Current Good Manufacturing Practice and Investigational New Drugs Intended for Use in Clinical Trials, 40453-40463 [E8-16011]
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40453
Rules and Regulations
Federal Register
Vol. 73, No. 136
Tuesday, July 15, 2008
This section of the FEDERAL REGISTER
contains regulatory documents having general
applicability and legal effect, most of which
are keyed to and codified in the Code of
Federal Regulations, which is published under
50 titles pursuant to 44 U.S.C. 1510.
The Code of Federal Regulations is sold by
the Superintendent of Documents. Prices of
new books are listed in the first FEDERAL
REGISTER issue of each week.
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Food and Drug Administration
21 CFR Part 210
[Docket No. FDA–2005–N–0170] (formerly
Docket No. 2005N–0285)
Current Good Manufacturing Practice
and Investigational New Drugs
Intended for Use in Clinical Trials
AGENCY:
Food and Drug Administration,
HHS.
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ACTION:
Final rule.
SUMMARY: The Food and Drug
Administration (FDA) is amending the
current good manufacturing practice
(CGMP) regulations for human drugs,
including biological products, to exempt
most phase 1 investigational drugs from
complying with the regulatory CGMP
requirements. FDA will continue to
exercise oversight of the manufacture of
these drugs under FDA’s general
statutory CGMP authority and through
review of the investigational new drug
applications (IND).
In addition, elsewhere in this issue of
the Federal Register, FDA is
announcing the availability of a
guidance document entitled ‘‘Guidance
for Industry: CGMP for Phase 1
Investigational Drugs’’ dated November
2007 (the companion guidance). This
guidance document sets forth
recommendations on approaches to
compliance with statutory CGMP for the
exempted phase 1 investigational drugs.
FDA is taking this action to focus a
manufacturer’s effort on applying CGMP
that is appropriate and meaningful for
the manufacture of the earliest stage
investigational drug products intended
for use in phase 1 clinical trials while
ensuring safety and quality. This action
will also streamline and promote the
drug development process.
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This rule is effective September
15, 2008.
FOR FURTHER INFORMATION CONTACT:
Monica Caphart, Center for Drug
Evaluation and Research (HFD–320),
Food and Drug Administration, 10903
New Hampshire Ave., Silver Spring, MD
20993, 301–796–3248, or
Christopher Joneckis, Center for
Biologics Evaluation and Research
(HFM–1), Food and Drug
Administration, 1401 Rockville Pike,
Rockville, MD 20852, 301–827–5000.
SUPPLEMENTARY INFORMATION:
DATES:
I. Rulemaking Procedure
In the Federal Register of January 17,
2006 (71 FR 2458), FDA published a
direct final rule to amend § 210.2 (21
CFR 210.2) to exempt most phase 1
investigational drugs from complying
with the CGMP requirements in parts
210 and 211 (21 CFR parts 210 and 211).
We explained that we issued this rule as
a direct final rule because we believed
it was non-controversial and that there
was little likelihood of receiving
significant adverse comments. We
concurrently published in the Federal
Register of January 17, 2006 (71 FR
2494) a companion proposed rule,
identical in substance to the direct final
rule, that provided a procedural
framework from which to proceed with
standard notice-and-comment
rulemaking in the event we were
required to withdraw the direct final
rule because of significant adverse
comments. A significant adverse
comment is defined as a comment that
explains why the rule would be
inappropriate, including challenges to
the rule’s underlying premise or
approach, or would be ineffective or
unacceptable without change. Any
comments received under the
companion proposed rule were treated
as comments regarding the direct final
rule and vice versa. A full description
of FDA’s policy on direct final rule
procedures may be found in a guidance
document published in the Federal
Register of November 21, 1997 (62 FR
62466).
We received 14 comments on the
proposed rule, of which several were
considered to be significant adverse
comments. Therefore, in the Federal
Register of May 2, 2006 (71 FR 25747),
we withdrew the direct final rule. This
final rule summarizes and responds to
the comments received on the direct
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final rule and proposed rule. See section
V of this document for a discussion of
the comments and FDA’s responses.
Together with the companion
guidance, this final rule will assist the
drug development process by
streamlining the application of CGMP
that is more appropriate to the
manufacture of the earliest stage
investigational drug products—those
intended for use in phase 1 clinical
trials.
II. Background
A phase 1 clinical trial includes the
initial introduction of an investigational
new drug product, including biological
drug products, into humans. Such
studies are conducted to establish the
basic safety of the drug, and are
designed to determine the metabolism
and pharmacologic actions of the drug
in humans. The total number of subjects
in a phase 1 clinical trial is limited
generally to no more than 80 subjects.
This is in contrast to phase 2 and phase
3 clinical trials when a substantially
greater number of subjects are involved,
more subjects are exposed to the drug
product, and the effectiveness of the
drug product is also tested in addition
to safety. During phase 2 or phase 3,
drug products may also be made
available for treatment use through one
of several mechanisms for expanded
access to investigational drugs.
FDA’s general CGMP regulations for
human drugs are set forth in parts 210
and 211. Although the preamble to a
final rule published in the Federal
Register of September 29, 1978 (43 FR
45014) (the 1978 final rule) issuing
these regulations expressly stated that
the CGMP regulations applied to
investigational drug products, it also
raised the possibility of proposing an
additional CGMP regulation to cover
drugs being used in research: ‘‘The
Commissioner finds that, as stated in
§ 211.1, these CGMP regulations apply
to the preparation of any drug product
for administration to humans or
animals, including those still in
investigational stages. It is appropriate
that the process by which a drug
product is manufactured in the
development phase be well documented
and controlled in order to assure the
reproducibility of the product for
further testing and for ultimate
commercial production. The
Commissioner is considering proposing
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additional CGMP regulations
specifically designed to cover drugs in
research stages’’ (43 FR 45014 at 45029).
Such additional regulations have never
been issued.
On February 21, 1991, FDA issued a
guidance document entitled
‘‘Preparation of Investigational New
Drug Products (Human and Animal)’’
(56 FR 7048) (the 1991 guidance). That
document, however, did not discuss all
manufacturing scenarios, and did not
clearly address small- or laboratoryscale production of drug products for
use in phase 1 clinical trials.
Additionally, the 1991 guidance did not
fully discuss FDA’s expectations on
appropriate approaches to
manufacturing controls for batches
produced during drug development.
For several reasons, FDA believes that
production of human drug products,
including biological drug products,
intended for use in phase 1 clinical
trials (phase 1 investigational drugs)
should be exempted from complying
with the specific regulatory
requirements set forth in parts 210 and
211. First, even if exempted from the
requirements of parts 210 and 211,
investigational drugs remain subject to
the statutory requirement that deems a
drug adulterated if ‘‘* * * the facilities
or controls used for, its manufacture,
processing, packing, or holding do not
conform to or are not operated or
administered in conformity with current
good manufacturing practices to assure
that such drug meets the requirements
of this chapter [of the Federal Food,
Drug, and Cosmetic Act (the act)] as to
safety and has the identity and strength,
and meets the quality and purity
characteristics, which it purports or is
represented to possess’’ (section
501(a)(2)(B) of the act (21 U.S.C.
351(a)(2)(B))). Second, FDA oversees
drugs for use in phase 1 trials through
its existing IND authority. Every IND
must contain, among other things, a
section on chemistry, manufacturing,
and control information that describes
the composition, manufacture, and
control of the investigational drug
product (§ 312.23(a)(7) (21 CFR
312.23(a)(7))). Submission of this
information, along with other
information required in the IND,
informs FDA of the steps that the
manufacturer is taking to ensure the
safety and quality of the investigational
drug. Under this IND authority, FDA has
the option to place an IND on clinical
hold if the study subjects would be
exposed to unreasonable and significant
risk or if the IND does not contain
sufficient information to assess the risks
to subjects (21 CFR 312.42). FDA also
may terminate an IND if the methods,
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facilities, and controls used for the
manufacturing, processing, and packing
of the investigational drug are
inadequate to establish and maintain
appropriate standards of identity,
strength, quality, and purity as needed
for subject safety (21 CFR
312.44(b)(1)(iii)).
Thus, even though FDA is exempting
phase 1 drug products from compliance
with the specific requirements of the
CGMP regulations, FDA retains the
ability to take appropriate actions to
address manufacturing issues. For
example, in addition to the authority to
put an IND on clinical hold or terminate
an IND, FDA may initiate an action to
seize an investigational drug or enjoin
its production if its production does not
occur under conditions sufficient to
ensure the identity, strength, quality,
and purity of the drug, which may
adversely affect its safety.
FDA believes this change in the
CGMP regulations (parts 210 and 211) is
appropriate because many of the issues
presented by the production of
investigational drugs intended for use in
the relatively small phase 1 clinical
trials are different from issues presented
by the production of drug products for
use in the larger phase 2 and phase 3
clinical trials or for commercial
marketing. We are considering
additional guidance and regulations to
clarify FDA’s expectations with regard
to fulfilling CGMP requirements when
producing investigational drugs for
phase 2 and phase 3 clinical trials.
Additionally, many of the specific
requirements in the regulations in part
211 do not apply to the conditions
under which many drugs for use in
phase 1 clinical trials are produced. For
example, the concerns underlying the
regulations’ requirement for fully
validated manufacturing processes,
rotation of the stock for drug product
containers, the repackaging and
relabeling of drug products, and
separate packaging and production areas
are generally not concerns for these very
limited production investigational drug
products used in phase 1 clinical trials.
Consequently, in this final rule, FDA
is amending the scope section of the
drug CGMP regulations in part 210 to
make clear that production of
investigational drugs for use in phase 1
clinical trials conducted under an IND
does not need to comply with the
regulations in part 211. However, once
an investigational drug product has
been manufactured by, or for, a sponsor
and is available for use in a phase 2 or
phase 3 study, thus demonstrating an
intent to expose more subjects to the
investigational drug and requiring that
the regulations’ CGMP requirements be
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met, the same investigational drug
product used in any subsequent phase
1 study by the same sponsor must be
manufactured in compliance with part
211. In addition to drug products that,
if eventually approved, would be
approved under section 505 of the act
(21 U.S.C. 355), this rule applies to
investigational biological products that
are subject to the CGMP requirements of
section 501(a)(2)(B) of the act. Examples
of such products include recombinant
and non-recombinant therapeutic
products, vaccine products, allergenic
products, in vivo diagnostics, plasma
derivative products, blood and blood
products, gene therapy products, and
somatic cellular therapy products
(including xenotransplantation
products) that are subject to the CGMP
requirements of section 501(a)(2)(B) of
the act. Therefore, this final rule
exempts the production of phase 1
investigational drugs from complying
with the regulatory requirements set
forth in parts 210 and 211.
III. Legal Authority
Under section 501(a)(2)(B) of the act,
a drug is deemed adulterated if the
methods used in, or the facilities, or
controls used for, its manufacture,
processing, packing or holding do not
conform to, or are not operated in
conformity with, CGMPs to ensure that
such drug meets the requirements of the
act as to safety, and has the identity and
strength, and meets the quality and
purity characteristics, which it purports
or is represented to possess. The
rulemaking authority conferred on FDA
by Congress under the act permits FDA
to amend its regulations as
contemplated by this final rule. Section
701(a) of the act (21 U.S.C. 371(a)) gives
FDA, through delegation from the
Secretary of the Department of Health
and Human Services, general
rulemaking authority to issue
regulations for the efficient enforcement
of the act. We refer readers to section V
of the preamble of the 1978 final rule for
a fuller discussion of our CGMP
rulemaking authority (43 FR 45014 at
45020–45026).
IV. Summary of the Final Rule
This final rule adds paragraph (c) to
§ 210.2, exempting certain
investigational drugs for use in a phase
1 clinical trial (including biological
drugs) from compliance with part 211.
However, these drugs remain subject to
the statutory requirements under section
501(a)(2)(B) of the act, i.e., CGMP. The
regulation also explains that the
exemption from compliance with part
211 does not apply to an investigational
drug that a sponsor has made available
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for a phase 2 or phase 3 clinical trial,
or has lawfully been marketed, and is
being used for a phase 1 clinical trial.
Such investigational drug products used
for a phase 1 clinical trial must comply
with part 211.
We have also changed the term
‘‘defined’’ to ‘‘described’’ for
clarification.
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V. Comments on the Proposed Rule and
FDA’s Responses
We received approximately 14
comments on the proposed rule. Several
comments were duplicate submissions
by the same entity; several other
comments submitted to the docket
pertained to the draft guidance under a
separate docket number. These
comments were also considered in
revising the draft guidance. The
following responses are specific to the
comments on the proposed rule.
A. General Comments
(Comment 1) Several comments
welcome the proposed changes and
commend FDA for revising the
regulations to exempt phase 1
investigational drugs from regulatory
CGMP under part 211. One comment
adds that, because most products do not
proceed beyond the clinical trial phase
of development, the burden of full
compliance with CGMP at the phase 1
stage far outweighs any perceived
benefit and suggests that FDA devise a
progressive scale for CGMP compliance
beginning with phase 1 clinical trials
through approval to market the product.
(Response) We appreciate these
supportive comments. Our expectation
in issuing this final rule is that sponsors
will take an appropriate approach to
instituting manufacturing controls
appropriate for the stage of
investigational drug development.
(Comment 2) Some comments oppose
exempting phase 1 investigational drugs
from compliance with part 211 because
they are concerned that there could be
an effect on product safety and human
subject protection. Another comment
believes that FDA’s proposed approach
to exempt phase 1 investigational drugs
from the applicability of part 211 not
only invites greatly reduced product
standards, but affects FDA’s ability to
take remedial action. One reason given
was that FDA does not have the
personnel to monitor the manufacture of
phase 1 investigational drugs during
clinical trials. Another comment
believes that if the phase 1
investigational drugs are not
reproducible, not well-documented, or
not well-controlled, the results of the
trial will be meaningless and delay
availability of new drugs for commercial
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use. The comment continued to state
that an establishment could interpret
FDA’s proposal as loosening the basic
requirements needed for phase 1
material, which would not only
jeopardize patients and the results of the
phase 1 clinical trial, but also the
investigational stages of development
that follow.
(Response) We are confident that
exempting phase 1 investigational drugs
from the CGMP regulations in part 211
will not jeopardize product safety or
human subject protection. This action is
intended to focus a manufacturer’s effort
on applying CGMP that is appropriate
and meaningful for the manufacture of
the earliest stage investigational drug
products intended for use in phase 1
clinical trials, while also ensuring the
products’ safety and quality. An
additional consequence of this action is
to streamline and promote the drug
development process. The companion
guidance provides our current thinking
on ways to comply, through the use of
specified quality controls, with statutory
CGMP for the production of phase 1
investigational drugs. As previously
described, we will continue to oversee
product safety and human subject
protection through articulation of
statutory CGMP requirements, clarified
in the companion guidance, and a
thorough review of the chemistry,
manufacturing, and control information
submitted in the IND application for
identity, quality, purity, strength, and
potency of the investigational drug
necessary to ensure the safety of the
subjects in the phase 1 clinical trial. We
believe that this exemption does not
‘‘loosen’’ the requirements, but
establishes quality control principles
that are appropriate and comprehensive
for the manufacture of phase 1
investigational drugs, i.e., interpreting
and implementing CGMP consistent
with good scientific methodology.
