By Jennifer M. Thomas –

The writers of this blog have often noted with dismay Relators’ attempts to enforce the FDCA and FDA regulations through the False Claims Act.  Here, and here, for example.  Last week, the Fourth Circuit confirmed that this is a losing strategy for Relators. 

Relator in United States ex rel. Barry Rostholder v. Omnicare, Inc., No. 12-2431 (Feb. 21, 2014), may have thought he had a slam dunk.  As described by the Fourth Circuit Court, the fact of Omnicare’s alleged non-compliance with current Good Manufacturing Practices ("cGMPs") was well-established, as demonstrated by multiple FDA enforcement actions.  Relator had instigated and assisted in FDA’s investigation every step of the way, leading the Court to conclude that Relator’s claims were not based on public disclosures, and that he was undeniably an original source.  Not only that, but Relator pleaded that he had informed the company of their cGMP violations long ago, only to be ignored as the company continued to violate the law.

Nevertheless, even after providing a detailed description of the company’s alleged cGMP violations, the Fourth Circuit readily affirmed the lower court’s dismissal of Relator’s case.   With all Relator’s allegations of bad acts, he had failed to allege the sine qua non of a False Claims Act claim – namely, a false claim.  The Court found that to qualify for reimbursement under the statutes governing Medicare and Medicaid, “a drug merely must be approved by the FDA,” and that those statutes “do not provide that when an already-approved drug has been produced or packaged in violation of FDA safety regulations, that particular drug may not be the proper subject of a reimbursement request under Medicare and Medicaid.”  Thus, “because compliance with the cGMPs is not required for payment by Medicare and Medicaid, Omnicare has not falsely stated such compliance to the government, as contemplated by the FCA.”

Not satisfied with rejecting Relator’s claim on statutory grounds alone, the Fourth Circuit went on to reject the policy argument implicit in claims like Relator’s, reasoning that “[w]ere we to accept relator’s theory of liability based merely on a regulatory violation, we would sanction use of the FCA as a sweeping mechanism to promote regulatory compliance, rather than a set of statutes aimed at protecting the financial resources of the government from the consequences of fraudulent conduct. . . . Congress did not intend that the FCA be used as a regulatory-compliance mechanism . . . .”

We couldn’t have said it better ourselves.

By Kurt R. Karst –      

In moves that may displease both brand-name and generic drug manufacturers, and that could lead to litigation from both sides, FDA has with one hand proposed to giveth New Chemical Entity (“NCE”) exclusivity to certain Fixed-Dose Combination Drugs (“FDCs”) and has with the other hand taketh away the possibility of NCE exclusivity for other FDCs. 

Last Friday, FDA announced in a notice that will be published in the Federal Register today the availability of a draft guidance document, titled “New Chemical Entity Exclusivity Determinations for Certain Fixed-Combination Drug Products,” that, if finalized, would reinterpret the NCE exclusivity provisions of the FDC Act to award NCE exclusivity for a newly approved FDC containing an NCE and a previously approved drug.  One the same day, FDA issued a Consolidated Response denying three Citizen Petitions submitted to the Agency in 2013 requesting that FDA interpret the law to award NCE exclusivity for approved FDCs containing an NCE and a previously-approved drug – specifically STRIBILD (elvitegravir, cobicistat, emtricitabine, tenofovir disoproxil fumarate) Tablets (Docket No. FDA-2013-P-0058); PREPOPIK (sodium picosulfate, magnesium oxide and citric acid) for Oral Solution (Docket No. FDA-2013-P-0119); and NATAZIA (estradiol valerate and estradiol valerate/dienogest) Tablets (Docket No. FDA-2013-P-0471).

As we previously reported (here and here), the three petitions take issue with FDA’s long-standing position that in order for a FDC to be eligible for 5-year NCE exclusivity, each of the active moieties in the drug product must be new (i.e., not previously approved).  This interpretation is based on FDA’s reading of the statutory language at FDC Act § 505(j)(5)(F)(ii) (concerning ANDAs) and FDC Act § 505(c)(3)(E)(ii) (concerning 505(b)(2) applications), and application of the Agency’s implementing regulation at 21 C.F.R. § 314.108(b)(2). 

FDC Act § 505(j)(5)(F)(ii) (and its sister provision at Section 505(c)(3)(E)(ii)) contains both an “eligibility clause” and a “bar clause.”  Under the “eligibility clause,” a drug is eligible for 5-year NCE exclusivity if it is “a drug, no active ingredient (including any ester or salt of the active ingredient) of which has been approved in any other [505(b)] application.”  Under the “bar clause,” the submission of any ANDA (or 505(b)(2) application) that “refers to the drug for which the [505(b)] application was submitted” is prevented for 5 years (absent a Paragraph IV certification).  Similarly, FDA’s implementing regulation at 21 C.F.R. § 314.108(b)(2) precludes FDA from accepting ANDAs and 505(b)(2) applications for drugs that contain the same active moiety as in a previously approved NCE for 5 years (absent a Paragraph IV certification). 

If a drug product contains any previously approved active moiety (i.e., it is not compsed of all NCEs), then FDA has historically denied NCE exclusivity and granted 3-year exclusivity, provided the statutory requirements are met.  This means that order counts, and that to obtain NCE exclusivity for a combination drug containing new and old actives, the NCE component must be approved first, followed by the combination drug.  In that case, NCE exclusivity granted with respect to the single entity approval would apply to the combination drug under FDA’s so-called “umbrella policy.”  See 54 Fed. Reg. 28,872, 28,897 (July 10, 1989) (“[W]hen exclusivity attaches to an active moiety or to an innovative change in an already approved drug, the submission or effective date of approval of ANDA’s and 505(b)(2) applications for a drug with that active moiety or innovative change will be delayed until the innovator’s exclusivity has expired, whether or not FDA has approved subsequent versions of the drugs entitled to exclusivity, and regardless of the specific listed drug product to which the ANDA or 505(b)(2) application refers.”).

The STRIBILD, PREPOPIK, and NATAZIA petitions argue that FDA’s historical approach of denying NCE exclusivity for a FDC drug containing a new and previously approved active moiety is contrary to the statute, congressional intent and FDA’s exclusivity regulations, and produces arbitrary outcomes that disfavor FDCs.  Instead, petitioners argue that “the best reading of the statute – and the one that best reflects the agency’s rulemaking choices – is that for a 505(b) application that contains a [FDC] of drugs, the exclusivity must be analyzed and granted as to each drug that is the subject of the application” (emphasis added).  That is, NCE exclusivity should be evaluated on a drug component-by-drug component drug basis, according to the petitioners. 

And, as FDA explains in both its draft guidance and Consolidated Response, the Agency agrees with petitioners: 

In light of the increasing importance of fixed-combination products to treat serious diseases and conditions, and considering the factors discussed above, FDA has concluded that the new interpretation urged by the petitioners would be beneficial to the public health.  Accordingly, FDA is changing its interpretation of the 5-year NCE exclusivity provisions to align the exclusivity incentives more closely with FDA’s public health goals.  Under the revised interpretation, the term drug in the eligibility clause of the statutory provisions, and in the regulatory definition of new chemical entity, refers to drug substance, not drug product.

