Pharmacists have begun prescribing abortion pills, rather than simply dispensing them, a development aimed at widening access to abortion.
The new initiative is small for now, a pilot program in Washington state, but the idea is expected to be tested in other states where abortion remains legal.
“I think it's going to grow, and it continues to grow,” said Michael Hogue, CEO of the American Pharmacists Association, a national professional association. The association is not involved in any new programs and does not take a position on abortion.
Many states now allow pharmacists to prescribe a wide range of drugs, he said, adding that the group's view is that “people in the community who have great access to safe access to treatments that are sometimes difficult to access” “It makes sense to be able to provide access to all kinds of people,” he added. ”
Abortion rights supporters believe pharmacists' prescribing of abortion pills is part of an effort to open up as many avenues as possible as anti-abortion opponents increasingly attack abortion pills.
The pill is now used in nearly two-thirds of abortions in the United States. But the Supreme Court has ruled against the original plaintiffs in a lawsuit aimed at forcing the Food and Drug Administration to significantly restrict mifepristone, the first pill in a two-drug abortion treatment. It was recently reinstated after the case was dismissed for lack of standing. The Texas attorney general recently sued a New York abortion provider for sending abortion pills to patients in Texas. Abortion rights advocates also worry that the 151-year-old federal vice law known as the Comstock Act could be invoked by the incoming Trump administration to block mailed abortion pills.
“The attacks on access to abortion care are creating an urgent health care, public health, and human rights crisis,” said the director of the new program, who heads Uplift International, a Seattle-based global health nonprofit. said Dr. Beth Libin. It's called the Pharmacist Abortion Access Project. “Even in Washington state, where abortion is legal, people still face barriers to abortion care, especially those who struggle to make ends meet, live in rural areas, and do not have easy access to reproductive health care. .”
Anti-abortion activists objected to pharmacists prescribing abortion pills, calling the practice reckless and dangerous.
“Pharmacists without clinical training should not be distributing these dangerous drugs,” Dr. Ingrid Scope, vice president and medical director of the anti-abortion organization Charlotte Rosier Institute, said in a statement. “By promoting these unsupervised abortions, the FDA and pro-abortion advocates continue down a slippery slope of undermining medical standards for women seeking abortions.”
On Tuesday, the Pharmacist Abortion Access Project reported that 10 pharmacists across Washington state prescribed abortion pills to 43 patients in a pilot program that ran from Oct. 31 to Nov. 26.
Prescriptions were administered via telemedicine screening, with patients filling out a form asking about pregnancy and medical history. Patients had to reside in Washington state and be up to 10 weeks pregnant. They paid $40, which was significantly lower than many services. The prescriptions were sent to Honeybee Health, a California-based mail-order pharmacy that partners with many telemedicine abortion services, and the company shipped the pills to patients.
Many studies have shown that medical abortion is safe and serious complications are rare. In addition to providing a hotline for questions and concerns, pharmacists can ask patients questions such as: and contacted the patient. “Has there been excessive bleeding or no bleeding? Do you have any fever or pain?”
During follow-up, he said, patients were asked typical questions, such as whether they were experiencing adequate levels of bleeding from passing through pregnant tissue. “We didn't have any serious negative consequences, but we had a well-prepared network of other resources to respond in case something happened,” he said.
Dr. Libin said the project aims to begin full-scale pharmacist prescribing by the end of this year and eventually allow in-person prescribing at pharmacies in Washington. This means patients will be able to go to the pharmacy and pick up their prescriptions and medications in one visit.
This aligns with recent FDA policy allowing pharmacies to become certified to dispense mifepristone, which previously was primarily dispensed by clinics or other abortion services. falls under a special regulatory regimen that required The second drug in abortion therapy, misoprostol, is less restricted and has been widely available since ancient times.
Last year, Walgreens and CVS began dispensing mifepristone in some states, as did dozens of smaller pharmacies in at least a dozen states.
Jessica Nouhavandi, a pharmacist and president of Honeybee Health and co-director of the new project, said the idea came to her several years ago. Washington state was the first because it has a decades-old system that allows pharmacists to prescribe drugs, requiring only a collaborative agreement with a doctor or nurse who approves the prescription plan. she said.
He said other states require additional steps, such as requiring pharmacists to obtain physician approval for daily prescriptions. Still, Dr. Downing, who pioneered other prescription programs that have become popular nationwide, said, “If abortion is actually legal in the state, I don't think there are too many barriers that would make it impossible.”
Dr. Hogue, of the Pharmacists Association, said nearly 40 states allow pharmacists to prescribe at least one drug, and patients have grown accustomed to pharmacists writing prescriptions during the coronavirus pandemic. . In many states, pharmacists can prescribe contraceptives and the morning-after pill.
Brian Noble, an evangelical pastor and chief executive of the Washington Family Policy Institute, said he is not opposed to pharmacists prescribing medications in general or counseling women who are deciding whether to continue with a pregnancy. said. But he said he was “against anything that ends life” and believes it begins at conception.
“I believe in the rights of aborted babies,” Noble said, adding, “I think women have the great privilege of carrying life inside their own bodies.”
Nuhavandi said the project's patient consultation form asks for slightly more information than abortion services, where doctors and nurses issue prescriptions. “We looked a little more closely at the medical history,” she said. “I wanted pharmacists to feel more at ease.”
Downing said the protocol was submitted to the state health department and approved by obstetricians and gynecologists. He said the pharmacists in the pilot project have day jobs at a variety of employers, including chain stores, community pharmacies, hospitals and insurance companies. They were prescribing it to pilots in their spare time and did not want to be identified.
Dr. Nouhavandi said she hopes the project will provide patients with more options as abortion regulations become stricter. “All we really need is to expand access,” she said, adding, “We need more providers, we need it to be more accessible, we need it to be cheaper.”
