Anti-abortion groups celebrated warehouse club Costco’s decision to not dispense abortion medication at its pharmacies, but they face an uphill battle in the wider fight to restrict the drug.

“There’s no question this is a win for Costco shareholders,” Michael Ross, legal counsel for Alliance Defending Freedom (ADF), told The Hill. “Retail pharmacies have little to gain and much to lose by turning themselves into abortion dispensaries.”

In 2024, ADF, along with other anti-abortion groups, sent letters to Costco, Walmart, Kroger, Albertsons and McKesson urging them to “resist politicized calls” to start dispensing mifepristone.

Most pharmacy chains have been unconvinced by the plea.

CVS and Walgreens, two of the country’s largest brick-and-mortar pharmacies, have continued to dispense the drugs in states where abortion is legal. And most abortion pills in the U.S. are distributed via mail-order pharmacies, which remain free to distribute the medication across state lines.

Crucially, the Food and Drug Administration (FDA) has not taken steps to change how the drug can be accessed under its Risk Evaluation and Mitigation Strategies (REMS), a safety program for certain drugs to monitor and manage adverse health events.

Health care policy experts told The Hill that the most effective way for anti-abortion advocates to restrict mifepristone is to change the REMS on the drug back to what they looked like a few years ago, before being temporarily scrapped during the COVID-19 pandemic.

During President Trump’s first term, these REMS required the drug to be dispensed in person at a clinic. These rules were permanently changed in 2023, allowing certified retail pharmacies and mail-order pharmacies to dispense the drug without an in-person visit.

“We’d love to see the original REMS put back on so women, at least, are told what could happen to them if they take the pills,” said........

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