Several unaffiliated drugstores throughout the nation have discreetly started providing the abortion medication mifepristone, following recent guidelines established by the Biden administration. However, there is a pending Supreme Court case that may reintroduce limitations or prohibit the use of these drugs altogether.

Thousands of branches of major pharmacy chains are poised to join them — making the drugs more accessible to millions of people nationwide and kicking off a new phase of the legal and political battle over the most popular method of ending a pregnancy.

GenBioPro, the producer of non-brand mifepristone, released a roster this week containing 19 certified pharmacies in nine states where the drug can be obtained. The company clarifies that the list only includes pharmacies that gave consent to being identified. The listed locations consist of independent local pharmacies, university-connected establishments, and compounding pharmacies, as well as a mail-order pharmacy that dispenses prescriptions in multiple states.

GenBioPro’s list, which has not been previously reported, offers an early look at one of the Biden administration’s most significant steps to expand abortion access post-Roe. Though the rollout has been slower and more limited than abortion-rights supporters have wanted, they say it still has the potential to radically alter the landscape, because most people live much closer to their local pharmacy than a doctor’s office or hospital.

According to Steve Moore, the owner of Condo Pharmacy in Plattsburgh, N.Y., their role as healthcare professionals is to assist individuals in obtaining necessary medication in a timely manner. Although everyone may have their own perspective, Moore stated that they have received certification to carry mifepristone but have not had any patients ask for it. He also mentioned that they have not faced any negative reactions.

Earlier this year, they committed to protesting, boycotting, and conducting pressure campaigns against pharmacies that sell the pills. They have restated their intention to do so as more pharmacies become certified.

“We are hoping abortion becomes unthinkable and are working towards that in our country, but in the meantime we want people to know that chemical abortion is not like getting a wart removed or taking an aspirin,” Jeanne Mancini, the president of March for Life, said in an interview on Friday.

The CEO of GenBioPro, Evan Masingill, stated that pharmacy fulfillment provides patients with an additional choice for obtaining abortion services.

According to a statement, GenBioPro believes in the right for all individuals to access healthcare based on evidence and safe and efficient medication, which includes medical abortion.

The pharmaceutical company, Danco, which produces the branded form of mifepristone, informed POLITICO that they have authorized several of the same pharmacies as GenBioPro, as well as others. However, they will not release their directory to the public until they have obtained permission from the pharmacies.

The company’s representative expressed enthusiasm for increasing availability of Mifeprex, allowing more patients to receive necessary abortion care.

Mifepristone, in combination with misoprostol, is authorized for use up to 10 weeks into pregnancy and is utilized in over 50% of abortions across the country. In January, the Biden administration announced that retail pharmacies would be allowed to distribute these pills, as part of a larger effort to protect and enhance access to abortion services in light of increasing restrictions in many states. Prior to this, individuals seeking pregnancy termination had to obtain the drugs from their physician or have it prescribed through telemedicine and delivered by mail, depending on the regulations in their particular state.

The majority of the initial pharmacies that have been approved to provide the medication are located in states that have laws protecting abortion in general and specifically the use of abortion pills. These states include California, Maryland, New York, Pennsylvania, and Washington. However, there are also some pharmacies in states with strict bans on abortion, such as Texas, and in states with restrictions on access to abortion in early pregnancy, like South Carolina (which has a six-week ban) and Arizona (which has a 15-week ban). The status of abortion laws in Wisconsin, where one pharmacy is certified to dispense, is currently uncertain.

A number of elements, however, are expected to prevent access to the pills for a significant number of individuals.

Major pharmacy chains in the United States have informed POLITICO that they will not currently offer the medication in states where Republican attorneys general have issued threats of legal action, or in states where there is ambiguity surrounding pharmacists’ authority to dispense these drugs in relation to abortion laws.

failed in court.

Individual pharmacies and pharmacists in states with legal protections are often declining to distribute abortion medication due to personal beliefs, a desire to avoid protesters, or the necessary requirements for eligibility.

Kirsten Moore, the head of the EMAA (Expanding Medication Abortion Access Project), stated that the pharmaceutical companies have been cautious when revealing which pharmacies are distributing the medication due to intimidation from Republican state officials and anti-abortion activists.

Moore, who is not related to Steve Moore, stated that the opposition strongly desires to restrict access to this medication once again. He believes that making this information public would essentially make the pharmacy an easy target.

CVS and Walgreens committed in January to distributing the medications in select states, following approval from the FDA. Walgreens representative Fraser Engerman stated to POLITICO that the company is nearly finished finalizing certification, while CVS representative Amy Thibault mentioned that their team is actively completing the necessary steps to obtain certification for dispensing the drug. These steps involve ensuring a sufficient supply of the medication, implementing a patient privacy protection system, and verifying that only certified doctors are sending prescriptions to certified pharmacists.

The American College of Obstetricians and Gynecologists, the American Medical Association, the American Academy of Family Physicians, and other medical and advocacy organizations have urged the Biden administration to eliminate the certification mandate for the pills. This would have allowed pharmacies to distribute them as they would any other medication earlier this year.

A White House representative stated that the administration’s top priority is guaranteeing access to mifepristone, a medication that was deemed safe and effective by the FDA over 20 years ago. They also reaffirmed their support for current policies.

In January, a memo was issued instructing agencies to relax limitations on the distribution of mifepristone. According to a spokesperson, this was in response to attempts by state officials to block women from obtaining the medication and discourage pharmacies from becoming certified to provide it.

Since the memo was released, advocates for abortion rights have been working to expand access to medication for terminating pregnancies, even outside of traditional pharmacy settings.

Recently enacted laws in California and other states with a Democratic majority have allowed doctors to prescribe and send medications to patients in states that have strict anti-abortion laws. As a result, there has been an increase in the number of virtual clinics that offer medication delivery across the country, without regard for individual state restrictions.

Alina Salganicoff, director of KFF’s Women’s Health Policy Program, believes that in the future, a significant portion of these transactions will occur through mail. She also acknowledges that there is still a societal stigma surrounding picking up prescriptions from a pharmacy, which may make some patients uncomfortable. This may be particularly true for those living in rural areas where they may know the employees at the pharmacy. Therefore, this option may not be available for everyone.

The Supreme Court is anticipated to review a decision made by a lower court that aims to prohibit pharmacies from dispensing and mailing mifepristone, as well as implementing additional limitations. This case is scheduled to be heard in either 2024 or 2025.

Rachel Rebouché, a specialist in laws related to reproductive health and the dean of Temple University’s Beasley School of Law, raised concerns about whether the current legal confusion surrounding the regulation of these pills has discouraged pharmacists from becoming certified to distribute them.

“Why bother going through the trouble of getting certified and keeping stock of mifepristone, with all the necessary reporting, storage, and identification involved, if the Supreme Court is going to essentially turn back the clock to before 2016?” she asked, in reference to the FDA’s decision in 2016 to allow the use of the drug for up to 10 weeks of pregnancy and reduce its dosage.

However, the major pharmacy companies have stated that they are not discouraged by the potential consequences of this decision and will proceed with dispensing the drugs, even if there is a risk of a nationwide rollback in the future.