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  • You’re Invited . . . To a Dance Party! Will You Dance the Amgen Waltz, or the Sandoz Shuffle?

    DancePartyInvite

    By Kurt R. Karst –     

    As you enter the Courtroom 402 “dance hall” at the U.S. Court of Appeals for the Federal Circuit on Wednesday, June 3, 2015, you’ll have to decide whether to take an initial right step and join the Amgen Inc. (“Amgen”) crowd, or move to the left and side with the folks from Sandoz Inc. (“Sandoz”) as the two sides battle over the applicability and correct interpretation of various provisions of the the Biologics Price Competition and Innovation Act of 2009 (“BPCIA”) in the context of Sandoz’s biosimilar version of Amgen’s NEUPOGEN (filgrastim), ZARXIO (filgrastim-sndz), which FDA licensed on March 6, 2015 under BLA 125553.  You’ll need to RSVP soon, however, because space is filling up fast!  There’s already a lineup of parties who want to be at the “must attend” BPCIA event of the year. 

    The party at the Federal Circuit was kicked off after Judge Richard Seeborg of the U.S. District Court for the Northern District of California ruled on March 19, 2015 in a 19-page decision that, among other things, the BPCIA’s reticulated information exchange and patent resolution procedures are not mandatory for Section 351(k) biosimilar applicants, and that the plain language of the statute allows for the 180-day notice of commercial marketing to come well before the licensure of a Section 351(k) application (see our previous post here).  

    The decision was a total victory for Sandoz, and thus, a total defeat for Amgen, which promptly appealed the decision to the Federal Circuit (see our previous post here).  Meanwhile, back in District Court, Amgen filed a Motion for Injunction Pending Appeal.  But Judge Seeborg denied that motion as well, saying that Amgen’s “tenuous and highly contingent showing of irreparable harm forecloses injunctive relief.”  Undeterred, and facing a possible launch of ZARXIO as early as Monday, May 11, 2015, Amgen is now asking the Federal Circuit for an Injunction Pending Appeal.  Sandoz recently filed its Opposition to Amgen’s motion, saying that “Amgen’s appeal involves no claim of patent infringement,” and instead, “Amgen seeks to enjoin launch of Sandoz’s FDA-approved biosimilar filgrastim product based solely on Sandoz’s purported violations of procedures of the [BPCIA],” which “contains no mechanism for Amgen to preclude Sandoz from launching absent a showing of patent infringement.” 

    Briefing on Amgen’s appeal is nearly complete.  As we previously reported, Amgen filed its Opening Brief on April 3, 2015 laying out the company’s arguments as to why Judge Seeborg erred in ruling on all fours for Sandoz.  Not long thereafter, Amgen received support from several parties that filed amicus briefs.  (Amgen’s Reply Brief is due on April 28, 2015.) 

    Janssen Biotech, Inc. (“Janssen”) urges the Federal Circuit in its amicus brief to “clarify that the statutory patent dispute resolution procedures are intended to be followed as written, and are not merely optional choices or empty formalities, as Sandoz contends.”  Janssen is currently challenging, in the U.S. District Court for the District of Massachusetts, Celltrion, Inc.’s (“Celltrion’s”) and Hospira, Inc.’s (“Hospira’s”) decision to exit from the BPCIA’s patent dance procedures in the context of a biosimilar version of Janssen’s REMICADE (infliximab) (see our previous post here). 

    AbbVie Inc. (“AbbVie”), which markets HUMIRA (adalimumab), among many other products, has not yet had to engage in litigation over the BPCIA’s information exchange and patent resolution provisions, but weighs in for Amgen in an amicus brief.  According to AbbVie, absent a reversal of Judge Seeborg’s decision, biosimilars patent litigation will devolve into chaos:

    The outcome of this appeal will have a profound effect on the transparency, efficiency, and fairness of the legal process going forward. If Amgen’s positions are adopted—and Congress’s directives are enforced—parties will enter the litigation process well informed; they will be able to identify the patents truly at issue, engage in good-faith negotiations, narrow their disputes, and litigate only those issues that warrant the courts’ time and attention.  If Sandoz were to prevail, the entire biosimilar litigation process would become a free-for-all, where biosimilar companies would utilize the data and work of innovator companies but refuse to provide basic information about their products, including their compositions, indications, formulations, and manufacturing processes, as well as the timing of their planned launches, leaving innovators to blindly guess as to which patents they should sue on and when.  The first option will lead to more focused cases, more transparency, and more frequent and earlier settlements; the second will burden the courts with inefficient and protracted litigation for years to come.

    Finally, the Biotechnology Industry Organization (“BIO”), whose members include both Amgen and Sandoz, says in its amicus brief that “the BPCIA patent dispute resolution process must be interpreted in accordance with its purpose — to provide a significant and real opportunity to resolve patent issues prior to the launch of the biosimilar,” which requires, in turn, “notice to the reference product sponsor of the initial submission of the biosimilar application and notice of potential commercial marketing upon approval.”

    Sandoz, in the company’s April 21, 2015 Non-Confidential Brief, does an excellent job of laying out why the waltz preferred by Amgen and its supporters is not the only move on the dance floor, and why a shuffle (or perhaps a side step?) is perfectly reasonable under the BPCIA.  According to Sandoz: 

    Read in the context of the BPCIA as a whole, the “shall” provision in Section 262(l)(2)(A) is a mandatory condition precedent to engaging in the patent-exchange process, not a mandatory requirement in all circumstances. . . .  This interpretation is consistent with uses of “shall” in other provisions in subsection (l), as well as with uses of “shall” in other statutory schemes.  It also gives full effect to both “shall” and “may” in subsection (l)(2)(A). . . .  Congress carefully balanced the interests between sponsors and applicants, determined what the consequences should be at each step of the process for not completing it, and allowed the parties to weigh the benefits of proceeding against the consequences of not.

    With respect to notice, says Sandoz, “[t]he plain terms of the ‘[n]otice of commercial marketing’ provision are satisfied when an applicant provides notice at least 180 days before it commercially markets its product.”  “If, as Amgen argues, a biosimilar must be licensed before notice may be given, that would transform this mere ‘[n]otice’ provision into an automatic, six-month bar against marketing of every licensed biosimilar product. Had that been Congress’s intent, it would have said so.”

    Sandoz’s arguments are reinforced in an amicus brief filed by the Generic Pharmaceutical Association (“GPhA”), which recently announced the launch of a new division, called the Biosimilars Council.  According to GPhA:

    The question here is whether the BPCIA’s patent dispute resolution provisions should be interpreted according to the statute’s clear structure, which in turn supports Congress’s overarching goals of increased competition and consumer access to affordable biologics.  The answer, as the district court found, is yes.  The contrary readings advanced by Amgen and its amici depend on illogical, context-free interpretations of selected individual words that if read as Amgen suggests would render superfluous important sections of the BPCIA, undercut the statute’s overarching purposes, and produce results that Congress could not possibly have intended.

    According to a recent docket entry, Celltrion and Hospira also tendered an amicus brief.  That brief is not yet public; however, we’ll update this post with a copy of the brief once it is available.  

