WASHINGTON, D.C. (WGHP) – Democratic members of North Carolina’s congressional delegation want to know why Walmart has instructed its pharmacies not to distribute a drug that is commonly prescribed for a variety of medical issues.

In a strongly worded letter to Walmart CEO C. Doug McMillon, all five Democrats representing the state want to know why Walmart on Aug. 1 issued a memo to its 192 pharmacies in the state directing them not to distribute misoprostol, which doctors say is essential for women who have miscarriages and is used for various medical issues, such as stomach ulcers and arthritis, for both men and women.

But misoprostol also can be used in combination with other drugs to induce a medical abortion, and Walmart’s policy appears to be an effort to address North Carolina’s 2013 abortion law and how medications related to abortion must be distributed.

The law would require that prescribing doctors must be in the presence of their patients when “the first drug or chemical is administered” during a drug-induced abortion.

Jay Campbell, the executive director of the North Carolina Board of Pharmacy, told The News & Observer in Raleigh, which first reported the policy, that such an interpretation of the law doesn’t apply to pharmacies because they only “dispense” medications, not “administer” it.

The N&O reported that the company’s memo requires a diagnosis code on the prescription that specifies it is not being used for an abortion. If that code specified an abortion, a doctor would have to be present with the patient.

The letter, authored by Rep. Kathy Manning (D-Greensboro) and cosigned by Rep. G.K. Butterfield (D-Wilson), Rep. Deborah Ross (D-Raleigh), Rep. David Price (D-Durham) and Rep. Alma Adams (D-Charlotte), makes clear that the delegation thinks Walmart’s actions are misguided and unnecessary.

“Recent federal guidance clarifies that pharmacies shall not refuse to dispense misoprostol when filling a valid prescription from a provider based on a concern about how the patient may ultimately use the medication,” the letter states. “Furthermore, on July 13, 2022, the Department of Health and Human Services issued guidance to national retail pharmacies explaining their obligations to ensure comprehensive reproductive health care services. 

“The guidance specifically states pharmacies refusing to stock misoprostol or refusing to fill misoprostol prescriptions because misoprostol can also be used to terminate a pregnancy risk violating anti-discrimination law. We have enclosed a copy of the guidance for your review. “

The letter suggests the policy violates the state’s code of ethics for pharmacists and it stipulates specific responses by Walmart – including lists of medications that require coding to be filled and company policies that prevent discrimination against certain customers – and sets Saturday as a deadline for a written response.

“Given the potentially dangerous and broad impact of Walmart’s reported misoprostol denial policy, Walmart must rescind its August memo, issue clarifying guidance to pharmacies instructing them to dispense the medication free from discrimination and unnecessary hurdles, and cease requiring a diagnosis code on the prescription or requiring doctors to escort patients to the pharmacy as proof of a valid medical need.”

Responses

It’s unclear whether Walmart distributed this memo to pharmacies in other states. But patients in Arizona, for one, have run into issues in filling prescriptions for certain medications at other pharmacies because of that state’s abortion law.

Walmart, which is based in Bentonville, Arkansas, did not respond immediately to an email seeking an update on its policy. But a spokesperson last month told the News & Observer that the 2013 law and its specification that doctors be with their patients when they took a drug for an abortion was the reason for the policy.

Campbell told the N&O that he doesn’t know of any state statute that “would prevent a pharmacy in North Carolina from dispensing misoprostol.” He said in an email to WGHP that he had not had further discussions about the issues since that original interview.

Abortion rights are an election issue

Manning, seeking re-election in the 6th Congressional District, has been active in seeking to help women’s access to abortion rights and other medical care since the Supreme Court in June struck down Roe v. Wade and returned decisions about abortion to states. A stay halting North Carolina’s 20-week limit on abortion was lifted following the ruling.

Manning supports codifying Roe v. Wade, and she sponsored a bill to protect access to birth control that passed the House but has not been taken up in the Senate.

Since the court’s ruling n Dobbs v. Jackson Women’s Health, abortion rights have emerged as a key topic in elections across the country, and polls show the issue to be a motivating factor for voters in North Carolina.

Ross, in the 2nd District, and Adams in the 12th District, both are candidates for re-election as well. Butterfield and Price are retiring.

The Democrats did not reach out to the eight Republicans representing the state to see if they wanted to be included in the letter. Each of those GOP delegates – and other candidates on the ballot on Nov. 8 – has established a firm position in support of the right to life.