Institutional Review Boards; Registration Requirements, 2358-2369 [E9-682]
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party listed in Appendix A to 31 CFR
Chapter V with the bracketed suffix
[NPWMD] of an item subject to the EAR.
If OFAC authorizes an export from the
United States or an export or reexport
by a U.S. person to a party listed in
Appendix A to 31 CFR Chapter V with
the bracketed suffix [NPWMD], such
authorization constitutes authorization
for purposes of the EAR as well.
(ii) U.S. persons must seek
authorization from BIS for the export or
reexport to a party listed in Appendix
A to 31 CFR Chapter V with the
bracketed suffix [NPWMD] of any item
subject to the EAR that is not subject to
OFAC’s regulatory authority pursuant to
Executive Order 13382.
(iii) Non-U.S. persons must seek
authorization from BIS for any export
from abroad or reexport to a party listed
in Appendix A to 31 CFR Chapter V
with the bracketed suffix [NPWMD] of
any item subject to the EAR.
(iv) Any export or reexport to a party
listed in Appendix A to 31 CFR Chapter
V with the bracketed suffix [NPWMD] of
any item subject to the EAR and not
authorized by OFAC is a violation of the
EAR.
(v) Any export or reexport by a U.S.
person to a party listed in Appendix A
to 31 CFR Chapter V with the bracketed
suffix [NPWMD] of any item subject to
the EAR that is not subject to regulation
by OFAC and not authorized by BIS is
a violation of the EAR. Any export from
abroad or reexport by a non-U.S. person
to a party listed in Appendix A to 31
CFR Chapter V with the bracketed suffix
[NPWMD] of any item subject to the
EAR and not authorized by BIS is a
violation of the EAR.
(3) Relation to other EAR license
requirements. The license requirements
in this section supplement any other
requirements set forth elsewhere in the
EAR.
(b) License exceptions. No license
exceptions are available for the EAR
license requirements imposed in this
section.
(c) Licensing policy. Applications for
EAR licenses required by this section
generally will be denied. You should
consult with OFAC concerning
transactions subject to OFAC licensing
requirements.
(d) Contract sanctity. Contract
sanctity provisions are not available for
license applications reviewed under this
section.
PART 746—[AMENDED]
7. The authority citation for part 746
continues to read as follows:
■
Authority: 50 U.S.C. app. 2401 et seq.; 50
U.S.C. 1701 et seq.; 22 U.S.C. 287c; Sec 1503,
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Public Law 108–11, 117 Stat. 559; 22 U.S.C.
6004; 22 U.S.C. 7201 et seq.; 22 U.S.C. 7210;
E.O. 12854, 58 FR 36587, 3 CFR, 1993 Comp.,
p. 614; E.O. 12918, 59 FR 28205, 3 CFR, 1994
Comp., p. 899; E.O. 13222, 3 CFR, 2001
Comp., p. 783; Presidential Determination
2003–23 of May 7, 2003, 68 FR 26459, May
16, 2003; Presidential Determination 2007–7
of December 7, 2006, 72 FR 1899 (January 16,
2007); Notice of July 23, 2008, 73 FR 43603
(July 25, 2008).
■
8. Revise § 746.7 to read as follows:
§ 746.7
Iran.
The Treasury Department’s Office of
Foreign Assets Control (OFAC)
administers a comprehensive trade and
investment embargo against Iran. This
embargo includes prohibitions on
exports and certain reexport
transactions involving Iran, including
transactions dealing with items subject
to the EAR. These prohibitions are set
forth in OFAC’s Iranian Transactions
Regulations (31 CFR part 560). In
addition, BIS maintains licensing
requirements on exports and reexports
to Iran under the EAR as described in
paragraph (a)(1) of this section or
elsewhere in the EAR (See, e.g.,
§ 742.8—Anti-terrorism: Iran).
(a) License requirements.
(1) EAR license requirements. A
license is required under the EAR to
export or reexport to Iran any item on
the CCL containing a CB Column 1, CB
Column 2, CB Column 3, NP Column 1,
NP Column 2, NS Column 1, NS
Column 2, MT Column 1, RS Column 1,
RS Column 2, CC Column 1, CC Column
2, CC Column 3, AT Column 1 or AT
Column 2 in the Country Chart Column
of the License Requirements section of
an ECCN or classified under ECCNs
0A980, 0A982, 0A983, 0A985, 0E982,
1C355, 1C395, 1C980, 1C981, 1C982,
1C983, 1C984, 2A994, 2D994, 2E994,
5A980, 5D980, or 5E980.
