CVS’ policy regarding abortion-inducing medications is at the center of a boycott after a Texas physician’s tweet began trending Saturday.
Messages on the popular social media site balked at the retail pharmacy refusing to fill a prescription for non-abortion related care, using #BoycottCVS. At the time of publishing, the tweet had 150,000 likes and 49,000 retweets. The prescription in question was eventually filled once the pharmacist confirmed with the prescribing physician that the patient was not seeking an abortion, according to the company's executive director of corporate communications at CVS, Mike DeAngelis.
In June, the U.S. Supreme Court overturned Roe v. Wade, the 1973 decision that had provided a constitutional right to abortion. The ruling is expected to lead to abortion bans in roughly half the states.
“My 55 yo friend who is having postmenopausal bleeding just called me from CVS in TX bc they refused to fill her Rx for misoprostol (used to open the cervix) bc she couldn’t prove she wasn’t having an abortion,” tweeted Emily Porter, M.D. “She is having surgery in 2 days. This is what total abortion bans do.”
Porter went on to tweet that the medication in question was being used to soften the patient’s cervix for a uterine biopsy, stating that the retail giant was “putting politics over patients.”
CVS responded through DeAngelis by stating that pharmacists are caught in the middle of the issue.
“These laws, some of which include criminal penalties, have forced us to require pharmacists in these states to validate with the provider that the intended indication is not to terminate a pregnancy before they can fill a prescription for misoprostol or methotrexate,” DeAngelis wrote in an email. “We will continue to focus on delivering care to our patients while complying with state laws and federal guidance that continues to evolve. To help ensure patients have quick and easy access to medications, we encourage providers to include their diagnosis on the prescriptions they write.”
My 55 yo friend who is having postmenopausal bleeding just called me from CVS in TX bc they refused to fill her Rx for misoprostol (used to open the cervix) bc she couldn’t prove she wasn’t having an abortion. She is having surgery in 2 days. This is what total abortion bans do.
— Emily Porter, M.D. (@dremilyportermd) August 28, 2022
Following the tweet, New York Attorney General Letitia James sent letters to CVS and Walgreens dissuading the pharmacy chains from denying customers their reproductive right to care in the Empire State. The letter requested both chains’ policies regarding refusal to provide services including employee refusal based on “personal, moral or religious grounds,” documentation of all refusals in the state within the last six years and policies regarding redirecting customers to other pharmacies when in need of timely medications such as Plan B.
"The actions taken by some CVS and Walgreens employees in other states have sparked concerns nationwide and have raised serious questions that must be addressed," James said in a press release. "Let me be clear: I will not accept New Yorkers being denied access to essential health care products and services."
On Aug. 31, a former CVS MinuteClinic nurse practitioner filed a suit in Virginia claiming she was fired in April 2022 by the company due to her refusal to prescribe abortion-inducing drugs, Becker's Hospital Review reported.
"We have a well-defined process in place for employees to request and be granted a reasonable accommodation due to their religious beliefs, which in some cases can be an exemption from performing certain job functions," DeAngelis told Becker's. "It is not possible, however, to grant an accommodation that exempts an employee from performing the essential functions of their job."
Treatment regarding sexual health matters–including pregnancy prevention, sexually transmitted infection prevention and screening and treatment–are essential job functions of CVS MinuteClinic providers and nurses, according to DeAngelis, in a statement to Becker's
The suit is seeking $100,000 in compensatory damages on the basis that CVS obstructed Virginia's Conscience Clause which prohibits employers from "terminating medical-professional employees for failure to participate in abortion," according to court documents (PDF).
In July, the Department of Health and Human Services (HHS) released guidance to retail pharmacies clarifying their “obligation to ensure access to comprehensive reproductive health care services.”
“The guidance makes clear that as recipients of federal financial assistance, including Medicare and Medicaid payments, pharmacies are prohibited under law from discriminating based on race, color, national origin, sex, age, and disability in their programs and activities,” the HHS guidelines state. “This includes supplying prescribed medications; making determinations regarding the suitability of prescribed medications for a patient; and advising a patient about prescribed medications and how to take them.”
The guidelines cited the Affordable Care Act in its claim that the nation's 60,000 pharmacies may not discriminate against Medicare and Medicaid recipients who are pregnant, were pregnant or have the capacity to be pregnant.
The agency's guidelines were released after the hashtag #BoycottWalgreens went viral on Twitter. The boycott was spurred by a tweet from Walgreens customer Nate Pentz alleging that a Wisconsin Walgreens employee refused to sell him condoms for which the employee gave the reason: “because of my faith.”
Walgreens tweeted its stance on the issue, "Our policy allows pharmacists to step away from filling a prescription for which they have a moral objection. At the same time, they are also required to refer the prescription to another pharmacist or manager on duty to meet the patient's needs in a timely manner."
The jury in a recent Minnesota trial sided with a pharmacist who refused to sell contraceptives in 2019, also citing his religious beliefs. The refusal to fill a prescription for Ella, an emergency contraceptive that prevents or delays ovulation, was not deemed discrimination by the jury.
The patient was directed to another pharmacy per the guidelines offered by the Minnesota Board of Pharmacy, which allow pharmacists to decline to fill prescriptions for emergency contraceptives if it goes against their beliefs. Due to a snowstorm, a three-hour round trip was needed to obtain the time-sensitive drug.
The legal group representing the patient, Gender Justice, plans to repeal the decision.
Misoprostol, the drug that sparked #BoycottCVS, is one of the five drug groups highlighted by The Washington Post as being under scrutiny following the Dobbs decision. The list includes four other drugs.
Methotrexate is used to treat severe rheumatoid arthritis along with certain cancers and can be used to terminate ectopic pregnancies. Mifepristone controls high blood sugar and in pill form, in conjunction with Misoprostol, can be used for medication abortions in the first 10 weeks of pregnancy or to complete a miscarriage. Anti-convulsants drugs prevent seizures, and some can also harm the baby’s growth or development. Isotretinoin, often known as Accutane, treats severe acne. The drug is already highly regulated and requires negative pregnancy tests before use due to the severe risk to a developing fetus.