Mifepristone and abortion pills: a fight over the future that’s pushed by the Biden administration after the Supreme Court’s decision

The company wants to be a certified pharmacy and will distribute the drug only in countries where it’s legal and feasible.

It is not certain if many or most pharmacy will do anything in ways that meaningfully increase access to medication abortion, says a law professor at the University of Michigan.

The laws vary by state but the medicines can be taken up to 11 weeks after the last menstrual period. Some states permit telehealth prescriptions, or a person can travel to a state where abortion is legal to get the pills.

More than half of U.S. abortions are now done with pills rather than surgery, according to the Guttmacher Institute, a research group that supports abortion rights.

The opinion said the mere mailing of drugs to a jurisdiction is insufficient to conclude that the sender intends the drugs to be used in violation of the law.

In the aftermath of the Supreme Court ruling, Attorney General Garland promised to work with the FDA and other federal agencies to protect access to drugs which some states have sought to ban.

The Biden administration partially implemented the change last year, announcing it would no longer enforce a long-standing requirement that women pick up the medicine in person. The updated drug’s labeling was formally implemented on Tuesday and can be used by more retail pharmacies if they pass a certification process.

Lindsay Wiley, a health law professor at University of California Los Angeles, said the fight underscores the rapid changes in policy following the Supreme Court’s Dobbs decision last year. “It’s a fight over the future that really matters under the current current legal regime,” she said in an interview with NPR. “Mifepristone and abortion pills have become a political football for state elected officials, governors, attorneys general to assert the power that they have to influence health care access.”

Generic versions of abortion pills were requested by two drugmakers. Agency rules require a company to file an application before modifying dispensing restrictions on drugs.

The FDA approved a second drug, called misoprostol, to be used with the first drug to allow for the terminated pregnancies of up to 10 weeks. Mifepristone is taken first to dilate the cervix and block the hormone progesterone, which is needed to sustain a pregnancy. The uterus contracts and expels fetal tissue after taking maoprostol for 24 to 48 hours.

Serious injuries are rare, but bleeding is a common side effect. The FDA says that more than 3 million women in the U.S. have used it.

In the case of excessive bleeding, prescribers need to be certified in order to provide emergency care. Pharmacies that dispense the pills also need a certification.

It’s not clear which other pharmacies will seek certification or what impact it will have on abortion access in places where it’s banned or restricted.

Richard Dang told NPR that Walgreens’ business would be “severely limited” by changes in state insurance plans, but that he had yet to hear any details on the plan.

Honeybee Health, an online pharmacy company that had been supplying and shipping abortion medications, posted on its verified Facebook page Tuesday that it “officially became the first pharmacy certified to dispense medication abortion.”

The certification process may not be easy for many pharmacies as they review and decide whether to go through it.

Probing the Laws of Abortion: A State-Of-Dependence Report to the Kansas Attorney General’s Office

Abortion is still legal in Alaska, Iowa and Montana, but they have laws or restrictions relating to the provision of abortion pills. The same is true of Kansas, whose attorney general sent a separate letter to the chains and where a law requiring physicians to dispense the drug is currently enjoined by a legal challenge.

“We don’t believe that anyone should be forced to travel in that way, and certainly, as this moves forward, there are a lot of very smart lawyers who are looking at the question of how they’ll be incorporated into drugstores and pharmacy chains, and where that can happen – and how these different federal and state provisions interplay,” she said.

He asked, “Would a state that was prosecuting somebody for diversion have access to those records? If they do, that will make it more difficult to give it to people in states that are banning it.

“Many people have difficulty accessing this care because of things like transportation or having time off of work to go to a clinic to get this care so this is really going to open the doors for them,” Dr. Kristyn Brandi, a member and fellow at the American College of Obstetricians and Gynecologists told NPR.

The FDA’s conclusion that patients are not at an increased risk when not seeing a doctor in-person may allow providers who were previously afraid to seek certification to do so.

Sue Liebel is the director of state affairs for Susan B. Anthony Pro-life America, a organization that says it is the political arm of the pro-life movement.

The FDA would require an in-person exam if they kept the safety regulations. Liebel toldNPR that women’s health and safety was not taken into account.

She suggested that as a result, more women “will wind up in the emergency room.” But when pressed for data that might show any increases in ER visits since the FDA temporarily lifted the in-person mandate, she was unable to point to recent studies.

“I think this next policy session is going to be very fascinating,” she said. We’re in a new territory with the decision. It is going to be a mixed bag in terms of what states try to do and see what works.

Do people want to go to emergency care? The case of mifepristone, an FDA ruled no-go theorem, and the crisis in California

“I would say that there’s absolutely no data that suggests that people are going in waves to seek emergency care after medication and that’s because there is a really great track record showing that they are incredibly safe,” Brandi said.

She thinks that clinical care won’t change very much. Patients will still be evaluated by a clinician. They will go through counseling. This will allow them to discuss whether or not it is the best choice.

The only difference, moving forward she explained, is that in the most dire situations they will no longer have to drive long distances for an exam or wait days to obtain the vital medication. “They’re going to have much easier access to it.”

Retail pharmacies have been caught in the middle of abortion battles. In states where there may be politically motivated reprisals, companies are hesitant to antagonize lawmakers. The Republicans have targeted businesses in the past.

Abortion rights advocates have sounded the alarm on the case, stressing that a ruling in favor of the plaintiffs would affect every corner of the country since the lawsuit is targeting a federal agency.

“If FDA approval of mifepristone is revoked, 64.5 million women of reproductive age in the US would lose access to medication abortion care, an exponential increase in harm overnight,” NARAL said in a statement in February, pointing to internal research.

The company said in a statement to NPR that it has responded to all of the attorneys general to assure them it won’t distribute mifepristone in their states.

A spokesman for Newsom did not immediately answer a question about the practical effects of the governor’s announcement. Late last week, Democratic California state Attorney General Rob Bonta issued a statement slamming Walgreens for bowing to political pressure from GOP officials.

The clash between Newsom and Walgreens, a massive chain with thousands of stores around the country, marks the latest round of fallout following the Supreme Court’s decision to overturn Roe v. Wade. The ruling, handed down in June of last year, shook up national politics ahead of the 2022 midterms – with many Democrats crediting the backlash for helping their candidates in tough, swing state and seat races – and complicated relationships between political and business leaders.

Bonta said Friday that medication abortion is a lifeline for people in need of critical care and that it is safe and effective. I’m disappointed that Walgreens has decided to give in to political pressure from anti-Abortion states and cut off access to important medication.

Abortion remains protected under Kansas state law. Last summer, the state voted overwhelmingly to block efforts by lawmakers to ban the procedure following the Supreme Court’s decision to overturn Roe v. Wade less than two months earlier.

California’s Walgreens problem in light of Republican threats and congressional calls for rethinking its stance in response to the Republican threats

California, which would be on track to becoming the world’s fourth largest economy if it were its own country, has immense buying power in the healthcare market.

Even if the state only cut Walgreens out of state employee insurance plans, the company might see a big financial impact: The state insures more than 200,000 full-time employees. CalPERS has another 1.5 million, including dependents up to the age of 26, covered by its retirement insurance program.

There were calls for a boycott of the company on social media. The chief executive of Walgreens was on a video call with the governor of Illinois. Mr. Pritzker, a Democrat, urged them to rethink their stance in response to the Republican threats.

“Violating the has-to-be-done-by-a-physician requirements in some of these states is punishable by jail,” Mr. Engerman said. In a number of states it is considered a criminal offense, and it can be punished with civil fines or licensing sanctions. These are restrictions that present risks to the pharmacy.