Topline:
California amassed a stockpile of an abortion drug last year after court rulings threatened availability of another medication used to terminate pregnancies. Now, the state is working to distribute the medication before it expires.
The backstory: Last spring, California authorities bought 250,000 misoprostol pills for about $100,000, a move the Governor’s Office said would continue to enable access to medication abortions in California in case the other key drug was restricted by the courts.
What’s next? Both medications have remained available, and California’s stockpile will be in danger of expiring in over a year. This week, all 250,000 pills were shipped to providers.
What’s happening in the courts? In March, the U.S. Supreme Court will hear a case that could restrict another drug used for medication abortions, putting more pressure on California’s stockpile.
A high-stakes legal battle last year over a widely used abortion pill prompted California to stockpile one of two drugs used in medication abortions.
Last April, state leaders bought more than 250,000 pills of misoprostol. The Governor’s Office said creating the reserve would continue to enable access to medication abortions in California in case the other key drug was restricted by the courts.
But now, with about a year left on its shelf life, California’s stockpile of misoprostol needs to be used before it expires.
That’s why state health officials expedited distribution of the medication, shipping them to California providers this week. Some may go to California’s 33 public university health clinics, which are required by state law to provide medication abortions to students. A recent LAist investigation found that over the past year, many of the state’s public universities had failed to let students know the service was available.
The state estimates the stockpile is enough for about 12,000 doses. The move will help stock shelves before supply could tighten this spring, when the U.S. Supreme Court reenters the abortion debate.
Why did California buy the pills?
Last April, Gov. Gavin Newsom announced the state spent $100,000 to buy the medication after access to another abortion drug, mifepristone, was put in legal jeopardy by a Texas district judge’s ruling.
The court sided with anti-abortion rights groups that sued the Food and Drug Administration over its approval of the abortion pill, mifepristone. The judge issued a ruling that would invalidate the drug's approval nationwide. However, a district judge in Washington state issued a contrary ruling on the same day, preserving access to the pills in certain states.
The legal back and forth put medication abortion in the national spotlight, and blue state governors, including Newsom, announced they would stockpile pills in anticipation of further restrictions as the case escalated to a federal appeals court.
Expecting demand to soar, California providers said they’d switch to misoprostol-only abortions. Usually, medication abortions consist of a two-drug protocol used to end pregnancies in the first trimester but misoprostol can be used on its own — a method data show is slightly less effective at terminating a pregnancy than the combination regimen.
The Governor’s Office said the stockpile of misoprostol was aimed at “ensure[ing] that California remains a safe haven for safe, affordable, and accessible reproductive care.”
Medication abortion facts
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- Medication abortion accounts for 54% of abortions in the U.S., and 98% of those used mifepristone, an abortion drug normally used alongside a second pill, misoprostol.
- Misoprostol can be used on its own to terminate a pregnancy, but the method is slightly less effective. The combination regimen is considered the gold standard by health providers.
- The side effects of a misoprostol-only abortion — fever, cramping and bleeding — can be worse with the single pill. And this method typically requires a follow-up appointment with a doctor.
Mifepristone stayed on the market after the U.S. Supreme Court put the lower court rulings on hold. Because the preferred two-drug regime remained available, the state’s stockpile of misoprostol sat virtually unused. Now, the countdown is on to distribute the pills before their two-year shelf life runs out.
Rather than let the medication expire in about a year, California health officials ramped up distribution to providers, including health clinics in the California State University and University of California systems, prioritizing “providers that confirm an ability to distribute the supply quickly to those who need it,” according to the Governor’s Office.
Who will get the stockpiled drug?
Ray Murillo, assistant vice chancellor of student affairs for the Cal State University system, said some of the campus student health clinics will likely receive some of the free misoprostol from the stockpile. The savings will be passed on to students.
“That will contribute to some campuses being able to offer the medication for free,” Murillo said.
California requires all 33 public university campus clinics to provide medication abortions to students who want them.
Even though the providers can get the medication for free, patients can still be charged.
Supreme Court to hear abortion pill case
In March, the U.S. Supreme Court is expected to review the lower court’s decision that would make mifepristone, the commonly used abortion pill, less accessible. If the Supreme Court rules this summer to restrict use of the drug, that could make demand for California’s stockpile surge as providers look for a safe alternative.
The Governor’s Office says the stockpile can be replenished if needed. The state can procure “up to 2 million pills” of misoprostol at a “low price” from the manufacturer.
New York also stockpiled the pills, while Massachusetts and Washington state chose to stockpile mifepristone, the drug at the center of the legal battle.
