May 17, 2012

Mark’s Memo: FDA Updates and News Briefs | 03/31/10

Mark Mansour, Partner, Bryan Cave, LLP

Mark Mansour, Partner, Bryan Cave, LLP

Industry Submits Comments on 510(k) Review, Use of DeNovo Process

Reports are predicting that, as the FDA considers changes to its 510(k) review process, it will face difficulties in expanding or creating a vehicle for the review of novel medical devices without requiring those technologies to go through the more cumbersome premarket approval process. Although some industry groups have called for the increased use of the DeNovo process for novel technologies, industry experts are indicating that the use of that avenue is complicated by a lack of resources and by the requirement that the FDA develop specific guidance documents for each approved device, a process that consumes agency resources and may make the agency more hesitant to such expansion.

Others are also submitting comments on the 510(k) review process, as it undergoes reevaluation from the FDA. Comments include that the database requiring manufacturers to enter exact keywords to locate a predicate device is ineffective. In addition, industry has submitted comments regarding whether the FDA should have rescission authority for its 510(k) substantial equivalence decisions. Industry lobbyists have commented that such rescission authority should be limited to extreme cases of fraud. These groups state that the agency can make use of other means to remove problematic devices from the market, such as banning the product, mandating a recall, or ordering a product seizure.

FDA Amends Public Hearing Regulations

The FDA is amending its regulations on public hearings before public advisory committees to reflect an internal change with respect to the staff that handles the nomination and selection process for nonvoting members representing consumer interests for standing technical advisory committees. The FDA is also revising the address where the nominations for nonvoting members representing consumer interests should be submitted. For more information click here.

FDA Proposes Amendments to DTC Advertising Regulations

The FDA is proposing to amend its regulations concerning direct-to-consumer (DTC) advertisements of prescription drugs. Specifically, the proposed rule would implement a new requirement of the Federal Food, Drug, and Cosmetic Act, added by the Food and Drug Administration Amendments Act of 2007 (FDAAA), that the major statement in DTC television or radio advertisements relating to the side effects and contraindications of an advertised prescription drug intended for use by humans be presented in a clear, conspicuous, and neutral manner. Written comments are due by June 28, 2010. For more information click here.

Mark Mansour is a partner in the firm, Bryan Cave, LLP

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Mark’s Memo: FDA Updates and News Briefs | 03/02/10

Mark Mansour, Partner, Bryan Cave, LLP

Mark Mansour, Partner, Bryan Cave, LLP

FDA May Ask for Rescission Authority for 510(k) Clearances

CDRH Director Jeffrey Shuren has stated that, as the agency considers proposed changes to the 510(k) process, it may request additional authority from lawmakers, including 510(k) rescission authority. The agency has said that it is challenged by a lack of robust ability to rescind device clearances. Industry officials argue that any new powers should be limited and restrained, while patient advocates praise rescission authority as an important step towards strengthening the safety of devices cleared through the 510(k) process.

Devicemakers Worried About Bayh’s Retirement

Devicemakers with facilities in Indiana, including Boston Scientific, DePuy Orthopaedics, Medtronic and Zimmer, have expressed concern about losing support in the Senate following Sen. Evan Bayh’s retirement at the end of this year. In announcing his decision to step down, Bayh touted his advocacy for device companies as a major accomplishment; the industry employs more than 45,000 in the state.

FDA Appoints Two to Tobacco Panel

Reports are stating that the FDA has selected Jack Henningfield, VP for research and health policy at Pinney Associates, which works on behalf of GlaxoSmithKline, and Neal L. Benowitz, a UC San Francisco professor who has consulted for GlaxoSmithKline and Pfizer, to a panel responsible for regulating the tobacco industry.

China Health Reform Spending Benefits Device Manufacturers

The $125 billion in spending by the Chinese government to start a national health insurance system is benefiting manufacturers of medical devices, including makers of imaging and diagnostic equipment. $41 billion of this amount is being spent to build 31,000 hospitals and equip them with diagnostic and imaging equipment.

Mark Mansour is a partner in the firm, Bryan Cave, LLP

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Finally, CDRH Acknowledges it Needs a New Approach

Mark Mansour, Partner, Bryan Cave, LLP

Mark Mansour, Partner, Bryan Cave, LLP

The past several months have brought forth numerous bits of news, pronouncements, expressions of concern and general uncertainty about the device regulatory regime, but also about FDA’s regulatory paradigm in general.  The recent piece in the New York Times regarding disagreement about the diabetes drug Avandia and the controversy involving accusations of conflict of interest by CDER head Janet Woodcock in the consideration of competing applications for enoxaperin, in the wake of last year’s resignation of Dan Schultz at CDER has led many to wonder where FDA is going under Dr. Margaret Hamburg.