(2) BIS authorization. To avoid
duplication, exporters or reexporters are
not required to seek separate
authorization from BIS for an export or
reexport subject both to the EAR and to
OFAC’s Iranian Transactions
Regulations. Therefore, if OFAC
authorizes an export or reexport, such
authorization is considered
authorization for purposes of the EAR as
well. Transactions that are not subject to
OFAC regulatory authority may require
BIS authorization.
(b) Licensing Policy. Applications for
licenses for transactions for
humanitarian reasons or for the safety of
civil aviation and safe operation of U.Sorigin aircraft will be considered on a
case-by-case basis. Licenses for other
purposes generally will be denied.
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(c) License Exceptions. No license
exceptions may be used for exports or
reexports to Iran.
(d) EAR Anti-terrorism controls. The
Secretary of State has designated Iran as
a country that has repeatedly provided
support for acts of international
terrorism. Anti-terrorism license
requirements and licensing policy
regarding Iran are set forth in § 742.8 of
the EAR.
(e) Prohibition on exporting or
reexporting EAR items without required
OFAC authorization. No person may
export or reexport any item that is
subject to the EAR if such transaction is
prohibited by the Iranian Transactions
Regulations (31 CFR part 560) and not
authorized by OFAC. The prohibition of
this paragraph (e) applies whether or
not the EAR requires a license for the
export or reexport.
Dated: January 9, 2009.
Christopher R. Wall,
Assistant Secretary for Export
Administration.
[FR Doc. E9–726 Filed 1–14–09; 8:45 am]
BILLING CODE 3510–33–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Food and Drug Administration
21 CFR Part 56
[Docket No. FDA–2004–N–0117] (formerly
Docket No. 2004N–0242)
RIN 0910–AB88
Institutional Review Boards;
Registration Requirements
AGENCY:
Food and Drug Administration,
HHS.
ACTION:
Final rule.
SUMMARY: The Food and Drug
Administration (FDA, we) is issuing a
final rule to require institutional review
boards (IRBs) to register through a
system maintained by the Department of
Health and Human Services (HHS). The
registration information includes
contact information (such as addresses
and telephone numbers), the number of
active protocols involving FDAregulated products reviewed during the
preceding 12 months, and a description
of the types of FDA-regulated products
involved in the protocols reviewed. The
IRB registration requirements will make
it easier for FDA to inspect IRBs and to
convey information to IRBs.
DATES: This rule is effective July 14,
2009. This effective date is necessary to
allow refinement of the electronic
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registration system so that it
corresponds to this final rule. All IRBs
must comply with the initial registration
requirement and, if necessary, make
required revisions to their registrations
by September 14, 2009.
FOR FURTHER INFORMATION CONTACT: Erik
Mettler, Office of Policy, Planning and
Preparedness, Food and Drug
Administration, WO1, rm. 4324, Silver
Spring, MD 20993–0002, 301–796–4830.
SUPPLEMENTARY INFORMATION:
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I. Introduction
What Led Us to Issue This Rule?
IRBs are ‘‘boards, committees, or
groups formally designated by an
institution to review, to approve the
initiation of, and to conduct periodic
review of, biomedical research
involving human subjects’’ (see 21 CFR
56.102(g)). An IRB’s primary purpose
during such reviews is to assure the
protection of the rights and welfare of
human subjects (id.). FDA’s general
regulations pertaining to IRBs are at part
56 (21 CFR part 56). (While section
520(g) of the Federal Food, Drug, and
Cosmetic Act (‘‘the act’’) (21 U.S.C.
360j(g)) refers to ‘‘institutional review
committees’’ rather than IRBs, FDA
considers institutional review
committees to be IRBs and to be subject
to the IRB regulations.)
Even though IRBs play an important
role in the conduct of clinical
investigations regulated by FDA, we
have never compiled a comprehensive
list of IRBs involved in reviewing
clinical investigations regulated by
FDA. Existing FDA regulations have
required some, but not all, clinical
investigators or sponsors of clinical
investigations to provide IRB names and
addresses to FDA, and the requirements
differ slightly among the different types
of products regulated by FDA. For
example, for human drug products, the
sponsor must disclose the name and
address of ‘‘each reviewing’’ IRB (see 21
CFR 312.23(a)(6)(iii)(b)). For medical
devices, the sponsor must disclose the
names and addresses of IRBs that ‘‘have
been asked or will be asked’’ to review
the investigation (see 21 CFR
812.20(b)(7)) (emphasis added). For
other types of clinical investigations
regulated by FDA (such as food additive
studies involving human subjects), the
regulations do not expressly require the
sponsor or the clinical investigator to
disclose or keep records showing an
IRB’s name and address, and they make
no distinction between ‘‘reviewing
IRBs’’ and IRBs that have been asked or
will be asked to review a study.
