The U.S. Supreme Court has temporarily reinstated online access to the abortion pill mifepristone.
The ruling comes in response to an emergency request from manufacturers Danco and GenBioPro to overturn a Friday ruling by a federal appeals court in New Orleans, which prevented mifepristone from being prescribed over the phone and sent through the mail in the U.S.
The Supreme Court move is an “administrative stay,” which allows the court time to review the request before making a ruling. The stay, which is in effect through May 11, also allows patients who were scheduled for appointments, to not have their treatment disrupted. The separate requests from the mifepristone manufacturers were filed Saturday afternoon and evening.
The order from the lower appeals court came in response to a lawsuit filed by Louisiana, which asked for the reinstatement of an FDA requirement that mifepristone be prescribed only by way of in-person consultation. The order was a temporary measure to block the online distribution of the pill until the lawsuit resolved.
The in-person requirement was lifted by the FDA in 2021 during the coronavirus pandemic. Louisiana contends that the online availability of mifepristone undermines its 2022 ban on abortions.
In their Saturday emergency filings (PDF) to the Supreme Court, Danco and GenBioPro called the ruling by the appeals court’s three-judge panel “unprecedented.” GenBioPro said in
“The Fifth Circuit’s order has unleashed regulatory chaos,” GenBioPro said (PDF) in its filing, referring to the lower-court move in New Orleans.
“The order is deeply unsettling to drug sponsors, healthcare providers, patients, and the public—all of whom rely on FDA’s exercise of scientific judgment and orderly administration of the Nation’s complex system of drug regulation,” the Las Vegas company wrote.
GenBioPro added that women from rural areas and those that have “transportation, childcare or occupational constrains” have difficulty seeing healthcare providers in person. These people now lack access to “time-sensitive medical care,” and face “attendant health risks,” the company said.
Roughly a quarter of the abortions in the U.S. are executed by way of telemedicine, with mifepristone used in approximately 60^ of the procedures.
Mifepristone typically is used to end pregnancy at up to 10 weeks by blocking the hormone progesterone, causing the embryo to detach. A second medication, misoprostol, then is used to cause contractions.
In April of 2023, the Fifth Circuit Court of Appeals moved to prohibit the pill from being delivered by mail and restricted the time frame mifepristone could be used during pregnancy from 10 weeks to 7 weeks. The ruling dovetailed with the Supreme Court’s controversial 2022 decision to overturn the landmark case Roe v. Wade, putting women’s reproductive health under threat.
In June of 2024, however, the Supreme Court preserved the mail-order access to mifepristone, which had been established three years earlier by the FDA.
In September of last year, the FDA and HHS pledged to review mifepristone’s Risk Evaluation and Mitigation Strategies (REMS), a drug-specific prescribing protocol required by the FDA that is designed to ensure safe use. That review is ongoing.
