In the United States, the end of the right to abortion threatens access to certain drugs

When Melissa, a nurse living in the US state of Alabama, went to pick up her usual treatment for rheumatoid arthritis last week, she was told that the medicine was “on hold” until the pharmacist confirms that ‘she wasn’t going to use it to induce an abortion.

“He told me + I have to check if you are on contraception +. But what is he saying?” she thought then.

Melissa, in her 40s and who did not wish to give her last name, finally managed to get the medicine by calling her doctor.

“I went to pick it up a few hours later, but I felt attacked,” she told AFP from this southern state of the United States, adding that she underwent a hysterectomy six years ago – – partial or total removal of the uterus. According to her, her recent absence of contraception could have caused the pharmacist to think that she could be pregnant.

Similar cases have emerged since the historic Supreme Court ruling on June 24 stripping the constitutional right to abortion and, in the wake, the decision by conservative states to ban or severely restrict access to abortion. ‘abortion.

At the heart of the problem, methotrexate, which helps limit inflammation and is commonly used against autoimmune diseases such as rheumatoid arthritis. It helps to stop cell division and is also used in high doses against cancer.

But methotrexate is also sometimes used as a means of performing a medical abortion – even if more rarely than the mifepristone-misoprostol combination, approved by the American health authorities.

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The new anti-abortion laws of certain States thus threaten to prosecute doctors and pharmacists supplying methotrexate.

The extent of the problems of access to the latter for its regular users, excluding abortion, is currently poorly known. Organizations of specialists in the diseases concerned, informed, invited patients to report to them the refusals of sale.

– “Creepy” –

A student in Ohio told AFP that she had been on methotrexate since 2020 to treat systemic lupus erythematosus, another autoimmune disease that affects her kidneys, liver and causes joint pain.

The pharmacist of a large chain explained to him that they “no longer accept prescriptions for methotrexate except” in the case of an approved medical treatment for breast cancer or if “the patient is obviously not fertile” .

The student says she then tried in a family pharmacy, without success. Then his doctor’s office sent him a letter announcing that he would no longer prescribe the drug because of the difficulty patients have in accessing it.

Although, in the end, the first pharmacy was able to sell her methotrexate, the experience left her “upset and pissed off,” she concludes.

Jennifer Crow, a 48-year-old resident of Tennessee (South), said she received an automatic call from the large American pharmacy chain CVS indicating that her treatment was suspended, before she finally managed to access it.

CVS and the distribution giant Walmart have confirmed to AFP that they are complying with new state legislation, following the decision of the very conservative Supreme Court.

“We encourage caregivers to include their diagnosis in prescriptions so that patients have easy and quick access to medications,” CVS added.

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Alisa Vidulich, director of public policy at the Arthritis Foundation, told AFP that she was confident that the situation would be resolved quickly with the implementation of directives by health personnel and pharmacies.

“But that may not be the case in all states, and it could turn into a long-term problem,” she acknowledged.

Melissa, the Alabama nurse, said she was outraged by the inequity of treatment that allowed one of her best friends, a man, to get methotrexate without worry.

“We’re going in the wrong direction and it’s terrifying. I have two daughters, I don’t want to see this for their future,” she added.

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