    UPDATE:  The amicus brief filed by Celltrion and Hospira was made public on Monday afternoon (April 27th) and is available here

    FDA Releases Draft Guidance Regarding Use of OUS Clinical Data in Device Submissions

    By Allyson B. Mullen

    On April 22, 2015, FDA released a draft guidance regarding use of clinical data generated outside of the U.S. (OUS) in medical device premarket submissions.  A copy of the draft guidance can be found here

    FDA states in the guidance that it has a longstanding policy of accepting OUS clinical data in device submissions.  However, as many of our readers know, FDA can be very picky when it comes to clinical study data that were not conducted in the U.S. under an Investigational Device Exemption.  In 2012, FDASIA attempted to allow greater use of OUS clinical data with the addition of Section 569B of the Federal Food, Drug, and Cosmetic Act.  Section 569B requires that FDA accept OUS clinical data if the sponsor has demonstrated that “such data are adequate under applicable standards to support approval, licensure, or clearance of the . . . device in the United States.”  21 U.S.C. § 360bbb-8b(a).  If FDA finds that the data are inadequate, FDA must provide written notice to the sponsor with FDA’s rationale for its conclusion. Id. § 360bbb-8b(b). 

    The draft guidance provides some clarification as to why CDRH and CBER may find that OUS clinical data are inadequate.  Specifically, the draft guidance highlights that premarket submission reviewers carefully consider the following when evaluating OUS clinical data:

    • Differences in Clinical Conditions.  The standard of care for clinical conditions may be different around the world.  FDA will likely want to understand how the clinical practice in the region(s) where the study was performed compare to the U.S. as differences in clinical practice can affect the risk benefit profile of the device.
    • Differences in Study Population.  The patient populations can vary greatly depending on the country in which the study is performed.  This differences can affect the applicability of the data to the proposed U.S. population.  For example, there may be significant demographic differences (race, ethnicity), rates of certain diseases, or prevalence of other factors (obesity, smoking).  FDA will likely want to understand how the study population is representative of the proposed U.S. patient population and that any differences are adequately explained.
    • Differences in Regulatory Requirements.  The draft guidance notes that the standards for regulatory approval vary depending on the region (e.g., safety and effectiveness versus safety and performance).  This difference could also affect a company’s selection of endpoints or control device, if one is used.  Thus, the draft explains that the outcome of the study must show that the probable benefits outweigh the probable risks, or although not stated, that the device meets the applicable premarket standard (e.g., substantial equivalence).

    None of these considerations come as a surprise and they are routine comments that come up during premarket submission reviews for submissions including OUS data.  The draft guidance does provide a number of helpful examples for companies who are unfamiliar with these issues.

    The draft guidance recommends that sponsors who intend to utilize OUS data in their submissions contact FDA through the pre-submission process as early as possible so that FDA can provide input.  This guidance, however, applies not to just prospective OUS studies, but also to those that have already been performed.  There may be little value in seeking FDA input through a pre-submission on a study that is already completed, when this same information can be obtained through the premarket submission review process.  This guidance could likely serve as a reminder checklist for sponsors utilizing OUS to data to confirm that they have addressed these considerations in their premarket submissions before submitting to FDA, regardless of whether a pre-submission meeting is held.

    Categories: Medical Devices

    HRSA Proposes to Collect Manufacturer Pricing Data Under 340B Program

    By David C. Gibbons

    On Tuesday, April 21, 2015, the U.S. Department of Health and Human Services Health Resources and Services Administration (“HRSA”) issued a Notice soliciting comments on its proposal to collect pricing data from drug manufacturers under the 340B drug discount program.  This Information Collection Request (“ICR”) is intended to implement § 340B(d)(1)(B)(i) of the Public Health Service Act (“PHSA”), a provision added in 2010 by the Affordable Care Act that requires HRSA to develop a system to verify the accuracy of calculated drug ceiling prices charged to 340B covered entities.

    The notice explains that HRSA is developing a secure system for manufacturers to submit Average Manufacturer Price, Unit Rebate Amount, Package Sizes, National Drug Code (“NDC”), the quarter of sale, and the manufacturer’s calculated 340B ceiling price for each NDC.  All but the last of these data points are already reported by manufacturers to CMS under the Medicaid Drug Rebate Program.  HRSA will compare the 340B ceiling prices submitted by manufacturers against those calculated by HRSA using CMS data, and resolve any discrepancies.  Validated submissions will be made available to 340B covered entities and accessible through a secure, Internet-based platform, as required by PHSA § 340B(d)(1)(B)(iii).  HRSA unrealistically estimates that it will take manufacturers one-half hour to prepare and submit each quarterly report.  Comments on this ICR my be submitted through May 21, 2015.

    POM Wonderful Petitions Court for Rehearing En Banc

    By Riëtte van Laack

    As we previously reported, the U.S. Court of Appeals for the D.C. Circuit issued a decision in what some have identified as a landmark advertising case of the Federal Trade Commission (FTC) against POM Wonderful et al. (POM).  On April 6, 2015, POM requested a rehearing from the entire D.C. Circuit to address, what POM claims is, “the exceptionally important question whether the [DC Circuit] must defer to an agency [in this case the FTC] finding that speech is not protected by the First Amendment.”

    In its January 2015 decision, a three-judge panel of the D.C. Circuit held that POM’s advertising made false claims that POM products could treat, prevent, or reduce the risk of heart disease, prostate cancer, and erectile dysfunction.  The panel gave deference to the FTC’s determination that 36 ads were false and misleading even though the Administrative Law Judge had previously determined that only 19 ads made improper claims.  In its Petition for Rehearing En Banc, POM argues that the panel should not have given deference to FTC’s determination regarding the additional 17 ads.  It claims that many of these 17 ads contained qualified language signaling that the research findings mentioned in the ads were not conclusive.  According to POM, the panel’s deference was inappropriate because all the FTC did was apply its own judgment as to how “reasonable” people would interpret the ads.

    Which ads are false or misleading is relevant for POM because it determines the scope of the FTC’s injunction.  If the 17 additional ads are not false or misleading, POM has a right to publish them.  POM maintains that these ads convey important information to consumers.

    POM further argues that the Court should grant the rehearing because 1). food advertising cases frequently settle and the Court is unlikely to get another chance to consider the present issues, 2). “the chilling effect of definitively endorsing the weak standard of review in this case will be immense,” and 3). a case like the present one with a large number of claims at issue is unlikely to arise again soon.

    In the alternative, POM requests that the panel reconsider its opinion and remove two specific paragraphs.  Although this edit will not affect the results for POM, it claims that it is important to remove these paragraphs because they “might be mischaracterized by future litigants to vastly expand the conduct that actually underlies POM’s . . . liability.”

    The FTC’s response to the Petition is due May 4, 2015.

