After pressure from Idaho company, Costco decides not to sell abortion drug

BOISE (Idaho Statesman) — After months of pressure from a Boise-area investment firm that offers its customers “biblically responsible” portfolios, Costco has decided not to sell mifepristone, a pill used for abortions and miscarriage management.

Costco’s decision was due to a lack of customer demand for the drug, rather than pressure from investors, a company spokesperson told the Statesman in an email.

“Our position at this time not to sell mifepristone, which has not changed, is based on the lack of demand from our members and other patients, who we understand generally have the drug dispensed by their medical providers,“ the spokesperson said.

Still, Inspire viewed the grocery giant’s decision as a “massive win,” its CEO, Robert Netzly, told the Idaho Statesman by email. Costco is based in Issaquah, Washington, and operates grocery stores with retail pharmacies across the country.

Mifepristone was not available in pharmacies until 2023, when former President Joe Biden created a process for major retail pharmacies to get certified to dispense the medication after the U.S. Supreme Court overturned Roe v. Wade, which guaranteed federal protections for abortion.

Soon after, Inspire reached out to Costco, Walmart and Albertsons to warn them of the “backlash” they would see if they began to sell the medication, Netzly previously told the Statesman.

Tim Schwarzenberger, who led efforts to lobby the grocery giant on behalf of Meridian’s Inspire Investing and other conservative firms, told the Statesman it was clear that Inspire’s advocacy played a role in Costco’s decision. In Inspire’s initial correspondence with Costco, he said, the company said only that it was still evaluating demand and did not respond to further outreach.

But as Inspire ratcheted up the pressure, ultimately warning Costco it would file a shareholder resolution if the company didn’t engage, Costco this month told Inspire in an email, which the Statesman reviewed, that it did not plan to seek the certification it would need to sell the drug.

“They went from not making a decision to making a decision,” Schwarzenberger said.

Nicole Erwin, a spokesperson for Planned Parenthood, said Costco’s decision wouldn’t have much immediate impact on Idaho, since the store had not been selling the medication.

But Loren Colson, an obstetrician and the president of the Idaho Coalition for Safe Healthcare, which advocates for women’s access to abortion, said he worried Costco’s decision would lead to a “domino effect” of other pharmacies declining to sell the drug, ultimately decreasing women’s access to it.

Meridian-based investment firm pressed Costco on abortion pill

Inspire evaluates and rates companies’ adherence to biblical values. It scores companies positively or negatively based on their stances on abortion access, LGBTQ+ advocacy and environmental protection, among other issues.

But it also seeks to engage with companies it has dinged before writing them off, to see whether it can persuade them to change their behavior.

Costco receives a score of -67 in Inspire’s rating system because it sells other drugs used for abortions, including misoprostol. But Schwarzenberger said he doesn’t know whether the company’s decision on mifepristone would lead to an improved score.

Inspire frames its advocacy as an effort to persuade companies to stay neutral on social issues, Netzly told the Statesman. On LGBTQ+ rights, for example, it opposes companies actively taking a stand, such as sponsoring a Pride event. Schwarzenberger framed Costco’s decision not to sell mifepristone in the same way.

“We commend (Costco) for staying out of this issue,” he said. “We think that choice protects its brand. It serves families, and it keeps the company focused on what it does best.”

Targeted ‘abortion drug’ used for miscarriages in Idaho

The number of abortions using medications like mifepristone are on the rise, according to the New York-based Guttmacher Institute, which advocates for sexual and reproductive health rights. In 2023, “medication abortions” accounted for more than 60% of all abortions in the U.S. health care system, compared with about 15% in 2005.

But in a state like Idaho, where abortion is illegal, mifepristone is likely being sold almost exclusively for its use in managing miscarriages, Colson said. “It’s the ‘abortion pill,’ and that’s why these groups are going after it, even though it’s not being used for abortion” in Idaho, he said.

The Society of Family Planning, an international nonprofit that promotes abortion and contraception science, recommends that doctors administer a combined regimen of mifepristone and misoprostol, another drug, for managing miscarriages. It generates its clinical guidance, which is peer-reviewed, through a “thorough, methodical review of available clinical evidence, best practices and expert opinion,” said Vanessa Wellbery, a spokesperson for the organization.

Netzly acknowledged that mifepristone could be used for purposes other than abortion but said that in those cases, it should be prescribed and dispensed directly from a doctor or hospital, rather than from a retail pharmacy.

“This practice is safer for the woman taking the drug and also adds protection against the drug being misused to induce an abortion,” he told the Statesman by email.

The vast majority of mifepristone prescriptions in the U.S. are for abortion, Schwarzenberger said, echoing concerns that the drug could be diverted for another use even if it’s prescribed for miscarriage.

Colson said “we just have no evidence” that mifepristone is diverted to be used for abortion after being prescribed for other reasons. The stakes for providers are “so high,” he said, because they could go to jail in Idaho if drugs they prescribed were used for an abortion.

Mifepristone remains a legal drug, but Colson warned that pressure from groups like Inspire could prompt companies to “back down” on selling it.

“That’s the kind of the world we’ve created, especially under this current administration federally,” he said. “If there’s a whiff that this might cause troubles for people, people just change how they do things, even if it’s not actually illegal.”