In 1998, the Department of Health and
Human Services’ Office of the Inspector
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General (OIG) issued several reports on
IRBs. The OIG sought to identify the
challenges facing IRBs and to make
recommendations on improving Federal
oversight of IRBs. One recommendation
was that all IRBs should register with
the Federal Government on a regular
basis as part of an effort to develop more
streamlined, coordinated, and probing
means of assessing IRB performance and
to enhance the Federal Government’s
ability to identify and respond to
emerging problems before they result in
‘‘serious transgressions’’ (see Office of
the Inspector General, Department of
Health and Human Services,
Institutional Review Boards: a Time for
Reform, pages 20 and 21, June 1998).
After reviewing the OIG’s
recommendation, we concluded that
IRB registration would serve several
important goals. IRB registration would:
• Enable us to identify more precisely
those IRBs reviewing clinical
investigations regulated by FDA. At
present, much of our knowledge about
the identities and numbers of IRBs
reviewing clinical investigations
regulated by FDA is based on
information from persons conducting or
sponsoring clinical investigations rather
than from IRBs themselves. This
information may be obsolete (because
there may be no obligation to update the
information) or incomplete (because the
requirements to report the names and
addresses of IRBs are not uniform across
all FDA-regulated products);
• Enable us to send educational
information and other information to
IRBs. Because we lack an accurate list
of IRBs, our outreach and educational
efforts are not as efficient as they might
be. Changes in IRB addresses result in
returned mail, and newly formed IRBs
may not appear in FDA’s mailing lists;
and
• Help us identify IRBs for
inspection, because we would have a
more accurate list of IRBs.
Consequently, FDA, in consultation
with the Department of Health and
Human Services, Office for Human
Research Protections (OHRP), published
a proposed rule in the Federal Register
of July 6, 2004 (69 FR 40556), that
would require IRB registration for IRBs
reviewing clinical investigations
involving FDA-regulated products.
OHRP issued a companion proposed
rule which appeared in the Federal
Register of July 6, 2004 (69 FR 40584)
that would require registration for IRBs
reviewing federally supported research.
The final OHRP IRB registration rule is
published elsewhere in this issue of the
Federal Register.
The goal of the two rules is to create
a simple, electronic registration system
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that all IRBs, regardless of whether they
review clinical investigations regulated
by FDA or federally supported research,
can use.
II. What Comments Did We Receive?
A. How Many Comments Did We
Receive, and Who Submitted
Comments?
We received over 15 comments in
response to the proposed rule.
Individuals, IRB members, IRB
associations, an IRB accreditation
association, government, health,
academic or trade associations, a
university system, and drug companies
submitted comments. In general, the
comments supported IRB registration,
although some disagreed with specific
aspects of the proposal or with other
issues that were discussed in the
preamble to the proposed rule. To make
it easier to identify comments and our
responses, the word ‘‘Comment,’’ in
parentheses, will appear before the
comment’s description, and the word
‘‘Response,’’ in parentheses, will appear
before our response. We have also
numbered each comment to help
distinguish between different
comments. The number assigned to each
comment is purely for organizational
purposes and does not signify the
comment’s value or importance or the
order in which it was received.
B. Who Must Register? (Section
56.106(a))
Proposed § 56.106(a) would require
the following IRBs to register:
• Each IRB in the United States that
reviews clinical investigations regulated
by FDA under sections 505(i) (21 U.S.C.
355(i)) or 520(g) of the act; and
• Each IRB in the United States that
reviews clinical investigations that are
intended to support applications for
research or marketing permits for FDAregulated products.
The preamble to the proposed rule
invited comment on whether there are
circumstances in which foreign IRBs
should be required or invited to register
(see 69 FR 40556 at 40558).
(Comment 1) One comment stated
that foreign IRBs are not needed in
America.
(Response) The comment may have
misinterpreted the preamble. The issue
is not whether foreign IRBs should or
should not review studies, but rather
whether foreign IRBs should be
included in the IRB registration system.