We also believe that the exemption
will not affect or change our ability to
take remedial action if necessary, or to
monitor the manufacture of such
investigational drugs; nor do we believe
that this action will delay availability of
new drugs for commercial use. As stated
elsewhere in this document and in the
proposed rule, compliance with CGMP
is required by section 501(a)(2)(B) of the
act and a drug can be deemed
adulterated by FDA for failure to
comply with statutorily mandated
CGMP.
(Comment 3) One comment states that
the proposed rule was misleading and
unclear. The comment asserts, correctly,
that a phase 1 investigational drug used
in phase 2 and phase 3 clinical trials
must comply with part 211, but argues
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that the progression of the study to
phase 2 and phase 3 is unknown at the
time of the phase 1 investigational drug
production. Therefore, the sponsor will
most likely produce the phase 1
investigational drug in compliance with
part 211 in lieu of not being able to use
data from the phase 1 study for phase
2 and phase 3.
(Response) We disagree that the
proposed rule was misleading and
unclear. In the preamble to the direct
final rule (71 FR 2458 at 2459), we
explained that we believe the exemption
for phase 1 investigational drugs ‘‘is
appropriate because many of the issues
presented by the production of
investigational drugs intended for use in
the relatively small Phase 1 clinical
trials are different from issues presented
by the production of drug products for
use in the larger Phase 2 and Phase 3
clinical trials or for commercial
marketing.’’ Given the differences
between phase 1 clinical trials and
phase 2 and phase 3 clinical trials
discussed in section II of this document,
we believe compliance with the
particular regulations in part 211 is not
appropriate for phase 1 investigational
drugs because many of the specific
requirements in part 211 do not apply
to the manufacture of phase 1
investigational drugs in the same
manner because they were intended to
apply to commercial drug manufacture.
For example, rotation of the stock for
drug product containers, the
repackaging and relabeling of drug
products, and separate packaging and
manufacturing areas are generally not of
concern for the limited production of
phase 1 investigational drugs.
Additionally, the requirement for fully
validated manufacturing processes may
not be appropriate for this early stage of
development. We believe that
recommending approaches and
considerations, and allowing the
manufacturer to develop specific
controls appropriate for the particular
product, manufacturing process, and
facility in order to comply with
statutory CGMP requirement is less
burdensome and more efficient for the
sponsor. We agree that drug products
used in phase 2 and phase 3 clinical
trials may be improved or refined (i.e.,
manufacturing process and/or product)
based on the results of the phase 1
clinical trial. However, limiting the
exemption from compliance with the
regulations in part 211 to drugs for use
in phase 1 clinical trials (and not
extending it to drugs that a sponsor has
made available for a phase 2 or phase
3 clinical trial, or has lawfully
marketed) does not preclude the use of
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data from a phase 1 clinical trial for
phase 2 and phase 3. While it is true
that some sponsors may choose to
manufacture phase 1 investigational
drugs in compliance with the regulatory
requirements in part 211 in anticipation
of expansion of the product into phase
2 clinical trials, this rule does not
require that they do so, and it is up to
the manufacturer to determine whether
it makes sense in their particular case to
manufacture the phase 1 drug in
compliance with the regulations in part
211.
(Comment 4) One comment states that
FDA is ignoring past reports of phase 1
clinical trial failure, i.e., the two subject
deaths in phase 1 clinical trials
conducted at Johns Hopkins University
and the University of Pennsylvania, and
the six subjects who experienced major
organ failure in a phase 1 clinical trial
in England. The comment also adds that
there have been several deaths and
recalls due to drugs compounded by
pharmacists and an increase of recalls of
medical devices due to CGMP
noncompliance. The comment also
makes the statement that FDA should
not assume that a medical researcher or
other employee would be able to make
safe phase 1 materials following
guidance.
(Response) We disagree with the
comment highlighting the cases as a
reason for not issuing this final rule.
Investigations of the referenced cases
found no evidence to suggest that the
adverse events were caused by the
manufacturing of the phase 1
investigational drug (Refs. 1, 2, and 3),
and neither the British not the Johns
Hopkins studies had been submitted to
FDA under IND, and so had
consequently not been prospectively
reviewed by FDA (See https://
www.fda.gov/cder/warn/2003/02–hfd–
45–0303.pdf), and thus, we are of the
opinion that nothing in this final rule
would have affected the outcome of any
of the specific cases mentioned as we
are not aware that CGMP was deficient
or contributed to the deaths. As to the
implication in the comment that these
three cases indicate that there are risks
in the manufacture of drugs for use in
phase 1 clinical trials, we believe that
there is risk in the manufacture of any
drug, whether investigational or not and
regardless of the stage of testing. We
note, again, that investigational drugs
for use in phase 1 clinical trials remain
subject to statutory CGMP, and a
companion guidance is being issued
concurrent with this rule to provide
suggested approaches for complying
with statutory CGMP for phase 1
investigational drugs.
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With regard to the comment on
pharmacy compounding errors, the
reported instances of recalls due to
drugs compounded by pharmacists are
not analogous to producing drugs for
phase 1 clinical trials, which is the
subject of this rulemaking. Moreover,
the comment concerning an increase of
medical device recalls due to CGMP
noncompliance apparently assumes that
this final rule relieves phase 1
investigational drugs of compliance
with any CGMP requirements. However,
as previously discussed, this final rule
exempts phase 1 investigational drugs
only from regulatory CGMP
requirements in parts 210 and 211. The
statutory requirement to comply with
CGMP still applies. We note that, in
addition to the considerations described
in the guidance, reference to technical
information and appropriate training are
necessary to comply with statutory
CGMP.
B. CGMP Regulation Specific to Phase 1
Investigational Drugs
(Comment 5) Several comments
request that FDA engage stakeholders
and issue a new rulemaking for CGMP
specific to phase 1 investigational drugs.
One comment suggests that FDA apply
the comments submitted to the docket
on the proposed rule and draft guidance
in proposing a new rule. Another
comment suggests that FDA amend only
the relevant requirements, e.g., on the
repackaging and relabeling of drug
products, retaining the oversight in all
phases of a clinical trial of a drug.
(Response) We appreciate the
comments and will consider the
appropriateness of such a proposed rule.
For current purposes, however, we
intend to proceed directly from the
statute, and direct the public to the
companion guidance that is being
issued concurrently with this rule,
suggesting some approaches to comply
with statutory CGMP for phase 1
investigational drugs.
C. Scope
(Comment 6) One comment requests
FDA to clarify the scope of the
rulemaking, i.e., that the scope does not
include active pharmaceutical
ingredients (API).
(Response) The scope of the
exemption from compliance with part
211 includes investigational new human
drug and biological products, including
finished dosage forms used as placebos,
for human use in a phase 1 study or
trial. Examples of such investigational
drugs include, but are not limited to, the
following:
• Investigational recombinant and
non-recombinant therapeutic products,
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• Vaccine products,
• Allergenic products,
• In vivo diagnostic products,
• Plasma derivative products,
• Blood and blood components1,
• Gene therapy products, and
• Somatic cellular therapy products
(including xenotransplantation
products).
However, if such products have
already been manufactured by an IND
sponsor for use during phase 2 or phase
3 clinical trials or have been lawfully
marketed, the manufacture of such a
product must comply with the
appropriate requirements of part 211 for
the product to be used in any
subsequent phase 1 clinical trial,
irrespective of the trial size or duration
of dosing.
Manufacturers of new active
pharmaceutical ingredients (also
referred to as ‘‘API’’ or ‘‘drug
substance’’) are already exempt from
compliance with part 211 and must also
conform with CGMP as required in
section 501(a)(2)(B) of the act. Thus, this
rule does not change in any way how
APIs are regulated with regard to CGMP.
As stated in the companion guidance,
limited guidance on CGMP for the
manufacture of new API for some IND
products used in clinical trials is also
available (see International Conference
on Harmonisation (ICH) Q7A GMP
Guide for API (ICH Q7A guidance)).
Manufacturers of APIs should
implement controls appropriate to the
stage of development and, thus, should
also consider the recommendations
described in the companion guidance
for manufacture of API used in
investigational drug products for phase
1 clinical trials.
(Comment 7) In the direct final rule,
FDA makes the statement ‘‘[T]his action
is intended to streamline and promote
the drug development process’’ (71 FR
2458 at 2459). One comment believes
that this proposal is outside the scope
of FDA’s mission mandated by
Congress, i.e., to ‘‘promote the public
health by promptly and efficiently
reviewing clinical research and taking
appropriate action on the marketing of
regulated products in a timely manner’’
and ‘‘with respect to such products,
protect the public health by ensuring
that * * * human and veterinary drugs
are safe and effective.’’ The comment
1 You should consult with the Office of Blood
Research and Review, Center for Biologics
Evaluation and Research (CBER), to determine
circumstances when an IND would be required for
blood or a blood component. Manufacturers of
blood and blood components intended for
transfusion and for further manufacture must still
comply with the applicable regulations in 21 CFR
parts 600 through 660.
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further states that FDA was established
to serve as a consumer protection
agency and a check and balance on
regulated industry.
(Response) As section III of this
document notes, CGMP is required by
section 501(a)(2)(B) of the act, and FDA
has been given the general authority to
issue regulations for the efficient
enforcement of the act. We note here as
well that, under section 505(i) of the act,
FDA is directed to issue regulations for
exempting from the requirements of
section 505 ‘‘drugs intended solely for
investigational use by experts qualified
by scientific training and experience to
investigation the safety and
effectiveness of drugs,’’ which include
drugs for use in phase 1 clinical trials.
While we agree that FDA is an agency
whose public health mission demands
an emphasis on safety, we note that this
does not require us to impose burdens
on drug development that do not have
a commensurate public health benefit.
We believe that this final rule is
appropriate because many of the
regulatory requirements in part 211
simply are not applicable to the
manufacture of products intended for
use in phase 1 clinical trials, and that
the agency can continue to protect
human subjects via interpretation of
statutory CGMP and the IND process.
D. Direct Final Rule and Companion
Proposed Rule Approach
(Comment 8) A couple of comments
object to the direct final rule/companion
proposed rule approach (rulemaking
approach). One comment believes that
the process did not allow for a
discussion regarding the quality of
clinical trial material, i.e., the
establishment of meaningful, consistent
standards that balance patient
protection with speed of development.
The comment then suggests that FDA
work with industry to address industrywide questions about quality for clinical
trial materials, e.g., equipment
qualification, water quality, method
validation or qualification, sterility
assurance, control of contractors,
complaints, cleaning, and
specifications.
(Response) We disagree with the
assertion that we did not allow for a
discussion regarding the quality of
clinical trial material. In developing the
companion guidance, we utilized our
experience with IND submissions and
facility inspections. In addition,
comments submitted to the docket were
considered in finalizing the rule and the
companion guidance, as well as
stakeholder comments provided in
multiple venues where FDA
representatives discussed the proposed
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rule and draft guidance. Both the
companion guidance and relevant IND
regulations emphasize safety as the
primary focus of phase 1 clinical trials.
The companion guidance is written to
allow for flexibility in utilizing
appropriate CGMP controls for the
product, manufacturing process, and
facility to assure product safety. We will
continue to work with stakeholders to
refine appropriate standards as needed
through continued discussions and
meetings in various venues with
stakeholders.
(Comment 9) One comment states that
FDA does not have the expertise to issue
guidance or regulation without
stakeholder input and adds that the
manufacture of clinical supplies is a
complex matter in which FDA has
almost no experience. The comment
also states that FDA lacks expertise in
clinical GMP compliance because FDA
has performed few inspections of early
clinical supply material.
(Response) We disagree with this
comment. The decision to generate
guidance for this early phase of clinical
trial manufacture was due primarily to
the constant requests for guidance in
this area from the pharmaceutical
industry, academia, and other research
organizations. The publication of the
draft guidance and the direct final and
proposed rules in January 2006 was to
address this apparent need, and to seek
broader stakeholder input. Additionally,
we have experience from numerous
sources, such as participation with
stakeholders in related workshops and
conferences, facility inspections, and
other interactions that result in
sufficient understanding necessary to
issue rulemaking and companion
guidance. Contrary to the suggestion of
the comment, conducting inspections of
early clinical trial material is not the
exclusive source of FDA expertise in
this area.
(Comment 10) One comment believes
that FDA’s finding that the subject is
suitable for this rulemaking approach is
based on assumptions, not data, such as
the results of ‘‘for cause’’ inspections,
treatment IND inspections, or reports of
adverse drug events occurring during
phase 1 clinical trials.
(Response) We disagree with the
comment. In the direct final rule, we
stated that the rulemaking approach is
appropriate because many of the issues
present in the manufacture of phase 1
investigational drugs are different from
those issues presented by the
manufacture of drugs for later
investigational phases or for commercial
marketing, and that many of the specific
requirements in part 211 are not
applicable in the manufacture of the
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smaller batches of investigational drugs
usually used in phase 1. These
statements are not based on
assumptions, as the comment suggests,
but on the knowledge of, and experience
with, good manufacturing practice for
phase 1 investigational drugs.
(Comment 11) One comment states
that the proponents of the rulemaking
approach cite the successful use of ICH
Q7A guidance and its use during
inspections without the need for a
regulation. The comment suggests that
the possible reason for the successful
use is that the ICH Q7A guidance is
more detailed than the draft guidance
and is used to manufacture material that
is further processed before being
delivered to patients.
(Response) We disagree with the
comment. Due to the more defined
routes of manufacture of APIs, and the
general application of CGMP to APIs in
the companion guidance, the ICH Q7A
guidance was able to provide more
detail for the commercial manufacture
of APIs. Early phase clinical trial
material may use many different routes
of manufacture, some of which may be
new and innovative. In addition, the
recommendations or expectations
contained in the ICH Q7A guidance (see
section XIX of that guidance, on APIs
for use in clinical trials) utilize an
approach to CGMP similar to that
outlined in the companion guidance.
For the reason stated in response to
comment 4, we believe that the
companion guidance provides adequate
considerations when supplemented
with additional technical information
and appropriate training to comply with
CGMP.
E. Exemption From Part 211
(Comment 12) One comment believes
that compliance with statutory CGMP
requirements and exemption of phase 1
investigational drugs from the
requirements in part 211 subjects phase
1 investigational drugs to unwritten
standards, developed case-by-case
without any input from the public or
industry. The comment also states that
unwritten standards would lead to
differing interpretations within FDA,
e.g., by individual investigators, district
offices, and review divisions.
