By Randall K. O’Bannon, Ph.D., NRL Director of Education & Research
Editor’s note. On Monday Dr. O’Bannon looked at how the Biden administration set up the pharmacy distribution system for mifepristone and some of the legal and regulatory challenges that could delay the efforts of some of the nation’s largest pharmacy chains to offer abortion pills. Today, we look at some of the other logistical hurdles and practical concerns that remain to be addressed.
Other factors in play
Both CVS and Walgreens have been in the news lately because of widespread dissatisfaction among their employees. Rite Aid, facing many of the same challenges, just announced that it was filing for bankruptcy, giving them more pressing matters than abortion pill certification to worry about.
Just last week thousands of pharmacy staff walked off the job at Walgreens. They complained about working conditions, being understaffed and overworked, having to deal with backlogs of prescriptions which they say put employees and patients at risk (Washington Post, 10/9/23).
CVS faced similar issues in a walkout in Missouri just a month earlier, citing many of the same complaints, shortly after the pharmacy chain announced plans to lay off 5,000 employees (USA Today, 9/22/23; ABC News, 8/1/23).
A quick resolution seems unlikely. This week, CNBC reported that Walgreens and CVS workers are planning a nationwide strike for the end of this month (Becker’s Hospital Review, 10/16/23).
No one at this point has publicly cited concerns about corporate efforts to push abortion pills. But it surely cannot be a policy that many CVS and Walgreens employees, certainly any pro-lifers who are dedicated to true health care, are anxious to implement or in which they wish to get involved.
A fatal error
A case out of Las Vegas involving two CVS pharmacists shows how easily and how badly things can go wrong.
Given a prescription for what was probably some progesterone suppository to help her ward off miscarriage, CVS employees instead provided Timika Thomas with misoprostol, the anti-ulcer prostaglandin used in conjunction with (and sometimes used alone) as an abortifacient. Taking the wrong drug, Thomas lost both of the babies she was carrying.
Media sources report two slightly different versions of the incident. In the first, a CVS technician thought misoprostol was the generic name for the brand prescribed by the doctor and entered the wrong name into the computer (KLAS, 8 News Now, 10/3/23). In the second, the technician had trouble deciphering the handwriting of Thomas’ fertility doctor and guessed at the medication, rather than calling the doctor to confirm (People magazine, 10/5/23)
Whether the first or the second is the accurate presentation of events or some combination of the two, after that point one pharmacist failed to catch the error and then a second failed to counsel and confirm with Thomas when she came to pick up the medicine.
In hearings before the pharmacy board, both pharmacists apologized, one sobbing and calling it “a human error,” and saying “I’m so sorry” (KLAS, 10/3/23).
One of those pharmacists pointed to cutbacks at CVS which left employees overwhelmed, unable to do all the necessary double checking (People, 10/5/23).
The two pharmacists were fined and had their licenses provisionally suspended (to be reinstated in 12 months if they comply with board rulings) and the pharmacy was fined $10,000.
It wasn’t good enough for Thomas, who told KLAS that “All I got was a sorry… It will never be good enough.”
Hard lessons to learn
Human error or no, there are many relevant lessons to be learned from this tragic event.
First, that there are many ways a prescription can go wrong and that the training of CVS pharmacists, however conscientious it may be, is not going to be good enough to protect patients from tragic mistakes like these.
Second, that the mere presence of abortifacients on the shelves of your neighborhood pharmacy creates the potential for deadly errors, so that casual missteps have horrific and irreparable consequences.
Third, that work conditions like those that exist at that pharmacy and apparently many others in the CVS and Walgreens chains make fatal slip-ups of this sort more likely.
In one sense, this shows that the FDA’s concerns putting these certification requirements in place are warranted and that the caution of these pharmacy chains is more than justified. In a larger sense, however, it illustrates how the corruption of medicine involved in a government agency authorizing the sale of baby killing drugs threatens to compromise if not completely undercut the integrity of the whole healthcare system.
All these factors taken together raise questions not only about when the abortion pill will be sold at CVS and Walgreens pharmacies, but also where and how. Will they only be sold at certain regional stores? Will they only be available for personal pickup?
Will internal pressures from unhappy employees scuttle the project? Or will external pressure from pro-life customers and political leaders cause CVS and Walgreens to rethink the moral and legal and economic implications of the decisions they’ve made?
How long before the next prescription mix-up and the next lawsuit against one of these pharmacists and their parent corporation?
Will the Supreme Court step in and agree with those who want these pulled from the market entirely or side with those who want them sold and shipped in states where their sale and use is controlled or prohibited?
All that remains to be seen.
What’s clear here, as it is with so many of the popular myths surrounding these abortion pills supporters promote as nearly “magic,” is that the reality is neither as plain nor as pleasant as mifepristone’s advocates would have us believe. These pills still come with significant risks and concerns which no amount of regulation or certification can readily resolve.
Hopefully sooner, rather than later, pharmacies will figure out that these pills are bad for babies, bad for mothers, and bad for business.