Behind the Counter Availability of Certain Drugs; Public Meeting, 56769-56770 [E7-19329]
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Federal Register / Vol. 72, No. 192 / Thursday, October 4, 2007 / Notices
notice is given that a food additive
petition (FAP 7A4769) has been filed by
Dean Foods Co., c/o Hogan and Hartson
LLP, 555 13th St., NW., Washington, DC
20004–1109. The petition proposes to
amend the food additive regulations in
part 172 Food Additives Permitted for
Direct Addition to Food for Human
Consumption (21 CFR part 172) to
provide for the safe use of vitamin D2 as
a nutrient supplement in soy-based food
products.
The agency has determined under 21
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that does not individually or
cumulatively have a significant effect on
the human environment. Therefore,
neither an environmental assessment
nor an environmental impact statement
is required.
Dated: September 26, 2007.
Laura M. Tarantino,
Director, Office of Food Additive Safety,
Center for Food Safety and Applied Nutrition.
[FR Doc. E7–19576 Filed 10–3–07; 8:45 am]
BILLING CODE 4160–01–S
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Food and Drug Administration
[Docket No. 2007N–0356]
Behind the Counter Availability of
Certain Drugs; Public Meeting
AGENCY:
Food and Drug Administration,
HHS.
Notice of public meeting;
request for comments.
pwalker on PROD1PC71 with NOTICES
ACTION:
SUMMARY: The Food and Drug
Administration (FDA) is announcing a
public meeting to obtain comments
regarding behind-the-counter (BTC)
availability of drugs. Currently, drugs
are available as prescription and nonprescription. Generally, nonprescription products are available in an
‘‘over-the-counter’’ (OTC) manner. The
FDA is interested in obtaining public
comment as it explores the public
health benefit of certain drugs being
available without a prescription but
only after intervention by a pharmacist.
The purpose of the meeting is to solicit
information and views from interested
persons on specific issues associated
with BTC availability, including the
impact on patient access to safe and
effective drug products.
Dates and Times: The public meeting
will be held on November 14, 2007,
from 8 a.m. to 5 p.m.
Location: The public meeting will be
held at the National Transportation
Safety Board Conference Center, 429
VerDate Aug<31>2005
16:20 Oct 03, 2007
Jkt 214001
56769
L’Enfant Plaza SW., Washington, DC
20594.
ADDRESSES: Submit written registration
and written comments to the Division of
Dockets Management (HFA–305), Food
and Drug Administration, 5630 Fishers
Lane, rm. 1061, Rockville, MD 20852.
Submit electronic registration to https://
www.accessdata.fda.gov/scripts/oc/
dockets/meetings/meetingdocket.cfm.
Submit electronic comments to https://
www.accessdata.fda.gov/scripts/oc/
dockets/commentdocket.cfm.
Transcripts of the meeting will be
available for review at the Division of
Dockets Management and on the
Internet at https://www.fda.gov/ohrms/
dockets approximately 30 days after the
meeting.
For Registration to Attend and/or
Participate in the Meeting: Seating at the
meeting is limited. People interested in
attending should submit written or
electronic registration to the Division of
Docket Management (see ADDRESSES) by
close of business on November 5, 2007.
Registration is free and will be on a firstcome, first-serve basis. Written or
electronic comments will be accepted
until November 28, 2007.
If you wish to make an oral
presentation at the meeting, you must
state your intention on your registration
submission (see ADDRESSES). To speak,
submit your name, title, business
affiliation, address, telephone number,
fax number, and e-mail address. FDA
has included questions for comment in
this notice. You should also identify by
number each question you wish to
address in your presentation. FDA will
do its best to accommodate requests to
speak. Individuals and organizations
with common interests are urged to
consolidate or coordinate their
presentations, and to request time for a
joint presentation. FDA will determine
the amount of time allotted to each
presenter and the approximate time that
each oral presentation is scheduled to
begin.
If you need special accommodations
due to a disability, please inform Erik
Mettler (see For Information on the
Meeting Contact).
For Information on the Meeting
Contact: Erik Mettler, Office of Policy
(HF–11), Food and Drug
Administration, 5600 Fishers Lane, rm.
14–101, Rockville, MD 20857, 301–827–
3360, FAX: 301–594–6777, e-mail:
Erik.Mettler@fda.hhs.gov.