Accordingly, a 5-year NCE exclusivity determination will be made for each drug substance in a drug product, not for the drug product as a whole.  As a result, an application for a [FDC] submitted under section 505(b) of the FD&C Act will be eligible for 5-year NCE exclusivity if it contains a drug substance, no active moiety of which has been approved in any other application under section 505(b).  For example, a fixed-combination drug product that contains a drug substance with a single, new active moiety would be eligible for 5-year NCE exclusivity, even if the fixed-combination also contains a drug substance with a previously approved active moiety. (Emphasis in original.)

As to the appropriateness of making this change in interpretation through guidance instead of formal notice-and-comment rulemaking, FDA says it has sufficient authority to do so:

The FD&C Act provides FDA with explicity authority to “develop guidance documents . . . [that] present the views of [FDA] on matters under the jurisdiction of [FDA],” and specifies further that for “guidance documents that set forth initial interpretations of s statute or regulation, changes in interpretation or policy that are of more than a minor nature,” among others, FDA “shall ensure public participation.”  Thus, Congress has provided the guidance process as a specific process through which FDA may adopt changes in interpretation or policy, and we believe that it is appropriate in this case to utilize the process in section 701(h) and our implementing Good Guidance Practice regulation to provide for public participation.

There’s a catch, however, with FDA’s proposed interpretation.  As FDA explains in the draft guidance:  “If the new interpretation is adopted, FDA intends to apply the new interpretation prospectively.  Therefore, this guidance does not apply to fixed-combination drug products that were approved prior to adopting the new interpretation.”  That gave the early heads-up that the Agency was denying the STRIBILD, PREPOPIK, and NATAZIA petitions.  (FDA’s Consolidated Response was posted on the Regulations.gov website several hours after the draft guidance was posted.)  FDA further explains its reasoning in the Consolidated Response:

Exclusivity runs from the date of approval of a drug product.  At the time of approval of the drug products at issue here (i.e., Stribild, Natazia, and Prepopik), our existing interpretation of the relevant statutory and regulatory provisions was in effect.  We have decided not to recognize 5-year NCE exclusivity based on our new interpretation of these provisions, which we had not announced prior to the approval of these products . . . .

First, although the relevant statutory and regulatory provisions are ambiguous, our existing interpretation of these provisions is longstanding and has been consistently applied in many prior cases presenting similar facts.  Second, the new interpretation we are proposing represents a departure from our past interpretation, and we wish to avoid any unnecessary disruption to regulated industry.  Third, if the new interpretation were to be applied to products for which ANDAs already have been filed, it could impose a burden on the ANDA sponsors, who relied on our existing interpretation in filing their applications.

In addition, we do not believe that applying our new interpretation to the Petitioners’ products would advance the goals of the Hatch-Waxman Amendments.  Although we recognize that the Hatch-Waxman Amendments contain incentives to reward the development an approval of novel drugs, these particular products already have been developed and approved.  Recognizing additional exclusivity in this case is not necessary to encourage the development of novel drugs.  We believe that changing our interpretation going forward will foster Congress’s goal of encouraging the development and approval of novel drugs.  (Emphasis in original.)   

In addition to denying 5-year NCE exclusivity for STRIBILD, PREPOPIK, and NATAZIA, FDA’s Consolidated Response seems to foreshadow how the Agency will rule in another case involving NCE exclusivity.  As we previously reported, FDA has been petitioned (Docket Nos. FDA-2013-P-0884 and FDA-2013-P-1397) to conclude that the start date of NCE exclusivity for products that contain a controlled substance and that require a scheduling decision by the Drug Enforcement Administration (“DEA”) under the Controlled Substances Act (“CSA”) is triggered only when FDA-approved labeling incorporating the final DEA CSA scheduling permits commercial marketing of the drug products, and not on the date of NDA approval.  FDA’s Consolidated Response, however, continues to confirm that “[e]xclusivity runs from the date of approval of a drug product.”  In light of this FDA position, there's been talk about amending the law to better accommodate controlled substances (see here). 

By Alexander J. Varond –

Purdue Pharma recently submitted a citizen petition challenging FDA’s decision to require labeling revisions and postmarket study requirements for extended-release and long acting opioid analgesic products but not immediate-release products.  We discussed these revisions here.

Purdue’s citizen petition, dated February 11, 2014, requests that the FDA undertake two actions:

1. Seek and, if necessary, impose safety labeling changes on immediate-release opioid analgesics that parallel the final safety labeling changes resulting from completion of the 505(o) procedures initiated on September 10, 2013 for extended-release and long-acting opioid analgesics.
2. Assure that the indications for use and other safety labeling information for immediate-release and extended-release and long-acting opioid analgesics convey the same warnings and precautions regarding the risks of opioid use and misuse.

Recall that, as Purdue highlights in its citizen petition, FDA’s rationale for its disparate treatment of ER/LA and IR opioids was:

that there are disproportionate safety concerns associated with these products compared to immediate-release (IR) opioids. For example, data show that the risk for misuse and abuse is greater for ER/LA opioids. . . . Further, because they are intended to release the drug over a longer period of time, many ER/LA opioids contain higher doses of opioids compared to IR opioids or opioid non-opioid combinations. This may make certain ER/LA opioids more desirable in the eyes of opioid abusers and addicts, and increases the risk of a fatal outcome in the event of an overdose.

Purdue argues that this disparate treatment is “contrary to public health and inconsistent with available data evaluating the respective risks of these medications.”

The citizen petition cites a number of sources to support its assertion that IR opioids are “associated with the same potential adverse consequences as ER/LA opioids.”  The sources include data from a commercial insurance claims database, poison centers, substance-use-disorder treatment centers, and a national prescription database.  Purdue also argues that FDA inaccurately represented the DAWN data, which had served as important support for FDA’s rationale for the disparate treatment of LA/ER and IR opioid products. 

Purdue contends that even if there are demonstrable differences in degree between the risks posed by ER/LA and IR opioids, the risk are not different in kind or in the any other relevant respect.  The citizen petition also notes that FDA’s actions could move patients to higher doses or longer courses of IR opioid analgesics, which could increase the opportunity for diversion and negatively impact public health.

If FDA grants Purdue’s citizen petition, IR opioid analgesics labeling would need to better communicate risks of the products and encourage careful prescribing, patient counseling, and monitoring.  It might also open the door for postmarket study requirements to generate data to assess risks of IR opioid misuse, abuse, addiction, overdose, and hypersensitivity to pain, as well as potentially encouraging the development of class-wide REMS for IR opioids (see our post on ER/LA class-wide REMS here).

