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Illustration: PGN

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What you need to know 

  • The FDA made changes to its requirements for the abortion pill mifepristone, allowing pharmacies, including CVS and Walgreens, to become certified to provide the drug. 
  • Until 2021, when the Biden administration allowed for the mailing of abortion pills, the drug could only be obtained in a hospital, clinic, or medical office. The option to obtain pills at a pharmacy could significantly expand access to medication abortion. 
  • For now, pharmacies in ban states may not be able to provide abortion pills. 

Mifepristone, a pill that can be used to end a pregnancy of up to 10 weeks of gestation, may soon be available at retail pharmacies like CVS or Walgreens. This week, the FDA made changes to a drug safety requirement for mifepristone, which means that pharmacies can now be certified to provide it. Previously, the FDA only allowed “certified prescribers” to provide the pill to a patient in a hospital, clinic, or medical office. Read on to learn more about what the change means. 

What does this mean for abortion access?

Medication abortion accounts for more than half of abortions in the U.S., so this change means that many more pregnant people across the nation will have access to the drug—which is especially vital in the post-Roe era. Mifepristone, also known by the brand name Mifeprex, has been approved by the FDA since 2000. The drug can end a pregnancy when used alongside misoprostol (another medicine that is not as tightly regulated and can be easily obtained at pharmacies). Before this change, pregnant people could access mifepristone in person at a hospital, clinic, or medical office, with an option to also get it via mail since 2021

Will pregnant people in ban states also have access to the medication? 

Though this is a major step for abortion access across the country, 18 states (like Alabama, South Dakota, and Tennessee, among many others) currently require pregnant people to receive abortion pills in person and prohibit the use of telemedicine to prescribe medication abortion. This requirement means that pharmacies in those states won’t be allowed to provide abortion pills to patients there for now. As the New York Times explains, “abortion bans or restrictions would make it illegal or very difficult for pharmacies to provide abortion pills.” But there are many online services now available that allow pregnant people in those states to still have access to these pills via mail. And this week, the Justice Department issued an opinion saying that the U.S. Postal Service can deliver abortion pills even to states that have banned or heavily restricted abortion.

How did this change happen?

In June 2022, GenBioPro and Danco Laboratories, both companies that make mifepristone, asked the FDA to change the drug’s Risk Evaluation and Mitigation Strategy (REMS)—a program that the FDA sometimes uses to make sure a drug’s benefits outweigh its risks—to allow pharmacies to dispense the drugs. But abortion advocates and physicians have been fighting for this change, and for the FDA to remove the REMS program for mifepristone altogether, for several years. In a statement in response to the news, Julia Kaye, a staff attorney at the ACLU, said: “We are happy the FDA has increased pharmacy access to this safe and effective medication, relieving one of the agency’s needless burdens on mifepristone patients. But leading medical groups have long called for outright elimination of the FDA’s special restrictions on mifepristone, which obstruct abortion and miscarriage patients from accessing the time-sensitive health care they need without a corresponding safety benefit.” 

When will pharmacies start dispensing mifepristone?

Large pharmacy retailers like CVS and Walgreens told the New York Times that they will begin the FDA’s certification process to offer the abortion pills in states where it’s legal to do so. So far,  it’s still unclear when exactly they’ll be able to start offering them.