SUPPLEMENTARY INFORMATION:
health benefit of certain drugs being
available BTC that were previously
prescription medications. BTC could be
comprised of certain medications
available behind the counter at the
pharmacy without a prescription and
require the intervention of a pharmacist
before dispensing.
Some groups have asserted that
pharmacist interaction with the
consumer could ensure safe and
effective use of a drug product that
otherwise might require a prescription.
Because pharmacists have the training
and knowledge to provide certain
interventions, they may be able to
ensure that patients meet the conditions
for use and educate patients on
appropriate use of the drug product.
These groups have suggested, moreover,
that the availability of certain drugs BTC
could increase patient access to
medications that may be underutilized,
particularly by patients without health
insurance because these medications
otherwise would be available only with
a prescription.
Variations of a BTC status are already
in effect in other countries, including
Australia, Canada, France, New
Zealand, United Kingdom (UK),
Denmark, Germany, Italy, Netherlands,
Sweden, and Switzerland. In the UK,
there is a ‘‘pharmacist-only’’ class of
drugs, while the other countries have
more than three classes. In general,
foreign countries have used the
following criteria for switching a drug
from prescription to intermediate class:
(1) Indications suitable for selfmedication, including self-diagnosis,
with the intervention of a pharmacist
and (2) the medicine has a low potential
for side effects or overdose, and
intervention by a pharmacist could
minimize these risks. Other
considerations include: Abuse potential,
patient choice and accessibility, and
public health issues. With the
pharmacy-only classification, typically
the pharmacist is required to ensure the
patient meets certain criteria prior to
dispensing, as well as to provide
education on proper use and
monitoring.
Accordingly, FDA is interested in
exploring the public health implications
of BTC dispensing of certain drug
products, including (among other
things) the implications for patient
access and utilization, including drug
prices, the continued safety and
effectiveness of drugs, and patient
compliance with drug therapy.
I. Background
FDA is committed to ensuring the
safety and efficacy of all drug products
it regulates. FDA is exploring the public
II. Scope of Meeting
FDA is interested in obtaining public
comment on BTC availability of certain
drugs, the appropriate regulatory
PO 00000
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Fmt 4703
Sfmt 4703
E:\FR\FM\04OCN1.SGM
04OCN1
pwalker on PROD1PC71 with NOTICES
56770
Federal Register / Vol. 72, No. 192 / Thursday, October 4, 2007 / Notices
framework for such drugs, and criteria
for BTC availability.
Specifically, we are seeking input on
the following issues related to BTC:
General
1. Should there be BTC availability of
certain drug products? If so why? If not
why?
2. What might the impact of BTC be
on patient access?
3. What might the impact of BTC be
on patient compliance with drug
therapy?
4. What should the criteria or
standards be for a drug to be treated as
BTC?
5. Please comment on the following
criteria for what roles a pharmacist or
other health professional might play,
which are included below for
discussion purposes. For example, a
pharmacist or other practitioner
licensed by law to dispense prescription
drugs prior to sale might:
(A) Review or conduct an initial
screening for clinical laboratory test
results, contraindications, or drug
interactions;
(B) Counsel the patient on safe use;
(C) Monitor for continued safe or
effective use.
6. Should BTC availability be used as
a temporary or transitional status for
drugs that move from prescription status
to OTC versus a permanent status?
7. Should there be criteria or
standards for a drug to transition out of
BTC status to OTC status? If so, what
should these criteria or standards be?
8. If safety concerns arise, should
there be criteria or standards for a drug
to transition out of BTC status to
prescription status? Or from OTC status
to BTC status? If so what should these
criteria or standards be for each
scenario?
9. What effect would BTC availability
have on patient access to medications in
this category?
10. How could we evaluate whether
BTC improves patient access to
medications?
11. Would BTC availability be costeffective to patients? Please explain.
12. What effect would BTC
availability have on patient safety?
13. What measures would be
necessary to ensure patient safety?
14. In general, what are the benefits
and costs to the healthcare system as a
whole related to BTC availability?
Logistics
1. Discuss logistical challenges for
pharmacy storage and dispensing of
BTC drugs. How might these challenges
be addressed?
2. What dispensing procedures should
be associated with BTC medications?
3. What types of records should be
kept in association with BTC
VerDate Aug<31>2005
16:20 Oct 03, 2007
Jkt 214001
dispensing? If such records were to
include patient laboratory values, how
would the pharmacist gain access to this
information as well as other information
in the patient’s medical records?