    CDER Announces Public Compendium of Clinical Outcome Assessments with Hopes of Facilitating Greater Use in Drug Development

    By James E. Valentine* & Josephine M. Torrente

    During FDA’s April 1, 2015 public workshop on clinical outcome assessments (COAs), in a presentation on the future of COA development and utilization in drug development programs, officials from CDER’s Study Endpoints and Labeling Development (SEALD) staff announced the development of a compendium of COA tools.  A clinical outcome assessment (COA) measures patients’ symptoms, overall mental state, or the effects of a disease or condition on how the patients function.  There are four types of COA measures:

    • Patient-reported outcome (PRO) measures
    • Clinician-reported outcome (ClinRO) measures
    • Observer-reported outcome (ObsRO) measures
    • Performance outcome (PerfO) measures

    The Compendium’s Two Stages of Development

    The COA compendium will be developed in two stages.  In Stage 1, or the pilot stage, the compendium will consist of (1) qualified tools, (2) ongoing qualification programs, and (3) previously labeled COAs (from new molecular entity labeling approved 2003 and later).  The compendium would be published a table that can be accessed through the FDA website, organized by therapeutic area and disease/condition.

    The measurement tools that will be in the Stage 1 compendium consist of those that have arisen under FDA’s two current pathways for review and use of COAs in drug development.  The first is the traditional way, which is within an individual drug development program under an IND.  These tools, when found acceptable in the course of drug development, can result in labeling claims.  The second pathway for use of COAs is through a relatively new process, the Drug Development Tool (DDT) qualification program, which is a formal way to qualify instruments outside of an individual drug development program.  These “qualified” COAs are published in the Federal Register and are available publically for use in drug development programs.  To date, there is only one qualified clinical outcome assessment, a PRO that is published here

    Stage 2 would expand the compendium, but exactly what information would be included has not been determined.  Future expansion may include an expanded scope (e.g., COAs from efficacy supplements), as well as identify gaps in available measurements tools (e.g., concepts highlighted as important in Patient-Focused Drug Development meetings but for which no tool exists). 

    Goals of the Compendium & Next Steps

    Because it is unrealistic to qualify all COAs, CDER hopes creating a public list of COAs used to support labeling claims would be useful to increase their development and use in drug development programs.  The compendium would essentially serve as a list of “potentially acceptable endpoints” that could support labeling claims, as well as encourage development COAs more generally.  However, the compendium would not include detail on endpoints so that sponsors will still need to discuss with FDA the selection and design of endpoints in clinical trials.

    CDER announced it plans to publish a Federal Register Notice in September 2015 in order to gather comments on the proposed compendium (and associated guidance to describe the compendium), with the roll-out of Stage 1 of the compendium following the notice-and-comment period. 

    Note: This public workshop on COAs was held to satisfy FDA’s Advancing Development of Patient-Reported Outcomes (PROs) and Other Endpoint Assessment Tools commitment in PDUFA V which, in part, committed FDA to “hold a public meeting to discuss FDA’s qualification standards for drug development tools, new measurement theory, and implications for multi-national trials.”

    *Admitted only in Maryland. Work supervised by the Firm while D.C. application pending.

    “Diet” Soda Fraud? US Right To Know Claims Coke and Pepsi Are Lying about their Diet Soda Products

    By Riëtte van Laack

    On April 9, 2015, US Right to Know (USRTK, Petitioner) filed a Citizen Petition (CP) with FDA and sent a letter to the Federal Trade Commission (FTC) requesting action against what USRTK claims is false and misleading use of the term “diet” on beverages that contain non-nutritional artificial sweeteners (NNAS).  

    Petitioner takes issue with the labeling of sodas sweetened with NNAS as “diet.”  Although the FDC Act section 403(r)(2)(D) and FDA’s regulations allow such labeling, the use of the term diet is only permitted if the labeling is not false and misleading.

    Citing certain dictionaries, Petitioner asserts that the term “diet” in the brand name of Diet Coke and Diet Pepsi constitutes a deceptive (and possibly fraudulent) claim that drinking these soft drinks will promote weight loss.  Without data to support its allegation, USRTK claims that reasonable consumers buy diet sodas, labeled as diet, not because they do contain zero calories or no sugar, but because they believe that the mere consumption of these products, without energy restriction, exercise, or other actions, will result in weight loss or reduced weight gain.

    Yet, according to USRTK, these diet sodas do not contribute to weight loss.  USRTK claims that certain scientific reviews and epidemiological studies suggest (USRTK does not claim certainty) that consumption of sodas containing NNAS is linked to weight gain.  It claims that evidence to the contrary should not be trusted because the underlying studies were funded by industry.  USRTK alleges that Coco-Cola Co. and PepsiCo Inc. are aware of these studies but continue to (fraudulently) use the term diet.

    Petitioners request that FDA issue warning letters or take other enforcement action against Coca-Cola Company and Pepsi Co. because their diet sodas products are misbranded even though they fully comply with the regulation, 21 C.F.R. § 105.66.  Petitioners also request that FDA conduct a “sweeping” investigation of products containing NNAS to determine whether those products are misbranded because they use the term “diet.”

    As mentioned above, USRTK also sent a letter to FTC requesting that FTC investigate and prohibit the apparently deceptive use of the term “diet” by Coke and Pepsi and conduct the sweeping investigation mentioned in the CP to FDA. 

    Tobacco Companies Challenge CTP Guidance on Substantial Equivalence

    By David B. Clissold

    In September 2011, the Center for Tobacco Products (“CTP”) issued a draft guidance entitled “Demonstrating the Substantial Equivalence of a New Tobacco Product: Responses to Frequently Asked Questions” (“Draft Guidance”).  In the Draft Guidance, the Food and Drug Administration (“FDA”) claimed that the Tobacco Control Act (“TCA”) requires manufacturers to submit information for FDA to review before changing the label of a tobacco product.  On March 4, 2015, FDA issued the guidance in final form (“Final Guidance”).  Among other things, the Final Guidance states that labeling changes that make a product “distinct” from the predecessor version of the product should be submitted to FDA in a “Same Characteristics SE Report.”  Although changes in product quantity were not discussed in the Draft Guidance, the Final Guidance also states that changes in the quantity of tobacco product in a package (e.g., from 20 to 24 cigarettes per pack) should be submitted in a “Product Quantity Change SE Report.”  The Final Guidance described these reports as “alternatives” to submitting a full substantial equivalence (“SE”) report or a premarket application under section 910(b) of the Federal Food, Drug, and Cosmetic Act for these types of changes.  The Final Guidance describes the contents of the “Same Characteristics SE Report” and the “Product Quantity Change SE Report.”  Among other requirements, each report must contain a certification statement, signed by a responsible official who is authorized to act on behalf of the company, using proscribed language.  For example, a “Same Characteristics SE Report” must include the following certification:

    I, [insert name of responsible official], on behalf of [insert name of company], certify that [insert new tobacco product name] has a different [identify distinction] from [insert name of predicate tobacco product] but is otherwise identical to [insert name of predicate tobacco product]. I certify that [insert name of company] understands this means there is no modification, except for [identify distinction] from the predicate tobacco product, including any change in materials, ingredients, design features, heating source, or any other features. I certify that this information and the accompanying submission are true and correct, and that I am authorized to submit this on the company’s behalf. I understand that under section 1001 of title 18 of the United States Code, anyone who makes a materially false, fictitious, or fraudulent statement to the Government of the United States is subject to criminal penalties.

    In a complaint filed on April 14, 2015 in the United States District Court for the District of Columbia, plaintiffs Philip Morris USA Inc., U.S. Smokeless Tobacco Company LLC, R.J. Reynolds Tobacco Company, American Snuff Company, LLC, Santa Fe Natural Tobacco Company, Inc., and Lorillard Tobacco Company argue that the Final Guidance was unlawful and ask the court to set it aside.  The tobacco company plaintiffs challenge the guidance on three principal grounds: The Administrative Procedure Act, and the First and Fifth Amendments to the U.S. Constitution.

