Why Walgreens won't dispense abortion pills in Ohio

COLUMBUS, Ohio (WCMH) – Walgreens will not dispense abortion pills at any of its 242 locations in Ohio, the pharmacy giant announced Thursday.

The decision comes about a month after Dave Yost of Ohio and 19 other Republican attorneys general cautioned Walgreens and CVS against their plans to sell abortion medication through the mail, a move backed by President Joe Biden that the attorneys general argued would run afoul of state and federal law.

“It is our responsibility as State Attorneys General to uphold the law and protect the health, safety, and well-being of women and unborn children in our states,” the attorneys general said in a letter to Walgreens. “Part of that responsibility includes ensuring that companies like yours are fully informed of the law.”

In early January, Walgreens and CVS announced their intent to dispense the abortion pill mifepristone to align with Food and Drug Administration guidelines that expanded the drug’s access by giving brick-and-mortar pharmacies the power to sell the drug in stores and ship it via the mail, so long as they get certified.

But the Biden administration’s guidance is moot in Ohio, as a 2004 state law prohibits nonphysicians, including pharmacists, from dispensing abortion medication. Abortion-seekers in Ohio, regardless of whether pharmacies like Walgreens agree to sell mifepristone, must meet with a physician in person 24 hours before obtaining the pill, which can't be mailed under state law.

“We are not dispensing Mifepristone at this time,” Walgreens’ senior director of external relations Fraser Engerman told NBC News. “We intend to become a certified pharmacy under the program; however, we will only dispense in those jurisdictions where it is legal to do if we are certified.”

Walgreens plans to account for the “very complex and in flux area of the law” that constitutes reproductive healthcare as the company applies for certification under the FDA's mifepristone program, Engerman said.

Mifepristone, typically taken in conjunction with misoprostol, was approved by the FDA in 2000 as a safe and effective method for terminating pregnancies up to 10 weeks. Used in 98% of medical abortions, the two-drug regimen is also considered the standard of care for miscarriage management, according to the American College of Obstetricians and Gynecologists.

Of the 20,000 abortions obtained in Ohio in 2020 and 2021, nearly 50% involved the use of mifepristone, a notable uptick since the drug’s use in only about 4% of abortions in 2015, according to data from the state Department of Health.

“Medication abortion is safe and accessible, and it’s an easier, more convenient, more accessible method of abortion for people who may live far from an abortion clinic," said Jessie Hill, one of the lead attorneys challenging Ohio’s indefinitely blocked six-week abortion ban.

Yost and his fellow GOP attorneys general, however, pointed to the potential for mifepristone to be abused, particularly mail-order abortion pills that "invite the horror of an increase in coerced abortions."

The attorneys general added that the Biden administration erroneously allowed pharmacies to mail the drug in its new FDA guidelines, as federal law prohibits mailing "every article or thing designed, adapted, or intended for producing abortion."

Other states where Walgreens said it will not dispense the drug include the 19 whose attorneys general threatened legal action against the pharmacy chain: Alabama, Alaska, Arkansas, Florida, Georgia, Indiana, Iowa, Kentucky, Louisiana, Mississippi, Missouri, Montana, North Dakota, Oklahoma, South Carolina, South Dakota, Texas, Utah and West Virginia.

The 20 attorneys general also delivered cautionary letters about the FDA's mifepristone program to pharmacy retailers who have yet to signal an intent to dispense the drug, including Costco, Rite Aid, Albertsons, Kroger and Walmart. It is unclear whether CVS will forge ahead with its plans to sell mifepristone.