(Comment 2) Several comments
differed as to whether foreign IRBs
should have to register. One comment
would require foreign IRBs to register if
they review research conducted in the
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United States; the same comment would
give foreign IRBs the option to register
if they review research conducted
outside the United States that may be
used to support a future marketing
application in the United States.
Several comments would allow for
voluntary registration of foreign IRBs or
ethical review committees. Two
comments explained that registering
foreign IRBs would enable them to have
access to educational materials and
other information. However, one
comment would limit such registration
to foreign IRBs reviewing research
conducted in the United States, and
another comment noted that local
privacy laws in foreign countries might
affect a foreign IRB’s ability to provide
certain registration information.
In contrast, one comment said that we
should respect oversight of ethical
review committees by foreign
authorities and that we should not
impose ‘‘additional bureaucracy.’’
Similarly, another comment opposed
registering foreign IRBs, stating that
such registration could pose ‘‘significant
difficulties’’ for clinical investigators
and sponsors and that foreign laws and
regulations might make it difficult for
foreign IRBs to register.
(Response) We agree in part with the
comments. We agree that foreign IRBs
would benefit from educational and
other materials that would be sent to
registered IRBs. Therefore, we have
revised § 56.106(a) to allow for
voluntary registration by foreign IRBs
and by any domestic IRB that is not
otherwise required to register.
We decline to require registration by
foreign IRBs that review research to be
conducted in the United States. We do
not believe a significant number of
foreign IRBs review research that is to
be conducted in the United States.
Furthermore, requiring registration by
foreign IRBs that review research
conducted in the United States could
lead to arguments over the validity of
our regulatory authority when applied
to actions occurring in a foreign
country.
As for possible problems foreign IRBs
might encounter in registering
information due to foreign laws and
regulations, the comments did not
identify specific registration elements
that would be a problem. Consequently,
we lack sufficient information to
determine whether we should modify
certain IRB registration elements to
accommodate foreign IRBs.
(Comment 3) One comment asked us
to clarify whether the reference to
section 520(g) of the act was limited to
research done under an investigational
device exemption (IDE) or encompassed
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all investigational devices in a clinical
investigation.
(Response) The reference to section
520(g) of the act encompasses all
investigational devices in a clinical
investigation, regardless of whether
FDA approval of an IDE is needed in
accordance with 21 CFR part 812 for the
clinical investigation.
(Comment 4) One comment asked us
to clarify whether the rule applied to
‘‘non-local’’ or ‘‘commercial’’ IRBs.
(Response) The comment did not
explain what it meant by the terms
‘‘non-local’’ or ‘‘commercial’’ IRB. For
purposes of this response, we will
assume that a ‘‘non-local’’ IRB is one
that is physically located away from the
clinical trial site(s) and that a
‘‘commercial’’ IRB is one that is paid to
review research.
If the ‘‘non-local’’ or ‘‘commercial’’
IRB is located in the United States and:
• Reviews clinical investigations
regulated by FDA under sections 505(i)
or 520(g) of the act; or
• Reviews clinical investigations that
are intended to support applications for
research or marketing permits for FDAregulated products, then the non-local
or commercial IRB must register under
§ 56.106(a). If the non-local or
commercial IRB does not perform any of
the reviews described immediately
above or is outside the United States,
then it may register voluntarily.
C. What Information Must an IRB
Register? (Section 56.106(b))
Proposed § 56.106(b) would describe
the information that IRBs would provide
as part of the registration process. For
example, proposed § 56.106(b)(1) would
require the name and mailing address of
the institution operating the IRB and the
name, mailing address, phone number,
facsimile number, and electronic mail
address of the senior officer of that
institution who is responsible for
overseeing the IRB’s activities. (A
facsimile number also is known more
commonly as a ‘‘fax number.’’)
(Comment 5) Several comments
addressed the registration information
in proposed § 56.106(b) generally. Two
comments said that the registration
information that OHRP and FDA would
require should either be the same or that
information required by OHRP, but not
by FDA, should be clearly delineated
and marked as optional for IRBs that are
subject to FDA regulation. Similarly,
one comment said that questions
relating to research funded by HHS,
which were part of OHRP’s proposed
registration system, should be identified
clearly so IRBs that do not review HHSfunded research are not obliged to
answer those questions.
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Another comment said the proposed
registration information is appropriate.
