March 28, 2023 

Hi CommonHealth reader,

People on all sides of the abortion debate have their eyes on a federal lawsuit in Texas that could have broad implications for abortion pills across the nation.

But what exactly could it mean for patients, providers and the medical industry in places where abortion remains legal? I wanted a better understanding.

I started by talking to my colleague, Martha Bebinger, who has been monitoring the situation from 1,000 miles away in Massachusetts.

In short, she said the ruling could change the standard practice for medication abortions in Massachusetts, as well as care for patients who experience a miscarriage.

If the judge hearing the case goes as far as some expect, his decision could pull one of two abortion pills off the market. The vast majority of providers use this medication in conjunction with another drug, so the decision could force providers to go with a less effective regimen.

"First, keep in mind that 49% of abortions reported in the state occur using the two pills, mifepristone and misoprostol," Martha explained. "When taken together, they end a pregnancy without the need for surgery in 99% of cases." (The two-drug combo may also be prescribed to help manage a miscarriage.)

"If the federal judge orders the Food and Drug Administration to remove mifepristone from the market, abortion providers say they will switch to misoprostol-only abortions," she continued. "These are effective 93% of the time. The side effects — fever, cramping and bleeding — can be worse with the single pill. And this method typically requires a follow-up appointment with a doctor."

In addition to the direct impact on patient care, I’ve been hearing that the whole court case could have a chilling effect on biotech and drug development. On Point interviewed Amanda Banks, who has worked in the industry for 30 years. She told Meghna Chakrabarti that, right now, the FDA’s process for approving drugs is long and hard but everyone is aware of what it entails.

“It's a very well known, no surprises kind of thing,” Banks said. “It offers an opportunity for stability in what's an incredibly and increasingly high-risk endeavor of developing new medicines.”

But Banks said that if one judge can order a well-studied and safe drug to be removed, it would inject a lot of uncertainty into the system. She worries that could scare investors away from drug development. 

“I think for the industry, the results could be catastrophic. For patients, it stands to be even more so,” Banks said. 

What people think about the potential impacts of this decision varies a lot depending on their views of abortion. As this case unfolds, we will be reporting on what happens in Texas and what the impactions are around the country.

Gabrielle Emanuel
Health reporter

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