    • The Administrative Procedure Act:  The complaint alleges that the Final Guidance is arbitrary, capricious, and contrary to the TCA, and also exceeds FDA’s authority under the TCA because it conflicts with the TCA’s structure and text and with FDA’s prior interpretations of the TCA.  In addition, it does not adequately inform manufacturers which label changes may render a product “distinct,” and therefore subject to FDA pre-approval.  The complaint also alleges that the Final Guidance sets forth final agency positions, imposes legal obligations, establishes consequences for non-compliance, and effects changes in existing law, and is thus a substantive rule for which FDA is required to conduct notice-and-comment rulemaking.  Plaintiffs also state that the Final Guidance interprets statutory or regulatory requirements and represents a change in FDA’s interpretation of the TCA, and therefore FDA was required to provide an opportunity for public comment.
    • First Amendment to the U.S. Constitution:  The complaint alleges that the Final Guidance prohibits manufacturers from changing the label of a tobacco product without first obtaining FDA’s pre-authorization, thus violating plaintiffs’ First Amendment right to communicate with consumers through product labels.
    • First and Fifth Amendments to the U.S. Constitution:  Plaintiffs argue that the Final Guidance does not give manufacturers fair notice of the label changes that may result in a “distinct” product subject to FDA pre-approval or articulate clear standards that prevent arbitrary enforcement by FDA.  This uncertainty chills plaintiffs’ exercise of their First Amendment right to communicate with consumers through product labels because, if FDA concludes that a change rendered the product “distinct” and a Same Characteristics SE Report was not filed, the manufacturers will be subject to significant civil and criminal penalties.

    Challenges to certain elements of the TCA on First Amendment grounds have been successful in the past.  For example, the D.C. Circuit struck down FDA regulations requiring graphic warnings on cigarette packaging on First Amendment grounds (see our analysis of that case here).  But what caught our eye in the latest complaint was the allegation that FDA is attempting to regulate industry through guidance instead of notice-and-comment rulemaking (we have previously commented on that issue here and here).  That allegation reminded us about a letter sent to FDA by Senator Lamar Alexander (R-TN), the ranking member of the Senate HELP Committee, along with Senators Richard Burr (R-NC), Johnny Isakson (R-GA), and Orrin Hatch (R-UT) “to express significant concern about [FDA’s] use of draft guidances to make substantive policy changes” (see our post on that letter here).  Last month, FDA responded to that letter with a letter of its own.  While the focus of the inquiry was on the use of draft guidances to implement FDA policy, FDA also explained how it uses guidance documents more generally:

    Guidance documents generally do not create legally enforceable rights or responsibilities and do not legally bind the public or FDA—importantly, they do represent the Agency’s current thinking.  Therefore, FDA employees may depart from guidance documents only with appropriate justification and supervisory concurrence.  Because guidance is not binding, affected parties may choose to use an approach other than the one set forth in a guidance document . . . [but any] alternative approach must comply with the relevant statutes and regulations.  FDA is willing to discuss an alternative approach with affected parties to ensure it complies with the relevant statutes and regulations.

    But if a guidance compels a submission to FDA, to be accompanied by a certificate made under penalty of perjury, and FDA believes that submission is required under its interpretation of the statute, doesn’t that “legally bind” the public to follow the guidance?  What “alternative approach,” following any amount of discussion with FDA would satisfy that perceived requirement?  We hope the court will address these issues during the course of this litigation.

    Categories: Tobacco

    Diagnostic Test Working Group Proposes Alternative to FDA’s LDT Framework

    By Allyson B. Mullen & Jeff N. Gibbs

    As we have previously blogged on numerous times (for example, here and here), FDA has released a framework for regulation of laboratory developed tests (LDTs).  FDA’s proposed framework has sparked much controversy, receiving support from diagnostic test manufacturers and some patient groups, while other patient groups and the laboratory community have strongly opposed the draft framework.  Numerous comments on the proposed framework were submitted to FDA earlier this year. 

    Recently, a different approach to LDT regulation has been floated.  The Diagnostic Test Working Group (DTWG), an independent group consisting of representatives from diagnostic manufacturers and clinical laboratories, released an alternative to FDA’s LDT Framework
     
    The DTWG proposal offers a compromise for those on both sides of the LDT debate.  For laboratories, it would mean greater regulation of LDTs while not trying to fit LDTs into the traditional medical device regulatory framework, and for IVD manufacturers, it would result in significant changes to the current regulatory model.  A few key points of interest in the DTWG proposal:

    • The proposal would apply to all in vitro diagnostic tests – both kits and LDTs, and components of the same (collectively IVDs) and calls for establishment of a new center within FDA.
    • The proposal allocates responsibility for oversight of IVDs across FDA, CMS and the individual states.  FDA would be responsible for IVD development, CMS would be responsible for laboratory operations, and the states would be responsible for medical applications (e.g., test result interpretation and consultation).  This allocation is designed to address the concern about overlapping regulation.
    • IVDs will be classified as high risk, moderate risk and low risk, and the proposal sets out criteria for classification into each category.  Developers of a new IVD will propose a classification to FDA, and FDA will have 60 days to object. 
    • • IVDs can move from high risk to low risk when the test and/or analyte become well characterized. 
    • • The proposal sets a new standard for IVDs: the developer must “establish a reasonable assurance of analytical validity and clinical validity for the intended use.”  Reasonable assurance would be established through competent and reliable evidence, which includes a number of different types of information such as published literature and clinical guidelines.  There would be a presumption that clinical trials would not be required to demonstrate clinical validity. 
    • The premarket requirements for each of the three classifications are different.  High and moderate risk IVDs require premarket submissions and low risk IVDs merely require notification to FDA.
    • New submissions would be required for test modifications to high and moderate risk IVDs, if the modification has a “meaningful clinical impact” or changes the intended use of the IVD.  A submission would be required for a low risk IVD, if the modification changes the intended use, purpose of the assay or the target disease or condition. 
    • The proposal includes special pathways for IVDs for rare diseases, emergency use IVDs, and IVDs for unmet needs. 
    • Post-market quality system and recall reporting will be generally the same as FDA’s current medical device requirements.  Adverse event reporting would be clarified to better fit IVDs.
    • There is a proposed three or four year transition period for LDTs currently on the market and those that would enter the market after the proposal goes into effect. 
    • Instrument platforms will be automatically classified as low risk.  Platform manufacturers would also be granted a safe harbor for discussion of off-label uses.
    • Paralleling a relatively new program for pharmaceuticals, the proposal also includes priority vouchers for innovative IVDs.

    In our view, this proposal is an intriguing start towards a potential LDT compromise. There are certainly many areas of clarification and development that are still required and many key details will still need to be worked out.  We expect that many laboratories will prefer the DTWG’s proposal as it would mean less onerous regulation compared to FDA’s proposed LDT framework.  Manufacturers may also find the change to IVD regulation to be attractive.  This proposal could form the basis of legislation that may be released in the near future.  We will keep readers apprised of any legislative developments. 

