Thursday, September 28,2000, the landscape for abortion really changed. It has
been a long time coming. The pill called RU-486 was developed in 1980. and in
1982 the first successful human testing was reported in France. After 10 long
years of promises American women will surely benefit. “Finally, American women
can benefit from this product,” said Edouard Sakiz, former head of the French
drug company Roussel, which put the pill on the market in France. RU-486 is now
widely available in Western Europe and even China, but 12 years after it
appeared it is far from the method of choice in the countries where it is
authorized, and it remains controversial in others. That being said 500,000
women have benefited from this non-invasive, private and relatively cheap method
of inducing a mis-carriage, where the expelled matter would be the size of a
grain of rice. It will probably cost $700 in the U.S. and some HMO’s may not
cover it. It is $66 in Spain and $200 in France fully reimbursed by their
history of RU-486 is a tortured one. In 1973 Roe v. Wade, followed by years of
waiting until 1982 when Roussel Uclaf reported the first successful human
testing. In 1983 the Population Council, set up almost 50 years ago by John D.
Rockefeller III to address the problem of overpopulation, received the FDA
approval to test the drug (mifepristone) in the U.S. During the next 6 years,
more than 300 received RU 486 at the University of Southern California.
September 1988 The French Health Ministry approved RU 486 combined with
prostaglandin for medical abortion. The following month Roussel Uclaf suspended
distribution because of pressure from antiabortion groups. After the Ministry
ordered them back on the market the following year they became available. In May
1994 Roussel Uclaf donated the U.S. patent to the Population Council. In March
1996 the Population Council filed a new drug application with the FDA. February
1997 the Hungarian pharmaceutical company Geodeon Richter backed out of an
agreement to make the drug. April 9, 1997 Roussel UCLAF abandoned the pill
to the researcher Edouard Sakiz for “zero franc zero centime.” The FDA
approved the drug in September 2000. There is much more to the story but these
details do not add very much.
RU-486 3 pill regimen in my opinion is safer because it can be used within the
first 49 days. In fact it can be used almost immediately after a woman discovers
that her cycle is off. It is also non-surgical, private, and patients can avoid
the emotional and psychological feelings associated with anti-abortionist
zealots and their tactics that are often violent.
to the ethical question that has plagued us for years, namely when does human
life begin, there are many answers to that. Hospital ethicists define the
beginning of life 1) at conception 2) at quickening or when the mother feels
movement 3) when the unborn child is viable 4) at birth. Pro-life people do not
subscribe to these definitions. For them life begins at conception which might
be within 24 to 72 hours.
survey after survey has found that most Americans (not so-called pro-life
people) prefer early interventions and feel most comfortable with this idea.
There is a sub-text to all this which may not emerge in the media. The very fact
that horrible pictures no longer characterize abortions (with the use of RU-486
in early stages the embryo is barely the size of a grain of rice) will hopefully
change the entire picture of abortion and wipe away both the stigma and guilt.
one can believe the AP (Associated Press) they reported October 3rd “Health
Insurers have generally agreed to cover the newly approved RU-486 abortion pill,
according to a survey of leading managed care plans.” The price has not been
set on Mifeprex (the brand name) though doctor visits and counseling are
expected to run about $700. I would bet my life that this is cheaper at Planned
Parenthood because they have a sliding scale. Covering new drugs is tricky and
when the FDA approves a new drug there is a managed care review before deciding
whether to cover it. This 3-pill regimen is different because it is dispensed
directly from a physician’s office and not through a pharmacy. Some managed
care plans have decided to cover it and others are not sure as yet. It
wouldn’t be cool to try and second-guess their motives but I wouldn’t rule
it a mere coincidence that 6 weeks before the Presidential elections RU-486 is
approved and once again reappears on the horizon? Rhetorical question, bien sur
but the political game continues infused with fresh blood (no pun intended). So
27 years after Roe v. Wade legalized it the U.S. remains the only so-called
modern western country where the abortion question raises so much hatred and
spoke with a CEO at Planned Parenthood for Westchester and Suffolk counties. She
told me this morning (October 4th, 2000) that the pills would not be available
before Thanksgiving, so other media reports of one month are really not valid at
this time. In New Mexico Planned Parenthood said “about six months. In the
meantime the FDA is trying to implement restrictions but The American College of
Gynecologists and Obstetricians co-signed a letter written by the AMA last
summer objecting to the restrictions, and requesting a meeting for July 24,2000.
The letter said that restrictions imposed “inappropriate conditions on the
practice of medicine and that the FDA has no authority to require such training
for physicians who prescribe RU486.” If you go looking for this in the Federal
Register or Congressional Record, there isn’t much to be found, considering
its “controversial” nature.
now it is too early to predict anything for sure. It seems that the total price
will be the same as a so-called surgical AB (abortion) = for a long time =
market power and the ability to affect prices = someone exerting power = OB/GYN
types? Who knows? One cannot mysteriously have the price of the drug equal to
the price of surgery.