4. How would patient privacy be
protected in a retail pharmacy setting?
Please discuss any privacy concerns that
would need to be addressed.
5. Should reimbursement be available
to pharmacists for providing services
associated with BTC dispensing? What
type? What type of billing procedures
could be utilized and how would third
party companies facilitate such
reimbursements?
6. Who would oversee a BTC
program? What impact would it have on
States and what might be the role for the
State boards of pharmacy?
7. Would special training be needed
for pharmacists to participate in
dispensing BTC medications? If any,
what type of training would this entail?
8. Would special training be needed
for other pharmacy staff to aid in
managing the work flow (storage, record
keeping, distribution) and additional
BTC responsibilities of the
pharmacist(s) and the pharmacy? If so,
what type of training or measures
should be put in place?
9. Could qualified healthcare
professionals/providers other than
pharmacists be responsible for
dispensing of BTC drugs? If so, what
types of healthcare professionals/
providers? And in what type of settings
could this situation be accommodated?
10. What impact would BTC
availability of drugs have on the
practice of pharmacy?
11. What impact would BTC
availability of drugs have on the
practice of medicine?
III. Comments
Interested persons may submit to the
Division of Dockets Management (see
ADDRESSES) written or electronic notices
of participation and comments for
consideration. To permit time for all
interested persons to submit data,
information, or views on this subject,
the docket for the meeting will open 14
days prior to the meeting and remain
open for 30 days following the meeting.
Persons who wish to provide additional
materials for consideration should file
these materials with the Division of
Dockets Management. You should
annotate and organize your comments to
identify the specific questions identified
by the number and subject to which
they refer in the previous text in this
document. Please identify comments
with the docket number found in
brackets in the heading of this
document. Received comments may be
PO 00000
Frm 00053
Fmt 4703
Sfmt 4703
seen in the Division of Dockets
Management between 9 a.m. and 4 p.m.,
Monday through Friday. Transcripts of
the meeting also will be available for
review at the Division of Dockets
Management.
Dated: September 25, 2007.
Jeffrey Shuren,
Assistant Commissioner for Policy.
[FR Doc. E7–19329 Filed 10–3–07; 8:45 am]
BILLING CODE 4160–01–S
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Food and Drug Administration
Docket No. [2001D–0193 (formerly 01D–
0193)]
Guidance for Industry and Food and
Drug Administration Staff; Biological
Indicator Premarket Notification
Submissions; Availability
AGENCY:
Food and Drug Administration,
HHS.
ACTION:
Notice.
SUMMARY: The Food and Drug
Administration (FDA) is announcing the
availability of the guidance entitled
‘‘Biological Indicator (BI) Premarket
Notification (510(k)) Submissions.’’ The
agency is issuing this guidance
document to provide information that
will help manufacturers prepare
premarket notification submissions for
these devices. The document provides
guidance regarding performance
characteristics for biological indicator
devices, which are intended to monitor
the effectiveness of sterilizers used in
healthcare facilities.
DATES: Submit written or electronic
comments on this guidance at any time.
General comments on agency guidance
documents are welcome at any time.
ADDRESSES: Submit written requests for
single copies of the guidance document
entitled ‘‘Biological Indicator (BI)
Premarket Notification (510(k))
Submissions’’ to the Division of Small
Manufacturers, International, and
Consumer Assistance (HFZ–220), Center
for Devices and Radiological Health,
Food and Drug Administration, 1350
Piccard Dr., Rockville, MD 20850. Send
one self-addressed adhesive label to
assist that office in processing your
request, or fax your request to 240–276–
3151 or 1–800–638–2041. See the
SUPPLEMENTARY INFORMATION section for
information on electronic access to the
guidance.
Submit written comments concerning
this guidance to the Division of Dockets
Management (HFA–305), Food and Drug
E:\FR\FM\04OCN1.SGM
04OCN1
]]>Agencies
[Federal Register Volume 72, Number 192 (Thursday, October 4, 2007)]
[Notices]
[Pages 56769-56770]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E7-19329]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Food and Drug Administration
[Docket No. 2007N-0356]
Behind the Counter Availability of Certain Drugs; Public Meeting
AGENCY: Food and Drug Administration, HHS.
ACTION: Notice of public meeting; request for comments.
