Since the reversal of Roe v. Wade, doctors have been sounding the alarm about post-Roe affecting patients' medications.
"We're also aware of patients having difficulty accessing methotrexate just because it happens to be a very effective alternative surgery for the treatment of ectopic pregnancies. I'm a dermatologist, I use it to treat certain autoimmune diseases, cancers, psoriasis — and some pharmacists and some states are refusing to stock or dispense methotrexate and other drugs," said Dr. Jack Resneck, the president of the American Medical Association.
Since that warning from the American Medical Association, some patients still struggle to get their meds like methotrexate.
The drug slows down inflammation and cell growth.
Patients take it most often in a low dose pill.
It's also given as an IV or injection.
"It is something they take long-term unless they develop side effects or it is no longer clinically beneficial to them," said Dr. Scott Joy, the chief medical officer of HCA Healthcare Physician Services Group.
Doctors use methotrexate for a variety of health conditions, including breast, lung, head, neck and blood cancers.
It's also used to treat autoimmune diseases like MS, Crohn's and lupus — conditions that can be chronic and often life-altering.
Just ask Kamai Wright.
Doctors diagnosed her with systemic lupus at 13.
She's suffered a stroke and lupus hurts her kidneys.
She has a team to help her manage.
"I have to have a lot of appointments and a lot of different doctors… I have rheumatologists, hematologists, nephrologists," said Wright.
So why is this drug in question? Because it can be used to end pregnancy, even for people not seeking abortions.
Methotrexate is considered a teratogenic medicine; meaning it can cause fetal or embryonic developmental issues.
Experts say the drug can be given to terminate ectopic pregnancies by stopping fetal cells from growing.
"It's something that we use in extreme caution, if not at all, in women who may be pregnant," said Joy.
Methotrexate is among a handful of drugs under scrutiny.
Others include seizure prevention meds or acne treatments.
Some of these medications have stricter rules for getting a prescription.
"It makes the pharmacist understand the indication for the drug. That may be something that we start doing for patients with methotrexate. Clearly, good practice is to always do a pregnancy test and a younger patient before you're starting methotrexate," said Joy.
Dr. Joy's concern for patients is all about cost.
"If someone was stopping methotrexate. We would have to jump to some of the more expensive medicines. But the price difference between a medicine like that and methotrexate is very significant and oftentimes is cost prohibitive for the patient to either start to continue," said Joy.
A month's course of methotrexate pills can cost about $6.50. An alternative Dr. Joy suggests costs more than $6,000.