Inconsistency, non-transparency, and
uncertainty slow product development
as the industry tries to comply on a
shifting landscape of uncertain legal
basis.
(Response) We disagree with the
comment. We believe that we have
provided sufficient opportunity for the
public and industry to comment on the
proposed exemption of phase 1
investigational drugs from compliance
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with part 211, the draft guidance, and
the impact of such action. The purpose
of the companion guidance is to provide
recommendations for compliance with
statutory CGMP and to promote
consistency in compliance. The
companion guidance is intended for use
not only by industry, but also by FDA
staff to assist in fulfilling their review
and enforcement responsibilities. It
bears emphasis that, because FDA has
set forth its interpretation of some
acceptable approaches to statutory
CGMP in the companion guidance, as
opposed to a rule, we remain open to
alternative approaches to compliance,
so long as they provide comparable
safety and protection for human
subjects. We believe this approach
maximizes flexibility and minimizes
burden, without diminishing safety
protections.
(Comment 13) One comment states
that unclear rules erode quality. For
example, financially strapped
companies will not be able to justify
expenses based on recommendations in
a draft guidance. Inevitably, some
companies will stumble, and quality
will drop.
(Response) Industry is not obligated to
implement draft guidance. Draft
guidance is for the purpose of soliciting
comments on FDA’s current thinking on
a subject.
In § 10.115(d)(1) (21 CFR
10.115(d)(1)), we explain that guidance
does not legally bind the public or FDA.
Therefore, a financially strapped
company may choose to use a less
expensive approach other than the one
recommended in a guidance, but the
alternative approach must comply with
the relevant statutes and regulations in
assuring patient safety, and the
company would be prudent to consult
FDA before using the alternative
approach. As previously stated in our
response to comment 12, we believe this
rule maximizes flexibility and
minimizes burden without diminishing
safety protections.
(Comment 14) One comment believes
that regulatory CGMP provides
minimum, legal requirements to safely
make drugs or biologics made for use in
humans. Another comment states that,
instead of the detailed, enforceable
standards laid out in part 211, FDA
proposes to rely upon three sources of
authority that are variously lacking in
detail and/or enforceability, i.e., the
statutory authority (section 501(a)(2)(B)
of the act), the IND submission
requirements in § 312.23, and the draft
guidance.
(Response) We disagree with this
comment, and believe the comment
confuses the requirements of the statute
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and the regulations. Many of the
regulatory requirements in part 211 are
not readily applicable to the
manufacture of investigational drugs for
use in phase I clinical trials. As
previously stated, because such
products still must comply with
statutory CGMP, and because FDA has
offered suggestions for acceptable
methods for complying with statutory
CGMP, we believe that manufacturers
will have sufficient guidance to know
what they must do to safely make drugs
or biologics for such early stage clinical
trial use in humans. We dispute the
assertion that we are eschewing
detailed, enforceable standards in favor
of relying upon three sources of
authority that are variously lacking in
detail and/or enforceability. Statutory
CGMP remains enforceable and we are
issuing a companion guidance that
details acceptable approaches for
complying with statutory CGMP, and
FDA’s authority to place clinical trials
on hold (under its IND authority)
remains unchanged.
(Comment 15) One comment states
that FDA assumes that, once this
rulemaking is final and phase 1
investigational drugs are exempt from
complying with part 211, new sponsors
would keep proper records, perform
necessary testing, or keep retention
samples for later investigations, or that
they would take the time to learn and
follow CGMP if there were no
regulations requiring them to do so.
Another comment states that FDA,
without evidence, claims that having to
actually produce drug or biological
products according to accepted
international standards is a barrier too
high for entry into phase 1 studies. The
comment continues to say that such
barriers do serve a social purpose, i.e.,
preventing those incapable of following
or unwilling to follow CGMP from
administering investigational products
to humans.
(Response) As mentioned in the
preamble to the proposed rule and draft
companion guidance, application of part
211 is not appropriate to the production
of IND products used in phase 1 studies.
The type and extent of CGMP for
investigational studies differs from
those typically employed for routine
commercial manufacturing, and in some
cases may even include more stringent
controls for certain manufacturing
operations of investigational products.
We believe that the proposed rule and
the draft companion guidance better
communicate FDA expectations and
facilitates compliance with CGMP for
the production of phase 1
investigational drugs rather than trying
to apply existing part 211 regulations.
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Our expectation that phase 1
investigational drugs be manufactured
following appropriate CGMP in
adequate manufacturing facilities has
not diminished with the adoption of
this approach.
FDA is not claiming that the
manufacture of a drug or biological
product for use in phase 1 studies
according to international standards
presents too high a barrier. FDA’s
position is that the United States’ good
manufacturing practice regulations were
written primarily to address commercial
manufacturing and do not consider the
differences between early clinical
supply manufacture and commercial
manufacture. The final rule and
companion guidance are intended to
address these differences, while still
requiring all drugs for human
consumption, including those used in
clinical trials, to be manufactured in
accordance with CGMP as required by
section 501(a)(2)(B) of the act.
F. Risk to Patients
(Comment 16) One comment
maintains that FDA understates the risk
to patients. The comment continues to
say that the CGMP regulations are
designed to protect patients from
mishaps that would have major impact
on the clinical subject, e.g.,
contamination with bacteria, penicillin,
or industrial cleaning agents; and
product mix-ups. Another comment
believes that § 312.23, which requires
companies to submit information about
the clinical material, has nonexistent
patient protections, and that submitting
general information is no substitute for
compliance with CGMP.
(Response) We disagree with the
assertion that we understated the risk to
subjects (patients). We believe that there
is no additional risk to subjects with
this exemption, and have provided
recommendations that interpret and
implement CGMP consistent with good
scientific methodology. In complying
with section 501(a)(2)(B) of the act, a
manufacturer must manufacture the
drug in conformity with good
manufacturing practice to assure that
the drug meets the requirements of the
act as to safety and has the identity and
strength, and meets the quality and
purity characteristics, which it purports
or is represented to possess. If the drug
does not meet these criteria, the drug is
considered adulterated and therefore a
possible risk to subjects. Because the
statutory requirements allow for
flexibility in describing CGMP, we have
issued the companion guidance to
recommend CGMP for phase 1
investigational drugs. These
recommended quality controls for
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producing a phase 1 investigational
drug are specifically designed to ensure
subject safety.
(Comment 17) One comment believes
that the exemption of phase 1
investigational drugs from part 211 puts
patients at risk because it is difficult to
prove what CGMP is, and makes it
difficult for FDA to investigate or
prosecute serious cases. The comment
also states that a quality assurance (QA)
unit is required for preclinical studies
and a quality control (QC) unit is
required for phase 2 and phase 3
studies. However, the new approach
does not provide for a QA or QC unit
for phase 1 studies.
(Response) We disagree with this
comment. As previously discussed in
section II of this document, CGMP
consists of steps that a manufacturer
takes to ensure the safety and quality of
the investigational drug. This
information is submitted to FDA in the
IND. Through FDA’s IND authority,
FDA has the ability to take appropriate
actions to address manufacturing issues
if there is a safety risk to subjects, i.e.,
place an IND on clinical hold, terminate
an IND, seize an investigational drug, or
prohibit its production.
The functions performed by QA and/
or QC unit(s) appropriate for this early
phase of clinical trial material
manufacture were clearly spelled out in
the draft companion guidance. We
describe in the companion guidance the
QC functions that should be in effect to
manufacture in compliance with CGMP
for phase 1 clinical trials. It is at the
discretion of the manufacturer if it
wishes to implement these
responsibilities through separate QA
and QC groups.
(Comment 18) One comment asserts
that if the study subjects are exposed to
unreasonable and significant risk or if
the IND does not contain sufficient
information to assess risk to patients,
any action by FDA, i.e., placing a
clinical hold or terminating an IND,
would occur after the fact and well after
patients are injured in the trial.
(Response) Sponsors must inform the
subjects of clinical trials of inherent,
unknown risks (21 CFR 50.25). FDA will
typically place a clinical hold or
terminate an IND as a result of
evaluating safety information provided
as part of the IND review. Such
evaluations are conducted prior to the
initiation of the clinical trial. Therefore,
we can and will, when appropriate, take
such actions before the clinical trial
proceeds. In addition to taking action
before the clinical trial begins, we also
have the ability under statutory CGMP
to take enforcement actions once the
phase 1 clinical trial begins.
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(Comment 19) One comment points
out that FDA recognizes that, although
part 211 applies to phase 2 and phase
3 investigational drugs, the extent of the
controls varies based on the phase of the
clinical study. The comments also state
that FDA agrees that not all sections of
part 211 may apply to phase 2 and
phase 3 investigational drugs. For this
reason, the comment suggests revising
the last sentence of proposed § 210.2(c)
to require that the drug for use in phase
1 study comply with the appropriate
sections of part 211. Another comment
also provided alternative language to
§ 210.2(c) stating that if the
investigational drug has been made
available for a phase 2 or phase 3 study
or the drug has been lawfully marketed,
and the manufacturer needs to conduct
further phase 1 studies to generate data
to support the registration of the clinical
indication being developed, the drug
used in the phase 1 clinical trial need
not comply with part 211.
(Response) We disagree with the
comment. Because of the wide
variability in the possible
manufacturing processes used to
produce early phase clinical trial
material, it is not feasible to specify
what parts of part 211 are appropriate in
a companion guidance, because what
may be appropriate for one
manufacturing situation may be
inappropriate for another.
We decline to use the alternative
codified language proposed by the
comment, which would exempt from
the requirements of parts 210 and 211
investigational drugs used in phase 1
clinical trials where the drugs have been
lawfully marketed or used in phase 2 or
phase 3 clinical trials. Because the drug
products in question have already been
manufactured using CGMP as indicated
in part 211, the manufacturing
knowledge is already available and
should be fully utilized.
(Comment 20) One comment
reiterates the proposal that phase 1
investigational drugs would be
manufactured following statutory
requirements and recommendations
through guidance for CGMP, and if used
for a phase 1 clinical trial after available
for phase 2 and phase 3 clinical trials or
marketed, the phase 1 material would be
manufactured using regulatory CGMP.
The comment raises the question of the
possibility that the phase 1
investigational drugs not manufactured
per the same standard and used on
human subjects is unethical. Another
comment suggests that if only certain
phase 1 investigational drugs follow
CGMP while others are exempt it
promotes a situation where subject
safety may be at risk.
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(Response) We believe that the
comment fails to recognize that the
scope of the specific recommendations
for CGMP in support of the statutory
requirements provides the same, if not
additional, protection of the phase 1
clinical trial subject. Given that FDA
retains oversight over these part 211exempt phase 1 products via the IND
mechanism, and that the agency is
issuing guidance on ways to comply
with statutory CGMP in the manufacture
of such products, we firmly believe that
this rule presents no safety or ethical
issue. However, as discussed elsewhere
in this preamble, we are requiring that
phase 1 investigational drugs that the
sponsor makes available for phase 2 and
phase 3 clinical trials or as lawfully
marketed drugs comply with part 211.
This is because, given the
manufacturing scale of a product that
will be administered beyond a phase 1
trial, such products are more like
products manufactured for use in phase
2 and phase 3 clinical trials or lawfully
marketed drugs. The fact that we are
requiring investigational drugs
manufactured in significant enough
quantities that they are available for
phase 2 or phase 3 testing or lawful
marketing to comply with regulatory
CGMP, does not mean that product that
is manufactured only for use in a phase
1 trial, and is thus exempt from
complying with regulatory CGMP, is
unsafe. The current rulemaking
exempting products from compliance
with part 211 is limited to products
manufactured exclusively for use in a
phase 1 trial and the fact that some
products used in phase 1 trials will be
manufactured in compliance with the
requirements of part 211 does not mean
that products that are not so
manufactured in compliance with
statutory CGMP are unsafe.
G. Use of Guidance
(Comment 21) One comment believes
that FDA should not use guidance in
place of minimum CGMP requirements
for the safe manufacture of drugs or
biologics for human beings. Another
comment requests that FDA not exempt
the manufacture of phase 1
investigational drugs from part 211, but
instead issue guidance to help
manufacturers find innovative, simple,
and inexpensive approaches to comply
with CGMP regulations and keep their
products safe for the trial subjects.
(Response) We are not issuing the
companion guidance in place of
minimum CGMP requirements. CGMP is
required by statute, and the companion
guidance provides our current thinking
on complying with statutory CGMP. As
previously stated, this action is
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intended to focus a manufacturer’s effort
on applying CGMP that is appropriate
and meaningful for phase 1
investigational drugs, and to streamline
and promote the drug development
process while ensuring the safety and
quality of the earliest stage
investigational drug products. We also
expect this action to help promote
innovative, simple, and inexpensive
approaches to complying with the
statutory CGMP requirements. As
discussed in our response to comment
13, we are willing to discuss with the
manufacturer alternative approaches
that comply with the statutory
requirements and that may be more
innovative, simple, or inexpensive than
the recommendations in the companion
guidance.
(Comment 22) Several comments
express concern that guidance is not
legally binding and therefore, not
enforceable. One of the comments states
that relying on guidance invites
misunderstandings and inconsistencies,
while another comment believes that if
not required under part 211,
manufacturers may not take the time to
read or familiarize themselves with
guidance related to CGMP, i.e., testing,
manufacturing sterile or aseptic dosage
forms, and employee qualification/
training. A comment also believes that
guidances do not undergo the same
level of notice and comment, and lacks
the complete input of interested parties.
(Response) We agree with the
comment that the companion guidance
is not legally binding and not
enforceable. However, the statutory
requirement that drugs, including
investigational drugs for use in phase 1
trials, comply with CGMP is legally
binding and enforceable. We believe
that a sponsor, guided by its knowledge,
experience, and technical information
applying good scientific methodology,
following FDA recommendations, and
undertaking appropriate activities (e.g.,
training), can adequately and
appropriately comply with statutory
CGMP. We disagree that relying on
guidance invites misunderstandings and
inconsistencies. In fact, to the contrary,
we believe that guidance reduces
misunderstandings and inconsistencies
because guidance provides FDA’s
interpretation of or policy on a
regulatory issue, while still allowing for
flexibility and innovation.
With regard to adequate notice to, and
comment by, interested parties on
guidance documents, the public can
participate in the development and
issuance of guidance documents as
described in § 10.115(f) and (g), i.e.,
provide comment on issued draft
guidance documents, suggest areas for
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guidance document development,
submit drafts of proposed guidance
documents for FDA to consider, suggest
that FDA revise or withdraw an already
existing guidance document, or
comment on FDA’s annually published
list of possible topics for future
guidance document development or
revision. Therefore, we disagree with
the comment that guidance does not
undergo sufficient notice and comment,
and lacks the complete input of
interested parties. Moreover, we
received extensive comments on the
draft companion guidance from
numerous entities and have considered
these comments in preparing the
companion guidance.
