Maryland Department of Health seeks approval from the Board of Public Works for stockpile purchase of abortion pill

Thank you for supporting our journalism. This article is available exclusively for our subscribers, who help fund our work at The Baltimore Sun.

The Maryland Department of Health will turn to the state for money to stockpile one of the most-prescribed medication abortion pills as the case to revoke its approval from the U.S. Food and Drug Administration continues its way through the courts.

In April, Democratic Gov. Wes Moore announced that, through a memorandum of understanding with the University of Maryland Medical System, the state would stockpile the medication abortion drug mifepristone, which is at risk of losing the FDA approval it’s had as an abortion method since 2000.


In combination with the drug misoprostol, mifepristone is used in 98% of medication abortions in the U.S. And medication abortions account for more than half of U.S. abortions, according to the Guttmacher Institute, a research nonprofit that aims to advance sexual and reproductive health and rights.

Though the initial plan was only to procure the drug in conjunction with the university’s medical system, Dr. Nilesh Kalyanaraman, the Maryland Department of Health’s deputy secretary for public health services, told The Baltimore Sun in a phone interview Thursday that the agency will have to dip into state funds through the Board of Public Works.


The board, made up of the governor, comptroller and state treasurer, approves major state procurement contracts.

Moore said in April that the state was looking to procure enough mifepristone to last 2 1/2 years at the rate it’s currently prescribed in Maryland.

According to Chase Cook, a state health department spokesman, the agency has received “approval to conduct an emergency procurement to acquire mifepristone.”

“As a result,” Cook continued, “MDH has purchased and is in possession of the medication.”

The agency plans to ask the Board of Public Works for approximately $1.3 million to cover the cost.

Medication abortions can be performed using only misoprostol, but medical professionals say patients may need to take multiple doses for it to work and side effects can last longer than with the two-pill regimen.

Maryland Policy & Politics


Keep up to date with Maryland politics, elections and important decisions made by federal, state and local government officials.

According to Kalyanaraman, the state has yet to use or distribute any of the stockpiled drug because it still can be acquired “through noble channels.” He said the Department of Health will be working with abortion care providers over the next two months on a distribution plan.

Though the state will maintain a stockpile of mifepristone, it’s unclear whether the drug could be prescribed if its approval is revoked.


Kalyanaraman explained that “there’s no good way” to respond until the courts hand down a ruling.

“That’s exactly the kind of question we can’t answer right now,” he said.

In November, several anti-abortion organizations and doctors led by the Alliance Defending Freedom legal group filed a lawsuit against the FDA in a Texas federal court in an attempt to revoke mifepristone’s long-standing approval as a drug used in medication abortions. They argue the FDA didn’t adequately assess the safety risks when it approved the drug in 2000.

Proponents argue the drug’s track record since then proves it’s safe for use, but a federal judge in Texas, appointed by Republican President Donald Trump, suspended the FDA’s approval of the drug in an April decision.

The U.S. Supreme Court issued a stay on access to mifepristone while the case is appealed in the lower courts.