Kristin Wipfler, PhD: Has Overturning Roe vs Wade Affected Access to Methotrexate?

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Kristin Wipfler, PhD, Biobank Director at FORWARD, The National Databank for Rheumatic Diseases, discusses her American College of Rheumatology Convergence presentation “Impact on Access to Methotrexate in the Post-Roe Era.” She and her team conducted a survey to address and assess medication access, specifically methotrexate, following the Supreme Court’s decision to overturn Roe vs Wade in June 2022.

“We had started seeing some anecdotal reports on social media, which was very concerning,” Wipfler explained. “Shortly after that, the ACR and a few other organizations in rheumatology published statements on this topic. Immediately, we were extremely concerned. It was unclear what the scope or the severity of this issue was at that time, and it still is to a large degree.”

Her team put together a questionnaire, including several potential issues such as excessive questioning about pregnancy from their doctors and pharmacists, delays in filling the prescription, and even experiencing a provider refuse to prescribe the drug.

“About 6% of [patients] reported experiencing a barrier,” Wipfler reported. “Most of them were pharmacy delays, in which several pharmacies apparently have a policy in place to confirm the purpose of such a prescription with the prescriber before filling it. In some cases, they were only delayed for a day or 2. But some of these individuals reported that they missed doses while they were waiting or had to switch to a different pharmacy.”

The registry was predominantly comprised of highly educated White women who were older than childbearing age.

“We imagine that the rate of problems is going to be much higher in higher-risk populations,” she emphasized. “But even among a population that's unlikely or unable to become pregnant, they're still having barriers to access.”