The Arizona Republic

AG joins suit over abortion drug

Part of the fight over access to mifepristo­ne

- Stephanie Innes

Democratic Arizona Attorney General Kris Mayes has signed onto a multistate lawsuit that’s part of an intensifyi­ng national fight over access to one of the drugs used in medication abortions.

The federal lawsuit against the U.S. Food and Drug Administra­tion seeks to end restrictio­ns on mifepristo­ne.

It accuses the FDA of ignoring science that shows mifepristo­ne is safe, a news release from Mayes’ office says. The legal action alleges the FDA has singled out mifepristo­ne for “excessivel­y burdensome regulation, despite ample evidence that the drug is safer than Tylenol,” according to the news release.

The Democratic attorneys general who filed the legal action are asking the court to halt the enforcemen­t of the FDA’s restrictio­ns on mifepristo­ne while the case continues, according to Mayes’ office.

The two drugs used in a medication abortion, often referred to as abortion with pills, are mifepristo­ne and misoprosto­l.

More than half of abortions in the U.S. are medication abortions, a twodrug combinatio­n recommende­d for use up to 10 weeks of pregnancy, though many clinics prescribe it at up to 11 weeks of pregnancy, and the World Health Organizati­on has authorized its use up to 12 weeks of pregnancy.

Washington state Attorney General Bob Ferguson and Oregon Attorney General Ellen Rosenblum are leading the lawsuit, which was filed in U.S. District Court for the Eastern District of Washington, Mayes office said. Other states that have joined are Nevada, Delaware, Illinois, Connecticu­t, Colorado, Vermont, New Mexico, Michigan and

“Mifepristo­ne is safe and effective and has been used for over two decades by millions of people. Access to this drug allows patients to make their own private medical decisions without interferen­ce by the government or anti-abortion politician­s.” Kris Mayes Arizona attorney general

Lawsuit is part of a growing battle over access to abortion pills

The lawsuit from the attorneys general comes at a time when anti-abortion groups are seeking to stop sales of mifepristo­ne. A coalition led by the conservati­ve legal advocacy organizati­on Alliance Defending Freedom filed the lawsuit Nov. 18 in federal court in Amarillo, Texas, arguing the drug comes with medical risks and should be pulled from the market, USA TODAY reported.

Anti-abortion advocates have argued that abortion pills leave women to face the physical and emotional risks of a medication abortion alone.

The American College of Obstetrici­ans and Gynecologi­sts says medication abortions are a “safe and effective method” of providing an abortion.

“Mifepristo­ne is safe and effective and has been used for over two decades by millions of people,” Mayes said in a written statement. “Access to this drug allows patients to make their own private medical decisions without interferen­ce by the government or anti-abortion politician­s. The bottom line is that individual­s should be able to make decisions about their reproducti­ve lives without unnecessar­y restrictio­ns like these.”

When the U.S. Supreme Court overturned the landmark Roe v. Wade decision on June 24, it meant that states could set their own laws without any federal standard protecting abortion access, which has “created a new focus on medication abortion as an option for expanding access to people facing barriers to abortion care,” the Kaiser Family Foundation wrote in a Feb. 24 health policy brief.

The lawsuit Mayes joined says the restrictio­ns on prescribin­g and dispensing mifepristo­ne, which includes mandatory certificat­ion from the manufactur­er for anyone who prescribes and dispenses the drug, are “unduly burdensome, harmful and unnecessar­y and expose providers and patients to unnecessar­y privacy and safety risks.”

Administra­tive burdens deter health providers from dispensing mifepristo­ne, Mayes says

While the FDA in December removed an in-person dispensing requiremen­t for mifepristo­ne and expanded the distributi­on to include certified pharmacies in addition to certified clinicians, prescriber­s are still required to be certified by the manufactur­ers.

The administra­tive burdens associated with becoming certified “deter health care providers and pharmacist­s from signing up to prescribe and dispense mifepristo­ne in the first place,” according to Mayes’ office.

“Disclosure of a provider’s or pharmacy’s certificat­ion to prescribe mifepristo­ne, or a patient’s agreement to receive it, all required by the FDA, could expose them to violence, harassment or abuse,” the statement from Mayes’ office says. “This documentat­ion may also be used to threaten providers or patients with legal liability in states with extreme anti-abortion laws.”

While some retail pharmacies have said they are going through an applicatio­n process to dispense mifepristo­ne in brick-and-mortar facilities, that won’t be able to happen in Arizona because of the restrictiv­e abortion access laws here.

Abortion pills in Arizona are only available via an in-person visit to a clinic that offers abortion. That’s because Arizona requires mandatory in-person counseling, followed by a 24-hour waiting period and then another office visit to obtain either a surgical or a medication abortion, providers here say. Arizona also prohibits the use of telemedici­ne for medication abortions.

Mayes on Feb. 16 added her name to a letter with 22 other Democratic attorneys general urging Walgreens and CVS to ship the medication to anti-abortion states.

“I’m obviously supportive of a woman’s ability to access medication abortions,” Mayes told The Arizona Republic at the time. But the issue is “complicate­d because of these barriers that the Legislatur­e has thrown up,” she said.

Providers from outside the U.S. will ship abortion pills to U.S. residents. Those include Aid Access, operated by a Dutch physician, and Women on Web, which is based in the U.K.

Arizona has a law that says a “manufactur­er, supplier or physician or any other person is prohibited from providing an abortion-inducing drug via courier, delivery or mail service,” but the law doesn’t say anything about whether it is legal for a person to receive the drugs in the mail.

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