    CDRH Releases Final Guidance for Expedited Access to Devices for Unmet Medical Needs

    By Allyson B. Mullen

    On April 13, CDRH released the final guidance document for “Expedited Access for Premarket Approval and De Novo Medical Devices Intended for Unmet Medical Need for Life Threatening or Irreversibly Debilitating Diseases or Conditions.”  We previously blogged on the draft guidance here.  The goal of the program is to facilitate access to novel devices through more interactive communications between FDA and manufacturers during the development process and more interactive reviews of premarket applications (e.g., IDEs, PMAs and de novo requests) and by focusing on post-market data. 

    This final guidance was issued merely a year after issuance of the draft, which is a short period of time for FDA.  This swift release of the final guidance is presumably due in part to the modest changes that were made to the guidance from the draft and lack of controversy.  These minor changes include:

    • The scope of the program was expanded from PMA devices only to PMA devices and de novo devices.  510(k)s, however, continue to be excluded. 
    • The guidance was generally revised to include an increased focus on patient benefit.
    • The final guidance clarified that interactive review, senior management involvement, and case manager assignment will be provided in the program to the extent resources are available.  It is still unclear, however, how availability will be determined and if any resources will be specifically allocated for this program.   
    • The expedited access program (EAP) designation process was clarified, including, in Appendix 1 where it indicates that CDRH plans to review a Pre-Submission requesting EAP designation within 30 days of receipt.  The guidance also clarifies that granting of EAP designation does not mean that CDRH agrees with the applicant’s draft Data Development Plan or that any proposed study design will support a subsequent marketing application. 
    • Additional examples have been added to facilitate better understanding of cases in which the EAP may be the appropriate pathway to device approval or de novo clearance.
    • The final guidance indicates that it may be possible for applicants to use registry data to satisfy post-approval study requirements. 

    Finally, the guidance includes a new Program Evaluation through which CDRH will publish statistics regarding the program, including the number of designation requests received and granted, and corresponding pre-market submissions approved or cleared following designation.  This evaluation will begin one year after issuance of the guidance and will continue for three years thereafter, after which CDRH will consider whether changes to the program are necessary. 

    This evaluation may be an important addition to the guidance because CDRH has attempted other priority review programs in the past, including the 510(k) Priority Review Program, and these programs have generally been unsuccessful.  In fact, since 1995, only 23 510(k)s have been designated for priority review, and between 2008 and 2012, a mere five 510(k)s were designated for expedited review.  These five 510(k)s had an only marginally better review time than the average time for all other 510(k)s during that same time period.  Perhaps CDRH’s commitment to track performance data will help spur better results than similar prior programs. 

    Categories: Medical Devices

    Organic Stakeholders Sue the National Organic Program over Alleged Substantive Change in Sunset Review Process

    By Riëtte van Laack

    In an effort to stop the implementation of the National Organic Program’s (NOP’s) interpretation of the sunset review process, a coalition of organic “stakeholders” have filed a lawsuit in the U.S. District Court for Northern California.  The lawsuit alleges that the NOP violated the federal rulemaking process when it changed procedures for the sunset review of substances included in the National List of Allowed and Prohibited Substances (National List).  Plaintiffs allege that the “unilateral” action by the NOP to adopt a major policy change without a public process violates a foundational principle and practice of the Organic Food Production Act (OFPA), namely public participation in organic policy-making.  Plaintiffs request that the court require the NOP to reconsider its decision on the alleged rule change and reinstitute the “customary public hearing and comment process.”

    The OFPA creates standards for organic certification and establishes the National Organic Standards Board (NOSB).  A major function of the NOSB is to oversee the allowance of synthetic and non-agricultural materials based on a determination that they do not harm human health and the environment and are necessary in organic food production and processing.  The National List identifies the synthetic substances that are allowed (exemptions) and the nonsynthetic (natural) substances that are not allowed (prohibitions) in organic production.  7 C.F.R. §§  205.601–604.  In addition, the National List identifies the nonorganic and nonagricultural substances that may be used in organic handling.  Id. §§ 205.605–205.606.

    At issue in the lawsuit is the interpretation of the so-called sunset provision of the OFPA.  Under the OFPA, a review of substances on the National List takes place on a five-year cycle.  This “sunset” provision provides that “No exemption or prohibition contained in the National List shall be valid unless the National Organic Standards Board has reviewed such exemption or prohibition as provided in this section within 5 years of such exemption or prohibition being adopted or reviewed and the Secretary has renewed such exemption or prohibition.” 7 U.S.C. § 6517(e).  Plaintiffs allege that, until September 2013, this provision had been interpreted to require that all substances included in the National List cycle off the list after five years unless the NOSB votes by a two-thirds majority to relist them and NOP accepts the recommendation. 

    In September, 2013, NOP issued a notice that announced what plaintiffs characterize as a substantive change in the process NOP had been operating under since the inception of the organic program.  In its notice, NOP asserted that the previously used sunset review process did not allow for “robust” public participation and delayed the sunset review process.  Essentially, the pre-Sept. 2013 sunset review process treated sunset substances as newly petitioned substances and the sunset rulemaking process from start to finish took as long as 30 months.  However, adding a substance to the National List involves a rigorous rulemaking process.  Once a substance is on the list, organic farmers and processors invest significant time and money to update their organic system plans and adjust their product formulations to reflect the change.  NOP concluded that, in light of this rigorous process, and given the importance of the National List to organic farmers and processors, the process to remove a sunsetting substance from the National List should be an equally rigorous process.

    Plaintiffs argue that the NOP 2013 notice represents a substantive rule under the Administrative Procedures Act (APA) and that NOP violated the APA rulemaking process when it changed procedures for reviewing the NOP’s sunset review process without using the notice and comment rulemaking procedures mandated by the APA and by the standards of the OFPA.

    Because there are a significant number of substances subject to sunset in the next few years, the outcome of this lawsuit will be relevant for many organic farmers and processors.

    Food and Water Watch Takes Another Shot at the AquAdvantage Salmon

    By Jay W. Cormier – 

    It has been quite some time since the September 2010 Veterinary Medicine Advisory Committee (“VMAC”) meeting that discussed FDA’s review of AquaBounty’s AquAdvantage Salmon application.  Earlier this month, Food and Water Watch – a long-time and very vocal opponent to the AquAdvantage Salmon – filed a Citizen Petition (“CP”) and a Food Additive Petition (“FAP”) in an effort to block marketing of AquAdvantage Salmon filets, should an approval ever occur (available here). 

    In the interest of full disclosure, your author, while working for FDA, helped develop FDA’s approach to the review and approval of genetically engineered animals, was one of the lead reviewers at FDA’s Center for Veterinary Medicine (“CVM”) for the AquAdvantage Salmon, and presented at the 2010 VMAC meeting on behalf of FDA. 

    By way of background, as it has been such a long time since the FDA Law Blog last discussed the AquAdvantage Salmon (here and here), the salmon is a genetically engineered Atlantic salmon that has had a single copy of a transgene inserted into its DNA.  Atlantic salmon typically take around 4 years of farming (Atlantic salmon are protected as an endangered species, so fishing and sale of wild Atlantic salmon is illegal) to reach market size.  During that time, the salmon only grow during specific times of the year, yet they require adequate food, clean water, and space to swim throughout the entire year.  The AquAdvantage Salmon, however, are engineered to grow all year; they do not grow any larger than their non-engineered counterparts – they just reach their size sooner.

