US Supreme Court upholds temporary access to abortion pill

The United States Supreme Court has extended a temporary ruling that allows access to the abortion pill mifepristone, as anti-abortion rights groups seek to roll back approval for the medication, which is used in about half of all of the country’s abortions.

Wednesday’s decision by US Supreme Court Justice Samuel Alito puts the issue on hold for two additional days, until Friday at 11:59pm US Eastern time (03:59 GMT Saturday).

A previous decision to maintain access to mifepristone had been set to expire later on Wednesday.

Anti-abortion groups are seeking to overturn the Food and Drug Administration’s approval of mifepristone, granted more than two decades ago in 2000.

On April 7, a Texas District Judge Matthew Kacsmaryk ordered the suspension of mifepristone, granting an anti-abortion rights lawsuit’s call for an injunction on the pill while the FDA’s approval was challenged in court.

Kacsmaryk gave the administration of President Joe Biden seven days to respond to the injunction before it took effect.

The Biden administration quickly appealed. On April 12, the New Orleans 5th Circuit Court of Appeals allowed mifepristone to stay on the market but upheld curbs that reverted rules governing the pill’s access to standards set in 2016.

Those standards allowed mifepristone to be used only up to seven weeks of pregnancy, not 10 as the FDA has subsequently allowed.

They also bar mifepristone from being sent in the mail and require patients to make three in-person doctor visits before receiving the medication, barriers that recent FDA guidelines had lifted in an effort to ease access.

The Biden administration challenged those limitations and had expressed confidence in recent days that the Supreme Court would take its side.

Alito’s decision is likely to heighten tensions in the US, where Republican efforts to restrict abortion access have surged following the court’s decision last June to repeal Roe v Wade, a 1973 case that had enshrined the constitutional right to abortion.

The court currently has a six-to-three conservative majority. Alito provided no explanation for Wednesday’s extension, but the court is expected to weigh in soon.

In the White House news briefing before Alito’s announcement, Biden administration Press Secretary Karine Jean-Pierre assured reporters that the Biden administration considers this a “high priority”.

“The stakes could not be higher,” she told the reporters. “We are prepared for any outcome the Supreme Court may issue, and we are prepared for a long legal fight if necessary.”

She also reaffirmed the administration’s commitment to stand by the FDA’s authority: “We will continue to support the FDA’s independent expert authority to review, approve and regulate a wide range of prescription drugs.”

Hundreds of drug company and biotech leaders — including the CEO of Pfizer, Albert Bourla — signed an open letter earlier this month warning that the Texas court’s decision threatening FDA approval of mifepristone could have a chilling effect on “the entire biopharma industry”.

“Judicial activism will not stop here,” they wrote. “If courts can overturn drug approvals without regard for science or evidence, or for the complexity required to fully vet the safety and efficacy of new drugs, any medicine is at risk for the same outcome as mifepristone.”

The initial April 7 injunction on mifepristone coincided with a separate ruling from a Washington state judge, which affirmed the abortion pill should stay on the market.

That decision stemmed from a case involving 12 Democratic-led states that are seeking to loosen restrictions around mifepristone, which they argue are “particularly burdensome” given the proven safety of the drug.

On Wednesday, the pharmaceutical company GenBioPro Inc — which makes the only generic version of mifepristone available in the US — also filed a lawsuit to ensure it can continue selling the abortion pill.

The Guttmacher Institute, a reproductive health nonprofit, has estimated that medications like mifepristone account for 53 percent of all abortion procedures conducted in the US as of 2020. That marks a jump from 2017, when only 39 percent of abortions used medication over other forms of intervention.

Mifepristone is also used in helping patients manage miscarriages, as well as for treating Cushing’s syndrome, which results from the body’s overproduction of the hormone cortisol.