Dec 13, 2023 - Health

Supreme Court agrees to hear abortion pill case

Illustration of a column wrapped in snakes from a caduceus.

Illustration: Shoshana Gordon/Axios

The Supreme Court on Wednesday agreed to review an August appeals court decision that curtailed access to the widely used abortion pill mifepristone.

Why it matters: It sets the stage for another major abortion case at the court 18 months after it overturned Roe v. Wade and ended the constitutional right to abortion.

  • A ruling upholding the appeals court decision could limit abortion access even in states that protect it.
  • Medication abortion accounts for more than half of abortions in the U.S., per the Guttmacher Institute, a research organization that supports abortion rights.
  • The case also has huge ramifications for the Food and Drug Administration, which could see its authority to approve drugs rolled back by courts, or restricted by state laws.

Catch up quick: The maker of mifepristone, Danco Laboratories, and the Department of Justice in September asked justices to review a 5th U.S. Circuit Court of Appeals ruling that the FDA failed to take into account safety concerns when it made mifepristone more easily accessible in 2016.

  • Danco cited the ruling's risks and confusion to women and the health system — and the way the challenge to the FDA's authority destabilizes the drug and biotech industries.
  • The three-judge panel at 5th Circuit partially blocked a lower court ruling that struck the FDA's approval of the drug, which was granted in 2000, in response to a suit from anti-abortion forces.

The pill remains available under an order the Supreme Court issued in April that maintained the status quo while legal challenges to the FDA's authority play out.

  • The justices on Wednesday also turned away a request from the Alliance of Hippocratic Medicine, an anti-abortion group, to review the merits of the FDA's original approval of mifepristone — a move legal experts said assures the pill will remain available and focuses the case on whether there will be additional restrictions.

What they're saying: "This administration will continue to stand by FDA's independent approval and regulation of mifepristone as safe and effective," White House spokesperson Karine Jean Pierre said in a statement.

Details: Mifepristone is commonly used in tandem with a second FDA-approved drug, misoprostol, for use in the first 10 weeks of pregnancy. The pills are increasingly prescribed online and mailed to patients after the FDA eliminated the requirement that they be picked up in person.

  • The overturning of Roe v. Wade led some Republican states to try to limit access to the pills, testing whether they had the authority to ban FDA-approved drugs.
  • Attorneys general in Missouri, Kansas and Idaho in November additionally sought to intervene in the case and challenge mifepristone's original approval along with the FDA's 2016 decision to expand access to the drug.
  • Justices could hear arguments by the spring, raising the prospect that a ruling could come before the 2024 election.
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