Washington: President Joe Biden’s administration and the medicine’s maker warned the US Supreme Court on Friday that if restrictions on the abortion pill mifepristone established by lower courts are allowed to take effect, they could not be accessible for months. This was done in an effort to preserve access to the drug.
While legal action in an anti-abortion group’s challenge to mifepristone’s regulatory clearance is ongoing, the Justice Department filed an emergency request asking the court to halt an order by US District Judge Matthew Kacsmaryk in Texas that substantially restricted the distribution of the pill.
The provisional injunction issued by Kacsmaryk was scheduled to go into force on Saturday at 12 a.m. CDT (0500 GMT).
Biden’s administration is seeking to defend the availability of mifepristone in the face of mounting abortion bans and restrictions enacted by Republican-led states since the Supreme Court in June 2022 overturned the landmark 1973 Roe v. Wade decision that had legalized the procedure across the country. The Supreme Court 6-3 conservative majority.
The Justice Department said the lower court orders issued in the past week limiting the availability of mifepristone would have “sweeping consequences” for women who need access to it and the FDA’s scientific judgment authority over drug safety.
Mifepristone, approved by the US Food and Drug Administration in 2000, is used in combination with another drug called misoprostol to perform medication abortion, which accounts for more than half of all US abortions. The FDA is the US agency that signs off on the safety of food products, drugs and medical devices.
Danco Laboratories, the manufacturer of mifepristone, also asked the Supreme Court for similar relief on Friday. The company said it may be forced to halt operations in the face of regulatory uncertainty.
Current drug labels for mifepristone do not account for the new limits and would have to be adjusted, a process that could take months, both the Justice Department and Danco said in their filings. The generic version of mifepristone would also lose its approval, the Justice Department said.
“The resulting disruption would deny women lawful access to a drug FDA deemed a safe and effective alternative to invasive surgical abortion,” the Justice Department told the justices.
In a case that could also undercut the FDA’s authority to decide on the safety of drugs, the New Orleans-based 5th US Circuit Court of Appeals on Wednesday declined the administration’s request to block the restrictions ordered by Kacsmaryk on 7 April. The 5th Circuit halted another part of Kacsmaryk’s order that would have suspended the FDA’s approval of the drug, effectively pulling it off the market.
‘Fundamental Errors’
“To the government’s knowledge, this is the first time any court has abrogated FDA’s conditions on a drug’s approval based on a disagreement with the agency’s judgment about safety – much less done so after those conditions have been in effect for years. And the lower courts reached that unprecedented result only through a series of fundamental errors,” the Justice Department said in its filing.
The restrictions set by the lower courts would restore curbs on the medication that had been lifted since 2016 as the FDA steadily expanded access. These revived restrictions include a requirement for three in-person doctor visits in order to obtain it and limiting its use to the first seven weeks of pregnancy, down from the current 10.
The challengers to mifepristone have called these limits critical safeguards to a medication they consider dangerous. The Justice Department has said the challengers have no basis for second-guessing the FDA’s scientific judgment and that when used as directed, adverse effects of mifepristone are exceedingly rare “just as they are for many common drugs like ibuprofen.”
Since last year’s Supreme Court decision, 12 US states have put in place outright bans while many others prohibit abortion after a certain length of pregnancy. The latest Republican-led move came in Florida, where Governor Ron DeSantis on Thursday signed a new law that bans most abortions after six weeks of pregnancy, setting the stage for abortion access to be drastically curtailed in the state and across the US South.
Anti-abortion groups led by the recently formed Alliance for Hippocratic Medicine and four anti-abortion doctors sued the FDA in November seeking to pull approval of misoprostol.
Kacsmaryk found that the FDA, in approving the drug, exceeded its authority by ignoring “legitimate safety concerns” about mifepristone and relying on “plainly unsound reasoning and studies” when approving it.
The 5th Circuit found that the plaintiffs had waited too long to challenge the FDA’s regulatory approval but were likely to succeed in targeting the agency’s decisions in recent years to make access to mifepristone easier.
Health policy and legal experts have said Kacsmaryk’s decision if allowed to stand, would threaten the FDA’s power to regulate all drugs nationwide and to act as the ultimate arbiter on drug safety. Executives from hundreds of biotech and pharmaceutical industry companies in an open letter called for a reversal of the judge’s “decision to disregard science.”
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