Beyond 'abortion': RU-486 and the needs of the crisis constituency

Article Abstract:

The fervor over abortion, including the political and economic fall-out of the issue, has threatened the ability of physicians and medical researchers to pursue important and potentially promising avenues of research. RU-486 (mifepristone) is a drug that has been classified as an antiprogestin abortifacient and has been used in France since January 1989 to induce abortion. Since that time, approximately 2,000 women a month have been treated without evidence of adverse effects on future pregnancies. Besides the antiprogestin action of the drug, it also acts as a blocking agent for corticosteroids, hormones produced by the adrenal glands. Blocking occurs because RU-486 inactivates corticosteroid receptor sites located on cells susceptible to corticosteroid stimulation. The generalized clinical importance of RU-486 concerns blocking actions that are dependent on progesterone or corticosteroids. The blockage occurs with glucocorticoids, yet patients treated with the drug do not exhibit the effects of adrenal insufficiency. RU-486 may be valuable in treating viral infections because many viruses require glucocorticoids for rapid growth. As a result of political action on the part of the antiabortion movement and the threat of boycott, Hoechst-Roussel, the manufacturer of RU-486, has withdrawn the drug from testing in the United States. As long as abortion remains legal in the United States the availability of mifepristone should be determined by normal clinical testing and not by political pressure groups. Separate from its use as an abortifacient, RU-486 should receive clinical trials for its possible value in treating AIDS, Cushing's disease, high blood pressure, diabetes, osteoporosis, obesity, and endometriosis. If Hoechst-Roussel can not resist the boycott, the rights to the commercial development of mifepristone should be assigned to a group not subject to economic pressure. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Economic policy, Pro-life movement, Contraceptive drugs, editorial, Hoechst-Roussel Pharmaceuticals Inc.

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A national action plan to meet health care quality information needs in the age of managed care

Article Abstract:

A national policy is needed to coordinate the various state and regional groups providing information on the quality of health care. Consumers, physicians, employers and health care plans all need information and the quality of health care. Although these information systems would be formed at the local level, they would use national standards to determine the quality of health care. Existing systems include the Minnesota Health Data Institute, the California Cooperative Health Care Reporting Initiative and the Cleveland Health Quality Choice program.

Analysis, Medical care, Quality management, Medical care quality, Performance standards, Job performance standards

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RU 486: how abortion politics have impacted on a potentially useful drug of broad medical application

Article Abstract:

An argument is made in favor of Mifepristone, saying that if it were not an abortifacient, it would be a medical breakthrough since it has shown effectiveness in clinical tests involving progesterone or corticosteroid blocking agents, such as in the treatment of breast cancer and Cushing's disease. In the face of threats of worldwide boycotts from right-to-life groups, it is suggested that manufacturer Roussel-Uclaf develop and highlight the drug's alternative medical applications.

Marketing, Abortifacients, Roussel Uclaf S.A.

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