(Comment 23) Two comments express
concern regarding the effect of the
companion guidance on the 1991
guidance on preparation of INDs, which
recommends the application of certain
sections of parts 210 and 211 to phase
2 and phase 3 clinical trials. The
comments also request that FDA clarify
the status of the 1991 guidance for
phase 2 and phase 3 materials with
regard to complying with CGMP
requirements. Another comment asks if
FDA expects an incremental application
of CGMP for the production and testing
of phase 2 and phase 3 clinical supplies,
or if the 1991 guidance will remain in
effect for phase 2 and phase 3 materials
until the new phase 2 and phase 3
guidance document is available.
(Response) As stated in the
introduction of the companion
guidance, the companion guidance will
replace the 1991 guidance only as it
applies to phase 1 investigational drugs.
This action does not affect the scope of
the 1991 guidance as it applies to phase
2 and phase 3 investigational drugs,
which remains in effect until
superseded by a subsequent guidance
document.
(Comment 24) One comment states
that the guidance would allow the same
person manufacturing the material (a
non-QC unit employee) to also release
the material to the clinic. The comment
further states that the release of material
by a non-member of the QC unit violates
United States CGMP and a nonQualified Person violates European
Union CGMP, and does not appear to
recognize the importance of having an
experienced and knowledgeable unit or
person to safely release the materials.
(Response) We agree with this
comment in part. The companion
guidance recognizes the need to have
quality control in this early phase of
clinical trial material manufacture and
has provided recommendations for the
quality control procedures that should
be used. We provide flexibility for
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operations where a very small amount
of clinical material is produced. While
we agree that release of material by an
untrained person violates United States
CGMP, this is not what is recommended
in the companion guidance, which
indicates that, under very limited
circumstances and where justified, only
a person trained in CGMP and quality
control functions should be given the
dual responsibility of manufacture and
release. The interpretation in the
companion guidance is consistent with
the quality unit functions under part
211 and the nature of commercial and
investigational products.
H. Impact
(Comment 25) FDA makes the
following statement in the direct final
rule (71 FR 2458 at 2461). ‘‘For drug
manufacturers that produce Phase 1
drug products in-house and also
produce approved drug products, this
direct final rule is expected to reduce
the amount of documentation they
produce and maintain when they
manufacture a Phase 1 drug. In some
cases, it should also reduce the amount
of component and product testing.’’
Two comments state that because it is
unknown at the time of clinical
manufacture if a phase 1 drug will
continue to phase 2, manufacturers will
likely elect to take a conservative
approach and manufacture a drug to
phase 2 requirements (part 211) to allow
the phase 1 drug to be used in future
phase 2 studies. Because of availability
concerns in the clinical phase,
manufacturers would most likely elect
to not discard phase 1 material that
could be used in phase 2. Therefore, the
statement regarding savings is
questionable.
(Response) We agree with the
comment that some manufacturers may
decide to follow part 211 when
manufacturing phase 1 investigational
drugs. However, the saving estimate was
intended to be an estimate of
incremental savings should
manufacturers chose to follow the
companion guidance, as some
manufacturers will.
(Comment 26) One comment requests
that FDA evaluate the cost of
compliance against the hypothetical
public health risk of a product that did
not reach the market and the likelihood
and severity of risks to volunteers.
Another comment states that the
additional risk to patients in a phase 1
clinical trial does not justify the
proposed savings of $1,440 per IND in
documentation, training, and other
‘‘reduced’’ requirements. The comment
also states that the potential costs of
$810 per IND is a gross underestimation
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of how much it will cost to manufacture
a sterile or aseptic product for the first
time.
(Response) In section V.F of this
document, the responses to comments
16 through 20 state that there will be no
change in the risk to patients in phase
1 clinical trials as a result of the final
rule. The cost estimate was intended to
capture the incremental cost of
complying with the proposed rule given
current practice under part 211; it does
not reflect total costs. A cost-benefit
analysis of phase 1 clinical trials or
clinical trials in general is beyond the
scope of this document.
(Comment 27) One comment believes
that the expense is not for compliance
with CGMP, especially if systems and
procedures are simple, but for the
training of personnel.
(Response) Training personnel is a
cost of complying with the current
CGMP regulation; the estimate in the
proposed rule captured the incremental
increase in training costs to comply
with the proposed rule.
VI. Analysis of Impacts
FDA has examined the impacts of this
final rule under Executive Order 12866
and the Regulatory Flexibility Act (5
U.S.C. 601–612), and the Unfunded
Mandates Reform Act of 1995 (Public
Law 104–4). Executive Order 12866
directs agencies to assess all costs and
benefits of available regulatory
alternatives and, when regulation is
necessary, to select regulatory
approaches that maximize net benefits
(including potential economic,
environmental, public health and safety,
and other advantages; distributive
impacts; and equity). The agency
believes that this final rule is not a
significant regulatory action under the
Executive order.
The Regulatory Flexibility Act
requires agencies to analyze regulatory
options that would minimize any
significant impact of the rule on small
entities. Because exempting production
of drugs for use in phase 1 clinical trials
from compliance with specific
regulatory requirements does not add to
the compliance burden of small entities,
and in most cases reduces it, the agency
certifies that the final rule will not have
a significant economic impact on a
substantial number of small entities.
Section 202(a) of the Unfunded
Mandates Reform Act of 1995 requires
that agencies prepare a written
statement, which includes an
assessment of anticipated costs and
benefits, before proposing ‘‘any rule that
includes any Federal mandate that may
result in the expenditure by State, local,
and tribal governments, in the aggregate,
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or by the private sector, of $100,000,000
or more (adjusted annually for inflation)
in any one year.’’ The current threshold
after adjustment for inflation is $127
million, using the most current (2006)
Implicit Price Deflator for the Gross
Domestic Product. FDA does not expect
this final rule to result in any 1-year
expenditure that would meet or exceed
this amount.
The purpose of this final rule is to
amend our current CGMP regulations to
exempt the manufacture of
investigational drugs used in phase 1
clinical trials from compliance with the
requirements in part 211. The rule
affects drug manufacturers, chemical
manufacturers, and laboratories that
manufacture drugs on a small scale for
use in phase 1 clinical trials.
For drug manufacturers that produce
in-house investigational drugs for use in
phase 1 clinical trials and also produce
approved drug products for marketing,
this final rule is expected to reduce the
amount of documentation they produce
and maintain when they manufacture an
investigational drug for use in a phase
1 clinical trial. In some cases, it should
also reduce the amount of component
and product testing.
Because they currently may not
supply the pharmaceutical industry,
some chemical manufacturers and
laboratories may experience a slight
increase in documentation if they do not
have written standard operating
procedures (SOPs) or if they need to
modify existing methods of
documentation. Although formats may
be different, the rule should not require
more information than is already
collected as part of standard laboratory
practices.
Because the actual SOPs and
manufacturing requirements are
different for each new drug product and
manufacturing facility, the procedures
to comply with the statutory CGMP
requirements for phase 1 manufacturing
are generated as part of product
development. The savings or costs
would be incurred on a per-IND and not
per-facility basis.
This rule is intended to clarify
compliance with the statutory CGMPs
that are necessary in the manufacture of
investigational drugs used in phase 1
clinical trials, and to exempt certain
drugs produced under IND and used for
phase 1 clinical trials from regulatory
CGMP requirements under part 211.
Some manufacturers may realize savings
because they no longer must meet
certain requirements. The savings to
drug manufacturers that manufacture inhouse the investigational drugs used in
phase 1 clinical trials will vary greatly
from product to product. FDA lacks data
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40461
to estimate where the cost savings will
occur in the manufacture of
investigational drugs. Some substantial
savings may be realized in testing and
analyzing components and in-process
materials. These costs can typically
range from $50 to $1,200 per component
tested. The extent of the need for SOPs
and methods validation may also be
greatly reduced. We estimate that large
drug manufacturers that manufacture inhouse investigational drugs used in
phase 1 clinical trials could potentially
save between 24 to 40 hours per IND2.
In addition, the clarifications we have
made could lead some large firms to
produce in-house future investigational
drugs for use in phase 1 clinical trials,
rather than contracting the work out.
For previously described chemical
manufacturers and laboratories, the
requirements in this rule may increase
the time required for developing SOPs
for quality, process, and procedural
controls and will be incurred on a
recurring basis for each new product
manufactured. There may also be an
incremental increase in training costs to
educate employees on the CGMP
requirements. We estimate that an
additional 12 to 24 hours may be
required for these activities depending
on the experience of the entity and its
employees with our current CGMP
rule.3
The facility that manufactures the
investigational drugs used in phase 1
clinical trials is identified in the IND.
We do not keep a database of these
facilities and, therefore, we do not have
a precise number of entities that might
be affected by this final rule. To
estimate the economic impact, we
derived an estimate of the number
affected annually based on the number
of INDs we receive.
We receive an average of 1,410 INDs
each year.4 However, this rule would
not apply to the majority of these INDs
because they are for drug products that
already have premarket approvals and,
thus, are subject to part 211. To derive
an estimate of the percentage of INDs
that would be affected by this rule, we
used the percentage of total new drug
2 Eastern Research Group (1195), Economic
Threshold and Regulatory Flexibility Assessment of
Proposed Changes to the Current Good
Manufacturing Practice Regulations for
Manufacturing, Processing, Packing, or Holding
Drugs (21 CFR 210 and 211), submitted to the Office
of Planning and Evaluation, FDA. Estimated hours
to change minor and major SOPs for large
establishments (p. 24, table 7).
3 Eastern Research Group (1995), ibid., Estimated
hours to change SOPs for small establishments.
4 The annual number of INDs received varies from
year to year; 1,410 is the mean of the total number
of research and commercial INDs received by the
Center for Drug Evaluation and Research and CBER
between 2001 and 2005.
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Federal Register / Vol. 73, No. 136 / Tuesday, July 15, 2008 / Rules and Regulations
applications (NDAs) that were for new
molecular entities (NMEs) and applied
that percentage to the number of annual
IND applications. Historically, about 30
percent of NDAs are for NMEs each
year. Assuming the relationship would
be the same for the INDs and that the
number of INDs will remain at about
1,410, this rule would affect about 425
INDs per year. A firm may produce
multiple drug products for phase 1
clinical trials in a given year and use
different companies to manufacture
each of these drugs. Therefore, we do
not know how many individual entities
would be affected by this rule each year.
The Small Business Administration
(SBA) defines manufacturers of biologic
drugs as small entities if they employ
fewer than 500 people and other drug
manufacturers as small if they employ
fewer than 750 people. FDA estimates
that about 65 percent of the entities that
submit NDAs and biologics license
applications to the agency meet SBA’s
definition of a small entity. We assume
that the distribution of large to small
entities that submit INDs would be
about the same. Although many of the
entities that produce investigational
drugs used in phase 1 clinical trials are
laboratories, they are usually part of
much larger institutions and are not
considered small under SBA’s
definition. All of the entities affected by
this rule have personnel with the skills
necessary to comply with the
requirements.
Because we do not know the
experience levels the affected entities
have with our current CGMP
requirements, we used the midpoint of
the estimated ranges to estimate the
potential recurring savings or costs.
Savings to large manufacturers from
reduced SOP and validation
requirements for phase 1 drug
manufacturing in-house, assuming a
time savings of 32 hours per
application, a fully loaded wage rate of
$46, 5 and 150 INDs per year
(approximately 35 percent of 425)
would total $220,800 per year or $1,472
per IND. This would be in addition to
any other savings from decreased
component testing.
The incremental average annual cost
to chemical manufacturers and
laboratories, assuming all would incur
costs and assuming an average increase
of 18 hours per application for writing
ebenthall on PRODPC60 with RULES
5 Bureau
of Labor Statistics, National
Compensation Survey, 2005. Wage rate is the
average of the hourly rate for postsecondary
chemistry teachers ($38.82) and postsecondary
biochemistry teachers ($27.01) plus 40 percent to
account for benefits and rounded to the nearest
whole dollar, www.bls.gov, data accessed
September 2006.
VerDate Aug<31>2005
13:23 Jul 14, 2008
Jkt 214001
SOPs and training, a fully loaded wage
rate of $46, and 275 INDs
(approximately 65 percent of 425)
affected per year, would total $227,700
per year or $828 per IND.
Although we do not know the number
and size distribution of the entities
affected by this rule, the impact on them
will be negligible and should actually
reduce the compliance burden for some.
Manufacturers of drug products for
phase 1 clinical trials are currently
required to manufacturer them using
CGMP, but some of the requirements in
part 211 are not applicable for the
manufacture of small quantities used in
phase 1 clinical trials. While exempting
these products from part 211, the
companion guidance clarifies FDA’s
thinking on how to manufacture phase
1 investigational drugs under CGMP and
does not include recommendations that
would increase the burden of
compliance.
VII. Paperwork Reduction Act of 1995
This final rule contains no new
information collection requirements that
are subject to review by the Office of
Management and Budget (OMB) under
the Paperwork Reduction Act of 1995
(44 U.S.C. 3501–3520). Under the final
rule, the production of human drug
products, including biological drug
products, intended for use in phase 1
clinical trials are exempted from
complying with the requirements under
part 211. Part 211 contains information
collection requirements that are
approved by OMB under control
number 0910–0139. As explained in the
following paragraph, the information
collection requirements in part 211 are
reduced in this final rule.
The OMB-approved hourly burden to
comply with the information collection
requirements in part 211 (OMB control
number 0910–0139) is 848,625 hours.
FDA estimates that, under the final rule,
approximately 425 investigational drugs
are exempted from complying with the
requirements under part 211. Based on
this number and the total number of
drugs that are subject to part 211
(122,795), FDA estimates that the
burden hours approved under OMB
control number 0910–0139 will be
reduced by approximately 2,936 hours
(425/122,795 x 848,625). Thus, as a
result of the final rule, the amended
burden hours in OMB control number
0910–0139 are approximately 845,689
hours.
VIII. Environmental Impact
The agency has determined under 21
CFR 25.30(h) that this action is of a type
that does not individually or
cumulatively have a significant effect on
PO 00000
Frm 00010
Fmt 4700
Sfmt 4700
the human environment. Therefore,
neither an environmental assessment
nor an environmental impact statement
is required.
IX. Federalism
FDA has analyzed this final rule in
accordance with the principles set forth
in Executive Order 13132. FDA has
determined that the rule does not
contain policies that have substantial
direct effects on the States, on the
relationship between the National
Government and the States, or on the
distribution of power and
responsibilities among the various
levels of government. Accordingly, the
agency has concluded that the rule does
not contain policies that have
federalism implications as defined in
the Executive order and, consequently,
a federalism summary impact statement
is not required.
