(Washington) US health authorities this week authorized the sale of prescription abortion pills in pharmacies. What does this measure change for American women, many of whom now live in states where all abortions are illegal anyway?
Where were they sold so far?
Performing a medical abortion involves taking two medications a day or two apart. the first (mifepristone) blocks pregnancy, the second (misoprostol) triggers bleeding.
It is the first pill, authorized since 2000 in the United States (now up to 10 weeks of pregnancy), which was hitherto subject to numerous restrictions.
Prior to COVID-19, it could only be delivered in person at very specific locations, including abortion clinics.
During the pandemic, after a legal action, the American Medicines Agency (FDA) temporarily accepted that it could be sent by post, including after a telemedicine consultation.
Then the FDA announced in December 2021 to permanently lift the in-person delivery requirement for mifepristone. The agency then asked the two companies marketing it (Danco Laboratories, which sells Mifeprex, and GenBioPro, which sells a generic) to set up a system allowing wider distribution. That’s what was approved this week.
What is the new system?
From now on, any pharmacy will be able to sell mifepristone if it signs a form to be sent back to the companies Danco and GenBioPro, thus guaranteeing in particular to be able to dispense the pills to patients in a maximum of 4 days (if the drug is not directly stored on site). .
The pharmacy must also ensure that the prescription comes from a certified healthcare professional, doctor or nurse if the state allows it.
To be certified, caregivers must themselves complete a document in which they ensure, among other things, that they are in contact with a medical center that can provide emergency care if necessary. They must also have their patients sign a consent form.
Since they no longer have to store the pills themselves, more doctors may decide to get started.
It is a “very decentralized” system, Kirsten Moore, director of an organization that campaigns for access to medical abortions, told AFP. The FDA does not intervene at all “in the day-to-day management”.
For researcher Antonia Biggs, a specialist in these issues at UCSF University, these certifications constitute an “unnecessary” restriction, but the FDA’s decision remains “a huge step” in the right direction.
When will pharmacies launch?
Difficult to predict. “I would say that in the next few weeks and months we will see more and more” participating pharmacies, Jenny Ma, a lawyer at the Center for Reproductive Rights, told AFP.
Two major US drugstore chains, Walgreens and CVS, have said they want to participate in states where it’s legal.
What impact in states where abortion is legal?
Where abortion is legal, this measure thus adds a third option to obtain these pills, in addition to clinics or mailing. This could allow some women to abort more quickly, without waiting to receive them or having to travel to a sometimes distant clinic.
“This will help people living in the countryside enormously”, especially those “who cannot afford transport costs”, underlined Jenny Ma.
This can also help those for whom the postal mailing is not suitable, such as “young people” living with their parents, “people in violent relationships” or “without stable housing”, listed Antonia Biggs.
And beyond these practical aspects, “the real consequence is that it de-stigmatizes abortions” by making this drug accessible almost like any other, said Jenny Ma.
What impact in states where abortion is illegal?
Since a Supreme Court decision last summer, every US state is free to legislate on abortion. A dozen of them made it illegal.
In these states, abortion pills cannot be sold, and the FDA’s decision will not change that. “This will make the disparities even greater” between the States, underlined Jenny Ma.
Still, for people deciding to travel to a state where abortion is legal, a pharmacy might be closer than a clinic, reducing travel time.