The Supreme Court agrees to hear the case on the most used abortion pill in the US to decide on its access

The Supreme Court decided this Wednesday that it will hear the case on access to the abortion pill mifepristone – the most used for abortion in the United States – to issue a ruling that will impact millions of people in the country. Mail access to the pill will also be part of the decision.

The highest court agreed to intervene in the appeals of the Administration of President Joe Biden and the pharmaceutical company Danco, which defend the approval of the pill by the Food and Drug Administration (FDA) more than two decades ago. Danco is the manufacturer of mifepristone, brand name Mifeprex.

(Mifepristone: the most used drug for abortion in the US returns to the Supreme Court)

The justices will hear oral arguments in the case early next year, and are due to make a decision by June.

The Supreme Court, with a conservative majority, has already demonstrated some hostility to the right to abortion, last year overturning the historic ruling in the Roe v. Wade. However, in April 2023, early in the mifepristone litigation, the court blocked a judge’s ruling seeking to completely reverse the FDA’s approval of the pill.

Mifepristone and misoprostol pills at a medical abortion clinic. Erin Hooley/Chicago Tribune via Getty Images archive

The legal dispute over the pill is not directly about abortion rights, but rather legal issues over the FDA’s process for approving these drugs.

The case, however, has raised questions about the Supreme Court’s decision to roll back federal protection of abortion rights, leaving each state to decide what to do.

The FDA’s approval of the pill — which dates back to 2000 — is not the litigation that will be heard by the court, which has already refused to deliberate on the issue.

Instead, the justices will focus on a series of measures the FDA adopted since 2016 that made mifepristone easier to access, including the 2021 permit to make it available by mail.

The Supreme Court will also review 2016 decisions that extended the time in which mifepristone can be used to terminate a pregnancy (from seven weeks of gestation to ten), as well as reducing the number of in-person medical visits for patients (from three to one).

In another ruling also that year, the FDA altered the recommended doses of mifepristone, finding that a smaller amount was sufficient to achieve an abortion.

More than 5 million women have used mifepristone to terminate their pregnancies safely, and currently more than half of those who decide to do so use this drug, according to the Department of Justice.

(What is the future of the abortion pill mifepristone after the Supreme Court decision?)

The FDA also approved a generic version of mifepristone that accounts for two-thirds of the domestic market, according to its manufacturer, Las Vegas-based GenBioPro.

Mifepristone is one of the two pills used in medical abortions, along with misoprostol. Health professionals have said they will resort to the latter only if mifepristone is not available or too difficult to obtain. Misoprostol is less effective in terminating pregnancy.