescribed to patients to treat. abortion.” Therefore, she says, pharmacies – even in states with hostile attorneys general – must commit to dispensing the drug: “Walgreens or pharmacists in all 20 states should carry mifepristone now that they are legally able to do so.”

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