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Physicians cheered the US Supreme Court’s unanimous decision on June 13 to uphold access to mifepristone, rejecting a request by a group of anti-abortion clinicians to outlaw the drug.
Bobby Mukkamala, MD, president-elect of the American Medical Association, said that the group applauded the ruling and would continue to support access to safe and effective “reproductive health care against the ongoing threats of interference in the practice of medicine.”
“Efforts to second guess the FDA’s scientific judgment and roll back access to mifepristone were based on a sham case that not only lacked standing, but relied on speculative allegations and ideological assertions to undermine decades of rigorous scientific review proving the drug is highly safe and effective for both termination of pregnancy and for medical management of miscarriage,” Mukkamala said in a statement released Thursday.
In December 2021, the FDA finalized a rule lifting a requirement for in-person dispensing of mifepristone, permitting patients to obtain a prescription through telehealth or through the mail.
Abortion opponents challenged the FDA’s decision in a 2022 lawsuit that sought to withdraw approval of the drug or reinstate dispensing requirements.
The 9-0 ruling, authored by Justice Brett Kavanaugh, found that the plaintiffs lacked standing in the case:
“The plaintiffs do not prescribe or use mifepristone. And FDA is not requiring them to do or refrain from doing anything,” the decision stated. “Rather, the plaintiffs want FDA to make mifepristone more difficult for doctors to prescribe and for pregnant women to obtain. Under Article III of the Constitution, a plaintiff’s desire to make a drug less available for others does not establish a standing to sue.”
According to the Guttmacher Institute, medication abortions accounted for almost two thirds of the procedure in the United States in 2023, an increase from a little over half in 2020. Mifepristone is the most common drug for medication abortion when combined with misoprostol.
“Had the court revoked mifepristone’s approval, the justices would have been substituting their legal opinions for the medical and scientific knowledge of experts dedicated to evaluating the safety of pharmaceuticals, setting a troubling precedent,” Isaac O. Opole, MBChB, PhD, president of the American College of Physicians, said in a statement. “Today’s decision affirms that scientific evidence must continue to be the guiding factor in approving medical treatments.”
The American College of Obstetricians and Gynecologists (ACOG) called on the FDA to drop remaining requirements to report potential adverse reactions to mifepristone to its Risk Evaluation and Mitigation Strategies (REMS) program, which requires health clinicians to complete paperwork, obtain a patient signature, and provide a patient with an agreement form and medication guide. The program also requires pharmacies to become certified and use a shipping service that provides tracking information when dispensing the drug.
The REMS requirements “do not enhance the drug’s safety profile and instead only continue to impose burdens on and create barriers for those who prescribe and those who need mifepristone,” said Stella Dantas, MD, president of ACOG, in a statement. “If this case has demonstrated anything, it is that we must ramp up our efforts to protect—and further increase access to—mifepristone.”
On social media, other physicians expressed their relief about the court’s ruling.
On X, Physicians for Reproductive Health wrote that the decision “means patients around the country can continue getting access to the affirming abortion care they need! As physicians, we’re so relieved that this safe and essential medication will remain accessible.”
Jamila Perritt, MD, MPH, who posts as Reprorightsdoc, tweeted: “Even broken clocks are right twice a day. But I don’t want us to lose sight of the fact that we should not have wait with bated breath for courts to decide our reproductive futures. This was always about politics, never science. Mifepristone is safe and abortion is health care.”
And Daniel Grossman, MD, an abortion expert, wrote: “As a medical professional dedicated to the health and well-being of my patients, I’m relieved that people will still have access to medication abortion care, at least for the time being… A case based on junk science that would undermine public health should never have been brought in front of the court. Decades of evidence demonstrate that medication abortion is safe and effective, and any attempt to restrict access is unscientific.”
Mia Sims contributed reporting to this story.
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