Health & Science

New FDA rule could slightly improve out-of-state access to the abortion pill mifepristone for pregnant Texans

The rule, which allows retail pharmacies to provide the pill, could mean faster pick up times.

AP Photo/Allen G. Breed, File
FILE – Boxes of the drug mifepristone sit on a shelf at the West Alabama Women’s Center in Tuscaloosa, Ala., on March 16, 2022. On Tuesday, Jan. 3, 2023, the Food and Drug Administration finalized a rule change that allows women seeking abortion pills to get them through the mail, replacing a long-standing requirement that they pick up the medicine in person.

Retail pharmacies like CVS and Walgreens can now provide the abortion pill mifepristone at their stores, according to a new rule by the Food and Drug Administration from earlier this week. Previously, Texans traveling out-of-state for abortion care could only get the prescription directly from the clinic or by mail order.

This will particularly impact Texans driving to the closest neighboring states where abortion is legal — New Mexico, Colorado and Nevada — a trip that could take more than 10 hours.

If the patient meets the right criteria, they can receive a prescription for medication abortion through a virtual visit — also known as a ‘no touch abortion,' said Dr. Kristina Tocce, Medical Director at Planned Parenthood Rocky Mountains. The pills are then shipped overnight, which can take 1-2 days to arrive.

The F.D.A. rule change will likely reduce that wait time. A pharmacy can usually fill a prescription within an hour.

"Anything that we can do to make that process better, less time consuming for patients and their families is monumental," Tocce said. "We need to really appreciate the impact on those patients who are traveling and so many of them are traveling from Texas."

She said reducing the burden on patients, whether distance traveled or time waited, is a key way to improve abortion access for patients where prescribing the pill is illegal, like Texas.

Mifepristone, which blocks the pregnancy hormone progesterone, is used in combination with misoprostol to terminate early pregnancies up to 10 weeks. Texas banned all kinds of abortion with no exceptions for rape and incest after Roe v. Wade was overturned by the U.S. Supreme Court this past summer. The trigger law went into effect on August 25th, 2022.

Before then, Texas already had the strictest abortion laws in the country. Senate Bill 8, which went into effect on September 1st, 2021, criminalized abortion around six weeks of pregnancy.

Six months later, Planned Parenthood clinics in Colorado saw a more than 1000% increase in abortion patients with Texas zip codes, compared to previous years.

Virtual appointments have played a major role in meeting demand. Many Texans don't travel the full distance to a clinic in order to cut down on drive time. At Planned Parenthood Rocky Mountains, patients can sign up for a telehealth appointment, as long as they are physically present in the states served by those clinics.

During some of these sessions, Dr. Tocce has seen patients desperate to return back to Texas quickly.

"I have seen patients take on additional drive time — hours and hours of drive time — because they can’t wait a day to get the medication mailed," Tocce said. "They pick them up and then turn right back around and drive back home because people have work obligations, child care, all of the logistics you need to plan any trip."

Dr. Tocce said the F.D.A. rule change might also have indirect impacts on improving access.

"If mifepristone is in the pharmacy, that really normalizes that medication in our world," Tocce said. "That’s going to help with perception, with willingness (among physicians) to provide, and that’s going to trickle down to increasing access and decreasing the bottleneck."

The New York Times reported that CVS and Walgreens will begin the certification process that will allow them to dispense the medication where abortion is legal.

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