One comment urged us to reexamine
the registration information to assure
that the information is necessary to
support the rule’s stated goals.
(Response) We coordinated our rule
with OHRP and tailored our respective
registration information elements to be
as consistent as possible and to use the
same internet-based registration system.
We agree that the IRB registration
system should specify whether certain
registration information is optional or
not required for IRBs subject only to our
jurisdiction. The preamble to the
proposed rule stated that, ‘‘In those
instances where the Internet registration
site would seek more information than
FDA would require under this proposal,
the site would clarify that IRBs
regulated solely by FDA may, but are
not required to, provide the additional
information’’ (69 FR 40556 at 40558).
The Internet registration site will be
structured so that required information
will be identified or marked as such,
and IRBs indicating that they are
registering pursuant to FDA’s regulation
also will be directed to questions
requesting information required only
under FDA’s regulation.
(Comment 6) Proposed § 56.106(b)(1)
would require IRBs to provide the name
and mailing address of the institution
operating the IRB and the name, mailing
address, phone number, facsimile
number, and electronic mail address of
the ‘‘senior officer of that institution
who is responsible for overseeing
activities performed by the IRB.’’ The
preamble to the proposed rule explained
that the senior officer ‘‘must not be an
IRB member, IRB staff, or a sponsor or
investigator participating in an
investigation under review by that IRB’’
(see 69 FR 40556 at 40558).
Several comments addressed this
provision. Two comments supported the
proposed requirement, but two other
comments stated that our interpretation
of ‘‘senior officer’’ was too prohibitive
or too restrictive. These comments said
that if a senior officer is on the IRB, his
or her membership should not
invalidate registration or subject the IRB
to enforcement action.
Another comment questioned what
we meant when we referred to ‘‘IRB
staff.’’ The comment said that some IRBs
distinguish staff from IRB members to
ensure the IRB’s integrity and
independence. The comment suggested
that we list persons who cannot be a
‘‘senior officer’’ and that we delete ‘‘IRB
staff’’ from that list.
(Response) We agree, in part, with the
comments. We recognize that, in some
cases, it may not be feasible to identify
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a ‘‘senior officer’’ who is not also an IRB
member or IRB staff. However, our
experience indicates that IRBs
sometimes form subcommittees or other
groups and that the institutions
overseeing the IRBs may not be aware of
these subcommittees or other groups.
Thus, when we said that the ‘‘senior
officer’’ should not be an IRB member
or IRB staffer, our goal was to ensure
that the institution overseeing the IRB’s
activities is truly aware of those
activities. For these reasons, where
feasible, we recommend that the senior
officer not be an IRB member or an IRB
staffer.
Additionally, as the preamble to the
proposed rule stated, information
regarding the institution will enable us
to identify the institution and to
determine whether problems that might
exist for one IRB at that institution exist
at other IRBs affiliated with that
institution (see 69 FR 40556 at 40558).
Additionally, on our own initiative,
we have revised § 56.106(b)(1) to require
the street address for the institution if
the street address is different from the
institution’s mailing address.
(Comment 7) One comment said we
should ensure that any addresses and
telephone numbers are current and are
kept current. The comment suggested
that we issue fines and penalties if IRBs
fail to keep such information current.
(Response) Section 56.106(e) requires
IRBs to revise their registration
information within 90 days if a contact
person or chairperson information
changes; this would encompass changes
in the contact person’s or chairperson’s
telephone number.
As for the comment’s suggestion of
imposing fines and penalties, we do not
have legal authority to impose fines for
failure to maintain IRB registration
information. As for other penalties, we
discuss the consequences of failing to
register in comment 24 of this
document.
(Comment 8) Proposed § 56.106(b)(2)
would require IRBs to provide the IRB’s
name, the names of each IRB chair
person and each contact person (if one
exists) for the IRB, and the IRB’s mailing
address, street address (if different from
the mailing address), phone number,
facsimile number, and electronic mail
address.
One comment supported the proposal.
However, another comment noted that
the OHRP proposal would require IRBs
to provide the name, gender, degree,
scientific or nonscientific specialty, and
affiliation of each IRB member and
suggested that we revise our rule to
require the same information as the
OHRP rule.
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(Response) We agree, in part, and
disagree, in part, with the comment’s
suggestion that we require the same
information as OHRP’s rule. We decline
to revise the rule as requested by the
comment. Unlike OHRP, we have never
required IRBs to give us the names,
educational background, and
qualifications of all IRB members. Our
rule does not include this information
because our regulatory emphasis has
been on the IRB’s overall composition.
