ACOG received hundreds of inquiries from irate members who were concerned about the implications and the impact of the letter. Since Searle never contacted ACOG nor made any effort to explain its action, we were left with the inadequate explanations presented in the letter. In our opinion, this was a very unprofessional way for the company to deal with physicians. Many of our physician members have been able to convince their hospitals to continue to make misoprostol available for off-label use. The real victims in this scenario are pregnant women who receive treatment in hospitals that will not allow the use of misoprostol.
Alternative medications are expensive and relatively ineffective.
Even worse, in some instances no alternative treatments are available. Searle seems to have ignored these women. An essential component of the protocol for mifepristone treatment mandated by the FDA is the later use of misoprostol. The timing of the letter, just weeks before the FDA announced its approval of mifepristone, left many people wondering whether there were other motivations for Searle's actions. Information has been given to ACOG that indicates that Searle and the FDA will be revising their indications and package insert.