As Pharmacies Expand Access to Medication Abortion, the Supreme Court Shouldn’t Put it Back Under Lock and Key

CVS and Walgreens recently announced that select drugstore locations will stock mifepristone, a medication used to end an early pregnancy and to support miscarriage care. This demonstrates what we’ve known all along: Mifepristone can and should be treated like any other FDA-approved medication. Beginning this month, a person in select states may walk into their neighborhood CVS or Walgreens with a prescription for abortion care in pill form and walk out with their medication in hand.

This is a big deal, and it’s something that reproductive health advocates have been working toward for decades. But here’s the more immediate rub: Even with more than 100 studies proving that mifepristone is safe and effective, and 20-plus years of real-world data on its use, a looming Supreme Court decision could undo this progress and put the medication back under lock and key.

The U.S. Food and Drug Administration first approved mifepristone for use in the U.S. in 2000. It is used in combination with another medication called misoprostol to safely and effectively end pregnancies up to 10 weeks, as well as to manage early miscarriage. Since its approval, more than 5.9 million people have used this medication combination – with some limitations on who can prescribe the medication and where it can be dispensed.

For the first 20 years of its availability, the FDA implemented an in-person distribution requirement, which meant that patients needed an in-office visit with a clinician, and the doctor they saw had to actually stock and dispense mifepristone themselves in a clinic or a hospital. However, data collected during the pandemic clearly demonstrated that mifepristone could be prescribed during a virtual visit and even delivered to the person’s home. Based on this evidence, the FDA permanently lifted the in-person distribution requirement early last year and decided that pharmacies can now dispense the medication.

Now, medication abortion can either be mailed to a patient or, increasingly, picked up at a pharmacy – both options that are critical to ensuring people have access to this medication in the way that works best for them. Yet tomorrow, the Supreme Court will hear oral arguments in Alliance for Hippocratic Medicine v. FDA, a case brought forward by anti-abortion extremists to ban mifepristone with no basis in science or medicine.

If the Supreme Court sides with them and reinstates the in-clinic dispensing requirement, it would be a backdoor ban on telehealth and, once again, limit people’s options for going to their own preferred health care provider for treatment of an unwanted pregnancy.

This cannot go unchecked. The juxtaposition of evidence versus ideology in this situation couldn’t be any starker.

On the one hand, science and research are leading the way to innovate and expand options for medical care. The FDA is following the science so that more people can get the care they need in the way that works for them.

On the other hand, those arguing the case against mifepristone represent a perfect storm of anti-abortion and anti-democracy extremism. Those who are opposed to abortion are cherry-picking extremist MAGA judges and using junk science to try and remove this option from the marketplace.

And make no mistake: While this case is about abortion, it also poses an existential challenge to the FDA’s ability to make independent decisions on the safety and efficacy of medications. If extremists have their way, it will jeopardize the future development of all medications, therapies and cures that have broad public health benefits.

In a post-Roe v. Wade America, every step we can take to protect reproductive rights and expand access to abortion matters. We hope other retailers will join CVS and Walgreens and start dispensing mifepristone soon and even more widely. Being able to get medication abortion at your local pharmacy can be a game-changer for so many who face barriers to care.

We haven’t come this far just to go back in time. The Supreme Court should reject the meritless arguments in the case before them and leave access to mifepristone as is – anything less will decimate the already limited patchwork of abortion access nationwide.