By Ricardo Carvajal –

FDA entered into a consent decree with the Center for Food Safety that specifies new deadlines for the agency’s submission of final rules implementing FSMA to the Federal Register for publication.  The consent decree marks the latest chapter in a case that started in August 2012 and wound its way to the 9th Circuit amid last year’s partial government shutdown.  The new deadlines corresponding to each rule are listed below:

August 30, 2015

• Preventive Controls for Human Food (FSMA Section 103(a) and 103(c))
• Preventive Controls for Animal Food (FSMA Section 103(a) and 103(c))

October 31, 2015

• Foreign Supplier Verification Program (FSMA Section 301(a))
• Produce Safety Standards (FSMA Section 105(a))
• Accreditation of Third Party Auditors (FSMA Section 307)

March 31, 2016

• Sanitary Transport of Food and Feed (FSMA Section 111)

May 31, 2016

• Intentional Contamination (FSMA Section 106(b))

Under the terms of the decree, FDA agrees “in good faith” to “make every effort” to meet the above deadlines.  However, the deadlines can be extended by mutual agreement between the parties, or through modification by the court based upon a request by FDA that must “show good cause and/or exceptional circumstances warranting the delay, and address the effect of the delay on the public health and safety, among other relevant considerations.” 

By Jeffrey N. Wasserstein –

Either Senator Lamar Alexander (R-Tenn) reads the FDA Law Blog, or great minds truly think alike.  On February 20, 2014, Senator Alexander wrote to Secretary of Health and Human Services (HHS) Kathleen Sebelius asking her to clarify HHS’s position regarding patient access to health information, noting the same discrepancy between FDA’s warning letter to 23andMe and the recent rule change that would require laboratories regulated under CLIA to provide test results directly to patients upon a patient’s request that we identified two weeks ago. 

Senator Alexander, with whom we share a love of plaid, noted in his letter that “[s]ome centers within your department seem to be in agreement with the goal to make personal health information available directly to consumers, as shown by the final rule allowing clinical laboratories to give complete test reports directly to patients, published by the Office of Civil Rights, Center for Medicare and Medicaid Services, and Center for Disease Control and Prevention. . . .  However, your statement and the final regulation appear to be in direct conflict with the Food and Drug Administration’s warning letter from November 22, 2013, to 23andMe, Inc., a direct-to-consumer genetic testing laboratory.  FDA stated one reason it was taking action to stop 23andMe is that FDA does not trust individuals with test results, because results are not adequately understood by patients.”

Senator Alexander asked Secretary Sebelius “What is your Department’s position on greater direct access to personal health information for patients? Further, please describe what criteria were used to evaluate the types of tests described in these two actions that resulted in such opposite outcomes.”  We expect that his letter may garner a more immediate response than our blogpost, but we remain hopeful that Secretary Sebelius may yet comment on our blogpost, or at least accept our friend request on Facebook. 

By James C. Shehan –

Vermont law has banned manufacturers of prescription drug, device, and biologics products from providing most gifts to physicians and other healthcare professionals since 2009 and has required these manufacturers to report permitted gifts and payments to Vermont HCPs since 2002 (summarized in our previous post here).

On February 4, 2014, Representative Tom Burditt introduced a bill (HB 836) that would exempt from the ban meals and other food given to a healthcare professional and his or her employees provided that the meals are consumed in the health care professional’s office.  The bill places no limits on the value of the food provided or the number of people who consume it.  If passed, HB 836 would become effective on July 1, 2014.  

The Vermont law is in many ways the most stringent state drug and device marketing law in the country.  It also has been enforced, with the Vermont Attorney General announcing settlements with 25 manufacturers in September 2013 and three more since then (see here). 

Prospects for the bill are not yet clear.  A similar bill was introduced into the Vermont Senate last year and remains in committee.  But as we previously reported here, legislation to loosen the gift ban restrictions has passed previously, allowing Vermont HCPs to partake of coffee, snacks and other refreshments provided at booths at conferences and seminars.

By Allyson B. Mullen –

On February 14, 2014, FDA issued a final rule amending 21 C.F.R. Part 803, Medical Device Reporting, to require medical device manufacturers and importers to submit MDRs in an electronic format (the “Final Rule”).  79 Fed. Reg. 8832 (Feb. 14, 2014).  The Final Rule does not materially change the underlying requirements for reporting MDRs.  Id. at 8833.  It simply requires reporting of the information electronically as an electronic MDR (or eMDR).  Id.  Manufacturers have been able to voluntarily submit MDRs electronically since 2008.  Id. Additionally, on the same day, FDA issued the Final Guidance Document “Questions and Answers about eMDR – Electronic Medical Device Reporting” (the “Guidance”).  FDA, Guidance for Industry, User Facilities and FDA Staff, Questions and Answers about eMDR – Electronic Medical Device Reporting (February 2014).

The original draft of the Final Rule was proposed on August 21, 2009.  74 Fed. Reg. 42203 (Aug. 21, 2009).  The most significant change between the proposed and Final Rule is that user facilities are not required, but are encouraged, to submit MDRs electronically.  79 Fed. Reg. at 8832.  The Agency believes that electronic submission of MDRs will improve its ability to collect and analyze such reports as it will make the information available more quickly.  Id. at 8833.

The Final Rule is a complete (but primarily non-substantive) revision of 21 C.F.R. Part 803, as there were too many changes to call out each one separately.  Although a number of clarifying changes have been made, the one significant substantive change is that manufacturers and importers are required to submit initial and supplemental MDRs and follow-up reports to the FDA electronically.  FDA is also encouraging submitters to provide responses to requests for additional information for an MDR electronically.  Guidance at 8.  The Final Rule will take effect on August 14, 2015.  79 Fed. Reg. at 8832.  Thus, medical device manufacturers and importers have eighteen months to revise their MDR procedures to comply with the new regulatory requirements.

Electronic MDR submissions can be accomplished through two different mechanisms, either by using FDA’s eSubmitter software for submission of a single report (low volume reporting) or Health Level 7 Individual Case Safety Reports (HL7 ICSR) for submission of batch reports (high volume reporting).  Id. at 8834.  The eSubmitter software can be downloaded for free from FDA’s website.  The software generates an electronic version of Form 3500A.  Id. The electronic report can also be printed and saved for archiving purposes.  Id. The HL7 ICSR is intended for use by reporters with large numbers of MDRs.  Id. This option extracts information directly from the reporter’s database to populate the eMDR.  Id. 

In both cases, once the eMDR has been completed, it is submitted to FDA using the FDA Electronic Submission Gateway (ESG).  Id.  The ESG is “a secure entry point for all electronic submissions to the Agency.”  Id.  In order to use the ESG, the reporter must have a digital certificate, which is an attachment to the electronic message that authenticates the identity of the sender.  Id.  In addition, the submitter will need to set up a Web Trader Account and submit test data through the ESG before the submitter can receive a production account.  Guidance at 3.  It is not clear how long the account set up and test process will take or when companies will begin receiving production accounts.  Therefore, reporters should work with their IT groups to ensure that they have the required digital certificate and that the test data has been submitted successfully prior to the Final Rule taking effect. 