    Importantly, AquAdvantage Salmon are also produced such that, with the exception of a small breeding group of fish, they are rendered sterile.  This is done by breeding the salmon so that their genomes contain three copies of each chromosome instead of the usual two copies.

    The shorter time to market size means that it would be economically feasible to grow salmon contained in inland tanks rather than in net pens in the open ocean.  As a result, water quality can be better managed and the salmon can be isolated from other species.  Thus, any number of issues that arise from high density ocean farming operations can be avoided.

    AquaBounty first submitted data to FDA in the mid-1990s regarding its AquAdvantage Salmon.  It took FDA roughly 15 years, but in 2010, CVM convened its VMAC for a two-day meeting to discuss the scientific review of the data supporting approval of the AquAdvantage Salmon.  The review team from CVM presented the conclusions of its review to the VMAC – the AquAdvantage Salmon was as safe to eat as non-engineered salmon, the transgene and its expression product was safe to the salmon and was effective, and the engineered salmon did not pose a significant risk to the human environment. 

    Over four-and-a-half years have passed since the VMAC meeting.  During that time, the AquAvantage Salmon application has languished.  CVM formally issued its draft Environmental Assessment and its draft Finding of No Significant Impact for public comment in 2012.  To date, FDA has not finalized these documents, and has not approved the AquAdvantage Salmon application.  Meanwhile, there have been several failed attempts in Congress to ban AquAdvantage Salmon or to deprive FDA of its ability to approve the application.

    In a new twist to this saga, on April 2nd, Food and Water Watch took the very unusual step of filing both a Citizen Petition and a Food Additive Petition for the same issue.  Specifically, Food and Water Watch seek to have the AquAdvantage Salmon listed as a substance which is prohibited from use in human food.  Under Food and Water Watch’s petitions, FDA would promulgate a regulation that would specifically and explicitly deem AquAdvantage Salmon adulterated food as a matter of law, irrespective of whether the food from AquAdvantage Salmon poses any risk at all to consumers.  Seemingly unsure of how to go about making such a request of FDA, Food and Water Watch filed both petitions, each asking FDA to consider the other in the event that one of the petitions is not the proper avenue for making the unusual request. 

    The Food and Water Watch petitions ask FDA to find that consuming the engineered salmon is injurious to health and should therefore be prohibited as a food additive.  The petitioners argue that, notwithstanding the fact that the statutory definition of a food additive excludes new animal drugs, FDA has the flexibility to consider AquAdvantage Salmon as both a new animal drug and a food additive.  The petitions take issue with FDA’s review process and the data used to support the approval of the AquAdvantage Salmon.  They further argue that the salmon must be reviewed as a food additive. 

    Whether FDA will agree with these arguments will not be known for some time, but we will continue to watch for any further developments as FDA continues to consider approving AquAdavantage Salmon.

    FDA Proposes to Update the Food Facility Registration Rules

    By Riëtte van Laack

    On April 9, 2015, FDA published a proposal to amend the regulations regarding registration of food facilities.  The proposal addresses a multitude of issues: codification of certain self-implementing provisions of the Food Safety Modernization Act 0f 2011 (FSMA), amendment of the regulations as directed by FSMA (e.g., to amend the definition of retail establishment), and update and improvement of the food facility registration system. 

    The Bioterrorism Act of 2002 amended the Federal food, Drug, and Cosmetic Act (FDC Act), adding section 415, which directs FDA to issue regulations to require registration of facilities engaged in the manufacturing, processing, packing or holding food for consumption in the United States.  FDA issued implementing regulations in 2003. FSMA amended section 415 to require that facilities submit additional registration information to FDA and renew their registration every two years. 

    Under the current regulation, food facilities that manufacture/process, pack, or hold food for consumption in the United States must register with FDA.  However, retail food establishments, farms, restaurants, and certain other entities are exempt from the requirement to register.  FDA proposes to amend the definition of a retail food establishment to increase the number of establishments that are considered retail food establishments (and therefore are not required to register).

    Currently, the regulation defines a retail food establishment as “an establishment that sells food products directly to consumers as its primary function.”  Whether the primary function is selling food directly to consumers depends on whether the annual monetary value of sale of food products directly to consumers exceeds the annual monetary value of sales of food products to all other buyers.  FDA proposes to amend the regulation so that the sale of food directly to consumers from an on-farm establishment will include direct sales by the establishment at direct sales platforms such as roadside stands, farmers’ markets, Community Supported Agriculture (CSA) programs, and other direct-to-consumer sales platforms, including door-to-door sales; mail, catalog and Internet order, including online farmers markets and online grocery delivery; religious or other organization bazaars; and State and local fairs.  This expansion of sales direct to consumers applies only to on-farm establishments.

    FDA further proposes to codify certain self-implementing provisions of FSMA that have been effective upon enactment of FSMA (i.e., provide e-mail address for the contact person or U.S. agent, bi-annual renewal of registration and assurance that FDA will be permitted to inspect the facility at the times and in the matter permitted by the FDC Act).  In addition, FDA proposes to add certain new requirements that the Agency anticipates will improve the food facility registration system.

    • All food facility registrations will be required to be submitted to FDA electronically.  FSMA authorizes FDA to require electronic registration no earlier than 5 years after enactment of the law, i.e., not before Jan. 4, 2016.  Among other things, electronic registration will reduce time and cost of processing forms, reduce registration errors, and reduce search and retrieval time. This provision will include a waiver for establishments that cannot register electronically.  
    • Registrations will be required to identify the type of activity conducted at the facility for each food product category.
    • FDA proposes various measures to assure that the food facility registration database is up to date by verifying accuracy of certain information submitted in registrations and reducing the time for updates and cancellation of registration from 60 to 30 days. For example, to prevent any uncertainty whether a US agent is authorized to register a foreign facility, FDA will not register the facility until it has been able to verify that the U.S. agent is indeed authorized.

    The proposed rule does not address the suspension of food facility registration provisions of FSMA.  FDA intends to address these provisions in a separate rulemaking.

    Public comments on FDA’s proposed rule may be submitted electronically or by regular mail until June 8, 2015.

    Awesome Baby; We Love This Game! An Update on Pending Hatch-Waxman and BPCIA Litigation

    By Kurt R. Karst –      

    Some days we feel like the “Dickie V” (Dick Vitale) of the Hatch-Waxman and Biosimilars worlds – enthusiastically calling play-by-play on litigation and other FDA happenings, just like the Basketball Hall of Fame broadcaster does for college basketball games.  (And while we’re on that topic, this blogger can’t help but express his disappointment in Wisconsin’s loss to Duke in the championship game – Go Badgers!)  But even Dickie V needs a break from the detailed play-by-play once in a while.  And today is our break.  Instead of putting out one of our typically detailed posts, we’re just going to give our readers brief updates on a couple of cases we’ve been following and that we’ve previously detailed.  After all, like Dickie V, who is now 75 years old, we too at the FDA Law Blog are getting old, having just celebrated our 8th anniversary.

