Three years ago, then-Gov. Jay Inslee announced the state’s first-ever abortion pill stockpile: 30,000 doses of mifepristone, which, along with the pill misoprostol, is commonly used in medication abortions, and was then at the heart of a lawsuit brought by anti-abortion activists. In this moment of crisis, advance provision was a common tactic, but in crafting a policy to get the pills to Washington patients, lawmakers failed to take into account the needs of local health care providers. We know this didn’t happen because they complained. In a Seattle Times op-ed published in October, Pro-Choice Washington board member and family doctor Glenna Martin said experts had tried to help the state come up with a better plan to distribute the pills, but hadn’t been taken up on it. As a result, the stockpile went largely unused, and in January, pills from that initial batch expired, with dire headlines (including Martin’s) suggesting it might be gone forever. That was not true. The state had struck a deal with the manufacturer to replace the pills as they expired, and there are still many waiting to be handed out. It turned out to be a classic case of the state legislature and governor kneecapping their own policy. As ever, byzantine policy and administrative hiccups kept Americans from their health care. When the state initially cobbled together this stockpile plan, the powers that be decided that instead of donating the pills, they’d have to be sold at cost, plus a tacked-on fee of $5 for each dose to cover the dispensing costs. This was an error and proved to be a major barrier. Pills from the state’s stockpile were a more expensive, less-practical option for reproductive healthcare clinics. Providers could easily obtain mifepristone for less directly from the pharmaceutical companies, so that was what many did. Ironically, a decision made in the interest of saving money on distribution costs and expanding access to mifepristone resulted in an unused supply of pills. “We appreciate that our state thought ahead and took action to protect medication abortion access,” says Mercedes Sanchez, executive director of Cedar River Clinics. But after the case that triggered the stockpile was decided and mifepristone remained accessible, she says, “it was not cost-effective at the time for us to purchase the medications, and as a nonprofit organization, we did have to think about the financial implications.” “It kind of defeated the purpose,” says Sarah Prager, a Seattle-based abortion provider. But guess what? The Legislature actually dealt with the issue this session by passing a law to set up a more effective distribution system for the pills—first and foremost by removing the pricing requirement and allowing the pills to be donated. It’s a change clinicians hope will make the stockpile a practical resource rather than one that’s almost purely theoretical. “Obviously, we don’t want to just throw away medication that can be used for reproductive health care,” says State Senator Jessica Bateman (D-22), sponsor of Senate Bill 5917, which was signed into law on March 1 and will get rid of the $5 fee and facilitate the stockpile’s distribution. Gov. Inslee’s plan to acquire the pills was a good idea, said Prager, especially considering threats to abortion pills that could have made the drugs unavailable. “But since it didn’t become obsolete, the pills that he purchased have kind of just been sitting there,” she says. Now, still-unexpired pills might actually be used. “Obviously, we don’t want to just throw away medication that can be used for reproductive health care.”State Senator Jessica Bateman (D-22) In addition to excising the fee, Bateman’s bill also lifts the requirement that the Department of Corrections obtains payment for the drugs. The DOC? Its involvement might seem strange, but there’s nowhere else for the drugs to go. Though it doesn’t prescribe medication directly, the DOC houses the state’s only pharmacy, and it’s not unusual for the state to employ it to hold medications for the Department of Social and Health Services, that said, the abortion stockpile’s scale is unusual compared to its holdings of other medications, according to Samantha Grono of the Washington State Women’s Commission. Bateman’s bill also establishes the Department of Health as a liaison between the DOC and local healthcare providers like Cedar River. The Department of Health will identify local healthcare organizations to donate the soon-to-expire drugs to, free of charge (and of fees), and prevent the medication from being wasted in the future. (The new policy also specifies that misoprostol be included in the stockpile.) “If we have to get an additional stockpile in the future, if this is an ongoing thing, we want to make sure that those two medications are included, and that the cost is not prohibitive, that they can actually be distributed based on need,” Bateman says. At a hearing on the bill, Seattle family medicine doctor Ying Zhang said she hoped the changes would make it easier to distribute the pills to her own patients. “There are so many needless barriers to patients accessing this essential, lifesaving medication,” she said. Despite its limitations, the stockpile was a logical response to a very real legal threat to abortion pills, the subject of several major ongoing cases, including a suit in Louisiana that would reclassify misoprostol and mifepristone as “controlled substances,” a category typically only applied to substances with demonstratively dangerous or addictive properties. That’s on top of existing regulations on mifepristone, which are already stringent thanks to a risk evaluation and mitigation strategy (REMS), a set of restrictions the FDA has imposed on mifepristone in spite of its well-documented safety. Addressing an uncertain situation like this, says Grono, was “the original intention” behind the abortion pill stockpile. “We don’t know what it’s going to look like as these changes continue to happen across the country,” she says, “and so we just want to be prepared.” Now that the new distribution policy has been signed into law, Sanchez and other providers expect the stockpile will finally serve its purpose—that it won’t just be a break-in-case-of-emergency glass box, but a legitimate resource for underfunded clinics. “I am hoping, now that the roadblocks are removed, it will be available for donation to clinics like ours and other providers in the region,” she says. “This will ensure that patients who need access to medication abortion can receive it.” The post Whatever Happened to the Abortion Pill Stockpile? appeared first on The Stranger. ...read more read less