Clearly, the new leadership at FDA is now acutely aware of the number and scale of the issues confronting FDA.  In their overwhelming majority, the scientists and technical specialists at FDA are dedicated and committed individuals.  At the higher levels, however, FDA has suffered from a series of problems, none more troubling in its long-term implications for the future of the industries it regulates, than its absence of imagination.

The FDA’s approach to science is rooted in statistical models, and those models and the people who analyze their results are wholly unwilling (as a matter of culture) to do finely tuned, meaningful risk-benefit analysis.  Several years ago, FDA’s own internal assessment cautioned that this blind reliance on statistical analysis will render it entirely incapable of assessing a new generation of complex devices, medications and combinations. The FDA is earning a reputation for inability to approve a product either safely or accurately, because it evaluates products in a statistical vacuum, without regard to societal benefit, need or even real-world safety variables.

There is some hope to be found in the fact that CDRH recently admitted that it needed new methods and new thinking, precisely along these lines.  That represents a refreshing start, but it will only make a difference if it is inculcated in FDA’s culture as a whole. Dr. Hamburg has quite a challenge ahead of her.

Mark Mansour is a partner in the firm, Bryan Cave, LLP

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Mark’s Memo: FDA Updates and News Briefs | 02/22/10

Mark Mansour, Partner, Bryan Cave, LLP

Mark Mansour, Partner, Bryan Cave, LLP

FDA Seeks Comments on Proposed Information Collections

The FDA has announced an opportunity for public comment on several proposed collections of information. The agency is seeking comment on information collection requirements relating to shipment of nonsterile devices that are to be sterilized elsewhere or are shipped to other establishments for further processing, labeling, or repacking. The agency is also seeking comments on a new exception from the general requirements for informed consent to permit the use of investigational in vitro diagnostic devices to identify chemical, biological, radiological, or nuclear agents without informed consent in certain circumstances. The agency also seeks comments on its Guidance for Industry on How to Submit a Protocol Without Data in Electronic Format to the Center for Veterinary Medicine. Comments are due by April 19, 2010.

In addition, the agency is seeking comments on Antimicrobial Animal Drug Distribution Reports and on its Guidance for Humanitarian Device Exemption Holders, Institutional Review Boards, Clinical Investigators, and Food and Drug Administration Staff: Humanitarian Device Exemption Regulation: Questions and Answers. Comments are due by March 22, 2010.

FDA Seeks Comments on Proposed Data Falsification Rule

The FDA is proposing to amend its regulations to require sponsors to report information indicating that any person has, or may have, engaged in the falsification of data in the course of reporting study results, or in the course of proposing, designing, performing, recording, supervising, or reviewing studies that involve human subjects or animal subjects conducted by or on behalf of a sponsor or relied on by a sponsor. Comments on the proposed rule are due by May 20, 2010. More information is available here.

Court of Appeals Agrees to Delay E-Cigarette Decision

A federal court of appeals has agreed to stay the decision of the U.S. District Court for the District of Columbia that lifted FDA restrictions on e-cigarettes. The court ruled last month that the FDA misused its authority when it classified e-cigarettes as a drug-device combination and placed the products under an import alert.

Drug Companies May Have to Wait Longer for REMS Final Guidance

It is being reported that the final guidance on risk evaluation and mitigation strategies (REMS) may be delayed, as the CDER staff developing the recommendations must also review all proposed REMS from drugmakers.

Companies Comment on Proposed Combination Products Rule

Manufacturers of combination products, including Johnson & Johnson, have submitted comments on the FDA’s proposed rule on good manufacturing practices (GMPs) for combination products, saying that the rule needs more guidance and should better address legacy products.

Mark Mansour is a partner in the firm, Bryan Cave, LLP

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Mark’s Memo: FDA Updates and News Briefs | 02/03/10

Mark Mansour, Partner, Bryan Cave, LLP

Mark Mansour, Partner, Bryan Cave, LLP

CDRH Publishes Strategic Priorities for 2010

CDRH has published its 2010 Strategic Priorities. The four major identified priorities of CDRH include: fully implementing a total product life cycle approach, enhancing communication and transparency, strengthening the workforce and workplace, and facilitating innovation and addressing unmet public health needs. Within these priorities, CDRH has set forth a timeline, in which it states that it intends to begin implementation of the recommendations of the 510(k) Working Group by September 30, 2010. Director Jeffrey Shuren has indicated that he plans to review public comments from a meeting this month and the findings of an internal review, to be completed this summer, before making any proposals. In its notice announcing this month’s meeting on the 510(k) process, the FDA stated that it is seeking comments pertaining to four areas: predicate devices; new technologies and scientific evidence; practices for managing the high volume of 510(k) submissions; and post-market surveillance.

