By Jeff Green and Jessica Nix, Bloomberg News
Costco Wholesale Corp. has decided not to dispense the abortion pill mifepristone at its more than 500 pharmacy locations, a decision hailed by a group of faith-based activists who urged the retailer to avoid selling the drug.
Costco said in a statement that it hasn’t seen consumer demand for the pill, and had no comment on whether the conservative group had any role in its decision. The religious coalition includes Idaho-based Inspire Investing; conservative activist organization Alliance Defending Freedom (ADF); and treasurers and other financial officials from states such as Ohio, Texas, Nevada and Utah. Last year, the group had asked the company to not begin selling the medication.
“It’s a very significant win and it’s one we hope to build on this coming year,” said Michael Ross, legal counsel for the corporate engagement team at ADF.
He said the group will now focus on Walgreens Boots Alliance and CVS Health Corp., which dispense mifepristone in pharmacies in states where abortion is legal. Patients in states where abortion is illegal can also get the pills through the mail in states where the procedure is not outlawed.
Last year, the religious investors wrote letters to Kroger Co., Walmart Inc. and Albertsons Cos Inc. in addition to Costco, asking them not to dispense the pill in their pharmacies. Kroger said it has never offered the abortion pill and continues to evaluate the regulatory environment. Walmart and Albertsons currently do not offer the medicine. Walmart and Albertsons declined to comment.
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Costco posted better-than-expected earnings in the third quarter, demonstrating its loyal customers were keeping the brand strong at a time of economic uncertainties, and the company has been credited with taking a stand against conservative opposition to its DEI policies during its most recent annual meeting. The retailer’s decision raises the stakes of a pitched battle over the drug. In July of last year, NYC Comptroller Brad Lander wrote the retailers on behalf of New York City pension funds to convince them to seek approval to offer the pill. That advocacy prompted the conservative groups to expand their own campaign in August to discourage mifepristone dispensing, Ross said.
“Costco’s decision to refuse to dispense mifepristone is disappointing and short-sighted,” said a spokesperson from Lander’s office. “Failure to provide access to proven safe and FDA-approved medication under the guise of ‘weak demand’ risks isolating customers and undermines the company’s credibility.”
The religious groups pledged to keep at it. “We have this momentum,” said Tim Schwarzenberger, director of corporate engagement at Inspire, which is the largest religious ETF. “Now there is a chance to turn to some of the other retailers.” Amazon.com doesn’t currently offer the pill, and Schwarzenberger said his group will lobby the company to keep it that way. Amazon did not respond to requests for comment. Walgreens had no comment, but pointed to information on the company’s website, which says, in part: “The U.S. Supreme Court’s ruling on mifepristone access allows Walgreens to continue to dispense mifepristone under the FDA guidelines.”
CVS said that its mifepristone distribution is in select states where legal, following a completion of a “robust certification process.”
“We have a long history of supporting and advancing women’s health and we remain focused on meeting their unique health needs. This includes providing access to safe, legal, and evidence-based reproductive health services,” the company said in a statement.
Overturning the national right to abortion created a patchwork system of access in the U.S., causing telehealth companies to fill some of the gaps. Some state lawmakers have introduced bills to classify mifepristone as a controlled substance and limit telehealth access. In the 2025 legislative session, 32 bills to ban medication abortion and 38 bills limiting access were introduced, the most since Roe was overturned, according to a tracker from the nonprofit research group Guttmacher Institute.
The majority of abortions in the U.S. are still done either at a clinic or with a mifepristone prescription from a physician and then filled a pharmacy such as CVS or Walgreens, according to data from the Society of Family Planning, an abortion advocacy group— a smaller portion are prescriptions filled through the mail. As more states have passed laws restricting or banning abortion, more women have sought a mifepristone prescription online; the product is then mailed. Those orders now account for about a quarter of abortions in the U.S., from 5% before the 2022 U.S. Supreme Court ruling that overturned abortion rights nationally. Eight states where abortion is legal have passed so-called shield laws that protect physicians from legal action if they prescribe mifepristone to a patient in a state with an abortion ban.
Part of the challenge for women seeking an abortion is that CVS, Walgreens and other pharmacies do not dispense the pill in states where abortion is illegal, said Ushma Upadhyay, a professor of reproductive sciences at the University of California, San Francisco. Telehealth companies are able to use so-called shield laws to their advantage to mail pills directly into a state with a ban, she said.
That’s created legal challenges. In July, a Texas man sued a California doctor for prescribing his girlfriend abortion medication. A New York doctor has been indicted on felony charges in Louisiana and sued by the Texas Attorney General for sending pills to patients in those states.
“The anti-abortion advocates are trying whatever they can to reduce people’s ability to obtain it,” Upadhyay said. “But they know that even the abortion laws are not preventing people from getting their abortions. So I think this is just another way that they are trying to control the market.”
Mifepristone blocks the hormone progesterone, which helps a woman’s body maintain the lining of the uterus during pregnancy. The pregnancy ends when the lining can no longer support the fetus. A second medication, misoprostol is then taken to complete the process. Misoprostol can also be used to end a pregnancy, but is less effective than mifepristone depending on how far along the pregnancy is. The group is not seeking to eliminate access to misoprostol because it has alternative uses to treat stomach ulcers.
Conservatives are also urging the U.S. Food and Drug Administration and U.S. Department of Health and Human Services to reexamine the risk evaluation and mitigation strategy, or REMS, of mifepristone, which are tools used to mitigate the safety risks of some drugs. In 2023, the FDA removed the in-person dispensing requirement for mifepristone and added a pharmacy certification process, essentially expanding access through telehealth. CVS and Walgreens are currently the only national pharmacies approved to dispense mifepristone under the REMS guidelines. Now, anti-abortion groups are pushing the FDA to add back the in-person dispensing requirement. Attorneys General from 22 states including Kansas, Texas and Ohio penned a July 31 letter urging Secretary of Health and Human Services Robert F. Kennedy Jr. to reinstate the previous restrictions.
“This is an issue that our investors care deeply about, not just from a moral perspective, but also from a fiduciary perspective,” Schwarzenberger from Inspire, said. “The legal landscape is far from settled.”
With assistance from Jaewon Kang.
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