X. References
The following references have been placed
on display in the Division of Dockets
Management (see ADDRESSES), and may be
seen by interested persons between 9 a.m.
and 4 p.m., Monday through Friday. (FDA
has verified the Web site addresses, but we
are not responsible for any subsequent
changes to the Web sites after this document
publishes in the Federal Register.)
1. Wood, A.J.J., J. Darbyshire, ‘‘Injury to
Research Volunteers—The Clinical-Research
Nightmare,’’ The New England Journal of
Medicine, 354:1869–1871, 2006.
2. Steinbrook, R., ‘‘Protecting Research
Subjects—The Crisis at Johns Hopkins,’’ The
New England Journal of Medicine, 346:716–
720, 2002.
3. Savulescu, J., ‘‘Harm, Ethics Committees
and the Gene Therapy Death,’’ The Journal of
Medical Ethics, 27:148–150, 2001.
List of Subjects in 21 CFR Part 210
Drugs, Packaging and containers.
Therefore, under the Federal Food,
Drug, and Cosmetic Act, and under
authority delegated to the Commissioner
of Food and Drugs, 21 CFR part 210 is
amended as follows:
I
PART 210—CURRENT GOOD
MANUFACTURING PRACTICE IN
MANUFACTURING, PROCESSING,
PACKING, OR HOLDING OF DRUGS;
GENERAL
1. The authority citation for 21 CFR
part 210 continues to read as follows:
I
Authority: 21 U.S.C. 321, 351, 352, 355,
360b, 371, 374; 42 U.S.C. 216, 262, 263a, 264.
2. In § 210.2, add paragraph (c) to read
as follows:
I
§ 210.2 Applicability of current good
manufacturing practice regulations.
*
E:\FR\FM\15JYR1.SGM
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*
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*
Federal Register / Vol. 73, No. 136 / Tuesday, July 15, 2008 / Rules and Regulations
(c) An investigational drug for use in
a phase 1 study, as described in
§ 312.21(a) of this chapter, is subject to
the statutory requirements set forth in
21 U.S.C. 351(a)(2)(B). The production
of such drug is exempt from compliance
with the regulations in part 211 of this
chapter. However, this exemption does
not apply to an investigational drug for
use in a phase 1 study once the
investigational drug has been made
available for use by or for the sponsor
in a phase 2 or phase 3 study, as
described in § 312.21(b) and (c) of this
chapter, or the drug has been lawfully
marketed. If the investigational drug has
been made available in a phase 2 or
phase 3 study or the drug has been
lawfully marketed, the drug for use in
the phase 1 study must comply with
part 211.
Dated: July 9, 2008.
Jeffrey Shuren,
Associate Commissioner for Policy and
Planning.
[FR Doc. E8–16011 Filed 7–14–08; 8:45 am]
BILLING CODE 4160–01–S
DEPARTMENT OF JUSTICE
Drug Enforcement Administration
28 CFR Part 0
[Docket No. DEA–310F]
Redelegation of Functions
Drug Enforcement
Administration, Department of Justice.
ACTION: Final rule.
AGENCY:
This rule makes one revision
to the Drug Enforcement
Administration’s (DEA) regulations
concerning agency management.
Additional personnel are authorized to
sign and issue administrative
subpoenas.
SUMMARY:
DATES:
Effective Date: July 15, 2008.
ebenthall on PRODPC60 with RULES
FOR FURTHER INFORMATION CONTACT:
Wendy H. Goggin, Chief Counsel, Drug
Enforcement Administration, 8701
Morrissette Drive, Springfield, VA
22152, Telephone (202) 307–1000.
SUPPLEMENTARY INFORMATION: This Final
Rule implements one change to Title 28,
Code of Federal Regulations (CFR), Part
0 by adding three officials to the list of
officials who may sign and issue
administrative subpoenas pursuant to
the Comprehensive Drug Abuse
Prevention and Control Act of 1970,
Public Law No. 91–513, 84 Stat. 1236
(1970), as amended (the Act), codified at
21 U.S.C. 801–971. In addition to the
Attorney General and the DEA
VerDate Aug<31>2005
13:23 Jul 14, 2008
Jkt 214001
Administrator, the current list of such
officials is set forth at 28 CFR, Chapter
I, part 0, Appendix to Subpart R,
Section 4. Title 21, U.S.C. 875 and 876,
provide the authority to issue such
subpoenas. By 28 CFR 0.100, the
Attorney General has delegated this
authority to issue administrative
subpoenas in support of his functions
and duties under the Act to the DEA
Administrator. The DEA Administrator
is permitted by 28 CFR 0.104 to
redelegate this authority ‘‘to any of [her]
subordinates[.]’’
By this Final Rule, DEA now extends
this administrative subpoena authority
to its senior officials overseas who often
supervise investigations with leads back
in the United States, i.e., DEA’s Regional
Directors, Assistant Regional Directors,
´
and Country Attaches. As Title 28 CFR,
Chapter I, Part 0, Appendix to Subpart
R, Section 4 is presently written, DEA
Resident Agents in Charge and Special
Agent Group Supervisors posted outside
the United States have such authority
while their superiors, i.e., Regional
Directors, Assistant Regional Directors,
´
and Country Attaches, do not. The
amendment to section 4 is designed, in
part, to rectify this anomaly.
Title 28 CFR, Chapter I, Part 0,
Appendix to Subpart R, Section 4
currently lists twelve categories of DEA
and FBI officials who are empowered to
sign and issue administrative subpoenas
under 21 U.S.C. 875 and 876. To this list
of senior officials DEA now adds its
Regional Directors, Assistant Regional
´
Directors, and Country Attaches. This is
being done to rectify an oversight. While
both DEA Resident Agents in Charge
and Special Agent Group Supervisors
posted outside the U.S. have authority
to sign and issue such administrative
subpoenas, unlike the case of Resident
Agents in Charge and Special Agent
Group Supervisors within the U.S., the
superior officials (Regional Directors,
Assistant Regional Directors, and
´
Country Attaches) of such Resident
Agents in Charge and Group
Supervisors serving overseas have not
heretofore been listed at Title 28 CFR,
Chapter I, Part 0, Appendix to Subpart
R, Section 4, as officials to whom the
Administrator has redelegated her
authority to sign and issue
administrative subpoenas.
Regulatory Certifications
Administrative Procedure Act
This rule relates to a matter of agency
management or personnel and is a rule
of agency organization, procedure, and
practice. As such, this rule is exempt
from the usual requirements of prior
notice and comment and a 30-day delay
PO 00000
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Fmt 4700
Sfmt 4700
40463
in effective date. See 5 U.S.C. 553(a)(2),
(b)(3)(A), (d)(3).
Regulatory Flexibility Act
The Acting Administrator, in
accordance with the Regulatory
Flexibility Act, 5 U.S.C. 601–612, has
reviewed this rule, and by approving it,
certifies that it will not have a
significant economic impact on a
substantial number of small entities
because it pertains to personnel and
administrative matters affecting the
Drug Enforcement Administration.
Further, a Regulatory Flexibility
Analysis was not required to be
prepared for this final rule because the
Drug Enforcement Administration was
not required to publish a general notice
of proposed rulemaking for this matter.
Executive Order 12866
This rule has been drafted and
reviewed in accordance with Executive
Order 12866, Regulatory Planning and
Review, section 1(b), Principles of
Regulation. This rule is limited to
agency organization, management and
personnel as described by Executive
Order 12866 section (3)(d)(3) and,
therefore, is not a ‘‘regulation’’ or ‘‘rule’’
as defined by that Executive Order.
Accordingly, this rule has not been
reviewed by the Office of Management
and Budget.
Executive Order 12988
This regulation meets the applicable
standards set forth in sections 3(a) and
3(b)(2) of Executive Order 12988, Civil
Justice Reform.
Executive Order 13132
This rule will not have substantial
direct effects on the States, on the
relationship between the national
government and the States, or on the
distribution of power and
responsibilities among the various
levels of government. Therefore, in
accordance with Executive Order 13132,
Federalism, the Drug Enforcement
Administration has determined that this
rule does not have sufficient federalism
implications to warrant the preparation
of a federalism summary impact
statement.
Unfunded Mandates Reform Act of 1995
This rule will not result in the
expenditure by State, local, and tribal
governments, in the aggregate, or by the
private sector, of $120 million or more
(adjusted for inflation) in any one year,
and it will not significantly or uniquely
affect small governments. Therefore, no
actions are necessary under the
provisions of the Unfunded Mandates
E:\FR\FM\15JYR1.SGM
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Agencies
[Federal Register Volume 73, Number 136 (Tuesday, July 15, 2008)]
[Rules and Regulations]
[Pages 40453-40463]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E8-16011]
========================================================================
Rules and Regulations
Federal Register
________________________________________________________________________
This section of the FEDERAL REGISTER contains regulatory documents
having general applicability and legal effect, most of which are keyed
to and codified in the Code of Federal Regulations, which is published
under 50 titles pursuant to 44 U.S.C. 1510.
The Code of Federal Regulations is sold by the Superintendent of Documents.
Prices of new books are listed in the first FEDERAL REGISTER issue of each
week.
========================================================================
Federal Register / Vol. 73, No. 136 / Tuesday, July 15, 2008 / Rules
and Regulations
[[Page 40453]]
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Food and Drug Administration
21 CFR Part 210
[Docket No. FDA-2005-N-0170] (formerly Docket No. 2005N-0285)
Current Good Manufacturing Practice and Investigational New Drugs
Intended for Use in Clinical Trials
AGENCY: Food and Drug Administration, HHS.
ACTION: Final rule.
-----------------------------------------------------------------------
SUMMARY: The Food and Drug Administration (FDA) is amending the current
good manufacturing practice (CGMP) regulations for human drugs,
including biological products, to exempt most phase 1 investigational
drugs from complying with the regulatory CGMP requirements. FDA will
continue to exercise oversight of the manufacture of these drugs under
FDA's general statutory CGMP authority and through review of the
investigational new drug applications (IND).
In addition, elsewhere in this issue of the Federal Register, FDA
is announcing the availability of a guidance document entitled
``Guidance for Industry: CGMP for Phase 1 Investigational Drugs'' dated
November 2007 (the companion guidance). This guidance document sets
forth recommendations on approaches to compliance with statutory CGMP
for the exempted phase 1 investigational drugs.
FDA is taking this action to focus a manufacturer's effort on
applying CGMP that is appropriate and meaningful for the manufacture of
the earliest stage investigational drug products intended for use in
phase 1 clinical trials while ensuring safety and quality. This action
will also streamline and promote the drug development process.
DATES: This rule is effective September 15, 2008.
FOR FURTHER INFORMATION CONTACT: Monica Caphart, Center for Drug
Evaluation and Research (HFD-320), Food and Drug Administration, 10903
New Hampshire Ave., Silver Spring, MD 20993, 301-796-3248, or
Christopher Joneckis, Center for Biologics Evaluation and Research
(HFM-1), Food and Drug Administration, 1401 Rockville Pike, Rockville,
MD 20852, 301-827-5000.
SUPPLEMENTARY INFORMATION:
I. Rulemaking Procedure
In the Federal Register of January 17, 2006 (71 FR 2458), FDA
published a direct final rule to amend Sec. 210.2 (21 CFR 210.2) to
exempt most phase 1 investigational drugs from complying with the CGMP
requirements in parts 210 and 211 (21 CFR parts 210 and 211). We
explained that we issued this rule as a direct final rule because we
believed it was non-controversial and that there was little likelihood
of receiving significant adverse comments. We concurrently published in
the Federal Register of January 17, 2006 (71 FR 2494) a companion
proposed rule, identical in substance to the direct final rule, that
provided a procedural framework from which to proceed with standard
notice-and-comment rulemaking in the event we were required to withdraw
the direct final rule because of significant adverse comments. A
significant adverse comment is defined as a comment that explains why
the rule would be inappropriate, including challenges to the rule's
underlying premise or approach, or would be ineffective or unacceptable
without change. Any comments received under the companion proposed rule
were treated as comments regarding the direct final rule and vice
versa. A full description of FDA's policy on direct final rule
procedures may be found in a guidance document published in the Federal
Register of November 21, 1997 (62 FR 62466).
We received 14 comments on the proposed rule, of which several were
considered to be significant adverse comments. Therefore, in the
Federal Register of May 2, 2006 (71 FR 25747), we withdrew the direct
final rule. This final rule summarizes and responds to the comments
received on the direct final rule and proposed rule. See section V of
this document for a discussion of the comments and FDA's responses.
Together with the companion guidance, this final rule will assist
the drug development process by streamlining the application of CGMP
that is more appropriate to the manufacture of the earliest stage
investigational drug products--those intended for use in phase 1
clinical trials.
II. Background
A phase 1 clinical trial includes the initial introduction of an
investigational new drug product, including biological drug products,
into humans. Such studies are conducted to establish the basic safety
of the drug, and are designed to determine the metabolism and
pharmacologic actions of the drug in humans. The total number of
subjects in a phase 1 clinical trial is limited generally to no more
than 80 subjects. This is in contrast to phase 2 and phase 3 clinical
trials when a substantially greater number of subjects are involved,
more subjects are exposed to the drug product, and the effectiveness of
the drug product is also tested in addition to safety. During phase 2
or phase 3, drug products may also be made available for treatment use
through one of several mechanisms for expanded access to
investigational drugs.
FDA's general CGMP regulations for human drugs are set forth in
parts 210 and 211. Although the preamble to a final rule published in
the Federal Register of September 29, 1978 (43 FR 45014) (the 1978
final rule) issuing these regulations expressly stated that the CGMP
regulations applied to investigational drug products, it also raised
the possibility of proposing an additional CGMP regulation to cover
drugs being used in research: ``The Commissioner finds that, as stated
in Sec. 211.1, these CGMP regulations apply to the preparation of any
drug product for administration to humans or animals, including those
still in investigational stages. It is appropriate that the process by
which a drug product is manufactured in the development phase be well
documented and controlled in order to assure the reproducibility of the
product for further testing and for ultimate commercial production. The
Commissioner is considering proposing
[[Page 40454]]
additional CGMP regulations specifically designed to cover drugs in
research stages'' (43 FR 45014 at 45029). Such additional regulations
have never been issued.
On February 21, 1991, FDA issued a guidance document entitled
``Preparation of Investigational New Drug Products (Human and Animal)''
(56 FR 7048) (the 1991 guidance). That document, however, did not
discuss all manufacturing scenarios, and did not clearly address small-
or laboratory-scale production of drug products for use in phase 1
clinical trials. Additionally, the 1991 guidance did not fully discuss
FDA's expectations on appropriate approaches to manufacturing controls
for batches produced during drug development.
