A study published on Monday found that U.S. pharmacies are primarily dispensing the abortion pill mifepristone through mail-order services in states where telehealth access is permitted, even though a 2023 FDA decision allowed retail pharmacies to directly dispense the drug.
In 2023, the U.S. Food and Drug Administration approved retail pharmacies to provide mifepristone, the first medication used in a two-drug abortion regimen within the first 10 weeks of pregnancy. This approval followed an earlier regulatory change that allowed the drug to be mailed to patients without requiring in-person pickup.
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Research from the University of Southern California, published in the medical journal JAMA, found that since January 2023, pharmacies have been filling around 2,700 prescriptions for mifepristone each month.
In the 27 states and the District of Columbia where telehealth abortion is permitted, less than 2% of these prescriptions were filled at physical retail pharmacies. In contrast, in 11 states where abortion is legal but telehealth access is restricted, about 61% of prescriptions were filled at in-store pharmacies, according to the study.
The findings highlight the growing importance of mail-order dispensing for mifepristone following the U.S. Supreme Court’s 2022 decision to overturn the constitutional right to abortion, which allowed individual states to impose bans or restrictions. Researchers also pointed out significant disparities in access, even in states with comparatively strong abortion protections.
“It’s striking how few retail pharmacies, particularly chains, are dispensing mifepristone where abortion is legal and telehealth is permitted,” said Dima Qato, the study’s lead author and senior scholar at the University of Southern California’s Schaeffer Institute.
Pharmacy chains have faced increasing pressure from both abortion-rights supporters and anti-abortion groups following recent FDA policy changes.
Since restrictions introduced after the Supreme Court’s ruling, medication abortion has risen significantly and now accounts for about 60% of all abortions in the United States. Nearly half of U.S. states have either banned or heavily restricted abortion, leading to ongoing legal battles at both state and federal levels, as well as renewed efforts by anti-abortion activists to restrict access to abortion pills.
Last week, a federal judge temporarily blocked Louisiana’s lawsuit aimed at limiting nationwide access to mifepristone. Meanwhile, Senate Republicans have launched investigations into manufacturers of the drug and have called on the FDA to tighten controls on its online distribution, even though the agency approved mifepristone more than 25 years ago.