CDRH has also announced that it intends to launch a “Unique Device Identification” (UDI) system by Sept. 30, 2013.

FDA Moves Radiological Devices Branch to OIVD

FDA Commissioner Margaret Hamburg has signed orders to officially move the Radiological Devices Branch to the Office of In Vitro Diagnostic Device Evaluation and Safety, a result of long-term discrepancies between how in vitro and in vivo diagnostics have been regulated by FDA. OIVD will now house four product divisions – the division of chemistry and toxicology devices; immunology and hematology devices; microbiology devices; and radiological devices.

FDA Enforcement Letters on Marketing Campaigns Doubled in 2009

An FDA official has stated that the agency sent 41 enforcement letters in 2009 related to questionable drug-marketing campaigns, almost twice as many as it issued in 2008.

Mark Mansour is a partner in the firm, Bryan Cave, LLP

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Mark’s Memo: FDA Updates and News Briefs | 01/04/10

Mark Mansour, Partner, Bryan Cave, LLP

Mark Mansour, Partner, Bryan Cave, LLP

Some Concerned that New FDA Chief Counsel Lacks Food, Drug Law Experience

Although many stakeholders praised the selection of Maryland’s insurance chief to serve as the FDA’s top lawyer, some have expressed concern that he lacks experience with food and drug law. Still, many see his litigation background as beneficial and complementary to the FDA’s increased emphasis on enforcement.

FDA May Revise Guidance on Medical Device Approvals

The FDA has indicated that it may review its current guidelines on medical device approval and may issue a revised guidance that would require medical device manufacturers to notify the agency of any alterations to approved products. The change would occur as part of a larger agency review under Commissioner Margaret Hamburg and her chief deputy, Joshua Sharfstein.

CDRH Officials to Make 501(k) Process More Predictable

Officials at CDRH have stated that they want to break from what they acknowledge are questionable prior decisions and make the 501(k) process more predictable but are warning that this may mean that companies will need to be wary of relying primarily on past 501(k) clearance requirements or determinations.

FDA Announces Meeting to Identify Strategies for CDRH

The FDA is announcing a public meeting entitled: “Incorporation of New Science Into Regulatory Decisionmaking Within the Center for Devices and Radiological Health.” The purpose of the public meeting is to identify strategies and means for incorporating new science into the regulatory decisionmaking process within the agency’s Center for Devices and Radiological Health (CDRH). The meeting will be held on February 9, 2010, from 8 a.m. to 5 p.m. in Gaithersburg, Maryland. More information is available here.

Mark Mansour is a partner in the firm, Bryan Cave, LLP

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Mark’s Memo: FDA Updates and News Briefs | 12/15/09

Mark Mansour, Partner, Bryan Cave, LLP

Mark Mansour, Partner, Bryan Cave, LLP

Trade Groups Urge FDA to Extend Compliance Period for eMDR Rule

The Advanced Medical Technology Association and other trade groups have called on the FDA to extend from one year to two years the period for complying with a proposed rule that would require device firms to electronically file adverse event reports with the agency.

DOJ Prosecutors Turn Attention to Manufacturing, Safety Issues

Recent cases suggest that the Department of Justice is increasingly pursuing cases related to device manufacturing, adverse event reporting and even product labeling. While the Food, Drug & Cosmetic Act does not have whistleblower provisions, Eugene Thirolf, director of DOJ’s Office of Consumer Litigation, has stated that he predicts that future qui tam cases will cite FDC Act violations, such as manufacturing controls or adverse event reporting issues, as evidence of fraud against the government in False Claims cases.

House Bill Would Let FDA Debar Device Researchers

The Strengthening of FDA Integrity Act, H.R. 3932, introduced by Rep. Joe Barton (R-TX), would grant the FDA authority to debar device clinical trial researchers convicted of felonies. The bill also would require the FDA to send annual debarment reports to Congress and would reduce the time it has to debar a researcher from five years to one.

Submitters Still Confused on Adverse Event Reporting to ClinicalTrials.gov

Device and drug firms that submit details about their clinical trials to ClinicalTrials.gov are still having problems reporting adverse events data, Deborah Zarin, the Web site’s director, told the FDA Risk Communication Advisory Committee on Nov. 12.