For several reasons, FDA believes that production of human drug
products, including biological drug products, intended for use in phase
1 clinical trials (phase 1 investigational drugs) should be exempted
from complying with the specific regulatory requirements set forth in
parts 210 and 211. First, even if exempted from the requirements of
parts 210 and 211, investigational drugs remain subject to the
statutory requirement that deems a drug adulterated if ``* * * the
facilities or controls used for, its manufacture, processing, packing,
or holding do not conform to or are not operated or administered in
conformity with current good manufacturing practices to assure that
such drug meets the requirements of this chapter [of the Federal Food,
Drug, and Cosmetic Act (the act)] as to safety and has the identity and
strength, and meets the quality and purity characteristics, which it
purports or is represented to possess'' (section 501(a)(2)(B) of the
act (21 U.S.C. 351(a)(2)(B))). Second, FDA oversees drugs for use in
phase 1 trials through its existing IND authority. Every IND must
contain, among other things, a section on chemistry, manufacturing, and
control information that describes the composition, manufacture, and
control of the investigational drug product (Sec. 312.23(a)(7) (21 CFR
312.23(a)(7))). Submission of this information, along with other
information required in the IND, informs FDA of the steps that the
manufacturer is taking to ensure the safety and quality of the
investigational drug. Under this IND authority, FDA has the option to
place an IND on clinical hold if the study subjects would be exposed to
unreasonable and significant risk or if the IND does not contain
sufficient information to assess the risks to subjects (21 CFR 312.42).
FDA also may terminate an IND if the methods, facilities, and controls
used for the manufacturing, processing, and packing of the
investigational drug are inadequate to establish and maintain
appropriate standards of identity, strength, quality, and purity as
needed for subject safety (21 CFR 312.44(b)(1)(iii)).
Thus, even though FDA is exempting phase 1 drug products from
compliance with the specific requirements of the CGMP regulations, FDA
retains the ability to take appropriate actions to address
manufacturing issues. For example, in addition to the authority to put
an IND on clinical hold or terminate an IND, FDA may initiate an action
to seize an investigational drug or enjoin its production if its
production does not occur under conditions sufficient to ensure the
identity, strength, quality, and purity of the drug, which may
adversely affect its safety.
FDA believes this change in the CGMP regulations (parts 210 and
211) is appropriate because many of the issues presented by the
production of investigational drugs intended for use in the relatively
small phase 1 clinical trials are different from issues presented by
the production of drug products for use in the larger phase 2 and phase
3 clinical trials or for commercial marketing. We are considering
additional guidance and regulations to clarify FDA's expectations with
regard to fulfilling CGMP requirements when producing investigational
drugs for phase 2 and phase 3 clinical trials.
Additionally, many of the specific requirements in the regulations
in part 211 do not apply to the conditions under which many drugs for
use in phase 1 clinical trials are produced. For example, the concerns
underlying the regulations' requirement for fully validated
manufacturing processes, rotation of the stock for drug product
containers, the repackaging and relabeling of drug products, and
separate packaging and production areas are generally not concerns for
these very limited production investigational drug products used in
phase 1 clinical trials.
Consequently, in this final rule, FDA is amending the scope section
of the drug CGMP regulations in part 210 to make clear that production
of investigational drugs for use in phase 1 clinical trials conducted
under an IND does not need to comply with the regulations in part 211.
However, once an investigational drug product has been manufactured by,
or for, a sponsor and is available for use in a phase 2 or phase 3
study, thus demonstrating an intent to expose more subjects to the
investigational drug and requiring that the regulations' CGMP
requirements be met, the same investigational drug product used in any
subsequent phase 1 study by the same sponsor must be manufactured in
compliance with part 211. In addition to drug products that, if
eventually approved, would be approved under section 505 of the act (21
U.S.C. 355), this rule applies to investigational biological products
that are subject to the CGMP requirements of section 501(a)(2)(B) of
the act. Examples of such products include recombinant and non-
recombinant therapeutic products, vaccine products, allergenic
products, in vivo diagnostics, plasma derivative products, blood and
blood products, gene therapy products, and somatic cellular therapy
products (including xenotransplantation products) that are subject to
the CGMP requirements of section 501(a)(2)(B) of the act. Therefore,
this final rule exempts the production of phase 1 investigational drugs
from complying with the regulatory requirements set forth in parts 210
and 211.
III. Legal Authority
Under section 501(a)(2)(B) of the act, a drug is deemed adulterated
if the methods used in, or the facilities, or controls used for, its
manufacture, processing, packing or holding do not conform to, or are
not operated in conformity with, CGMPs to ensure that such drug meets
the requirements of the act as to safety, and has the identity and
strength, and meets the quality and purity characteristics, which it
purports or is represented to possess. The rulemaking authority
conferred on FDA by Congress under the act permits FDA to amend its
regulations as contemplated by this final rule. Section 701(a) of the
act (21 U.S.C. 371(a)) gives FDA, through delegation from the Secretary
of the Department of Health and Human Services, general rulemaking
authority to issue regulations for the efficient enforcement of the
act. We refer readers to section V of the preamble of the 1978 final
rule for a fuller discussion of our CGMP rulemaking authority (43 FR
45014 at 45020-45026).
IV. Summary of the Final Rule
This final rule adds paragraph (c) to Sec. 210.2, exempting
certain investigational drugs for use in a phase 1 clinical trial
(including biological drugs) from compliance with part 211. However,
these drugs remain subject to the statutory requirements under section
501(a)(2)(B) of the act, i.e., CGMP. The regulation also explains that
the exemption from compliance with part 211 does not apply to an
investigational drug that a sponsor has made available
[[Page 40455]]
for a phase 2 or phase 3 clinical trial, or has lawfully been marketed,
and is being used for a phase 1 clinical trial. Such investigational
drug products used for a phase 1 clinical trial must comply with part
211.
We have also changed the term ``defined'' to ``described'' for
clarification.
V. Comments on the Proposed Rule and FDA's Responses
We received approximately 14 comments on the proposed rule. Several
comments were duplicate submissions by the same entity; several other
comments submitted to the docket pertained to the draft guidance under
a separate docket number. These comments were also considered in
revising the draft guidance. The following responses are specific to
the comments on the proposed rule.
A. General Comments
(Comment 1) Several comments welcome the proposed changes and
commend FDA for revising the regulations to exempt phase 1
investigational drugs from regulatory CGMP under part 211. One comment
adds that, because most products do not proceed beyond the clinical
trial phase of development, the burden of full compliance with CGMP at
the phase 1 stage far outweighs any perceived benefit and suggests that
FDA devise a progressive scale for CGMP compliance beginning with phase
1 clinical trials through approval to market the product.
(Response) We appreciate these supportive comments. Our expectation
in issuing this final rule is that sponsors will take an appropriate
approach to instituting manufacturing controls appropriate for the
stage of investigational drug development.
(Comment 2) Some comments oppose exempting phase 1 investigational
drugs from compliance with part 211 because they are concerned that
there could be an effect on product safety and human subject
protection. Another comment believes that FDA's proposed approach to
exempt phase 1 investigational drugs from the applicability of part 211
not only invites greatly reduced product standards, but affects FDA's
ability to take remedial action. One reason given was that FDA does not
have the personnel to monitor the manufacture of phase 1
investigational drugs during clinical trials. Another comment believes
that if the phase 1 investigational drugs are not reproducible, not
well-documented, or not well-controlled, the results of the trial will
be meaningless and delay availability of new drugs for commercial use.
The comment continued to state that an establishment could interpret
FDA's proposal as loosening the basic requirements needed for phase 1
material, which would not only jeopardize patients and the results of
the phase 1 clinical trial, but also the investigational stages of
development that follow.
(Response) We are confident that exempting phase 1 investigational
drugs from the CGMP regulations in part 211 will not jeopardize product
safety or human subject protection. This action is intended to focus a
manufacturer's effort on applying CGMP that is appropriate and
meaningful for the manufacture of the earliest stage investigational
drug products intended for use in phase 1 clinical trials, while also
ensuring the products' safety and quality. An additional consequence of
this action is to streamline and promote the drug development process.
The companion guidance provides our current thinking on ways to comply,
through the use of specified quality controls, with statutory CGMP for
the production of phase 1 investigational drugs. As previously
described, we will continue to oversee product safety and human subject
protection through articulation of statutory CGMP requirements,
clarified in the companion guidance, and a thorough review of the
chemistry, manufacturing, and control information submitted in the IND
application for identity, quality, purity, strength, and potency of the
investigational drug necessary to ensure the safety of the subjects in
the phase 1 clinical trial. We believe that this exemption does not
``loosen'' the requirements, but establishes quality control principles
that are appropriate and comprehensive for the manufacture of phase 1
investigational drugs, i.e., interpreting and implementing CGMP
consistent with good scientific methodology.
We also believe that the exemption will not affect or change our
ability to take remedial action if necessary, or to monitor the
manufacture of such investigational drugs; nor do we believe that this
action will delay availability of new drugs for commercial use. As
stated elsewhere in this document and in the proposed rule, compliance
with CGMP is required by section 501(a)(2)(B) of the act and a drug can
be deemed adulterated by FDA for failure to comply with statutorily
mandated CGMP.
(Comment 3) One comment states that the proposed rule was
misleading and unclear. The comment asserts, correctly, that a phase 1
investigational drug used in phase 2 and phase 3 clinical trials must
comply with part 211, but argues that the progression of the study to
phase 2 and phase 3 is unknown at the time of the phase 1
investigational drug production. Therefore, the sponsor will most
likely produce the phase 1 investigational drug in compliance with part
211 in lieu of not being able to use data from the phase 1 study for
phase 2 and phase 3.
(Response) We disagree that the proposed rule was misleading and
unclear. In the preamble to the direct final rule (71 FR 2458 at 2459),
we explained that we believe the exemption for phase 1 investigational
drugs ``is appropriate because many of the issues presented by the
production of investigational drugs intended for use in the relatively
small Phase 1 clinical trials are different from issues presented by
the production of drug products for use in the larger Phase 2 and Phase
3 clinical trials or for commercial marketing.'' Given the differences
between phase 1 clinical trials and phase 2 and phase 3 clinical trials
discussed in section II of this document, we believe compliance with
the particular regulations in part 211 is not appropriate for phase 1
investigational drugs because many of the specific requirements in part
211 do not apply to the manufacture of phase 1 investigational drugs in
the same manner because they were intended to apply to commercial drug
manufacture. For example, rotation of the stock for drug product
containers, the repackaging and relabeling of drug products, and
separate packaging and manufacturing areas are generally not of concern
for the limited production of phase 1 investigational drugs.
Additionally, the requirement for fully validated manufacturing
processes may not be appropriate for this early stage of development.
We believe that recommending approaches and considerations, and
allowing the manufacturer to develop specific controls appropriate for
the particular product, manufacturing process, and facility in order to
comply with statutory CGMP requirement is less burdensome and more
efficient for the sponsor. We agree that drug products used in phase 2
and phase 3 clinical trials may be improved or refined (i.e.,
manufacturing process and/or product) based on the results of the phase
1 clinical trial. However, limiting the exemption from compliance with
the regulations in part 211 to drugs for use in phase 1 clinical trials
(and not extending it to drugs that a sponsor has made available for a
phase 2 or phase 3 clinical trial, or has lawfully marketed) does not
preclude the use of
[[Page 40456]]
data from a phase 1 clinical trial for phase 2 and phase 3. While it is
true that some sponsors may choose to manufacture phase 1
investigational drugs in compliance with the regulatory requirements in
part 211 in anticipation of expansion of the product into phase 2
clinical trials, this rule does not require that they do so, and it is
up to the manufacturer to determine whether it makes sense in their
particular case to manufacture the phase 1 drug in compliance with the
regulations in part 211.
(Comment 4) One comment states that FDA is ignoring past reports of
phase 1 clinical trial failure, i.e., the two subject deaths in phase 1
clinical trials conducted at Johns Hopkins University and the
University of Pennsylvania, and the six subjects who experienced major
organ failure in a phase 1 clinical trial in England. The comment also
adds that there have been several deaths and recalls due to drugs
compounded by pharmacists and an increase of recalls of medical devices
due to CGMP noncompliance. The comment also makes the statement that
FDA should not assume that a medical researcher or other employee would
be able to make safe phase 1 materials following guidance.
(Response) We disagree with the comment highlighting the cases as a
reason for not issuing this final rule. Investigations of the
referenced cases found no evidence to suggest that the adverse events
were caused by the manufacturing of the phase 1 investigational drug
(Refs. 1, 2, and 3), and neither the British not the Johns Hopkins
studies had been submitted to FDA under IND, and so had consequently
not been prospectively reviewed by FDA (See https://www.fda.gov/cder/
warn/2003/02-hfd-45-0303.pdf), and thus, we are of the opinion that
nothing in this final rule would have affected the outcome of any of
the specific cases mentioned as we are not aware that CGMP was
deficient or contributed to the deaths. As to the implication in the
comment that these three cases indicate that there are risks in the
manufacture of drugs for use in phase 1 clinical trials, we believe
that there is risk in the manufacture of any drug, whether
investigational or not and regardless of the stage of testing. We note,
again, that investigational drugs for use in phase 1 clinical trials
remain subject to statutory CGMP, and a companion guidance is being
issued concurrent with this rule to provide suggested approaches for
complying with statutory CGMP for phase 1 investigational drugs.
With regard to the comment on pharmacy compounding errors, the
reported instances of recalls due to drugs compounded by pharmacists
are not analogous to producing drugs for phase 1 clinical trials, which
is the subject of this rulemaking. Moreover, the comment concerning an
increase of medical device recalls due to CGMP noncompliance apparently
assumes that this final rule relieves phase 1 investigational drugs of
compliance with any CGMP requirements. However, as previously
discussed, this final rule exempts phase 1 investigational drugs only
from regulatory CGMP requirements in parts 210 and 211. The statutory
requirement to comply with CGMP still applies. We note that, in
addition to the considerations described in the guidance, reference to
technical information and appropriate training are necessary to comply
with statutory CGMP.
B. CGMP Regulation Specific to Phase 1 Investigational Drugs
(Comment 5) Several comments request that FDA engage stakeholders
and issue a new rulemaking for CGMP specific to phase 1 investigational
drugs. One comment suggests that FDA apply the comments submitted to
the docket on the proposed rule and draft guidance in proposing a new
rule. Another comment suggests that FDA amend only the relevant
requirements, e.g., on the repackaging and relabeling of drug products,
retaining the oversight in all phases of a clinical trial of a drug.
(Response) We appreciate the comments and will consider the
appropriateness of such a proposed rule. For current purposes, however,
we intend to proceed directly from the statute, and direct the public
to the companion guidance that is being issued concurrently with this
rule, suggesting some approaches to comply with statutory CGMP for
phase 1 investigational drugs.
C. Scope
(Comment 6) One comment requests FDA to clarify the scope of the
rulemaking, i.e., that the scope does not include active pharmaceutical
ingredients (API).