Once the eMDR is submitted to FDA through the ESG, FDA will send the submitter three different acknowledgement messages, all of which must be maintained as part of the MDR file pursuant to new 21 C.F.R. § 803.18(b)(1)(iii).  79 Fed. Reg. 8834-8835.  Acknowledgement 1 indicates that the submission was received at the ESG. Id. at 8834.  Acknowledgement 2 indicates that the submission reached CDRH.  Id.  Finally, Acknowledgement 3 notifies the submitter that the submission was either successfully loaded into CDRH’s adverse event database or that the submission contained errors, which will be specified in the letter.  If a submitter receives a notice that there were errors, the submitter will need to correct the file and re-submit. If there are no issues, FDA expects that all three Acknowledgement letters will be sent on the same day or within 24 hours of the submission. 

We are concerned that FDA has not stated how long it expects it will take to send the three Acknowledgement letters if there are loading issues in the final step because, as we will discuss below, the successful loading of the MDR directly relates to its “receipt date.” Hopefully, we will not experience the same e-copy issues with the eMDR system that have been experienced with the e-copy requirements for device pre-market submissions since the eMDRs will be created through FDA’s own software (it is interesting that electronic MDRs are eMDRs, but an electronic copy of a pre-market submission is an e-copy, why not e-MDRs?).

The most notable part of the new eMDR submission requirement is the change to the “receipt date” for the eMDRs.  Guidance at 5-6. Submitters will no longer be able to submit their reports on the last day allowed under the regulations, and rely on the date stamp, because the “receipt date” for purposes of a company’s timely reporting of MDRs will be the date that Acknowledgement 1 is received, but only if the eMDR is ultimately successfully loaded at CDRH (thus, a successful Acknowledgement 3 is received).  Id. If a failure occurs during loading (an unsuccessful Acknowledgement 3 is received), the submitter will need to resubmit the eMDR with the necessary corrections, and the “receipt date” will be the date of the new Acknowledgement 1 (yes, you will receive 3 letters with each and every submission) when the eMDR is successfully loaded.  FDA will consider the local time of the submitter when determining the submission date.  Id. at 6.

By way of example, this means that if a manufacturer submits their eMDR on the 30th day and the automated system does not deliver Acknowledgement 1 until the following day (the 31st day), the eMDR will be late.  Alternatively, if the manufacturer submits their eMDR on the 29th day, but receives an Acknowledgement 3 indicating that there were errors in the loading process on the 30th day, that the manufacturer will need to resolve the loading issues (assuming that the technical issues can be resolved in such a short time frame) and resubmit the eMDR that day in order not to be late.  We anticipate that there will be a number of late eMDRs as this process takes effect.  We also imagine there will be many companies frantically trying to resolve technical issues on the 30th day.  We will be interested to see if FDA issues a warning letter citing a company for a late eMDR under this system.  Even more interesting will be the first company that responds to such a warning letter explaining that their eMDR was submitted within the 30 day window, but due to “loading” issues, the Agency refused to acknowledge receipt.  Furthermore, one can imagine scenarios in which many eMDRs are late due to malfunctions or bugs within FDA’s software or the ESG.

Lastly, in the Guidance, FDA states that it is committed to providing industry with adequate notices of system outages and changes to the submission software.  Id. at 8.  In our view, the Final Rule and Guidance have been well thought through and considers the main questions that industry will need answers to as it implements the new eMDR requirements.  However, we expect (as is common with all new systems) that there will be bugs to work out in August 2015 when the eMDR requirements take effect.

 By Karla L. Palmer –

Last week, the United States District Court for the District of Oregon ruled that the Drug Enforcement Administration’s (“DEA”) administrative subpoena powers are not unfettered when it comes to obtaining protected health information (“PHI”) submitted by pharmacies to Oregon’s Prescription Drug Monitoring Program (“PDMP”).  The Oregon PDMP challenged DEA’s attempt to obtain PHI based on a state statute permitting such disclosure only after the requesting party obtains a valid court order based on probable cause (and issued at the request of a federal, state or local law enforcement agency).  ORS 431.966(2)(a)(C).  Notwithstanding the statutory provision limiting access to PHI, the DEA issued administrative subpoenas pursuant to 21 U.S.C. § 876 to obtain prescription drug records from the state PDMP concerning a patient and two physicians.  These DEA administrative subpoenas warrants are typically issued under the authority of a local DEWA official and are not self-enforcing.  Oregon claimed (as it had several times in the past) that it could not comply with the administrative subpoenas absent a court order; thus it filed a declaratory judgment action asking the federal court to decide whether DEA could obtain access absent a court order.

The ACLU intervened as of right pursuant to Fed. R. Civ. P. 24(a) on behalf of four Doe intervenors and a Roe prescriber, raising arguments concerning the intervenors’ Fourth Amendment rights related to PHI.  The intervenor patients each utilized controlled substances in schedules II-IV to treat various medical conditions.  The intervenor prescriber asserted that, as a consequence of his patient population, he prescribes more scheduled substances than typical doctors.  Nevertheless, DEA had interviewed and investigated him in the past. The doctor expressed concern that his patients’ records have been accessed or may in the future be accessed without a warrant, which affected his prescribing practices.  The parties cross-moved for summary judgment.

The district court sided with the intervenors and granted their motion for summary judgment on Fourth Amendment grounds.  The court noted that medical records have enjoyed a long history of confidentiality dating back centuries, and that privacy protection is rooted in both Oregon law and certain aspects of federal law.  The court stated that the intervenor patients had a subjective expectation of privacy in prescription information, “as would nearly any person that used prescription drugs.” The prescriber also had a subjective expectation of privacy in his prescribing information.  Importantly, the court found that “by reviewing doctors’ prescribing information, the DEA inserts itself into a decision that should ordinarily be left to the doctor and his or her patient.” The court “easily” concluded that the intervenors’ subjective expectation of privacy in prescription information was objectively reasonable.  Although the court recognized no absolute right to privacy in prescription information (because patients and prescribers must expect physicians, pharmacists and other medical personnel to access their information),  the court found that it is “more than reasonable for patients to believe that law enforcement agencies will not have unfettered access to their records.” 

In addition, the court found that prescription drug information held by the PDMP is “intensely private” because it connects a person’s identifying information to the prescriptions drugs they use.  Such prescription records are protected by a heightened privacy interest rendering the use of the administrative subpoena unreasonable. The court also rejected DEA’s attempt to hold any expectation of privacy unreasonable under the “third party doctrine,” which holds that an individual does not have an expectation of privacy in information held by a third party (here, the pharmacy or PDMP).  Distinguishing other third party doctrine cases dealing with bank and telephone records, the Oregon court held that prescription records are “more inherently personal or private” than those types of records.  Furthermore, the submission of information to the PDMP, unlike telephone and bank records, is required by law – the only way for a patient to avoid the submission is to forego medical care or leave the state.  Deeming this “not a meaningful choice,” the court concluded that the DEA’s use of administrative subpoenas to obtain prescription records from the Oregon PDMP violates the Fourth Amendment. 

