Nationwide access to abortion pills is again in legal limbo, almost two years after the Supreme Court threw out a case challenging mail-order prescribing of the widely used drug mifepristone.

Why it matters: A circuit court ruling on Friday that dramatically dialed back access to the drug has caused confusion for pharmacies, telehealth companies and other clinicians, even in states where abortion is legal.

• Some providers are stopping their prescriptions, others are switching to different drugs, and patients are left wondering what's coming next.
• While the Supreme Court yesterday froze that decision for a week, it could rule as soon as next week that the drug can only be dispensed in person.

The big picture: Regardless of what happens, the 5th U.S. Circuit Court of Appeals decision put abortion access front and center in an election year and placed the Trump administration in a political bind.

• The administration has argued that courts should pause proceedings until the FDA completes a safety review of the drug, which was first approved in 2000.
• That stance has angered anti-abortion advocates who want the administration to invalidate a Biden administration policy and restore in-person dispensing requirements.

What they're saying: The back-and-forth has created "whiplash and chaos" for patients and providers making time-sensitive medical decisions, said Alexis McGill Johnson, president of Planned Parenthood Action Fund.

• Friday's ruling amounts to "the biggest disruption to abortion access since the Dobbs decision" overturning Roe v. Wade, said Brittany Fonteno, CEO of the National Abortion Federation.

Context: Louisiana originally brought the lawsuit against the FDA to challenge Biden administration rules that expanded access to mifepristone by removing the requirement that patients see a provider in person before getting the medication.

• Federal judges have not yet issued any decisions on the underlying legal argument.

The administration has been conspicuously silent since Friday's ruling, and White House and HHS spokespeople did not respond to a request for comment yesterday.

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An AI model frequently outperformed a pair of experienced human doctors triaging emergency room cases, suggesting diagnoses and choosing next steps, researchers wrote in Science.

Why it matters: It's a sign that large language models have eclipsed most benchmarks of clinical reasoning, often using just limited information about the patient's condition at a particular time.

• That can be crucial in emergency situations, when clinicians have to respond quickly and mistakes can be fatal.

What they found: Harvard and Stanford researchers tested OpenAI's o1 preview model on 76 emergency room cases at Beth Israel Deaconess Medical Center in Boston.

• At the early stages, AI identified the correct diagnosis or came very close in about 67% of cases, compared with 50-55% for the physicians.
• While the gap narrowed as more information about the patients became available, the model continued to outperform doctors by 2%-10%.

What they're saying: "We're witnessing a really profound change in technology that will reshape medicine," said Arjun Manrai, the senior co-author of the study, per Harvard Magazine. "We need to evaluate this technology now and rigorously conduct prospective clinical trials."

Reality check: The study was based entirely on text-based inputs. In the real world, doctors speak with patients, review test imagery and other sources of clinical information.

Foreign-born doctors have been exempted from a Trump administration travel ban that froze green cards and work permit renewals.

Why it matters: The policy had been blamed for exacerbating physician shortages, particularly in rural communities that depend more on immigrant doctors to fill workforce gaps.

Driving the news: U.S. Citizenship and Immigration Services last week updated its website to say physicians are no longer subject to the processing hold.

• "USCIS is now processing certain applications associated with medical physicians," an agency spokesperson told Axios, without elaborating on specifics.

Yes, but: Some doctors who've contacted the agency about their renewal status have been told their case is still being held, one doctor in this situation told Axios.

The freeze scrambled arrangements for doctors from 39 countries, forcing some to take unpaid absences from their jobs. They can legally stay in the U.S. if their employer continues to sponsor them.

• Immigrant doctors caught in the squeeze could either return to their home countries, immigrate elsewhere or stay in the U.S. unable to work.
• Visa holders have a grace period allowing them to continue working in the U.S. after applying for a renewal. For the common H-1B visa, that period is 240 days.

Trump's original travel ban covered 19 countries. In January, it was expanded to 39.

The average cost of developing a drug from discovery to launch reached $2.7 billion last year — a roughly 20% increase over the average cost in 2024, Deloitte said yesterday in its annual report on pharmaceutical innovation.

Why it matters: Manufacturers often justify high prices for new drugs by citing high research and development costs.

What they found: 17 of 20 companies Deloitte analyzed have increased year-over-year R&D spending, while the number of drugs in late-stage testing has fallen 4.6%.

• GLP-1 obesity drugs have supplanted cancer drugs as the largest contributor to pipeline value for the first time, accounting for approximately 25% of total forecast sales for products in late-stage testing.
• That's a huge shift from 2022, when obesity drugs contributed just 1% of projected value, Deloitte said.

🧠 HHS will issue guidance encouraging doctors to consider lifestyle changes, not drugs, to treat depression. (WSJ)

⚡️ The administration is doubling down on health fraud enforcement with a strike force targeting Arizona, Nevada and Northern California. (Healthcare Dive)

🧳 Immigration changes are driving foreign researchers to leave the U.S. — or not come to begin with. (Stat)