CVS, Walgreens to begin filling prescriptions for abortion pill mifepristone

The nation's largest pharmacy chains, CVS and Walgreens, will begin dispensing the abortion pill mifepristone in select stores within weeks, according to news reports.

Historically, patients had to get mifepristone in person from a certified doctor in a clinic, medical office or hospital. But in recent years, the Food and Drug Administration (FDA) has adjusted its regulations to ease people's access to the drug, which is part of a two-pill regimen used to induce an abortion. For example, the FDA has recently allowed certified pharmacies to dispense the pill.

Both CVS and Walgreens say they've now been certified to sell mifepristone, as required by the FDA, The New York Times reported. This certification process requires a pharmacy to file a form with the drug's manufacturer stating that they agree to follow certain rules. For example, pharmacies must ensure the doctor prescribing the pill is certified through the FDA's Mifepristone Risk Evaluation and Mitigation Strategy Program.

Related: Are 'home remedies' for abortion safe? (Experts say no.)

Walgreens announced that it will start selling mifepristone "within the week" at select locations in New York, Pennsylvania, Massachusetts, California and Illinois. CVS, meanwhile, will start dispensing the pill in Massachusetts and Rhode Island "in the weeks ahead," a company spokesperson told the Times. Neither pharmacy will mail the drug to patients, they've said, although the FDA does allow the pill to be distributed in that way.

The FDA changed its rules around mifepristone dispensing in January 2023, clearing the way for certified pharmacies to distribute the drug. In fact, some small, independent pharmacies actually began doing so last year.

In 2021, the FDA did away with the requirement that mifepristone could only be dispensed in person by a certified doctor in a health care setting. This pandemic-prompted change opened the door for the pill to be prescribed through telemedicine and delivered via mail, which data suggest is as safe and effective as getting abortion pills in person.

Mifepristone is part of a two-pill treatment to trigger a "medication abortion," or an abortion brought about by drugs rather than through a physical procedure. The second drug in the regimen, misoprostol, is also used to treat other, non-pregnancy-related conditions and is not as tightly regulated as mifepristone; it's already available at pharmacies with a prescription.

To induce an abortion, mifepristone blocks the hormone progesterone, which the body needs to maintain a pregnancy, and misoprostol then triggers contractions that empty the uterus. This regimen is approved to end a pregnancy up to 70 days from the start of the person's last menstrual period.   

Medication abortions are now very common, with data suggesting they accounted for more than 50% of abortions in the U.S. in 2020. The same pills are also used to manage miscarriages. 

Medication abortion has very low complication rates. A review of data from more than 45,500 women who underwent medication abortions showed that the drugs failed to terminate the pregnancy in around 1 in 100 cases. Among these patients, fewer than 1 in 300 people required hospitalization, and around 1 in 1,000 needed blood transfusions due to heavy bleeding. 

Despite these results and others that support the drug's safety and effectiveness, the approval of mifepristone has recently been challenged in court. It will soon be discussed by the U.S. Supreme Court, whose ruling could affect whether the pill will continue to be available through the mail in states where the practice isn't already restricted or banned.

That said, overall, data suggest that the rate of complications for medication abortions is slightly higher than that for procedural abortions — about 2% for medication abortion, compared with 1.3% for first-trimester aspiration abortions, for example, which use a small vacuum to clear out the womb. 

That's likely partly because, compared with medication, aspiration abortions have a slightly lower risk of being "incomplete," meaning the pregnancy has ended but not all the tissues built up during pregnancy have been expelled from the uterus, according to the University of California, San Francisco. Incomplete abortions require medical attention because they pose a risk of infection and heavy bleeding.

This article is for informational purposes only and is not meant to offer medical advice.