This raises the question of whether and to what extent other state PDMPs will follow suit and require DEA to obtain a court order based on probable cause to obtain certain prescription records from state PDMPs (… and almost every state has a PDMP). Will this curtail DEA’s ability to quickly obtain information during an investigation into illicit activities involving controlled substances? Must DEA obtain a court order or warrant upon a showing of probable cause before reviewing prescription records located in PDMP databases or, more importantly, at pharmacies?  Similarly, because the Oregon district court reached its decision on Fourth Amendment grounds (and not based on a Supremacy Clause analysis comparing the federal and state statutes at issue), this case could be a starting point for other states – and prescribers and patients – to attempt to curtail what they may believe is DEA’s intrusion into “intensely private” personal information.

By Kurt R. Karst –      

Last Friday, BioMarin Pharmaceutical Inc. (“BioMarin”) and FDA announced (here and here) the approval of a BLA for a new biological product for patients with Mucopolysaccharidosis type IVA, also known a “Morquio A syndrome”: VIMIZIM (elosulfase alfa) Injection.  The approval of VIMIZIM not only marks the first FDA-approved product for Morquio A syndrome, a rare, severely debilitating and progressive disease that previously had no standard accepted treatment other than supportive care, but also the first time a company has secured a Rare Pediatric Disease Priority Review Voucher (“Pediatric PRV”).

The Pediatric PRV was created by Section 908 of the 2012 FDA Safety and Innovation Act (“FDASIA”), which is codified at FDC Act § 529 (see our FDASIA summary at pages 54-56).  The Pediatric PRV program is intended to encourage the development of treatments for rare pediatric diseases.  The program was inspired by the existing Tropical Disease PRV (“TD-PRV”) program set forth at FDC Act § 524, as added by the 2007 FDA Amendments Act of 2007 (“FDAAA”) (see our FDAAA summary at page 45, and draft FDA TD-PRV guidance here), but differs from that PRV program in several respects.

A Pediatric PRV is a voucher issued to the sponsor of a “rare pediatric disease product application” that entitles the holder of such voucher to priority review (instead of a longer standard review) of a single NDA or BLA after the date of approval of the rare pediatric disease product application.  A qualifying rare pediatric disease product application is an NDA or BLA for a drug or biologic intended to prevent or treat a rare pediatric disease.  Such drug or biologic may not contain any active ingredient (including any ester or salt of the active ingredient) previously approved in any drug or biologic application.  The application must also be deemed eligible for priority review and rely on clinical data derived from studies examining a pediatric population and dosages of the drug intended for that population.  A sponsor cannot seek an adult indication as part of a rare pediatric disease application.

FDA defines a “rare pediatric disease” similar to that as a “rare disease,” but in pediatric patients.  That is, a “rare pediatric disease” is a disease that affects fewer than 200,000 individuals primarily aged from birth to 18 years in the U.S.  The definition also extends to diseases that affect more than 200,000 individuals primarily aged from birth to 18 years in the U.S. but for which no drug or biologic treatments are available because a company cannot reasonably expect to recover the costs of developing and marketing such products.

Upon the request of a sponsor, FDA may designate a new drug or biologic as a product for a rare pediatric disease, and the application for such drug or biologic as a rare pediatric disease product application.  The request for designation must be made at the same time as a request for orphan drug designation or fast track designation; however, requesting orphan drug or fast track designation is not a prerequisite to receiving a PRV.  Within 60 days of receiving a request for a determination, FDA must determine whether a product qualifies as a new drug or biologic for a rare pediatric disease and whether an application qualifies as a rare pediatric disease product application.  PRVs are awarded upon approval.  FDA will publish notice of the issuance of a Pediatric PRV or the approval of a drug that used a Pediatric PRV within 30 days of the issuance or approval, respectively.  

FDA can revoke a Pediatric PRV if the product for which the voucher was awarded is not marketed within 1 year of approval.  In addition, a sponsor of an approved rare pediatric disease product must submit a report within 5 years of approval that provides information on the estimated population in the U.S. suffering from the rare pediatric disease, the estimated demand in the U.S. for the sponsor’s product, and the actual amount of such product distributed in the U.S. for the past four years.

An important limitation on the Pediatric PRV program is its sunset clause.  Under the statute, no further vouchers can be awarded “after the last day of the one-year period that begins on the date” that the third voucher is granted.   Therefore, less than a handful of vouchers will be issued.

A sponsor must notify FDA of its intent to use a pediatric PRV no later than 90 days prior to submitting a drug or biologic application, and “[s]uch notification shall be a legally binding commitment to pay for the [Pediatric PRV] user fee,” in addition to other applicable user fees.  Although FDA has not yet determined the Pediatric PRV user fee, the fee to use a TD-PRV, which is calculated using a similar formula, is substantial (see here and here).

In general, Pediatric PRVs may be sold or transferred, and there is no limit on the number of times a priority review voucher can be transferred.  The transferee or purchaser must notify FDA of a change of ownership within 30 days after such transfer or purchase.   A sponsor that provides notification of its intent to use a Pediatric PRV, while committed to pay the Pediatric PRV user fee, “may transfer the voucher after such notification is provided, if such sponsor had not yet submitted the human drug application described in the notification.”

The TD-PRV program is similar in many ways to the Pediatric PRV program, and, therefore, may provide a good example of how Pediatric PRVs might work.  However, not a lot of TD-PRVs have been granted thus far. 

When the TD-PRV program was introduced, many industry experts predicted that a market could be created for PRVs.  At the time, PRVs were speculated to be worth between a whopping $50 million and $500 million!  Despite their high valuation, only two drug sponsors have developed products that have received TD-PRVs: (1) Novartis’s COARTEM (artemether, lumefantrine), which was approved on April 7, 2009 for the treatment of acute, uncomplicated malaria infections in adults and children weighing at least 5 kilograms; and (2) Janssen Therapeutics’ SIRTURO (bedaquiline), which was approved on December 28, 2012 for pulmonary multi-drug resistant tuberculosis.  The COARTEM PRV was used by Novartis when in 2011 the company submitted a supplemental NDA for ILARIS (canakinumab) to add an indication for gouty arthritis.  It is unclear whether Janssen has used its PRV.  A third TD-PRV may be granted if FDA approves a pending application for IMPAVIDO (miltefosine) for the treatment of visceral, mucosal and cutaneous leishmaniasis (see here). 

One takeaway from the TD-PRV program is that the value of PRVs is uncertain and has not encouraged large-scale development of new therapies for tropical diseases.  It is important to note, however, that there are at some key differences between TD-PRVs and Pediatric PRVs that may make the latter more appealing.  First, a sponsor using a TD-PRV is subject to a one-year notification requirement before submitting a human drug application for priority review, whereas a sponsor using a pediatric PRV is only subject to a 90-day notification requirement.  Second, transfer of TD PRVs is limited to a single sale or transfer, whereas a Pediatric PRVs can be traded or sold multiple times.  These differences, among others, may make the Pediatric PRV more appealing to companies.