-----------------------------------------------------------------------
SUMMARY: The Food and Drug Administration (FDA) is announcing a public
meeting to obtain comments regarding behind-the-counter (BTC)
availability of drugs. Currently, drugs are available as prescription
and non-prescription. Generally, non-prescription products are
available in an ``over-the-counter'' (OTC) manner. The FDA is
interested in obtaining public comment as it explores the public health
benefit of certain drugs being available without a prescription but
only after intervention by a pharmacist. The purpose of the meeting is
to solicit information and views from interested persons on specific
issues associated with BTC availability, including the impact on
patient access to safe and effective drug products.
Dates and Times: The public meeting will be held on November 14,
2007, from 8 a.m. to 5 p.m.
Location: The public meeting will be held at the National
Transportation Safety Board Conference Center, 429 L'Enfant Plaza SW.,
Washington, DC 20594.
ADDRESSES: Submit written registration and written comments to the
Division of Dockets Management (HFA-305), Food and Drug Administration,
5630 Fishers Lane, rm. 1061, Rockville, MD 20852. Submit electronic
registration to https://www.accessdata.fda.gov/scripts/oc/dockets/
meetings/meetingdocket.cfm.
Submit electronic comments to https://www.accessdata.fda.gov/
scripts/oc/dockets/commentdocket.cfm. Transcripts of the meeting will
be available for review at the Division of Dockets Management and on
the Internet at https://www.fda.gov/ohrms/dockets approximately 30 days
after the meeting.
For Registration to Attend and/or Participate in the Meeting:
Seating at the meeting is limited. People interested in attending
should submit written or electronic registration to the Division of
Docket Management (see ADDRESSES) by close of business on November 5,
2007. Registration is free and will be on a first-come, first-serve
basis. Written or electronic comments will be accepted until November
28, 2007.
If you wish to make an oral presentation at the meeting, you must
state your intention on your registration submission (see ADDRESSES).
To speak, submit your name, title, business affiliation, address,
telephone number, fax number, and e-mail address. FDA has included
questions for comment in this notice. You should also identify by
number each question you wish to address in your presentation. FDA will
do its best to accommodate requests to speak. Individuals and
organizations with common interests are urged to consolidate or
coordinate their presentations, and to request time for a joint
presentation. FDA will determine the amount of time allotted to each
presenter and the approximate time that each oral presentation is
scheduled to begin.
If you need special accommodations due to a disability, please
inform Erik Mettler (see For Information on the Meeting Contact).
For Information on the Meeting Contact: Erik Mettler, Office of
Policy (HF-11), Food and Drug Administration, 5600 Fishers Lane, rm.
14-101, Rockville, MD 20857, 301-827-3360, FAX: 301-594-6777, e-mail:
Erik.Mettler@fda.hhs.gov.
SUPPLEMENTARY INFORMATION:
I. Background
FDA is committed to ensuring the safety and efficacy of all drug
products it regulates. FDA is exploring the public health benefit of
certain drugs being available BTC that were previously prescription
medications. BTC could be comprised of certain medications available
behind the counter at the pharmacy without a prescription and require
the intervention of a pharmacist before dispensing.
Some groups have asserted that pharmacist interaction with the
consumer could ensure safe and effective use of a drug product that
otherwise might require a prescription. Because pharmacists have the
training and knowledge to provide certain interventions, they may be
able to ensure that patients meet the conditions for use and educate
patients on appropriate use of the drug product. These groups have
suggested, moreover, that the availability of certain drugs BTC could
increase patient access to medications that may be underutilized,
particularly by patients without health insurance because these
medications otherwise would be available only with a prescription.
Variations of a BTC status are already in effect in other
countries, including Australia, Canada, France, New Zealand, United
Kingdom (UK), Denmark, Germany, Italy, Netherlands, Sweden, and
Switzerland. In the UK, there is a ``pharmacist-only'' class of drugs,
while the other countries have more than three classes. In general,
foreign countries have used the following criteria for switching a drug
from prescription to intermediate class: (1) Indications suitable for
self-medication, including self-diagnosis, with the intervention of a
pharmacist and (2) the medicine has a low potential for side effects or
overdose, and intervention by a pharmacist could minimize these risks.
Other considerations include: Abuse potential, patient choice and
accessibility, and public health issues. With the pharmacy-only
classification, typically the pharmacist is required to ensure the
patient meets certain criteria prior to dispensing, as well as to
provide education on proper use and monitoring.
