July 14 (Reuters) – Annie England Noblin, a 40-year-old resident of rural Missouri, had never had trouble filling her monthly methotrexate prescription until this week.
On Monday, Noblin’s pharmacist said he could not give her the drug until he had confirmed with Noblin’s doctor that the drug would not be used to cause an abortion.
Missouri now bans almost all abortions and methotrexate can be used to end a pregnancy. It also happens to be one of the first drugs prescribed by doctors to treat rheumatoid arthritis, which affects more than a million Americans.
Register now for FREE and unlimited access to Reuters.com
Sign up
The pharmacy eventually filled the prescription, but Noblin said it will likely switch to a different, more expensive drug in case they refuse to fill his prescription in the future.
“It’s outrageous,” Noblin said. “It made me feel like I couldn’t trust the medication they prescribed me just because I have a uterus.”
Dozens of women in states such as Texas, Alabama, Georgia, South Carolina and Tennessee have also had trouble getting their methotrexate, either because of problems at pharmacies or because they say their doctors have stopped prescribing the drug, according to social media posts reviewed by Reuters and patient advocacy groups, the Global Healthy Living Foundation and the Arthritis Foundation.
More than 30 states have enacted legislation restricting access to drugs that can be used to terminate a pregnancy. In Texas, it is now a crime to dispense methotrexate to a pregnant woman over seven weeks of age who uses it to end a pregnancy. Indiana prohibits abortion with medications, including methotrexate, from 10 weeks of pregnancy.
Six more state laws specifically mention methotrexate as an abortion-inducing drug, said Steven Schultz, director of state legislative affairs at the Arthritis Foundation.
These laws have a “creepy effect” on doctors and pharmacists, often leading them to not dispense drugs that can also cause abortion for fear of legal repercussions, said Temple University law professor Rachel Rebouche.
On Wednesday, the U.S. government health agency instructed retail pharmacies that were required to fill prescriptions under federal civil rights laws, calling the denial of methotrexate as possible discrimination. Read more
The government’s guide underscores the broad potential impact of limiting these prescriptions, but it may not be enough to nullify concerns about state bans.
“He got the message out that there are federal rules that can be enforced,” Rebouche said. “We’ll have to wait and see what the federal government is willing to do to make sure people have the information they need.”
Pharmacists are caught in the “crossfire” between conflicting federal and state regulations, the National Association of Community Pharmacists, which represents 19,000 independent pharmacists, said in a statement.
Spokesmen for two of the largest U.S. pharmacy chains Walgreens Boots Alliance and CVS Health say they are telling their pharmacists to confirm that methotrexate will not be used to terminate pregnancy before dispensing it to people in prohibiting states. abortion in many circumstances.
COMMON PRESCRIPTION MEDICINE
Methotrexate, a low-cost generic drug manufactured by more than half a dozen companies, is commonly prescribed to treat autoimmune diseases such as lupus and has been approved to treat rheumatoid arthritis for more than 30 years.
It is also used to treat cancer and, in much higher doses, can terminate the pregnancy, complete miscarriages, or end a life-threatening ectopic pregnancy.
Last year, some 500,000 methotrexate prescriptions were written a month, according to pharmaceutical market research firm IQVIA (IQV.N).
Restrictions on drug abortion could be further enshrined in law. Pharmaceutical manufacturer GenBioPro is currently challenging a Mississippi law that requires patients to see a doctor in person to get mifepristone, a drug used in medication abortion. Read more
Lawmakers who don’t have medical training can open a “Pandora’s box,” with far-reaching effects in other areas of medicine, said Michele Goodwin, a professor of global health policy at the University of California, Irvine School of Law.
“For many women we will see this access reduced,” Noblin said. “Ultimately, it will end up costing us money and costing us dignity.”
Register now for FREE and unlimited access to Reuters.com
Sign up
Report by Rose Horowitch in Washington; Edited by Caroline Humer and Bill Berkrot
Our standards: the principles of trust of Thomson Reuters.