With abortion pill access uncertain, states strike deals to stock up

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Mifepristone was approved more than 20 years ago to induce first-trimester abortions in combination with a second drug, misoprostol. / AP

Updated April 11, 2023 at 1:40 PM ET

Several states say they are stocking up on medications used to induce abortions as a major abortion pill appears poised to potentially become unavailable in the U.S.

New York has become the latest state to announce it's stocking up on abortion pills. Gov. Kathy Hochul announced Tuesday that the state is preparing to purchase a five-year supply of misoprostol, a drug used in combination with another pill that is now the subject of legal battles in federal courts. The New York State Department of Health is buying 150,000 misoprostol doses.

In California, Gov. Gavin Newsom's office said Monday that it's made plans to secure an emergency stockpile of up to 2 million pills of misoprostol.

Officials say California currently has more than 250,000 of the pills already on hand, which were purchased for about $100,000. That's enough pills to cover an estimated 12,000 misoprostol-only abortions, according to a spokesman for Newsom, and the state is prepared to purchase more.

"While California still believes Mifepristone is central to the preferred regimen for medication abortion, the State negotiated and purchased an emergency stockpile of Misoprostol in anticipation of Friday's ruling by far-right federal judge Matthew Kacsmaryk to ensure that California remains a safe haven for safe, affordable, and accessible reproductive care," Newsom's office said in a statement provided to NPR.

Meanwhile, Massachusetts Gov. Maura Healy said Monday afternoon that her state has stockpiled some 15,000 mifepristone pills or more than a year's worth of doses. Last week, Washington Gov. Jay Inslee announced his state had prepared a stockpile of about three years' worth of mifepristone.

In the United States, most medication abortions involve two drugs: mifepristone followed by misoprostol, a protocol approved by the Food and Drug Administration in 2000. A coalition of anti-abortion-rights groups are suing the FDA, seeking to force mifepristone to be pulled from the market.

Last Friday, Kaczmaryk, a Trump-appointed federal judge in Texas with a long history of ties with conservative activists, ruled that the FDA should halt its approval. His nationwide order is scheduled to go into effect this Friday unless the 5th Circuit Court of Appeals intervenes.

More than half of abortions in the U.S. are now medication abortions, and the vast majority of those involve the two-drug protocol, which is considered the gold standard here. But the second medication in that regimen, misoprostol, also can be used alone to induce abortion.

Researchers say the single-drug approach is slightly less effective and can be more painful for patients, but misoprostol alone is endorsed by the World Health Organization as an effective option.

Newsom's office says the pills were secured through the state's CalRx prescription drug program, and California is providing information about its purchase agreement to other states that may be interested in taking similar action.

Pharmacies facing shortages will be directed to a state website where they can find information about how to request pills from the misoprostol supply.

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