Washington: A group of US senators have urged federal regulators to act against illegal online sales of abortion pills, flagging links to overseas supply chains, including India. 

In a letter to Food and Drug Administration (FDA) Commissioner Martin Makary on Wednesday, the lawmakers called for “immediate action” to stop “misbranded and unapproved versions of the chemical abortion drugs, mifepristone and misoprostol” entering the US market.

They said the “illegal sale of these drugs harms women and undermines the FDA’s core mission to protect American consumers.”

The senators warned that easy online access without medical supervision “poses serious risks to women’s health and increases the risk of forced and coerced abortions.”

The letter draws attention to global supply chains. It said drugs sold by foreign websites “often come from a variety of manufacturers in India.”

Lawmakers said the scale of the online market is growing fast. One provider sent 43,259 packages to 30 US states in a year. Another estimate said “as many as 1,00,000 packages” were shipped into the US in 2023.

The senators identified four main channels. These include US-based telehealth clinics, foreign clinics, informal networks, and online pharmacies. Many, they said, operate without prescriptions or proper oversight.

They said some websites falsely claim to sell “FDA-approved” drugs. In reality, they ship unapproved versions from overseas manufacturers.

The letter also raised safety concerns. Some platforms advise users not to tell doctors they took the drugs.

The lawmakers urged the FDA to step up enforcement. They called for warning letters, action against website domains, and stronger coordination with customs and postal authorities to intercept shipments.

They also asked for criminal investigations. The letter cited a 2020 case where a US resident was prosecuted for selling abortion pills sourced from India without prescriptions.

The senators said the FDA must “fully leverage its authorities” and prioritise the issue.

The letter was led by Senator Bill Cassidy. It was signed by Senators Steve Daines, James Lankford, Cindy Hyde-Smith, and Lindsey Graham.

They have asked the FDA to respond with details of enforcement steps by April 8.

Medication abortion is widely used in the US. It typically involves mifepristone followed by misoprostol under regulated conditions.