When Alabama nurse Melissa picked up her regular prescription for rheumatoid arthritis last week, she was told the drug was “on hold” while the pharmacist verified she would not use it to induce an abortion.
“He said, ‘Well, I need to check if you’re using any contraceptives to prevent pregnancy.’ The hell you do,” she recalled thinking.
Melissa – who is in her early 40s and asked to be identified by her first name only, fearing that speaking could affect her livelihood – then called her doctor, who managed to get the southern US state pharmacy to clear the drug .
“I picked it up a few hours later but I felt hurt,” she told AFP, explaining that she had a hysterectomy six years ago and that her lack of recent birth control history may have led the pharmacist to believe she was pregnant was.
In the weeks since the United States Supreme Court overturned Roe v. Wade on June 24, stories of people facing similar struggles have come to light, highlighting an overlooked succession of new state-level bans or tough abortion restrictions .
It’s not yet clear how widespread the cases are, but national organizations including the Lupus Foundation of America and the American College of Rheumatology said they were aware of such concerns and asked those affected to come forward.
“The Arthritis Foundation supports unhindered access to and coverage of FDA-approved medications for the treatment of arthritis consistent with scientific and clinical guidelines and evidence-based medical recommendations,” the organization said.
At the heart of the problem is methotrexate, a drug that reduces inflammation and is commonly used to treat autoimmune diseases like inflammatory arthritis, psoriasis, and lupus.
Methotrexate stops cell division and is administered in higher doses as a cancer drug.
It can also sometimes be used in medical abortions, although not as commonly as the Food and Drug Administration-approved combination of two other drugs, mifepristone and misoprostol.
Still, many states have enacted laws threatening legal action against medical workers and pharmacies selling methotrexate.
– “It’s scary” –
Another woman contacted by AFP, a 20-year-old Ohio university student, said she has had a methotrexate prescription since 2020 to treat her lupus, which affects her kidneys and liver and causes joint pain.
A national chain pharmacist told her that they “no longer accept prescriptions for methotrexate unless it is for FDA-approved use of (treatment of) breast cancer or the patient is unlikely to be fertile,” she said.
She tried again unsuccessfully to fill her prescription at a family pharmacy, and this week she received a letter from her doctor’s office, explaining that the practice would no longer prescribe methotrexate because many patients have difficulty accessing it.
Although the first pharmacy later changed its position, the experience left it “upset and angry,” she said.
A third woman, 48-year-old Jennifer Crow, a writer and vegetable gardener in Tellico Plains, Tennessee, told AFP she received an automated call from CVS telling her that her methotrexate refill was “subject to approval by the provider” had been rejected.
Crow said methotrexate has helped her tremendously in managing her inflammatory arthritis, allowing her to roll out of bed and dress without severe pain and walk without a cane for the first time in years.
Although her doctor was able to resolve the situation, Crow, who also underwent a hysterectomy, said she was worried about other chronic disease patients who didn’t have the same access to resources as she did.
In statements to AFP, national pharmacy chains CVS and Walmart confirmed they are working to comply with new state regulations in light of the Supreme Court’s decision to overturn the constitutional right to abortion.
CVS added, “We encourage providers to include their diagnosis in the prescriptions they write to ensure patients have quick and easy access to medication.”
Alisa Vidulich, the Arthritis Foundation’s policy director, told AFP she was confident the situation could be resolved quickly as medical professionals and pharmacies develop new guidelines.
“But that may not be the case in all states, and it may actually become a longer-term problem,” she acknowledged.
Melissa, the nurse, said she was outraged by the double standards that allowed one of her best friends, a man, to receive his methotrexate prescription immediately and with no questions asked.
“We’re going in the wrong direction and it’s frightening. I have two daughters. I don’t want to see that,” she said.
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