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Abortion pill could soon become much easier to obtain

MARY LOUISE KELLY, HOST:

Since the Supreme Court overturned Roe v. Wade back in June, the Biden administration has been trying to protect access to abortion. Now an abortion pill called mifepristone could become easier to obtain.

NPR pharmaceuticals correspondent Sydney Lupkin is here to tell us more. Hey there, Sydney.

SYDNEY LUPKIN, BYLINE: Hi, Mary Louise.

KELLY: Hi. So let's talk about what this pill is. This is not a new one. This has been around for a while, right?

LUPKIN: Right. Mifepristone has been approved by the Food and Drug Administration for more than two decades. It stops a hormone needed to maintain a pregnancy in the first trimester, and it's usually taken around 24 hours before a second pill, which causes the uterus to expel the pregnancy tissue. Doctors also use both pills during miscarriages to speed things along and minimize infection risk.

KELLY: OK. So it's been around, but it has been hard to get in the past. How might access be about to get easier?

LUPKIN: Yeah, for years it could only be dispensed in person by clinics certified to do so. So patients couldn't just get a prescription and fill it at the drugstore. They had to make an extra trip to take a pill in front of someone. And retail chains were specifically barred from dispensing it.

KELLY: And why? Why so many rules?

LUPKIN: So the short answer is safety. Drugs with certain safety issues have extra rules around them to control where they go. The long answer - if you ask some advocates - is politics. Medical societies have long said the restrictions weren't clinically necessary. The American College of Obstetricians and Gynecologists, for instance, says the drug is safe and effective and requiring it to be dispensed in person doesn't do anything to improve safety. It just adds hurdles. For what it's worth, the Food and Drug Administration suspended the in-person rule during most of the pandemic. So now, in the wake of the Dobbs decision overturning Roe v. Wade, the agency is making more - a more permanent rule change.

KELLY: OK, including, as we mentioned, dropping the in-person requirement for accessing the pill. What else is changing?

LUPKIN: That's right. And now those big pharmacy chains aren't barred from carrying and filling prescriptions for mifepristone anymore. So it could be available at local drugstores and retail pharmacy chains, not to mention via telehealth going forward. The pharmacies would need to meet certain requirements and receive special certification before being allowed to fill those prescriptions.

And to be clear, patients still need a prescription for these pills. They're not going to be available over the counter. Medical societies do say it's a step forward.

KELLY: So what does this mean practically? If I am a patient, if I want to get this abortion pill, can I walk into my local CVS or Walgreens right away and get it?

LUPKIN: You can't yet. So for starters, no one is required to carry these pills under the new rule, so they can choose not to seek the certification required to carry and fill these prescriptions. I reached out to CVS and Walgreens, and both told me they were reviewing the new FDA changes. CVS told me it was looking at requirements in states that don't already restrict these drugs for medication abortion.

KELLY: Right. Well, speaking of states, I was wondering, because we now have quite a few states with laws on their books restricting abortion, so how does that come into play?

LUPKIN: So the Guttmacher Institute tracks state laws and policies surrounding abortion, including medication abortion. It says 29 states specifically require physicians to administer medication abortions. So not just any clinician. And 18 of those states effectively banned the pills used in telemedicine by requiring the physician to be in the room when a patient takes this pill. Two states - Indiana and Texas - outright banned medication abortion after a certain point in pregnancy. So this doesn't make abortion accessible everywhere in the country, and it doesn't change things immediately. It will take time to see how it plays out.

KELLY: All right. NPR's pharmaceuticals correspondent Sydney Lupkin. Thank you.

LUPKIN: You bet. Transcript provided by NPR, Copyright NPR.

Sydney Lupkin is the pharmaceuticals correspondent for NPR.