Earlier this month, Politico breaking news Confirmed by Walgreens, the second largest pharmacy chain in the country 21 Republicans from the Attorney General no Distribute abortion pills in their states if the company agrees to disburse them. The decision was met sharp protest by Walgreens customers, abortion rights activists, and Democrats, who have accused the pharmacy of succumbing to pressure unnecessarily.
But fear of state prosecution isn’t the only factor shaping Walgreens’ decision-making. Another limitation of the company that was not previously reported is that the only supplier of Mifeprex — the brand-name drug of the abortion pill mifepristone that was first approved by the Food and Drug Administration in 2000 — has circulated a list to its corporate clients. In January 31 countries said they would no longer supply them with abortion drugs. Vox spoke with two sources who reviewed that list newly.
only united states distributor for Mifeprex is Amerisource Bergenone of the largest Pharmaceutical distribution companies in the world. (Federal government He is currently suing AmerisourceBergen to Allegedly distributing opiates with knowledge They would later end up on the illegal market. The Pennsylvania-based company has denied this.) Back in January, Amirsource Bergen Created her list of 31 countries used as the website source for The Guttmacher Institute, the reproductive research organization that tracks government abortion restrictions, according to sources with knowledge of the origin of the list.
The existence of the list underscores the precarious state of abortion rights in the United States in the wake of Dobbs v. Jackson – Supreme Court ruling of 2022 that overturned Roe v. Wade, effectively leaving abortion rights to every state. Walgreens drew condemnation for saying it would not distribute abortion pills, even in states where it is currently permitted. AmerisourceBergen’s listing indicates another reason affecting Walgreens’ position: the distributor – the only one for this drug – has indicated that it will not supply abortion pills to pharmacies.
Walgreens and Danco Laboratories, the manufacturer of Mifeprex, declined to comment. A source familiar with the contractual agreement between Walgreens and AmerisourceBergen told Vox that The parties are legally prohibited from speaking publicly about the resource, but that Advocates have been trying to persuade AmerisourceBergen to adopt a less risk-averse stance on abortion pill distribution.
The situation is “dynamic and ever-evolving,” Lauren Esposito, a spokeswoman for AmerisourceBergen, told Vox via email. Any information you’re referring to from January is certainly out of date now. Additionally, as I’m sure you can estimate, we can’t discuss specific products. for contractual purposes.”
Vox asked Guttmacher about the list of suppliers and reported use of the institute’s website as a guide for compiling the list. “We would like to understand the data on which AmerisourceBergen bases these claims, as we are not aware of any policies that would prevent the shipment of mifepristone to such a large number of states,” said Elisabeth Nash, a policy analyst at Guttmacher. “Private companies should be very careful not to restrict access to mifepristone in response to threats from anti-abortion groups or politicians.”
Abortion rights advocates and consumers He responded angrily to the Politico report, calls for Walgreens County even swooped in. In particular, there’s the fact that four states on Walgreens’ list — Montana, Kansas, Iowa and Alaska — have restrictions on pharmacists. that have been blocked In court. California Democrat Governor Gavin Newsom announce He will not renew a multimillion-dollar contract with the drugstore chain to indicate his disagreement.
A Walgreens spokesperson, Fraser Engerman, maintained the company’s no-do position changed, and that they still intend to dispense with mifepristone “in any jurisdiction where it is legally permitted to do so.”
In January, the Food and Drug Administration announced that traditional pharmacies could apply for certification to sell abortion drugs in their stores, a move that was hailed as an important step toward expanding access to the safe and effective drug that has It has become the most popular method for termination of pregnancy in the United States.
CVS and Rite Aid representatives, who said they would do as well as Walgreens Requests Testimony, has remained conspicuously quiet on the issue for the past two weeks, and has not responded to requests for comment. (No pharmacy has yet been approved, and it’s not clear how long that process will take.)
The debate over what pharmacies like Walgreens can do when it comes to distributing mifepristone reflects the political challenge of navigating the country’s conflicting patchwork. Post-abortion restrictionsru era. With a host of new laws and litigation, individuals, abortion providers, and companies are left to make dependency decisions in a highly charged and confusing legal environment — which, in the case of Walgreens and AmerisourceBergen, means inaction in the face of uncertainty.
Pharmacists are caught in the middle
Caught in the middle of this legal and political tug of war are abortion providers. While it is easy for democratic governors in states like Illinois And California telling companies they should be cashing in on medical abortion is hard to insist That they should put Pharmacists are at risk.
“Violating the requirements of what a physician must do in some of these states is punishable by imprisonment,” a Walgreens New York Times spokesperson. “In other countries it is punishable by a civil fine, and in a number of them it is punishable by licensing penalties. And so these are restrictions that pose real risks to pharmacists.”
Guttmacher’s Nash explained that the 21 states where Walgreens said it would not distribute mifepristone fell into a few different categories. Some have banned abortions outright, while others have laws requiring doctors to dispense medications in person, or order in-person counseling and ultrasounds, making the prospect of dispensing mifepristone through a pharmacy impractical. Others, like Alaska, Nash said, should be practically able to dispense through the pharmacy.
“Overall, there is a lot of confusion in the market as pharmacies and pharmacists try to follow all the laws, regulations, and litigation,” said Elisa Bernstein, interim CEO of the American Association of Pharmacists. “The situation is not stable now.”
Bernstein told Vox that in addition to the legal risks, members are grappling with new safety issues: “Safety of pharmacy staff is a concern, whether it’s going into a pharmacy and looking for people who might be Protest and sit-in outside Or at the pharmacy, where team members want to make sure they are in a safe place while they work.” Anti-abortion activists recently They protested at Walgreens’ annual shareholder meetingand pharmacies ranked as the new abortion clinic.
The American Pharmacists Association is holding it next week its annual meeting where hundreds delegates from across the country to review group policies on mifepristone and Reproductive health care.
No matter what pharmacists want their group policies to be, they will still be restricted by the FDA Risk assessment and mitigation strategies List (REMS), a restrictive designation that the federal government places on mifepristone over objections Groups such as the American Congress of Obstetricians and Gynecologists. Pharmacists will also be restricted by their company attorneys and other actors involved in the medical abortion supply chain, such as drug distributors and lawmakers.
Esposito, a spokesperson for AmerisourceBergen, told Vox, “We continue to provide FDA-approved medications, including reproductive health medications, to health care facilities and providers in all 50 states and territories that meet local, state, and federal requirements for dispensing and dispensing.”
But whether AmerisourceBergen will Have Walgreens and other drugstores sell Mifeprex at all drugstore locations Be willing to let it go is another question.