US Appeals Court Temporarily Blocks mail-order Abortion Pill Access Nationwide

A US appeals court on Friday temporarily blocked a federal rule allowing the abortion drug mifepristone to be dispensed by post, significantly curtailing access to the drug nationwide, particularly in states that have banned abortion.

 

A conservative three-judge panel of the New Orleans-based 5th US Circuit Court of Appeals ruled unanimously that the Republican-led state of Louisiana was likely to prevail in its challenge to the 2023 rule adopted by former Democratic President Joe Biden’s administration.

While the ruling is temporary, it is the first to significantly restrict access to mifepristone in a series of lawsuits challenging the drug’s initial approval in 2000 and subsequent rules that made it easier to obtain. The 2023 US Food and Drug Administration regulation removed a requirement that mifepristone be dispensed in person.

The ruling was welcomed by Louisiana’s Republican Attorney General, Liz Murrill, who said in a statement that she “looks forward to continuing to defend women and babies as this case proceeds”.

The decision is not the final word on the issue, but is, for now, the most sweeping threat to abortion access since the Supreme Court rolled back abortion rights in 2022, said Kelly Baden, vice-president at the Guttmacher Institute, an abortion rights advocacy group.

“Reimposing medically unnecessary in-person dispensing requirements for mifepristone will send shockwaves of chaos and confusion across the country and dramatically upend patients’ ability to obtain abortion care,” Baden said in a statement.

The FDA did not immediately respond to requests for comment.

Restricting access to mifepristone, including through telehealth appointments with out-of-state providers, has been a top priority for Republican-led states that have banned abortion, including Louisiana.

Nearly half of US states have banned or severely restricted abortion since the Supreme Court rolled back its recognition of a woman’s constitutional right to the procedure in 2022. This has driven a surge in medication abortion, prompting a series of legal battles over access to the drugs.

Medication abortion is a two-drug regimen consisting of mifepristone — used in about two-thirds of US abortions — followed by misoprostol, which is used to terminate a pregnancy within the first 10 weeks.

In states where abortion is legal and doctors are permitted to prescribe drugs via telehealth, fewer than 2 per cent of prescriptions for abortion drugs are filled in person, according to research from the University of Southern California.

Louisiana sued the FDA last year, claiming the agency, in adopting the 2023 rule, had ignored the risks of serious adverse events posed by mifepristone, including sepsis and haemorrhaging.

The Biden administration had maintained that mifepristone is effective and safe, citing studies showing major adverse events occur in fewer than 1 per cent of patients.

Drug companies GenBioPro and Danco Laboratories have intervened in Louisiana’s lawsuit to defend the FDA regulation. The brand-name version of mifepristone, Mifeprex, is Danco’s only product, while GenBioPro derives most of its revenue from the generic version, the companies said in court filings. The FDA last year approved another generic version made by Evita Solutions.

 

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