Supreme Court temporarily restores access to mifepristone through the mail

In the ongoing legal battle over the abortion pill mifepristone, Justice Samuel Alito issued a temporary stay on April 14 allowing the drug to be sold while the Supreme Court decides whether to issue a formal order.

The stay expires on April 19 at midnight, and follows a Texas federal judge’s ruling reversing the approval of mifepristone (the same day a federal judge in Washington issued a contradictory decision). A federal appeals court weighed in and allowed the drug to be available, with some limitations, while the legal hearings played out. The appeals court ruling, which was supposed to take effect on April 15, would ban mail orders and limit the timeframe when a person could use it (from 10 weeks pregnant down to seven weeks).

“If allowed to take effect, the lower courts’ orders would upend the regulatory regime for mifepristone, with sweeping consequences for the pharmaceutical industry, women who need access to the drug, and FDA’s ability to implement its statutory authority,” according to Solicitor General Elizabeth Prelogar’s emergency application to the Supreme Court.

The ruling would force telehealth companies like Wisp, which provides sexual and reproductive healthcare including abortion pills, to pivot their business models to ensure patients have access to the medication they need, the company’s chief marketing officer, Monica Cepak, told Healthcare Brew.

“We are fundamentally committed to expanding access and meeting patients at a really critical time of need in their healthcare journey. So we’ll roll with the punches and continue to evolve and consider how even further down the line we modify our medical protocols as needed,” Cepak said.

Wisp plans to provide a misoprostol-only regimen to patients in the nine states where the company can ship the medication, but expects a one- to two-week delay for internal operational changes, Cepak said. Some states ban telehealth access to abortion medication, while others limit access by requiring patients to have an in-person visit with a physician for an abortion.

During a telehealth abortion appointment at Wisp, patients first determine if they are eligible for a medication abortion based on their location and how far along they are in the pregnancy. They then speak with a licensed provider over a secure messaging platform who prescribes the medication and walks them through the procedure, according to Wisp’s website.

Wisp has partnered with the Abortion Freedom Fund, an organization that supports telehealth abortion access, and provides its services for $50, making it one of the more affordable options on the market, according to Cepak.

In the long term, Wisp is working toward offering advance provision, which “would allow patients to essentially stock up on misoprostol in the event that they need it at some point further down the road,” Cepak said.

The company is also looking into prescribing mifepristone in a telehealth appointment, and then patients would pick up their prescription at a pharmacy, she said.