The reason: At a higher dose, methotrexate — a drug used to treat certain cancers, arthritis and a host of autoimmune diseases — can also cause abortions and terminate ectopic pregnancies, though that’s not its most common use. Power told the Washington Post. Emma Thompson was finally able to get her prescription, but the delay highlights the medical complications some patients face in states with strict abortion rules. Even if the drugs are not prescribed to terminate the pregnancy, the reversal in June Roe v. Wade has thrown pharmacists, patients and doctors into a “constant juggling act,” Power said, balancing medical care with changing policies and potential legal ramifications. “I don’t think everyone understands the consequences of such a sweeping, sweeping anti-abortion law and how many other women are affected by it,” she added. “Like how can we decide that women can’t have this drug that men can? This is sexist. And how can you make a law that doesn’t allow me to provide standard care to my patients?” Abortion bans complicate access to drugs for cancer, arthritis and even ulcers Throughout Emma’s life, rheumatoid arthritis — an inflammatory disorder that causes the body’s immune system to attack healthy joint tissue — has resulted in long hospital stays, clinical trials and just “too much pain to have a normal life said her mother. Kaitlin Preble. For 10 years, her daughter’s doctors had experimented with different doses of methotrexate, finally finding the right amount about a year ago that allows Emma to thrive, go to school and “just be a normal teenager,” Preble said. All of that seemed to be in jeopardy on Sept. 25, when Preble checked her Walgreens app to see if Emma’s prescriptions were ready. Instead of a green light indicating they could be picked up, a message appeared saying the methotrexate refill had been declined. “He didn’t even give a reason,” Preble said. “He just said I should call my doctor.” Still, Preble said she was under the impression that the state’s new abortion ban — which dates back to the 19th century and prohibits the procedure except to save the pregnant woman life — had something to do with it. Her suspicions were confirmed the next day, when Preble drove up to the pharmacy “and made a big deal about it inside,” she said. Arizona is one of several Republican-controlled states pointing to a century-old law as the rationale for removing access to abortion. (Video: Julie Yoon, Joshua Carroll/The Washington Post) At first, no one would explain why her daughter couldn’t take a drug that is “critical to her health,” Preble said. He then urged a pharmacy technician to get some answers. “The pharmacist said she denied it because Emma is 14,” which is considered childbearing age, Preble said. “The pharmacy technician then asked, ‘Okay, did you look at her history?’ He’s been taking this medicine for a long time,’ and the pharmacist said, ‘No,’ which I think was very important.” Through it all, Preble was shaking and in tears: “I understand that pharmacists are afraid because they don’t want to be accountable for anything. But it is extremely unfair to put a child in this unpredictable situation. And we don’t have to jump through all these hoops to get a drug.” In a statement to The Post, a Walgreens spokesperson said that while the company could not discuss individual patients, “new laws in various states require additional steps to fill certain prescriptions and apply to all pharmacies, including Walgreens.” “In these states, our pharmacists work closely with prescribers as needed to fill legal, clinically appropriate prescriptions,” the spokesperson said. “We provide ongoing training and information to help our pharmacists understand the latest requirements in their area.” Patients across the country face similar situations as more drugs come under scrutiny. Many of the drugs are teratogens, or drugs that can lead to fetal abnormalities and miscarriages if taken by a pregnant woman. In some cases, women must prove they are on birth control or take a pregnancy test at pharmacies to fill prescriptions for drugs that can end a pregnancy, The Post previously reported. As for methotrexate — which is used or has been used by nearly 60 percent of rheumatoid arthritis patients — medical groups have already said there are increasing challenges in accessing the drug. In Texas, for example, pharmacists are allowed to refuse to fill prescriptions for misoprostol and methotrexate under the state’s “heartbeat bill.” The American College of Rheumatology in July urged pharmacists nationwide to provide the drug “without delay and under the assumption that it is not being used to terminate a pregnancy.” “Methotrexate must remain accessible to people with rheumatic conditions, and legal safeguards must protect rheumatology professionals, pharmacists and patients from potential legal penalties,” the medical group said in a statement. Federal officials warn pharmacists against refusing abortion drugs The new laws have also affected patients with other conditions, such as Crohn’s disease and ulcerative colitis. In August, the Crohn’s & Colitis Foundation said it “strongly opposes” policies that prevent patients from accessing approved treatments. “The decision about what is the most appropriate treatment for their disease should be made as a joint decision between a patient and their healthcare professional, based on medical evidence,” the agency wrote in a statement. Although her daughter’s next refill isn’t scheduled for another month, Preble said she’s already dreading the possibility of another denial. “These laws are too extreme and don’t take into account all the different scenarios that people go through,” he said.
