On Wednesday, the US Supreme Court agreed to take on a case challenging the use of the drug mifepristone, which is most commonly used for abortions in the US. A decision in the case is likely to arrive in summer 2024, and the outcome of the case could affect access to the drug and also the Federal Drug Administration’s (FDA) authority to regulate in matters of dosages and medications.
The Debate over Mifepristone
This is being hailed as the most significant reproductive rights case in the US after the court overturned Roe v. Wade. The clash over access to this drug began in November 2022, when a group of anti-abortion doctors and activists known as the Alliance for Hippocratic Medicine sued the Food and Drug Administration (FDA) for having unlawfully approved mifepristone back in 2000.
This year, in August, the US Court of Appeals for the Fifth Circuit, which is one of the most conservative federal appeals courts in the US, ruled that it would not suspend the FDA’s approval of the drug but asked the agency to significantly restrict access to it. After this, the Biden administration and Danco Laboratories, which manufactures mifepristone, took the case to the Supreme Court.
The Supreme Court had back then paused lower courts’ rulings, because of which mifepristone still remains widely available in states that permit abortion. If, in future hearings, the Supreme Court allows the fifth circuit ruling to stand, then it would affect the supply and use of the drug.
What is Mifepristone ?
In recent times, the battle over abortion in the US has been centered around medication-based abortions, which are happening at the moment. It is the most common method of having an abortion in the US, according to the Guttmacher Institute, a pro-abortion research group. This most widely used method has been the two-drug regimen method that was approved for use up to 10 weeks of pregnancy by the FDA in 2000. In this regimen, a patient is first given mifepristone to induce an abortion and then misoprostol to empty the uterus. Since 2016, the FDA has further eased access to the drug by allowing doctors to treat patients via telemedicine and send prescriptions by mail.
Contrasting view points on this matter
Abortion advocates in the U.S. have long supported medication abortion because it is a less expensive and less invasive method for having an abortion. Along with this, in several studies that have been conducted, mifepristone has been found to be safe. However, anti-abortion groups have countered these claims and have called abortion pills cast as “chemical abortion” to be dangerous and ineffective.
This has led many legal and medical experts to question whether the challengers of this drug have properly demonstrated that they have been harmed by mifepristone or its continued legality. Greer Donley, an associate law professor at the University of Pittsburgh Law School, said that one should not be allowed to “bring random lawsuits to court.” She further stated that the people who are bringing up this lawsuit should be thoroughly examined by the court to confirm if they have any stake in this case.
Nancy Northup, the president of the pro-choice group Centre for Reproductive Rights, said in a statement that abortion pills have been used safely in the country for more than 20 years and have become more important in the post-Roe landscape. She said that due to this reason, the anti-abortion movement is focused on attacking them.
Another issue that is coming up in this case is that if the Supreme Court restricts the sale of mifepristone, then it could harm the FDA’s regulatory power and pose a threat to pharmaceutical companies.
Possible Outcome on ban of Mifepristone
Several abortion clinics have said that if they are deprived of access to mifepristone, they will keep providing medication abortions using only misoprostol. Although misoprostol only abortions have been found safe, they have been reported to have side effects and have been found slightly less effective than the two-drug method.