Accordingly, FDA is interested in exploring the public health
implications of BTC dispensing of certain drug products, including
(among other things) the implications for patient access and
utilization, including drug prices, the continued safety and
effectiveness of drugs, and patient compliance with drug therapy.
II. Scope of Meeting
FDA is interested in obtaining public comment on BTC availability
of certain drugs, the appropriate regulatory
[[Page 56770]]
framework for such drugs, and criteria for BTC availability.
Specifically, we are seeking input on the following issues related
to BTC:
General
1. Should there be BTC availability of certain drug products? If so
why? If not why?
2. What might the impact of BTC be on patient access?
3. What might the impact of BTC be on patient compliance with drug
therapy?
4. What should the criteria or standards be for a drug to be
treated as BTC?
5. Please comment on the following criteria for what roles a
pharmacist or other health professional might play, which are included
below for discussion purposes. For example, a pharmacist or other
practitioner licensed by law to dispense prescription drugs prior to
sale might:
(A) Review or conduct an initial screening for clinical laboratory
test results, contraindications, or drug interactions;
(B) Counsel the patient on safe use;
(C) Monitor for continued safe or effective use.
6. Should BTC availability be used as a temporary or transitional
status for drugs that move from prescription status to OTC versus a
permanent status?
7. Should there be criteria or standards for a drug to transition
out of BTC status to OTC status? If so, what should these criteria or
standards be?
8. If safety concerns arise, should there be criteria or standards
for a drug to transition out of BTC status to prescription status? Or
from OTC status to BTC status? If so what should these criteria or
standards be for each scenario?
9. What effect would BTC availability have on patient access to
medications in this category?
10. How could we evaluate whether BTC improves patient access to
medications?
11. Would BTC availability be cost-effective to patients? Please
explain.
12. What effect would BTC availability have on patient safety?
13. What measures would be necessary to ensure patient safety?
14. In general, what are the benefits and costs to the healthcare
system as a whole related to BTC availability?
Logistics
1. Discuss logistical challenges for pharmacy storage and
dispensing of BTC drugs. How might these challenges be addressed?
2. What dispensing procedures should be associated with BTC
medications?
3. What types of records should be kept in association with BTC
dispensing? If such records were to include patient laboratory values,
how would the pharmacist gain access to this information as well as
other information in the patient's medical records?
4. How would patient privacy be protected in a retail pharmacy
setting? Please discuss any privacy concerns that would need to be
addressed.
5. Should reimbursement be available to pharmacists for providing
services associated with BTC dispensing? What type? What type of
billing procedures could be utilized and how would third party
companies facilitate such reimbursements?
6. Who would oversee a BTC program? What impact would it have on
States and what might be the role for the State boards of pharmacy?
7. Would special training be needed for pharmacists to participate
in dispensing BTC medications? If any, what type of training would this
entail?
8. Would special training be needed for other pharmacy staff to aid
in managing the work flow (storage, record keeping, distribution) and
additional BTC responsibilities of the pharmacist(s) and the pharmacy?
If so, what type of training or measures should be put in place?
9. Could qualified healthcare professionals/providers other than
pharmacists be responsible for dispensing of BTC drugs? If so, what
types of healthcare professionals/providers? And in what type of
settings could this situation be accommodated?
10. What impact would BTC availability of drugs have on the
practice of pharmacy?
11. What impact would BTC availability of drugs have on the
practice of medicine?
III. Comments
Interested persons may submit to the Division of Dockets Management
(see ADDRESSES) written or electronic notices of participation and
comments for consideration. To permit time for all interested persons
to submit data, information, or views on this subject, the docket for
the meeting will open 14 days prior to the meeting and remain open for
30 days following the meeting. Persons who wish to provide additional
materials for consideration should file these materials with the
Division of Dockets Management. You should annotate and organize your
comments to identify the specific questions identified by the number
and subject to which they refer in the previous text in this document.
Please identify comments with the docket number found in brackets in
the heading of this document. Received comments may be seen in the
Division of Dockets Management between 9 a.m. and 4 p.m., Monday
through Friday. Transcripts of the meeting also will be available for
review at the Division of Dockets Management.
Dated: September 25, 2007.
Jeffrey Shuren,
Assistant Commissioner for Policy.
[FR Doc. E7-19329 Filed 10-3-07; 8:45 am]
BILLING CODE 4160-01-S