By Kurt R. Karst – 

Although it’s been more than 10 years since the December 8, 2003 enactment of the Medicare Modernization Act (“MMA”) – or, more accurately, The Medicare Prescription Drug, Improvement, and Modernization Act, Pub. L. No. 108-173 – which created a new regime for 180-day generic drug marketing exclusivity, the pre-MMA version of the statute governing 180-day exclusivity is still alive and kicking.  In fact, because of how the pre-MMA-to-post-MMA changeover operates, pre-MMA 180-day exclusivity may be around for quite some time, frustrating some generic drug applicants along the way, but rewarding others.

Under the pre-MMA version of FDC Act § 505(j), 180-day exclusivity is patent-based, such that an ANDA applicant is (or different applicants are) eligible for 180-day exclusivity with respect to different Orange Book-listed patents covering the Reference Listed Drug if such applicant submitted the first ANDA to FDA containing a Paragraph IV certification to a particular patent.  Pre-MMA 180-day exclusivity is triggered by the earlier of either the first commercial marketing (for all patents certified to as Paragraph IV by a first-filer), or by a court decision favorable to an ANDA applicant (with respect to a particular patent).  Of course, where there is no court decision (because, for example, an ANDA applicant was not sued for patent infrongement, or there was a settlement of litigation without a holding on the merits), the possibility of “parked” exclusivity arises . . . at least until there is commercial marketing of the drug or the patent(s) on which 180-day exclusivity is based expires. 

The MMA amended the FDC Act such that the first company to submit an ANDA to FDA containing a Paragraph IV certification to any Orange Book-listed patent covering the RLD – i.e., a “first applicant” – is eligible for 180-day exclusivity.  Post-MMA, 180-day exclusivity is considered drug product-based and is triggered by first commercial marketing of the drug product by any first applicant.  A first applicant can forfeit 180-day exclusivity eligibility under one or more forfeiture provisions created by the MMA. 

The MMA includes – at § 1102(b)(1) – an effective date provision for purposes of deciphering when the pre- or post-MMA 180-day exclusivity regime will apply.  That provision states: “the amendment made by subsection (a) shall be effective only with respect to an [ANDA] filed . . . after [December 8, 2003] for a listed drug for which no [Paragraph IV certification] was made before [December 8, 2003].”

As a result of the MMA’s effective date provision, a drug product subject to the pre-MMA rules on 180-day exclusivity is forever evaluated under the old version of the statute.  This includes, as FDA previously determined, so-called “MMA Straddles.”  An MMA-Straddle situation arises  when one or more ANDAs were submitted to FDA on or before December 8, 2003, but the first Paragraph IV certification was submitted to FDA after December 8, 2003.  A few known MMA Staddle drug products include Topiramate Sprinkle Capsules, 15 mg and 25 mg (TOPAMAX) and Methylphenidate HCl Extended-Release Tablets, 18 mg, 27 mg, 36 mg, and 54 mg (CONCERTA). 

Also included the pre-MMA category of drugs are brand-name products for which an ANDA was submitted to FDA on or before December 8, 2003 containing a Paragraph IV certification that may have already resulted in a period of 180-day exclusivity associated with that patent, and for which a new patent is issued post-MMA and information for which is listed in the Orange Book.  The new patent listing gives rise to the possibility of another period of 180-day exclusivity – either by operation of an amendment to a pending ANDA or through the submission of a new original ANDA – for a brand-name drug that went generic long ago.  It also means, however, that subsequent ANDA sponsors certifying to a newly listed patent cannot be approved until the first-filer’s exclusivity is over (or is otherwise lost).   Thus, for example, U.S. Patent No. 7,022,340 applicable to NDA No. 019955 for DDAVP Tablets (desmopressin acetate), 0.1 mg and 0.2 mg, has given rise to a new period of 180-day exclusivity eligibility and has blocked subsequent applicants from opbtaining final approval.  Similarly, U.S. Patent No. 8,476,010 applicable to NDA No. 019627 for DIPRIVAN (propofol) Injection, 10 mg/mL, has given rise to a new period of 180-day exclusivity eligibility for generic versions of that drug product.  (Another interesting case is the listing of U.S. Patent No. 7,091,236 for various Glycopyrrolate Tablet drug products approved in August 1961 under NDA No. 012827, and marketed under the ROBINUL trade name.  The patent is apparently the first patent listed in the Orange Book for those brand-name drug products.)  

Because of the pre-MMA patent-by-patent approach to 180-day exclusivity, FDA’s interpretation of when the pre-MMA statute applies in a post-MMA world, and the issuance of new patents for drugs approved long ago, any list of pre-MMA drug products is naturally fluid.  Drug products can move on or off of that list.  Although ANDAs with a number less than or equal to 076933 are applications submitted to FDA on or before December 8, 2003 (pre-MMA), and ANDAs with a number equal to or greater than 076934 are post-MMA applications, a post-076934 ANDA could be subject to (or be eligible for) pre-MMA exclusivity because of an older ANDA submission.  In some cases, that means a revision to a pre-MMA list of drugs to add a new drug.  In another situation, a brand-name drug for which an ANDA was submitted to FDA pre-MMA may be withdrawn for reasons of safety or effectiveness (e.g., TEQUIN, SELDANE, and “old” OXYCONTIN), or converted in a prescription-to OTC switch under a new NDA (e.g., MIRALAX).  Those products have to be removed from any pre-MMA list of drugs.

So what’s this all leading up to you ask?  You guessed it, as part of our celebration of the 30th anniversary of the Hatch-Waxman Amendments we put together a current list of all the drug products we think are subject to the pre-MMA 180-day exclusivity statute.  The list may not be perfect (after all, not all of the MMA Straddles are known), but it’s as complete a list as we have ever seen.  Here you go . . . and enjoy!

By Ricardo Carvajal –

FDA published a notice announcing the availability of a Draft Approach for Designating High-Risk Foods, and asking for comments and information to help the agency refine that approach.  Designation of a food as a High-Risk Food (HRF) would trigger additional recordkeeping requirements intended to facilitate product tracing (current recordkeeping requirements for purposes of product tracing are limited to identity of immediate previous sources and subsequent recipients of a food). 

As explained in the Draft Approach, FSMA section 204(d)(2)(A) sets forth a number of factors on which HRF designations must be based.  In light of those statutory factors, FDA proposes to rely on the following criteria:

1. Frequency of outbreaks and occurrence of illnesses;
2. Severity of illness, taking into account illness duration, hospitalization and mortality;
3. Likelihood of contamination; 
4. Growth potential/shelf life;
5. Manufacturing process contamination probability/intervention;
6. Consumption; and
7. Economic impact.

Throughout the Draft Approach, links to FDA’s other food safety initiatives and activities are evident.  For example, where data on the likelihood of contamination are not available, FDA proposes to rely on RFR reports, its recall database, and its compliance programs.   As an additional example, scoring of the probability of manufacturing process contamination would take into account lessons learned from implementation of preventive controls (i.e., “available control measures and interventions that have been validated… and can be applied during manufacturing to eliminate, reduce (to acceptable levels), or otherwise control a hazard”).

