Life Science Compliance Update

June 15, 2017

Gottlieb Establishes Committee to Address Opioid Crisis

  170405-scott-gottlieb-mn-1500_c6d31e19815ab8c60db211379e1a3850.nbcnews-ux-2880-1000

FDA Commissioner Scott Gottlieb – sworn in on May 11, 2017 – has established a steering committee to address the opioid crisis and advise regulators on such steps as prescription limits. Gottlieb, who said overuse of painkillers was his top priority during his confirmation hearing, wrote in a blog post that he “believes it is within the scope of FDA’s regulatory tools – and our societal obligations – to take whatever steps we can, under our existing legal authorities, to ensure that exposure to opioids is occurring under only appropriate clinical circumstances, and for appropriate patients.”

Before announcing the steering committee, Gottlieb made sure to acknowledge the work that has been done by FDA to date, and how many people are working hard on this problem.

Gottlieb noted the committee will address whether the FDA should mandate training for health professionals and work with providers to ensure the number of doses prescribed is closely related to the condition for which a patient is being treated. Gottlieb mentioned how there are few situations when a patient needs a 30-day supply of opioids. The committee will also consider whether the agency's drug review process for opioids adequately considers risk and the potential for abuse.

Specifically, there are three initial questions Gottlieb has asked the Steering Committee to answer. They are:

  1. Are there circumstances under which FDA should require some form of mandatory education for health care professionals, to make certain that prescribing doctors are properly informed about appropriate prescribing recommendations, understand how to identify the risk of abuse in individual patients, and know how to get addicted patients into treatment?
  2. Should FDA take additional steps, under our risk management authorities, to make sure that the number of opioid doses that an individual patient can be prescribed is more closely tailored to the medical indication? For example, only a few situations require a 30-day supply. In those cases, we want to make sure patients have what they need. But there are plenty of situations where the best prescription is a two- or three-day course of treatment. So, are there things FDA can do to make sure that the dispensing of opioids more consistently reflects the clinical circumstances? This might require FDA to work more closely with provider groups to develop standards for prescribing opioids in different clinical settings.
  3. Is FDA using the proper policy framework to adequately consider the risk of abuse and misuse as part of the drug review process for the approval of these medicines? Are we doing enough when we evaluate new opioid drugs for market authorization, and do we need additional policies in this area?

The actions are the first Gottlieb has taken on opioid misuse since taking the helm of the FDA. The steering committee will be made up of senior agency leaders and will solicit public comment.

Gottlieb closes his blog by noting,

Working together, we need to do all we can to get ahead of this crisis. That’s why we’ll also be soliciting public input, through various forums, on what additional steps FDA should consider. I look forward to working closely with my FDA colleagues as we quickly move forward, capitalizing on good work that has already been done, and expanding those efforts in novel directions. I will keep you updated on our work as we continue to confront this epidemic.

June 09, 2017

FDA Office of Regulatory Affairs to Undergo Realignment

Ucm195424

In a March hearing before the House Energy & Commerce Committee, FDA’s Jeffery Shuren announced the FDA’s Office of Regulatory Affairs (ORA), would undergo a program realignment. As the FDA notes, on September 6, 2013, then Commissioner Margaret Hamburg, M.D., created a Program Alignment Group (PAG) comprised of senior FDA officials. The PAG was charged with identifying and developing plans to modify FDA’s functions, processes, and structure in order to meet the challenges posed by scientific innovation, globalization, the increasing breadth and complexity of the products that we regulate, and new legal authorities.

May 2017 Realignment

Regulatory Focus received direct comment from FDA on the imminent changes. As they wrote, the long-planned program alignment for ORA will kick off in May 2017, saying the office "will be moving away from a geographic (regional) management model and align with a commodity-based program structure. All regional food and drug directors (RFDDs), regional directors and regional staff will transition into other positions in ORA."

As of May 17, Meyer says that FDA will sunset its five regional offices, replacing them with six commodity-focused divisions for drugs, biologics, medical devices, bioresearch monitoring, food and tobacco. Meyer also told Focus that the agency will maintain its 20 existing districts, with district directors gaining program specific responsibilities. Meyer also noted that the agency would not be closing any offices, and no employees will lose their jobs or be asked to move as a result of realignment.

How does ORA's new model affect FDA stakeholders?

As described the FDA, for a given product type the entire reporting chain for ORA’s inspection and compliance staff will specialize in that particular commodity. This is a significant change from ORA’s existing geographic-based model, where employees, regardless of their area of expertise, may do work in more than one program area. Ultimately these changes will result in a high level of technical expertise and more uniform application of ORA’s policies and processes. 

