Major investors in pharmacy and grocery chains across the country are pushing back against pressure from a New York official to have the stores expand the sale of mifepristone as access to the abortion pill takes center stage in the fight over reproductive health.
Hundreds of individual investors, along with 38 financial managers who hold nearly $173 million combined in stocks for Costco, Albertsons, Kroger, McKesson, and Walmart, wrote in response to pressure on the companies from the New York City comptroller for the chains to begin dispensing the abortion pill.
Comptroller Brad Lander last month threatened to withdraw nearly $1.32 billion in investment from the five companies if they did not begin selling mifepristone, arguing that failing to stock the abortion pill on pharmacy shelves would cause consumer confidence to drop.
The large group of financial advisers and investors, including the CEOs of Inspire Investing, Bower Research, and Pax Financial Group, said the comptroller’s argument is simply “not true.”
“The ‘growing market opportunity’ of abortion drugs is legally and politically fraught, raises significant reputational issues, and reduces the company’s customer base, both literally and because it would drive away many existing customers,” the financial managers wrote.
Access to mifepristone has become a flashpoint in the fight over abortion access in the lead-up to the 2024 election.
Mifepristone, initially approved by the Food and Drug Administration in 2000, works by cutting off the progesterone supply from the mother to the developing fetus. Within 24 to 48 hours of taking mifepristone, the patient is instructed to take the drug misoprostol to induce contractions to expel the fetus and other pregnancy tissue.
During the COVID-19 pandemic, the FDA deregulated mifepristone by removing in-person screening requirements prior to physicians dispensing the drug, allowing the pill to be shipped by mail and sold in pharmacies.
In March, the Supreme Court heard a controversial case regarding the FDA’s approval of the pill, which was ultimately dismissed on a narrow legal technicality.
“The legality of dispensing and distributing the abortion drug is in flux,” the financial advisers wrote. “The Supreme Court’s recent ruling in FDA v. Alliance for Hippocratic Medicine has temporarily allowed pharmacies to continue to dispense the drug. But the Court decided the case on procedural grounds and left unresolved whether the current system of dispensing and distributing the drug is legal.”
The financial advisers also noted that dispensing the abortion drug by mail could be prosecuted under the Comstock Act of 1873, a federal law that prohibits the mailing of obscene and abortion-related materials.
Nearly half of states have also implemented some sort of gestational age restriction after which abortion is illegal, including 14 states that have a total ban on elective abortion at any stage of pregnancy.
Jeremy Tedesco, the senior vice president of corporate engagement at Alliance Defending Freedom, the legal advocacy group behind the mifepristone case, told the Washington Examiner that the legal landscape on the abortion pill is “anything but settled.”
“The FDA’s own label admits that roughly one in 25 women who take this drug will end up in the ER,” Tedesco said. “Retail pharmacies are there to serve the health and wellness of their customers, but abortion drugs like mifepristone undermine that mission by putting women’s health at risk.”
The financial investors noted in their letter that, according to the FDA’s warning label for mifepristone, approximately 1 in 25 women who take the drug will present at the emergency room for severe complications, such as hemorrhaging or sepsis.
As of 2023, nearly 643,000 abortions in the United States involved mifepristone. Based on the FDA’s warning, that equates to nearly 26 million women requiring emergency treatment.
As of March, Walgreens and CVS were the only national pharmacy chains to sell mifepristone.
Walgreens announced in June that it would be closing a “significant” number of its 8,600 U.S. locations. CVS has also closed approximately 600 stores since 2022 and is expected to close 300 more this year.