FDA’s notice emphasizes that the Draft Approach is open to revision based on comments submitted to the agency, and that it likely will be subject to peer review.   The notice also asks for comments a number of specific topics, including how food allergens should be considered in developing a list of HRF.  Comments are due by April 7, 2014.

By Jennifer D. Newberger –

On February 5, 2014, CDRH released its 2014-2015 Strategic Priorities, in which it stated that the most important areas of focus over the next two years will be to “strengthen the clinical trials enterprise,” “strike the right balance between premarket and postmarket data collection,” and “provide excellent customer service.”

Clinical Trials Enterprise

The key component of this priority is to find ways to encourage sponsors of clinical trials to conduct those trials in the United States rather than overseas and to do so early in the device development process.  CDRH aims to achieve this goal by improving the efficiency, consistency, and predictability of the IDE process to reduce the time and number of cycles needed to obtain IDE approval, and to increase the number of early feasibility/first-in-human IDE studies submitted to FDA and conducted in the U.S.

CDRH has already taken steps over the last two years to improve the IDE and clinical trial processes.  For example, in 2012, FDA issued a guidance document that describes the factors it considers in making premarket risk/benefit determinations, including patient perspective on risks and the willingness to accept increased risk for certain conditions.  To build on this, CDRH states that as part of its strategic priorities it will “formalize the incorporation of [its] benefit-risk framework, including patient-specific factors such as tolerance for risk and perspective on benefit, into the IDE process.”  Such formalization will help sponsors better understand the various factors that might influence whether and how quickly an IDE might be approved, which could possibly, in turn, positively influence a decision about conducting the study in the United States.  CDRH should also address the amount of data needed to initiate a study, which can, in and of itself, be an insurmountable burden.

Premarket v. Postmarket Data Collection

The question of the appropriate amount of data to collect premarket versus postmarket generally applies to devices approved through the PMA process, and is an area that industry and FDA have long debated.  Industry’s position has been that FDA may request data that is too extensive to gather premarket, and will delay entry of potentially life-saving or highly beneficial devices to the U.S. market.  FDA has argued that without sufficient premarket data, it could be allowing products onto the market that have not demonstrated reasonable assurance of safety and effectiveness.

The strategic priorities indicate that CDRH recognizes that burdensome data requirements can adversely affect when patients in the U.S. will have access to a device, and notes that it is “critical” for CDRH to “strike the right balance between premarket and postmarket data collection.”  The “balance” is between improving patient access to devices while assuring postmarket data collection will occur in a timely fashion, thereby enabling a more rapid evaluation of safety of the device in use.

This strategic priority may be the first time CDRH has specifically put forth a plan for determining the devices for which data requirements may be shifted from pre to postmarket.  This plan involves reviewing all device types subject to PMA approval “to determine whether or not to shift some premarket data requirements to the postmarket setting or to pursue down classification, and communicate those decisions to the public.”  Certainly there is no guarantee that CDRH will find that a data shift or down classification is appropriate for any PMA device, or will do so in a meaningful time frame (another FDA Center just responded to a Citizen Petition almost 39 years after it was submitted) but it is encouraging to see CDRH recognizing this as a possibility and setting forth timeframes within which such a review should occur.  As part of the review, CDRH will seek public input on when data shifting is appropriate.  Hopefully, FDA and industry can work together to reach agreement with respect to when it is appropriate to shift data requirements to the postmarket setting, allowing the public earlier access to medical devices while continuing to assure the safety and effectiveness of those devices.

Provide Excellent Customer Service

This is perhaps the most interesting and unexpected of the strategic priorities.  Industry has long complained about the unresponsiveness of CDRH to its inquiries and the lack of transparency and consistency with respect to its decision-making.  Perhaps this priority is a sign that CDRH is finally considering how its interactions with industry impact whether manufacturers choose to pursue clearance or approval in the U.S.

To provide excellent customer service, CDRH will be implementing “customer service standards,” which include active listening, problem solving, seeking out the ideas of others, explaining the reason for CDRH’s decisions and requests for information, learning from its mistakes, and “doing our best.”  These are all sufficiently vague (particularly “doing our best”) that is not clear how the “customers” (industry and other stakeholders) will determine whether an adequate level of customer service has been obtained.  The strategic priorities indicate that there will be a survey tool in emails and on the website, and a CDRH program will be established to monitor and address feedback and improve quality and performance.  It is not clear how CDRH will ensure that it obtains feedback from a majority of “customers” or how those customers are intended to rank issues like whether CDRH did its best, or what CDRH will do with this feedback.  It is encouraging to see CDRH acknowledging that its interactions with stakeholders must be improved, but it is not clear from the information in the strategic priorities precisely how that will be accomplished or measured. 

In sum, CDRH’s strategic priorities seem to constitute positive steps.  Whether they will result in regulatory improvements or represent aspirations that will go unfulfilled remains to be seen.

By Delia A. Deschaine & Alan M. Kirschenbaum –

On January 31, 2014, the HHS Office of the Inspector General ("OIG") issued its Work Plan for FY 2014.  The Work Plan sets forth OIG’s priorities for evaluations, inspections, and audits to be conducted in FY 2014 (Oct. 1, 2013 through Sept. 30, 2014).  The 2014 Work Plan describes a number of new and continuing studies and reports on pharmaceutical issues to be conducted by OIG’s Office of Evaluations and Inpections, including the following:

Conflicts of interest involving compendia (p. 23):  Generally, Medicare covers drugs that are approved by FDA and used for indications that are either approved or supported in one or more drug compendia recognized by CMS. OIG explains that, while publishers are required to have “publicly transparent processes for evaluating anti-cancer drug therapies and or identifying potential conflicts related to inclusion of those therapies in the compendia,” there are no such requirements for non-anticancer drugs.  OIG will initiate a new study of the processes used by the publishers of these drug compendia to evaluate anticancer and non-anticancer drug therapies and identify conflicts of interest related to the therapies included in the compendia.

Medicaid Drug Rebate Program (MDRP) (pp. 34-35):  OIG intends to continue its ongoing evaluation of whether manufacturers are complying with average manufacturer price ("AMP") reporting requirements.  In addition, a new review will assess manufacturer compliance with MDRP requirements for calculating rebates for new formulations of existing oral dosage form innovator drugs.  The Affordable Care Act made significant changes to the statutory definition of AMP and added the new formulation provision, effective October 1, 2010.  However, CMS has not issued final regulations to implement these new statutory provisions, many aspects of which are subject to varying interpretations.  Manufacturers who have undergone OIG reviews of their AMP calculation methodologies in the past have faced the difficulty of being reviewed against ambiguous statutory requirements in the absence of written policies and interpretations from CMS.  In reviews of compliance with the new formulation provision of the statute, which is unclear at best, the regulatory void will be even more problematic.  CMS expects to issue its final MDRP rule in May 2014, but if the past is any indication, OIG will be reviewing manufacturer methodologies that predate the final rule.

