Fifth Circuit blocks mail-order mifepristone nationwide, reinstating in-person requirement

The U.S. Court of Appeals for the Fifth Circuit rules that the FDA exceeded its authority when it modified the mifepristone REMS in 2021 and 2023 to allow mail dispensing without an in-person visit. The three-judge panel issues a nationwide injunction reinstating the in-person dispensing requirement for mifepristone across all 50 states, including states where abortion is legal. The ruling cuts off mail-order access for an estimated 3.5 million women annually who obtained mifepristone through telehealth services. Danco Laboratories and the Biden DOJ-era party structure appeal to the Supreme Court. The decision is the most sweeping judicial restriction on mifepristone access since the 2023 Kacsmaryk ruling — and unlike that ruling, this one was not immediately stayed.