    First off is Otsuka Pharmaceutical Co., Ltd.’s (“Otsuka”) two-count Complaint and Motion for Summary Judgment filed against FDA in the U.S. District Court for the District of Maryland concerning ABILIFY (aripiprazole).  As we previously reported, Otsuka alleges in Count I that FDA impermissibly broadened a recent supplemental approval for ABILIFY to include treatment of all patients with Tourette’s disorder, instead of treatment of pediatric patients with Tourette’s Disorder.  In Count II, Otsuka alleges that FDA is precluded from approving generic versions of ABILIFY on April 20, 2015 (when a period of pediatric exclusivity associated with U.S. Patent No. 5,006,528 expires) based on FDC Act § 505A(o) (concerning the inclusions and omission of protected pediatric information in generic drug labeling) and the fact that the labeling of ABILIFY is “loaded with pediatric information.” 

    In a Motion to Dismiss filed earlier this week, FDA argues that Otsuka’s case is unripe, that the company lacks standing, and that there hasn’t been any final agency action to challenge in the first place.  According to FDA:

    FDA has made no determination with respect to the issues raised in Otsuka’s January 21, 2015 letter and, to the extent it ultimately finds it necessary to decide these issues, would only do so if, and when, it approves any generic versions of Abilify.  In order to make any generic Abilify approval decisions, however, the agency may also need to consider other potentially important parts of the regulatory scheme, which Otsuka’s letter does not take into account.  These may include the scope of the permissible difference to the same labeling requirement in the statute (see 21 U.S.C. § 355(j)(2)(A)(v)), regulations (see 21 C.F.R. § 314.94(a)(8)(iv)), and applicable case law, as well as the effect of 21 U.S.C. § 355A(o) on labeling that is protected by both Hatch-Waxman and orphan exclusivity.  FDA may also deem it important to consider arguments potentially raised by generic drug sponsors.

    In addition, even when FDA has tentatively approved an ANDA,any number of events may nevertheless prevent or delay final approval (e.g., a pre-approval inspection that reveals manufacturing deficiencies or a change in standards governing impurity are just two examples).  FDA will consider all relevant factors, in making any future decisions on these matters.  However, FDA will make these final determinations at the time that it approves any generic versions of Abilify (and not before).

    FDA also makes some hay out of a recent Otsuka Motion to Compel Supplementation of the Administrative Record, saying that the company is attempting to change the action challenged in Count I.  (Later in the day on April 8th, the District Court issued a Memorandum Opinion granting Otsuka's motion.)

    Intervenor-Defendants Apotex Inc. and Apotex Corporation, and Teva Pharmaceuticals USA, Inc. take a tack similar to FDA in their combined Motion to Dismiss, but they also address the substantive legal issues raised by Otsuka:

    [T]he ultimate question Otsuka’s motion poses is whether FDA has authority to approve ANDAs that carve out the orphan indication for Tourette’s disorder (whether or not the indication includes any reference to a pediatric population).  FDA’s authority to do so is clear. Otsuka’s motion rests on a myopic view of FDA’s authority to approve ANDAs that carve out portions of brand-name drug labeling—a view that is belied by the FDCA as a whole, the Orphan Drug Act, agency regulations entitled to deference, and clear Fourth Circuit authority.  Otsuka’s claims must fail because FDA has authority to approve ANDAs carving out a Tourette’s disorder indication, and that authority is not abrogated or constrained by Section 505A(o).

    Other Intervenors-Defendants, Alembic Pharmaceuticals Limited, Alembic Limited, Alembic Global Holdings SA and Alembic Pharmaceuticals, Inc., filed a brief Memorandum opposing Otsuka’s Motion for Summary Judgment.

    Second up today is an update on Amgen Inc.’s (“Amgen”) appeal to the U.S. Court of Appeals for the Federal Circuit (Case No. 2015-1499) of a March 2015 decision from the U.S. District Court for the Northern District of California concerning Sandoz Inc.’s  (“Sandoz”) biosimilar version of Amgen’s NEUPOGEN (filgrastim) and the applicability and interpretation of various provisions of the the Biologics Price Competition and Innovation Act of 2009 (“BPCIA”).  As we previously reported, the District Court denied Amgen’s Motion for a Preliminary Injunction (as well as an earlier filed Motion for Judgment on the Pleadings or, in the Alternative, Motion for Partial Summary Judgment) and ruled, among other things, that the BPCIA’s “patent dance” procedures are not mandatory for Section 351(k) biosimilar applicants, and that the statutory 180-day notice of first commercial marketing can come well before biosimilar licensure. 

    Amgen asked the Federal Circuit for and was granted an expedited briefing schedule, with briefing to be completed by the end of April 2015.  Amgen lays out the company’s arguments in its Opening Brief filed last week, and asks the Federal Circuit to address four issues:

    1. Whether the district court erred in holding that, under the [BPCIA], Sandoz . . .may elect not to comply with the requirement that it “shall provide” to Amgen, the reference product sponsor (or, “RPS”), a copy of its biologics license application (“BLA”) and information describing “the process or processes used to manufacture the biological product that is the subject of such application.” 42 U.S.C. § 262(l)(2)(A).

    2. Whether the district court erred in holding that Sandoz may comply with the requirement that the Applicant “shall provide notice to the reference product sponsor not later than 180 days before the date of the first commercial marketing of the biological product licensed under subsection (k)” by giving notice before the biological product becomes “licensed.” 42 U.S.C. § 262(l)(8)(A).

    3. Whether the district court erred in holding that where Sandoz refused to provide its BLA and manufacturing information and provided untimely notice of commercial marketing, Amgen cannot compel Sandoz’s compliance and its sole remedy is a declaratory judgment on patent issues under 42 U.S.C. § 262(l)(9).

    4. Whether the district court erred in denying Amgen’s motion for a preliminary injunction based on an erroneous interpretation of the BPCIA and an erroneous finding of no irreparable harm.

    Another case raising similar issues is brewing in the U.S. District Court for the District of Massachusetts.  In that case, Janssen Biotech, Inc. (“Janssen”) is challenging Celltrion, Inc.’s and Hospira, Inc.’s biosimilar version of Janssen’s REMICADE (infliximab).  On April 8, 2015, Janssen filed a Motion for Partial Summary Judgment and a Preliminary and Permanent Injunction

    No Beginning and No End: A Moment of Zen in the Patent Term Extension World

    By Kurt R. Karst –      

    It’s not all that often that we see the Patent and Trademark Office (“PTO”) dismiss or deny a request to extend the term of a patent covering a medical device, though such actions on a Patent Term Extension (“PTE”) request do come up from time to time (see our previous posts here and here).  The PTO’s recent dismissal of a PTE request for U.S. Patent No. 5,762,599 (“the ‘599 patent”) filed by Vesiflo Inc. (“Vesiflo”) and covering the company’s inFlow Intraurethral Valve-Pump and Activator (“inFlow”) device for a replaceable urinary prosthesis for use in female adults who cannot contract the muscles necessary to push urine out of the bladder presents an interesting moment of zen in the PTE world. 