Coupons for Part D drugs (p. 31):  Continuing a study begun in FY 2013, the OIG will identify the safeguards that drug manufacturers have in place to ensure that Medicare beneficiaries do not use copay coupons to obtain drugs paid for by Part D.  OIG explains that a recent survey suggests that copay coupons for brand drugs cause Medicare to pay more than necessary when less costly versions of the drug are available, and that the use of copay coupons in Federal health care programs “implicates the anti-kickback statute.”

Medicare coverage of off-label uses (p. 22):  Medicare Part B generally covers approved drugs for on-label indications and also off-label indications that are supported in recognized compendia or supported by clinical evidence reported in medical literature.  OIG will conduct a new study of the oversight of CMS and its contractors to ensure that payments for Part B drugs meet the appropriate coverage criteria.

Manufacturer reporting of Average Sales Price ("ASP") (p. 21):  ASPs reported quarterly by manufacturers are used by CMS to set payment rates for drugs covered under Medicare Part B.  OIG previously found that a number of manufacturers were not reporting ASP to CMS, either because they were not required to (because they did not have a Medicaid Rebate Agreement, on which the ASP reporting requirement is predicated), or because they were violating the requirement to report.  OIG will conduct a new study to “determine the potential effect on average sales price reporting if all manufacturers of Part B-covered drugs were required to submit ASPs to CMS …. [and] whether CMS has improved its process for collecting ASP data ….”

Payment for compounded drugs (p. 23):  OIG will conduct a new study to examine the policies and procedures of Medicare Administrative Contractors for processing Part B claims for compounded drugs and assess the appropriateness of such claims.  Medicare pays for compounded drugs only when they are prepared in compliance with the Federal Food, Drug, and Cosmetic Act.  The Drug Quality and Security Act, which was enacted on November 27, 2013, imposes conditions for the lawful compounding of prescription drugs.

By Kurt R. Karst –       

A couple of weeks ago we announced a massive and unprecedented undertaking by FDA’s Office of Generic Drugs (“OGD”) to address an outpouring of concern about, among other things, a Manual of Policies and Procedures (“MAPP”) – MAPP 5200.3 – titled “Responding to Industry Inquiries with respect to Abbreviated New Drug Applications in the Office of Generic Drugs” that FDA published in September 2013 and that was criticized as restricting communication between OGD and ANDA sponsors concerning pending applications.  The fruits of OGD’s undertaking are beginning to rollout, and ANDA sponsors should expect to begin receiving correspondence from the Office. 

What will that correspondence look like?  Below is a representative letter from OGD (with fictitious products) detailing the status of various application components.   Applicants may receive multiple communications based on the number of ANDAs pending in OGD.  OGD emphasizes in the letter that “[t]his is a one-time communication intended to assist [applicants] to ascertain the current status of submissions.”  And while ANDA sponsors will certainly be tempted to contact OGD for further information – because in some cases the correspondence may raise more questions than provide answers – OGD says they should not do so: “Please do not respond to this communication by asking FDA or your Regulatory Project Manager for additional or more detailed information. . . .  It is not feasible for us to respond to a high volume of follow up inquiries.”  

DATE: February 12, 2014

TO: Generic Drugs, Inc.

ATTN: Responsible Company Official

E-Mail:

FAX:

RE: Update summary of filed and pending original ANDA(s)

Dear Sir or Madam:

The Office of Generic Drugs (OGD) in the Center for Drug Evaluation and Research, Food and Drug Administration (FDA), is providing you with this one-time communication on the status of your filed and pending original abbreviated new drug application(s) (ANDA) submitted under section 505(j) of the Federal Food, Drug, and Cosmetic Act. OGD is providing these updates as an interim measure to help applicants assess the status of their current submissions as we transition towards predictable goal times pursuant to the Generic Drug User Fee Amendments of 2012 (GDUFA).

Your status update is limited to available review information as of January 29, 2014. Any additional information regarding your ANDA collected after this date is neither considered nor provided. Furthermore, your ANDA status is subsequently subject to revision pending additional information or concerns raised by any of the discipline reviews (bioequivalence, clinical, chemistry, microbiology, labeling, facility), other unforeseen legal, scientific or regulatory issues, or inspectional results, which can also impact the status or ability to issue a complete response. Any applicable fees can also affect the status of your ANDA.

OGD is providing your ANDA status update in the attached chart with a list of applicable acronyms. The chart only contains current information regarding discipline review and does not forecast if and when OGD will issue a complete response, tentative approval, or final approval letter.

Please do not respond to this communication by asking FDA or your Regulatory Project Manager for additional or more detailed information. This is a one-time communication intended to assist you to ascertain the current status of submissions. It is not feasible for us to respond to a high volume of follow up inquiries.

Sincerely yours,

CAPT Aaron W. Sigler, USPHS
Chief, Review Support Branch

CHART ACRONYMS

Column Headings

ANDA - The application number for your Abbreviated New Drug Application
DRUG NAME - The official filed name of the drug associated with the ANDA number
CHEM - Product Quality Chemistry Review
BIO - Bioequivalence Review, typically including OSI, if applicable
MICRO - Microbiology Review
LABEL - Labeling Review
CLINICAL - Clinical Review
FACILITY – Overall Facility inspections summary. All facilities must be acceptable at the time of 29 JAN 14 in order to warrant an adequate notation. If one of more facility is not acceptable then the FACILITY column will be marked as such. OSI information is not considered.

Discipline Notations

IQ – Inadequate. This particular discipline is currently found to be inadequate.

AQ - Adequate. This particular discipline was found to be adequate when the information was gathered for this communication.

UR - Under Review. This particular discipline is currently assigned OR under review with the discipline team.

NR – Not Reviewed. This particular discipline is either currently not under review or assigned.

NA – Not applicable. This particular discipline is not required for the approval of this ANDA.

Facility Notations

PN – Pending, i.e., one or more facilities have been inspected and are pending an outcome.

AC - All facilities are acceptable at the time of this publication.

*Please note that you may receive your updates in multiple communications over time, based on the number of ANDAs pending in OGD.

At the Food and Drug Law Institute’s (“FDLI’s”) 2014 Medical Device Conference – Key Legal and Regulatory Developments, which will take place in Washington, D.C. on February 27, 2014, top FDA officials will discuss their most significant recent activities and forecast upcoming medical device activities.  Experts will analyze the most important cases of 2013 and predict what legal and policy developments to expect in 2014.  In addition, panelists will analyze pressing compliance issues, including regional warning letters and off-label promotion issues. This conference will cover hot topics in the medical device realm, including mobile medical apps, combination products and the Sunshine Act.

Hyman, Phelps & McNamara’s Jeffrey K. Shapiro will present with CDRH Ombudsman David Buckles, PhD, FACC in a session covering two FDA guidance documents issued last year – one on  Medical Device Reporting (“MDR”) requirements and the Appeals Process (see our previous posts here and here).

To register for the conference and to obtain additional details, please go to the FDLI website.  FDA Law Blog readers can obtain a discount by using the code MEDDEV14.