(Response) The scope of the exemption from compliance with part 211
includes investigational new human drug and biological products,
including finished dosage forms used as placebos, for human use in a
phase 1 study or trial. Examples of such investigational drugs include,
but are not limited to, the following:
Investigational recombinant and non-recombinant
therapeutic products,
Vaccine products,
Allergenic products,
In vivo diagnostic products,
Plasma derivative products,
Blood and blood components\1\,
Gene therapy products, and
Somatic cellular therapy products (including
xenotransplantation products).
However, if such products have already been manufactured by an IND
sponsor for use during phase 2 or phase 3 clinical trials or have been
lawfully marketed, the manufacture of such a product must comply with
the appropriate requirements of part 211 for the product to be used in
any subsequent phase 1 clinical trial, irrespective of the trial size
or duration of dosing.
---------------------------------------------------------------------------
\1\ You should consult with the Office of Blood Research and
Review, Center for Biologics Evaluation and Research (CBER), to
determine circumstances when an IND would be required for blood or a
blood component. Manufacturers of blood and blood components
intended for transfusion and for further manufacture must still
comply with the applicable regulations in 21 CFR parts 600 through
660.
---------------------------------------------------------------------------
Manufacturers of new active pharmaceutical ingredients (also
referred to as ``API'' or ``drug substance'') are already exempt from
compliance with part 211 and must also conform with CGMP as required in
section 501(a)(2)(B) of the act. Thus, this rule does not change in any
way how APIs are regulated with regard to CGMP. As stated in the
companion guidance, limited guidance on CGMP for the manufacture of new
API for some IND products used in clinical trials is also available
(see International Conference on Harmonisation (ICH) Q7A GMP Guide for
API (ICH Q7A guidance)). Manufacturers of APIs should implement
controls appropriate to the stage of development and, thus, should also
consider the recommendations described in the companion guidance for
manufacture of API used in investigational drug products for phase 1
clinical trials.
(Comment 7) In the direct final rule, FDA makes the statement
``[T]his action is intended to streamline and promote the drug
development process'' (71 FR 2458 at 2459). One comment believes that
this proposal is outside the scope of FDA's mission mandated by
Congress, i.e., to ``promote the public health by promptly and
efficiently reviewing clinical research and taking appropriate action
on the marketing of regulated products in a timely manner'' and ``with
respect to such products, protect the public health by ensuring that *
* * human and veterinary drugs are safe and effective.'' The comment
[[Page 40457]]
further states that FDA was established to serve as a consumer
protection agency and a check and balance on regulated industry.
(Response) As section III of this document notes, CGMP is required
by section 501(a)(2)(B) of the act, and FDA has been given the general
authority to issue regulations for the efficient enforcement of the
act. We note here as well that, under section 505(i) of the act, FDA is
directed to issue regulations for exempting from the requirements of
section 505 ``drugs intended solely for investigational use by experts
qualified by scientific training and experience to investigation the
safety and effectiveness of drugs,'' which include drugs for use in
phase 1 clinical trials. While we agree that FDA is an agency whose
public health mission demands an emphasis on safety, we note that this
does not require us to impose burdens on drug development that do not
have a commensurate public health benefit. We believe that this final
rule is appropriate because many of the regulatory requirements in part
211 simply are not applicable to the manufacture of products intended
for use in phase 1 clinical trials, and that the agency can continue to
protect human subjects via interpretation of statutory CGMP and the IND
process.
D. Direct Final Rule and Companion Proposed Rule Approach
(Comment 8) A couple of comments object to the direct final rule/
companion proposed rule approach (rulemaking approach). One comment
believes that the process did not allow for a discussion regarding the
quality of clinical trial material, i.e., the establishment of
meaningful, consistent standards that balance patient protection with
speed of development. The comment then suggests that FDA work with
industry to address industry-wide questions about quality for clinical
trial materials, e.g., equipment qualification, water quality, method
validation or qualification, sterility assurance, control of
contractors, complaints, cleaning, and specifications.
(Response) We disagree with the assertion that we did not allow for
a discussion regarding the quality of clinical trial material. In
developing the companion guidance, we utilized our experience with IND
submissions and facility inspections. In addition, comments submitted
to the docket were considered in finalizing the rule and the companion
guidance, as well as stakeholder comments provided in multiple venues
where FDA representatives discussed the proposed rule and draft
guidance. Both the companion guidance and relevant IND regulations
emphasize safety as the primary focus of phase 1 clinical trials. The
companion guidance is written to allow for flexibility in utilizing
appropriate CGMP controls for the product, manufacturing process, and
facility to assure product safety. We will continue to work with
stakeholders to refine appropriate standards as needed through
continued discussions and meetings in various venues with stakeholders.
(Comment 9) One comment states that FDA does not have the expertise
to issue guidance or regulation without stakeholder input and adds that
the manufacture of clinical supplies is a complex matter in which FDA
has almost no experience. The comment also states that FDA lacks
expertise in clinical GMP compliance because FDA has performed few
inspections of early clinical supply material.
(Response) We disagree with this comment. The decision to generate
guidance for this early phase of clinical trial manufacture was due
primarily to the constant requests for guidance in this area from the
pharmaceutical industry, academia, and other research organizations.
The publication of the draft guidance and the direct final and proposed
rules in January 2006 was to address this apparent need, and to seek
broader stakeholder input. Additionally, we have experience from
numerous sources, such as participation with stakeholders in related
workshops and conferences, facility inspections, and other interactions
that result in sufficient understanding necessary to issue rulemaking
and companion guidance. Contrary to the suggestion of the comment,
conducting inspections of early clinical trial material is not the
exclusive source of FDA expertise in this area.
(Comment 10) One comment believes that FDA's finding that the
subject is suitable for this rulemaking approach is based on
assumptions, not data, such as the results of ``for cause''
inspections, treatment IND inspections, or reports of adverse drug
events occurring during phase 1 clinical trials.
(Response) We disagree with the comment. In the direct final rule,
we stated that the rulemaking approach is appropriate because many of
the issues present in the manufacture of phase 1 investigational drugs
are different from those issues presented by the manufacture of drugs
for later investigational phases or for commercial marketing, and that
many of the specific requirements in part 211 are not applicable in the
manufacture of the smaller batches of investigational drugs usually
used in phase 1. These statements are not based on assumptions, as the
comment suggests, but on the knowledge of, and experience with, good
manufacturing practice for phase 1 investigational drugs.
(Comment 11) One comment states that the proponents of the
rulemaking approach cite the successful use of ICH Q7A guidance and its
use during inspections without the need for a regulation. The comment
suggests that the possible reason for the successful use is that the
ICH Q7A guidance is more detailed than the draft guidance and is used
to manufacture material that is further processed before being
delivered to patients.
(Response) We disagree with the comment. Due to the more defined
routes of manufacture of APIs, and the general application of CGMP to
APIs in the companion guidance, the ICH Q7A guidance was able to
provide more detail for the commercial manufacture of APIs. Early phase
clinical trial material may use many different routes of manufacture,
some of which may be new and innovative. In addition, the
recommendations or expectations contained in the ICH Q7A guidance (see
section XIX of that guidance, on APIs for use in clinical trials)
utilize an approach to CGMP similar to that outlined in the companion
guidance. For the reason stated in response to comment 4, we believe
that the companion guidance provides adequate considerations when
supplemented with additional technical information and appropriate
training to comply with CGMP.
E. Exemption From Part 211
(Comment 12) One comment believes that compliance with statutory
CGMP requirements and exemption of phase 1 investigational drugs from
the requirements in part 211 subjects phase 1 investigational drugs to
unwritten standards, developed case-by-case without any input from the
public or industry. The comment also states that unwritten standards
would lead to differing interpretations within FDA, e.g., by individual
investigators, district offices, and review divisions. Inconsistency,
non-transparency, and uncertainty slow product development as the
industry tries to comply on a shifting landscape of uncertain legal
basis.
(Response) We disagree with the comment. We believe that we have
provided sufficient opportunity for the public and industry to comment
on the proposed exemption of phase 1 investigational drugs from
compliance
[[Page 40458]]
with part 211, the draft guidance, and the impact of such action. The
purpose of the companion guidance is to provide recommendations for
compliance with statutory CGMP and to promote consistency in
compliance. The companion guidance is intended for use not only by
industry, but also by FDA staff to assist in fulfilling their review
and enforcement responsibilities. It bears emphasis that, because FDA
has set forth its interpretation of some acceptable approaches to
statutory CGMP in the companion guidance, as opposed to a rule, we
remain open to alternative approaches to compliance, so long as they
provide comparable safety and protection for human subjects. We believe
this approach maximizes flexibility and minimizes burden, without
diminishing safety protections.
(Comment 13) One comment states that unclear rules erode quality.
For example, financially strapped companies will not be able to justify
expenses based on recommendations in a draft guidance. Inevitably, some
companies will stumble, and quality will drop.
(Response) Industry is not obligated to implement draft guidance.
Draft guidance is for the purpose of soliciting comments on FDA's
current thinking on a subject.
In Sec. 10.115(d)(1) (21 CFR 10.115(d)(1)), we explain that
guidance does not legally bind the public or FDA. Therefore, a
financially strapped company may choose to use a less expensive
approach other than the one recommended in a guidance, but the
alternative approach must comply with the relevant statutes and
regulations in assuring patient safety, and the company would be
prudent to consult FDA before using the alternative approach. As
previously stated in our response to comment 12, we believe this rule
maximizes flexibility and minimizes burden without diminishing safety
protections.
(Comment 14) One comment believes that regulatory CGMP provides
minimum, legal requirements to safely make drugs or biologics made for
use in humans. Another comment states that, instead of the detailed,
enforceable standards laid out in part 211, FDA proposes to rely upon
three sources of authority that are variously lacking in detail and/or
enforceability, i.e., the statutory authority (section 501(a)(2)(B) of
the act), the IND submission requirements in Sec. 312.23, and the
draft guidance.
(Response) We disagree with this comment, and believe the comment
confuses the requirements of the statute and the regulations. Many of
the regulatory requirements in part 211 are not readily applicable to
the manufacture of investigational drugs for use in phase I clinical
trials. As previously stated, because such products still must comply
with statutory CGMP, and because FDA has offered suggestions for
acceptable methods for complying with statutory CGMP, we believe that
manufacturers will have sufficient guidance to know what they must do
to safely make drugs or biologics for such early stage clinical trial
use in humans. We dispute the assertion that we are eschewing detailed,
enforceable standards in favor of relying upon three sources of
authority that are variously lacking in detail and/or enforceability.
Statutory CGMP remains enforceable and we are issuing a companion
guidance that details acceptable approaches for complying with
statutory CGMP, and FDA's authority to place clinical trials on hold
(under its IND authority) remains unchanged.
(Comment 15) One comment states that FDA assumes that, once this
rulemaking is final and phase 1 investigational drugs are exempt from
complying with part 211, new sponsors would keep proper records,
perform necessary testing, or keep retention samples for later
investigations, or that they would take the time to learn and follow
CGMP if there were no regulations requiring them to do so. Another
comment states that FDA, without evidence, claims that having to
actually produce drug or biological products according to accepted
international standards is a barrier too high for entry into phase 1
studies. The comment continues to say that such barriers do serve a
social purpose, i.e., preventing those incapable of following or
unwilling to follow CGMP from administering investigational products to
humans.
(Response) As mentioned in the preamble to the proposed rule and
draft companion guidance, application of part 211 is not appropriate to
the production of IND products used in phase 1 studies. The type and
extent of CGMP for investigational studies differs from those typically
employed for routine commercial manufacturing, and in some cases may
even include more stringent controls for certain manufacturing
operations of investigational products. We believe that the proposed
rule and the draft companion guidance better communicate FDA
expectations and facilitates compliance with CGMP for the production of
phase 1 investigational drugs rather than trying to apply existing part
211 regulations. Our expectation that phase 1 investigational drugs be
manufactured following appropriate CGMP in adequate manufacturing
facilities has not diminished with the adoption of this approach.
FDA is not claiming that the manufacture of a drug or biological
product for use in phase 1 studies according to international standards
presents too high a barrier. FDA's position is that the United States'
good manufacturing practice regulations were written primarily to
address commercial manufacturing and do not consider the differences
between early clinical supply manufacture and commercial manufacture.
The final rule and companion guidance are intended to address these
differences, while still requiring all drugs for human consumption,
including those used in clinical trials, to be manufactured in
accordance with CGMP as required by section 501(a)(2)(B) of the act.
F. Risk to Patients
(Comment 16) One comment maintains that FDA understates the risk to
patients. The comment continues to say that the CGMP regulations are
designed to protect patients from mishaps that would have major impact
on the clinical subject, e.g., contamination with bacteria, penicillin,
or industrial cleaning agents; and product mix-ups. Another comment
believes that Sec. 312.23, which requires companies to submit
information about the clinical material, has nonexistent patient
protections, and that submitting general information is no substitute
for compliance with CGMP.
(Response) We disagree with the assertion that we understated the
risk to subjects (patients). We believe that there is no additional
risk to subjects with this exemption, and have provided recommendations
that interpret and implement CGMP consistent with good scientific
methodology. In complying with section 501(a)(2)(B) of the act, a
manufacturer must manufacture the drug in conformity with good
manufacturing practice to assure that the drug meets the requirements
of the act as to safety and has the identity and strength, and meets
the quality and purity characteristics, which it purports or is
represented to possess. If the drug does not meet these criteria, the
drug is considered adulterated and therefore a possible risk to
subjects. Because the statutory requirements allow for flexibility in
describing CGMP, we have issued the companion guidance to recommend
CGMP for phase 1 investigational drugs. These recommended quality
controls for
[[Page 40459]]
producing a phase 1 investigational drug are specifically designed to
ensure subject safety.
(Comment 17) One comment believes that the exemption of phase 1
investigational drugs from part 211 puts patients at risk because it is
difficult to prove what CGMP is, and makes it difficult for FDA to
investigate or prosecute serious cases. The comment also states that a
quality assurance (QA) unit is required for preclinical studies and a
quality control (QC) unit is required for phase 2 and phase 3 studies.
However, the new approach does not provide for a QA or QC unit for
phase 1 studies.
(Response) We disagree with this comment. As previously discussed
in section II of this document, CGMP consists of steps that a
manufacturer takes to ensure the safety and quality of the
investigational drug. This information is submitted to FDA in the IND.
Through FDA's IND authority, FDA has the ability to take appropriate
actions to address manufacturing issues if there is a safety risk to
subjects, i.e., place an IND on clinical hold, terminate an IND, seize
an investigational drug, or prohibit its production.