Third Parties Could Train Auditors for AP Inspection Program, AdvaMed Says

Janet Trunzo, executive VP of technology and regulatory affairs at AdvaMed, has suggested that the FDA allow FDA-certified, third-party auditing firms train their own investigators.

Mark Mansour is a partner in the firm, Bryan Cave, LLP

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FDA Considers Publication of Clinical Trial Data, Complete Response Letters

Mark Mansour, Partner, Bryan Cave, LLP

Mark Mansour, Partner, Bryan Cave, LLP

The medical device industry is pushing back against calls for the FDA to release data from unsuccessful clinical trials, and has stated that, because the agency’s decision not to approve or clear a device often does not constitute final agency action, the FDA lacks the authority to release that data.

In addition, the FDA’s transparency task force is considering publishing the so-called complete response letters sent to drug companies outlining the outstanding issues, in the hope that the publication of the letters will ultimately speed the review process. Some companies, however, have concerns that the agency’s complete response letters contain trade secrets that would compromise their research if shared.

Mark Mansour is a partner in the firm, Bryan Cave, LLP

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Mark’s Memo: FDA Updates and News Briefs | 11/16/09

Mark Mansour, Partner, Bryan Cave, LLP

Mark Mansour, Partner, Bryan Cave, LLP

DOJ To Expand Use Of False Claims Act To Manufacturing And AER Violations

The Department of Justice has announced that it will expand the use of the False Claims Act and that drug manufacturers that sell products to the government that do not meet specifications or that fail to report serious adverse events could face False Claims Act allegations and potentially severe penalties in the near future.

PhRMA Recommends Uniform Graphic for Online Drug Marketing

The Pharmaceutical Research and Manufacturers of America has recommended that the FDA use a uniform graphic as part of its new guidelines for online drug marketing. The graphic would link to FDA-approved prescribing information, including safety warnings. PhRMA has stated that the uniform logo would allow for the acknowledgement of risk information in formats not easily allowing for lengthy statements.

FDA Investigators Cracking Down on Devicemakers During Inspections

At a recent FDAnews webinar, Elizabeth Troll emphasized that FDA investigators are cracking down on devicemakers that are not able to produce documents during inspections and that the opportunity to get a second chance to correct observations from inspections is more limited.

FDA Issues Reminder on Cybersecurity for Medical Devices

The FDA has issued a reminder that cybersecurity for medical devices and their associated communication networks is a shared responsibility between medical device manufacturers and medical device user facilities.

Mark Mansour is a partner in the firm, Bryan Cave, LLP

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Mark’s Memo: FDA Updates and News Briefs | 11/10/09

Mark Mansour, Partner, Bryan Cave, LLP

Mark Mansour, Partner, Bryan Cave, LLP

FDA Uses Risk-Based Approach to Select Sites for Inspection

Leslie Ball, director of the Division of Scientific Investigations at CDER, has stated that the FDA is following a risk-based approach to selecting clinical trial sites to inspect. Ball also noted that the FDA is taking additional steps, including requesting third-party audits of representative samples of sites for a given study to compare with sponsor-monitoring reports and agency inspection results.

FDA Ratchets Up Overseas Inspections For FY 2010

The FDA has stated that it expects to increase its oversight of overseas pharmaceutical company activities by one-third in fiscal 2010, and double its total number of foreign inspections. Foreign drug facility inspections would increase to 924, up from just under 600 in FY ’09. The projected number of biologics inspections is 43.

SOCMA Calls for Combined Risk-Ranking

The Society of Chemical Manufacturers and Affiliates has called on the FDA to use combined risk-ranking for domestic and foreign food and drug manufacturers, stating that FDA refusal to combine risk-ranks puts U.S. firms at a disadvantage.

Warning Letters

The FDA has issued a warning letter to Procter & Gamble notifying the company that its Vicks DayQuil Plus Vitamin C and Vicks Nyquil Plus Vitamin C are illegally marketed combinations of drug ingredients and a dietary ingredient.

Recalls

The FDA and Cordis are notifying healthcare professionals of a nationwide recall of all lots of the CROSSOVER Sheath Introducer due to stretching or fracture of the sheath during use.

Pointe Scientific and FDA are notifying healthcare professionals of a nationwide recall of all size kits of Liquid Glucose Hexokinase Reagent catalog number G7517.

FDA Questions Role of Payments in Zimmer Study

Federal health officials have stated that an implant from Zimmer Holdings Inc. appears to be effective in treating spinal problems, but that they question whether company payments to physicians conducting the trial may have influenced the results.

Mark Mansour is a partner in the firm, Bryan Cave, LLP

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