Behind Walgreens’ Decision to Forgo Abortion Pill Distribution in Some States

Last week, Walgreens announced that it would no longer distribute abortion pills in 20 states across the US following legal warnings made by the attorneys general of those states.

Specifically, Walgreens has stated that it would only dispense mifepristone in “any jurisdiction where it is legally permissible to do so.” The decision was immediately met with public pushback from California Governor Gavin Newsom, who tweeted, “California won't be doing business with Walgreens — or any company that cowers to the extremists and puts women's lives at risk.” Then on Thursday, Newsom took action, withdrawing a contract that would have furnished Walgreens with $54 million of state money and effectively declaring that California would look for other pharmacy options to fill its needs. 

After the US Supreme Court overturned Roe v. Wade in 2022, the protection of medication abortion ended in several states. In response, the FDA, under the Biden Administration’s direction, lifted restrictions on retail pharmacies to dispense abortion medication pills via mail unless those pharmacies were operating in states where the practice was banned.

A combination of mifepristone and misoprostol is the most common way that abortion is obtained in the United States. According to the FDA, it is considered safe and effective through the first ten weeks of pregnancy.

In Walgreens Boots Alliance’s letter to Kansas Attorney General Kris Kobach, the company said it has not yet begun to dispense mifepristone by mail at any of its locations following the FDA’s 2023 decision to allow retail pharmacies to do so. In addition, the Global Chief Legal Officer of Walgreens, Danielle C. Gray, has said that the company is still working through the certification process to determine where it will dispense the drug and how it will train pharmacists to comply with protocols.

However, Governor Newsom’s tweet and decision to withdraw funding may have ramifications on California’s pharmaceutical market and other pro-choice states that may share similar sentiments.

Walgreens operates 600 stores in the state of California, comprising roughly 10% of the pharmaceutical market in the state. Recently, Governor Newsom and governors from 19 other states announced that they would form the Reproductive Freedom Alliance, which declared itself to be a firewall against strict abortion laws that have emerged since Roe V. Wade’s overturning on June 29, 2022. If other Governors included in the alliance decide to join Newsom in his fight against Walgreens, it may push the company to go back on its decision to distribute abortion pills.

Regardless if other states join Newsom, the abortion pill mifepristone will likely become the next legal battleground in the fight for equitable access to care.