    The inFlow device was reviewed by FDA through the de novo classification process and is the subject of an October 14, 2014 Classification Order, which FDA announced on the same day.  The de novo process, formally known as Evaluation of Automatic Class III Designation, is established by FDC Act § 513(f)(2).  It was added to the statute by the 1997 FDA Modernization Act (“FDAMA”), as modified by the 2012 FDA Safety and Innovation Act (“FDASIA”), to address novel medical devices that lack a predicate device but pose only a low-to-moderate risk, making them ill-suited to the PMA process under FDC Act § 515 (see our previous post here).  Vesiflo utilized the de novo process after a long history of being shut out of other marketing routes for its inFlow device.  As stated by Vesiflo in its PTE application:

    [T]he applicant sought FDA approval for over 17 years prior to the De Novo Petition (DEN130044) being granted on October 14, 2014.  Throughout the process, the FDA maintained its stance that the InFlow™ device required § 515 approval and was a class III device.  The initial IDE (G970029) was performed from 1997 to 2000 in accordance with § 515 for a class III device.  The applicant subsequently prepared for submission and attempted to file pre-PMAs under § 515 in 2002 and 2011, an application under § 513(g) in 2005, and an application under § 510(k) in 2006, but the FDA, based on the actions of the Urology Branch Chief Janine Morris, refused to accept of any of the applications.  It was not until 2013 that the FDA changed its stance, when it down-classified the InFlow™ to class II based on its re-examiniation of the safety data from the pivotal (IDE) trial and agreed to accept a submission under §513(g), rather than under § 515 as it had been treated for the prior seventeen years.  Ultimately, DEN 130044 was filed and approved based on the same data from G970029 that was originally submitted in 2002.

    Shortly after FDA handed down the October 14, 2014 Classification Order, Vesiflo requested a PTE for the ‘599 patent.  But just a few months later, on March 4, 2015, the PTO dismissed the request, concluding that the ‘599 patent is ineligible for a PTE.

    Under the PTE statute at 35 U.S.C. § 156, the owner of record of a patent (or its agent) must submit a PTE request to the PTO “within the sixty-day period beginning on the date the product received permission under the provision of law under which the applicable regulatory review period occurred for commercial marketing or use.”  For a medical device, the “regulatory review period” is defined at 35 U.S.C. § 156(g)(3)(B) to be the sum of:

    (i) the period beginning on the date a clinical investigation on humans involving the device was begun and ending on the date an application was initially submitted with respect to the device under section 515, and

    (ii) the period beginning on the date an application was initially submitted with respect to the device under section 515 and ending on the date such application was approved under such Act or the period beginning on the date a notice of completion of a product development protocol was initially submitted under section 515(f)(5) and ending on the date the protocol was declared completed under section 515(f)(6).

    Thus, the definition of “regulatory review period” for a medical device requires that an application for a medical device be submitted under FDC Act § 515 – i.e., a PMA – and also that the PMA be approved.  And that’s where Vesiflo’s troubles began and ended.  According to the PTO’s dismissal decision:

    Since no application under section 515 of the FFDCA was filed with FDA, the time period in § 156(g)(3)(B)(i) has not ended.  Turning to the § 156(g)(3)(B)(ii) period, since no application was filed under either 515 or 515(f)(5), the regulatory review specified in § 156(g)(3)(B)(ii) did not begin nor did it end.  Instead, an order under 513(f)(2) of the FFDCA for applicant’s medical device was issued October 14, 2014.  This means that the triggering event in §156(d)(1) has not occurred since the product was not reviewed under “the provision of law”—section 515 of the FFDCA —under which the applicable “regulatory review period” occurred —the regulatory review period as defined in 35 U.S.C. 156(g)(3)(B)(i) and (ii).

    Vesiflo’s ineligibility for a PTE also doomed the company’s hopes for an interim PTE, requested pursuant to 35 U.S.C. § 156(e)(2), on the ‘599 patent.  Citing legislative history and the Federal Circuit’s decision in Somerset Pharmaceuticals, Inc. v. Dudas, 500 F.3d 1344 (Fed. Cir. 2007), the PTO concluded that an interim extension cannot be granted if a patent is not eligible for extension under 35 U.S.C. § 156(a).

    FDA Revises Formal Meetings Guidance for PDUFA Products

    By Alexander J. Varond

    After six years of operating under its May 2009 “Guidance for Industry: Formal Meetings Between the FDA and Sponsors of Applicants,” FDA refreshed its guidance.  On March 11, FDA announced its draft guidance entitled “Formal Meetings Between the Food and Drug Administration and Sponsors or Applicants of Prescription Drug User Fee Act (PDUFA) Products.”

    Despite the amount of time that passed since the last version was issued, the draft guidance makes relatively few changes.  This is fairly impressive, given the importance of FDA meetings; but this also speaks to the relative maturity of the PDUFA program—now in its fifth incarnation.  We posted an in-depth discussion about the 2009 guidance here.

    In the chart below, we provide a brief overview of each meeting type and highlight the changes made by the draft guidance document.

    Table 1:  Summary of Meeting Types and an Overview of Changes

    Meeting Type

    TYPE A MEETING

    TYPE B MEETING

    TYPE C MEETING

    Meeting Timing  (days after FDA’s receipt of request)

    30 days

    60 days

    75 days

    New meeting designations  (added by draft guidance)

    Post-action meeting requested within 3 months after an FDA regulatory action other than approval

    Breakthrough therapy development meetings (meetings to discuss overall development programs for breakthrough therapy-designated products)

    Post-action meetings requested ³3 months after an FDA regulatory action other than approval

     Risk evaluation and mitigation strategies (REMS) or postmarketing requirements meetings that occur outside the context of the review of a marketing application

    N/A

    Meeting designations (existing)

    Meetings that are necessary for an otherwise stalled development program to proceed or to address an important safety issue, including:

    Dispute resolution meetings

    Meetings to discuss clinical holds

    Special protocol assessment meetings

    Pre-IND meetings

    Pre-emergency use authorization meetings

    Certain end-of-phase 1 meetings for subpart E or subpart H or similar products

    End-of-phase 2/pre-phase 3 meetings

    Pre-NDA/pre-BLA meetings

    Any meeting other than a Type A or Type B meeting regarding the development and review of a product

    Additional draft guidance changes

    Meeting packages must be submitted with Type A meeting requests

    (in the past, a Type A meeting package could be submitted 2 weeks prior to the meeting date)

    Sponsors can now request written responses to pre-IND questions rather than face-to-face meetings, videoconferences, or teleconferences

    Sponsors can now request written responses to Type C meetings rather than face-to-face meetings, videoconferences, or teleconferences

    Meeting package due date

    Must be submitted at the same time as the meeting request

    1 month prior to meeting

    1 month prior to meeting

    The draft guidance also clarifies the appropriate timeframe for scheduling meetings.  In the 2009 guidance FDA stated “If a sponsor or applicant requests a meeting date that is beyond [30/60/75] days from the date of the request receipt, we will work with the sponsor or applicant to determine the earliest agreeable date.”  (Emphasis added).  The last clause has been made more specific, such that the scheduling requirement is now “If a request for a meeting date that is beyond [30/60/75] days from the date of the request receipt, the meeting date should be within 14 calendar days of the requested date.”  (Emphasis added).