The functions performed by QA and/or QC unit(s) appropriate for
this early phase of clinical trial material manufacture were clearly
spelled out in the draft companion guidance. We describe in the
companion guidance the QC functions that should be in effect to
manufacture in compliance with CGMP for phase 1 clinical trials. It is
at the discretion of the manufacturer if it wishes to implement these
responsibilities through separate QA and QC groups.
(Comment 18) One comment asserts that if the study subjects are
exposed to unreasonable and significant risk or if the IND does not
contain sufficient information to assess risk to patients, any action
by FDA, i.e., placing a clinical hold or terminating an IND, would
occur after the fact and well after patients are injured in the trial.
(Response) Sponsors must inform the subjects of clinical trials of
inherent, unknown risks (21 CFR 50.25). FDA will typically place a
clinical hold or terminate an IND as a result of evaluating safety
information provided as part of the IND review. Such evaluations are
conducted prior to the initiation of the clinical trial. Therefore, we
can and will, when appropriate, take such actions before the clinical
trial proceeds. In addition to taking action before the clinical trial
begins, we also have the ability under statutory CGMP to take
enforcement actions once the phase 1 clinical trial begins.
(Comment 19) One comment points out that FDA recognizes that,
although part 211 applies to phase 2 and phase 3 investigational drugs,
the extent of the controls varies based on the phase of the clinical
study. The comments also state that FDA agrees that not all sections of
part 211 may apply to phase 2 and phase 3 investigational drugs. For
this reason, the comment suggests revising the last sentence of
proposed Sec. 210.2(c) to require that the drug for use in phase 1
study comply with the appropriate sections of part 211. Another comment
also provided alternative language to Sec. 210.2(c) stating that if
the investigational drug has been made available for a phase 2 or phase
3 study or the drug has been lawfully marketed, and the manufacturer
needs to conduct further phase 1 studies to generate data to support
the registration of the clinical indication being developed, the drug
used in the phase 1 clinical trial need not comply with part 211.
(Response) We disagree with the comment. Because of the wide
variability in the possible manufacturing processes used to produce
early phase clinical trial material, it is not feasible to specify what
parts of part 211 are appropriate in a companion guidance, because what
may be appropriate for one manufacturing situation may be inappropriate
for another.
We decline to use the alternative codified language proposed by the
comment, which would exempt from the requirements of parts 210 and 211
investigational drugs used in phase 1 clinical trials where the drugs
have been lawfully marketed or used in phase 2 or phase 3 clinical
trials. Because the drug products in question have already been
manufactured using CGMP as indicated in part 211, the manufacturing
knowledge is already available and should be fully utilized.
(Comment 20) One comment reiterates the proposal that phase 1
investigational drugs would be manufactured following statutory
requirements and recommendations through guidance for CGMP, and if used
for a phase 1 clinical trial after available for phase 2 and phase 3
clinical trials or marketed, the phase 1 material would be manufactured
using regulatory CGMP. The comment raises the question of the
possibility that the phase 1 investigational drugs not manufactured per
the same standard and used on human subjects is unethical. Another
comment suggests that if only certain phase 1 investigational drugs
follow CGMP while others are exempt it promotes a situation where
subject safety may be at risk.
(Response) We believe that the comment fails to recognize that the
scope of the specific recommendations for CGMP in support of the
statutory requirements provides the same, if not additional, protection
of the phase 1 clinical trial subject. Given that FDA retains oversight
over these part 211-exempt phase 1 products via the IND mechanism, and
that the agency is issuing guidance on ways to comply with statutory
CGMP in the manufacture of such products, we firmly believe that this
rule presents no safety or ethical issue. However, as discussed
elsewhere in this preamble, we are requiring that phase 1
investigational drugs that the sponsor makes available for phase 2 and
phase 3 clinical trials or as lawfully marketed drugs comply with part
211. This is because, given the manufacturing scale of a product that
will be administered beyond a phase 1 trial, such products are more
like products manufactured for use in phase 2 and phase 3 clinical
trials or lawfully marketed drugs. The fact that we are requiring
investigational drugs manufactured in significant enough quantities
that they are available for phase 2 or phase 3 testing or lawful
marketing to comply with regulatory CGMP, does not mean that product
that is manufactured only for use in a phase 1 trial, and is thus
exempt from complying with regulatory CGMP, is unsafe. The current
rulemaking exempting products from compliance with part 211 is limited
to products manufactured exclusively for use in a phase 1 trial and the
fact that some products used in phase 1 trials will be manufactured in
compliance with the requirements of part 211 does not mean that
products that are not so manufactured in compliance with statutory CGMP
are unsafe.
G. Use of Guidance
(Comment 21) One comment believes that FDA should not use guidance
in place of minimum CGMP requirements for the safe manufacture of drugs
or biologics for human beings. Another comment requests that FDA not
exempt the manufacture of phase 1 investigational drugs from part 211,
but instead issue guidance to help manufacturers find innovative,
simple, and inexpensive approaches to comply with CGMP regulations and
keep their products safe for the trial subjects.
(Response) We are not issuing the companion guidance in place of
minimum CGMP requirements. CGMP is required by statute, and the
companion guidance provides our current thinking on complying with
statutory CGMP. As previously stated, this action is
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intended to focus a manufacturer's effort on applying CGMP that is
appropriate and meaningful for phase 1 investigational drugs, and to
streamline and promote the drug development process while ensuring the
safety and quality of the earliest stage investigational drug products.
We also expect this action to help promote innovative, simple, and
inexpensive approaches to complying with the statutory CGMP
requirements. As discussed in our response to comment 13, we are
willing to discuss with the manufacturer alternative approaches that
comply with the statutory requirements and that may be more innovative,
simple, or inexpensive than the recommendations in the companion
guidance.
(Comment 22) Several comments express concern that guidance is not
legally binding and therefore, not enforceable. One of the comments
states that relying on guidance invites misunderstandings and
inconsistencies, while another comment believes that if not required
under part 211, manufacturers may not take the time to read or
familiarize themselves with guidance related to CGMP, i.e., testing,
manufacturing sterile or aseptic dosage forms, and employee
qualification/training. A comment also believes that guidances do not
undergo the same level of notice and comment, and lacks the complete
input of interested parties.
(Response) We agree with the comment that the companion guidance is
not legally binding and not enforceable. However, the statutory
requirement that drugs, including investigational drugs for use in
phase 1 trials, comply with CGMP is legally binding and enforceable. We
believe that a sponsor, guided by its knowledge, experience, and
technical information applying good scientific methodology, following
FDA recommendations, and undertaking appropriate activities (e.g.,
training), can adequately and appropriately comply with statutory CGMP.
We disagree that relying on guidance invites misunderstandings and
inconsistencies. In fact, to the contrary, we believe that guidance
reduces misunderstandings and inconsistencies because guidance provides
FDA's interpretation of or policy on a regulatory issue, while still
allowing for flexibility and innovation.
With regard to adequate notice to, and comment by, interested
parties on guidance documents, the public can participate in the
development and issuance of guidance documents as described in Sec.
10.115(f) and (g), i.e., provide comment on issued draft guidance
documents, suggest areas for guidance document development, submit
drafts of proposed guidance documents for FDA to consider, suggest that
FDA revise or withdraw an already existing guidance document, or
comment on FDA's annually published list of possible topics for future
guidance document development or revision. Therefore, we disagree with
the comment that guidance does not undergo sufficient notice and
comment, and lacks the complete input of interested parties. Moreover,
we received extensive comments on the draft companion guidance from
numerous entities and have considered these comments in preparing the
companion guidance.
(Comment 23) Two comments express concern regarding the effect of
the companion guidance on the 1991 guidance on preparation of INDs,
which recommends the application of certain sections of parts 210 and
211 to phase 2 and phase 3 clinical trials. The comments also request
that FDA clarify the status of the 1991 guidance for phase 2 and phase
3 materials with regard to complying with CGMP requirements. Another
comment asks if FDA expects an incremental application of CGMP for the
production and testing of phase 2 and phase 3 clinical supplies, or if
the 1991 guidance will remain in effect for phase 2 and phase 3
materials until the new phase 2 and phase 3 guidance document is
available.
(Response) As stated in the introduction of the companion guidance,
the companion guidance will replace the 1991 guidance only as it
applies to phase 1 investigational drugs. This action does not affect
the scope of the 1991 guidance as it applies to phase 2 and phase 3
investigational drugs, which remains in effect until superseded by a
subsequent guidance document.
(Comment 24) One comment states that the guidance would allow the
same person manufacturing the material (a non-QC unit employee) to also
release the material to the clinic. The comment further states that the
release of material by a non-member of the QC unit violates United
States CGMP and a non-Qualified Person violates European Union CGMP,
and does not appear to recognize the importance of having an
experienced and knowledgeable unit or person to safely release the
materials.
(Response) We agree with this comment in part. The companion
guidance recognizes the need to have quality control in this early
phase of clinical trial material manufacture and has provided
recommendations for the quality control procedures that should be used.
We provide flexibility for operations where a very small amount of
clinical material is produced. While we agree that release of material
by an untrained person violates United States CGMP, this is not what is
recommended in the companion guidance, which indicates that, under very
limited circumstances and where justified, only a person trained in
CGMP and quality control functions should be given the dual
responsibility of manufacture and release. The interpretation in the
companion guidance is consistent with the quality unit functions under
part 211 and the nature of commercial and investigational products.
H. Impact
(Comment 25) FDA makes the following statement in the direct final
rule (71 FR 2458 at 2461). ``For drug manufacturers that produce Phase
1 drug products in-house and also produce approved drug products, this
direct final rule is expected to reduce the amount of documentation
they produce and maintain when they manufacture a Phase 1 drug. In some
cases, it should also reduce the amount of component and product
testing.'' Two comments state that because it is unknown at the time of
clinical manufacture if a phase 1 drug will continue to phase 2,
manufacturers will likely elect to take a conservative approach and
manufacture a drug to phase 2 requirements (part 211) to allow the
phase 1 drug to be used in future phase 2 studies. Because of
availability concerns in the clinical phase, manufacturers would most
likely elect to not discard phase 1 material that could be used in
phase 2. Therefore, the statement regarding savings is questionable.
(Response) We agree with the comment that some manufacturers may
decide to follow part 211 when manufacturing phase 1 investigational
drugs. However, the saving estimate was intended to be an estimate of
incremental savings should manufacturers chose to follow the companion
guidance, as some manufacturers will.
(Comment 26) One comment requests that FDA evaluate the cost of
compliance against the hypothetical public health risk of a product
that did not reach the market and the likelihood and severity of risks
to volunteers. Another comment states that the additional risk to
patients in a phase 1 clinical trial does not justify the proposed
savings of $1,440 per IND in documentation, training, and other
``reduced'' requirements. The comment also states that the potential
costs of $810 per IND is a gross underestimation
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of how much it will cost to manufacture a sterile or aseptic product
for the first time.
(Response) In section V.F of this document, the responses to
comments 16 through 20 state that there will be no change in the risk
to patients in phase 1 clinical trials as a result of the final rule.
The cost estimate was intended to capture the incremental cost of
complying with the proposed rule given current practice under part 211;
it does not reflect total costs. A cost-benefit analysis of phase 1
clinical trials or clinical trials in general is beyond the scope of
this document.
(Comment 27) One comment believes that the expense is not for
compliance with CGMP, especially if systems and procedures are simple,
but for the training of personnel.
(Response) Training personnel is a cost of complying with the
current CGMP regulation; the estimate in the proposed rule captured the
incremental increase in training costs to comply with the proposed
rule.
VI. Analysis of Impacts
FDA has examined the impacts of this final rule under Executive
Order 12866 and the Regulatory Flexibility Act (5 U.S.C. 601-612), and
the Unfunded Mandates Reform Act of 1995 (Public Law 104-4). Executive
Order 12866 directs agencies to assess all costs and benefits of
available regulatory alternatives and, when regulation is necessary, to
select regulatory approaches that maximize net benefits (including
potential economic, environmental, public health and safety, and other
advantages; distributive impacts; and equity). The agency believes that
this final rule is not a significant regulatory action under the
Executive order.
The Regulatory Flexibility Act requires agencies to analyze
regulatory options that would minimize any significant impact of the
rule on small entities. Because exempting production of drugs for use
in phase 1 clinical trials from compliance with specific regulatory
requirements does not add to the compliance burden of small entities,
and in most cases reduces it, the agency certifies that the final rule
will not have a significant economic impact on a substantial number of
small entities.
Section 202(a) of the Unfunded Mandates Reform Act of 1995 requires
that agencies prepare a written statement, which includes an assessment
of anticipated costs and benefits, before proposing ``any rule that
includes any Federal mandate that may result in the expenditure by
State, local, and tribal governments, in the aggregate, or by the
private sector, of $100,000,000 or more (adjusted annually for
inflation) in any one year.'' The current threshold after adjustment
for inflation is $127 million, using the most current (2006) Implicit
Price Deflator for the Gross Domestic Product. FDA does not expect this
final rule to result in any 1-year expenditure that would meet or
exceed this amount.
The purpose of this final rule is to amend our current CGMP
regulations to exempt the manufacture of investigational drugs used in
phase 1 clinical trials from compliance with the requirements in part
211. The rule affects drug manufacturers, chemical manufacturers, and
laboratories that manufacture drugs on a small scale for use in phase 1
clinical trials.
For drug manufacturers that produce in-house investigational drugs
for use in phase 1 clinical trials and also produce approved drug
products for marketing, this final rule is expected to reduce the
amount of documentation they produce and maintain when they manufacture
an investigational drug for use in a phase 1 clinical trial. In some
cases, it should also reduce the amount of component and product
testing.
Because they currently may not supply the pharmaceutical industry,
some chemical manufacturers and laboratories may experience a slight
increase in documentation if they do not have written standard
operating procedures (SOPs) or if they need to modify existing methods
of documentation. Although formats may be different, the rule should
not require more information than is already collected as part of
standard laboratory practices.
Because the actual SOPs and manufacturing requirements are
different for each new drug product and manufacturing facility, the
procedures to comply with the statutory CGMP requirements for phase 1
manufacturing are generated as part of product development. The savings
or costs would be incurred on a per-IND and not per-facility basis.
This rule is intended to clarify compliance with the statutory
CGMPs that are necessary in the manufacture of investigational drugs
used in phase 1 clinical trials, and to exempt certain drugs produced
under IND and used for phase 1 clinical trials from regulatory CGMP
requirements under part 211. Some manufacturers may realize savings
because they no longer must meet certain requirements. The savings to
drug manufacturers that manufacture in-house the investigational drugs
used in phase 1 clinical trials will vary greatly from product to
product. FDA lacks data to estimate where the cost savings will occur
in the manufacture of investigational drugs. Some substantial savings
may be realized in testing and analyzing components and in-process
materials. These costs can typically range from $50 to $1,200 per
component tested. The extent of the need for SOPs and methods
validation may also be greatly reduced. We estimate that large drug
manufacturers