The agency states it wishes to keep pace with the acceleration of scientific innovation, global expansion of markets, and modern legal authorities, such as the FDA Safety and Innovation Act of 2012, the Drug Quality and Security Act of 2013, and the 21st Century Cures Act of 2016.

In addition to the FDA’s comments, the FDA Law Blog made several important points about this realignment back in 2016. Three specific quotes of interest:

“In other words, if you are spending two-thirds of your time as an investigator inspecting run-of-the-mill food, feed or tobacco facilities, does it really make sense for that same person to also be conducting inspections of recombinant biotech drug firms? The answer seems self-evident, until you realize that little in a huge bureaucracy is self-evident, and even less is readily achievable even when it is self-evident.”

“So, what to make of these objectives? From an industry perspective, having specialists, rather than generalists, analyzing a firm’s key systems seems like a no-brainer in terms of the specialist being better able to understand the complexities of the businesses being inspected and developing a better understanding of the inspected firm’s concerns. However, that alone does not mean that the quality of future inspections will be satisfactory.”

“One thing is certain. Firms that have thus far counted on investigators not discovering fundamental problems with their key systems are less likely to succeed after the PAG plan’s implementation, owing to the greater level of knowledge and specialization of investigators.”

June 06, 2017

Senate HELP Committee Advances FDARA

3

On Thursday, May 11, 2017, the Senate Health, Education, Labor, and Pensions (HELP) Committee advanced an amended version of the Food and Drug Administration Reauthorization Act (FDARA) to the Senate floor by a 21-2 vote during an executive session. Senator Bernie Sanders and Senator Rand Paul were the two votes against the bill.

In addition to the manager’s amendment, two additional amendments were added by voice vote, including one from Senators Susan Collins of Maine and Al Franken of Minnesota that would expedite the review of some generic drug applications, and another led by Senator Orrin Hatch of Utah that would expand clinical trial criteria to allow sicker patients to participate.

Generic Approvals

Senator Collins and Senator Franken’s amendment was intended to improve access to affordable medicines by increasing the competition of generic drugs. Senator Collins noted that the language gives a clear time frame of eight months for the FDA to act on the issue and that new reporting requirements would provide transparency on the backlog of generics that are currently awaiting approval. She also noted that the amendment would require the FDA to track when drugs are exiting the market to help prevent shortages.

Clinical Trial Criteria

Senator Orrin Hatch of Utah spoke about the importance of including the Enhanced Clinical Trial Design Act. He explained that the amendment was bipartisan and proposed ways to address the way clinical trials are designed early in their development and included a wider patient mix in earlier trials. He noted that it would enhance the safety of drugs and allow patient access to effective therapies by making it easier for patients to use an FDA program to receive unapproved drugs when they do not qualify for trials.

Importation Amendment

Further, the committee voted 13-10 to table an importation amendment by Senator Bernie Sanders of Vermont that would have allowed for prescription drug importation from Canada. The amendment also received support from Senator Bob Casey from Pennsylvania, who explained that the language included several safeguards that were overlooked by the debate. He also clarified that foreign manufacturers are required to register with the FDA and only those drugs that are approved by the Administration may be imported.

Senator Hatch made clear that he did not support the amendment, declaring that it would pose serious public health concerns for Americans due to the lack of foreign site inspections by the Canadian government – over the past two years he noted that the Canadian government has only completed seventeen foreign site inspections (compared to the 842 the FDA completed just last year).

The amendment also received support from Democrat Senators Elizabeth Warren, Christopher Murphy, and Maggie Hassan.

While Committee Chairman Lamar Alexander acknowledged support of the concept, he described the amendment as controversial and asked to delay a vote on it until the bill reaches the floor to keep the committee process bipartisan. Committee Ranking Member Patty Murray and Senator Tim Kaine, both Democrats, agreed with Senator Alexander’s assessment of holding off on the vote.

Conclusion

Many Democrats used the hearing to protest the Senate process for developing a counterpart to the House-passed ACA repeal bill, calling on committee Republicans to hold hearings.

Newsletter


Preview | Powered by FeedBlitz

Search


 
Sponsors
June 2017
Sun Mon Tue Wed Thu Fri Sat
1 2 3
4 5 6 7 8 9 10
11 12 13 14 15 16 17
18 19 20 21 22 23 24
25 26 27 28 29 30