Despite federal guidance, pharmacists hesitant to fill some orders since Roe

Some pharmacists have been more cautious about filling prescriptions as legal concerns rise for healthcare workers offering reproductive care since the U.S. Supreme Court overturned Roe v. Wade, the Dallas Morning News reported July 18. 

The HHS told the nation's 60,000 retail pharmacies July 13 not to withhold any emergency contraceptives and medication abortion pills. But other treatments unrelated to reproductive health have been thrown in the crossfire, such as the autoimmune drug methotrexate. In the weeks after the Dobbs v. Jackson Women's Health Organization decision, patients who use methotrexate took to social media to warn they're being denied access since methotrexate can induce an abortion. 

HHS also warned pharmacists to not delay distributing methotrexate, adding that doing so is discriminatory toward those who are pregnant or can become pregnant. 

In Texas, the Heartbeat Act says it's illegal to "knowingly [engage] in conduct that aids or abets the performance or inducement of an abortion," according to the Dallas Morning News. The word "intent" is getting pharmacists' attention, causing some pharmacies to avoid the HHS guidance. 

One pharmacist who's been practicing for more than 15 years, Ashley Garling, PharmD, said she questioned whether to fill prescriptions because of this confusion. 

Tom Mayo, a health care law expert and law professor at Southern Methodist University, told Dallas Morning News the state's law is ambiguous when it comes to treatments not specified for reproductive health but that also affect pregnancy. 

"If they don't have the required intent, then it's just a drug for stomach acid or a drug for leukemia or rheumatoid arthritis," he said. "I have no idea how that would get resolved by a judge."

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