Consequently, our final rule does not
require such information about
individual IRB members.
We have, however, revised
§ 56.106(b)(2) to replace ‘‘chair person’’
with ‘‘chairperson.’’ This change reflects
the common spelling for this noun and
does not alter the application or
interpretation of § 56.106(b)(2).
Additionally, we have revised
§ 56.106(b)(2) to require the phone
number and electronic mail address for
the IRB chairperson; this will enable us
to communicate with the IRB
chairperson quickly if such a need
arises.
On our own initiative, we have
revised § 56.106(b)(2) to delete the
parenthetical of ‘‘(if one exists)’’ after
‘‘the contact person’s name’’ and to
require and the name, mailing address,
phone number, facsimile number, and
electronic mail address of the contact
person providing the registration
information. This information will
enable us to communicate with the
contact person if any questions arise
regarding the IRB or its registration
information, and the information now
required is similar to that required for
the contact person under OHRP’s rule.
We also have reorganized the provision
to make it easier to understand what
information is required.
(Comment 9) Proposed § 56.106(b)(3)
would require IRBs to provide the
‘‘number of active protocols (small,
medium, or large) involving FDAregulated products reviewed.’’ The
proposal explained that a ‘‘small’’
number of protocols is 1 to 25 protocols;
‘‘medium’’ is 26 to 499 protocols, and
‘‘large’’ is 500 protocols or more.
Several comments interpreted this
provision in different ways or sought
clarification as to its meaning. In brief:
• One comment asked us to define
‘‘protocol’’ because it said questions
would arise regarding multi-site studies
involving a single protocol.
• Another comment would redefine
the numerical ranges so that ‘‘small’’
would be 1 to 99 protocols, ‘‘medium’’
would be 100 to 499 protocols, ‘‘large’’
would be 500 to 1,999 protocols, and
‘‘very large,’’ a new category, would be
2,000 protocols or more. The comment
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explained that a ‘‘substantial number’’
of organizations oversee thousands of
protocols and that these organizations
operate differently compared to those
that review 500 protocols.
• Another comment expressed
concern about the protocol numbers,
stating that it was unclear how useful or
accurate the data would be due to
complexities in IRB review and
‘‘protocol driven research activities,’’
the level of IRB review (such as full IRB
review or expedited review), and
frequent or daily changes in protocol
review numbers.
Similarly, another comment stated
that protocols are neither uniform nor
uniformly complex, so that protocol
activity is not a reasonable basis for
determining IRB activity. A third
comment said that we should consider
the protocol ranges to be only
approximations of IRB workloads and
use the information carefully and
cautiously in evaluating or
characterizing IRBs.
• Another comment disputed the
need for protocol review information,
arguing that compliance with regulatory
requirements is an issue regardless of
the number of protocols reviewed by an
IRB.
(Response) The preamble to the
proposed rule explained that
information regarding the number of
protocols reviewed would enable us to
determine how active an IRB is and to
assign our inspection resources based
on IRB activity levels (see 69 FR 40556
at 40558). Our intent was not to get an
exact or precise figure, and the
proposal’s use of ‘‘small,’’ ‘‘medium,’’
and ‘‘large’’ protocol ranges reflected
that intent.
Consequently, we decline to revise
the rule to define ‘‘protocol’’ in the final
rule. Webster’s II—New Riverside
University Dictionary defines
‘‘protocol,’’ in relevant part, as ‘‘the plan
for a scientific experiment or treatment’’
(see Webster’s II—New Riverside
University Dictionary at page 947
(1988)). Thus, in the comment’s
scenario, if an IRB conducts one review
for a multi-site study, that single review
could be considered as one ‘‘protocol.’’
If an IRB conducts separate reviews for
individual study sites, then it
conceivably could have reviewed
multiple ‘‘protocols’’ notwithstanding
the fact that the study plan remains
essentially the same for all sites.
However, on our own initiative, we
have amended § 56.106(b)(3) to define
what the term ‘‘active protocol’’ means.
The final rule defines ‘‘active protocol’’
as ‘‘any protocol for which an IRB
conducted an initial review or a
continuing review at a convened
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meeting or under an expedited review
procedure during the preceding 12
months.’’ We have made this change to
be consistent with changes made by
OHRP in its final rule.
With respect to the proposal’s
numerical ranges and their usefulness to
us, we reiterate that our intent was to
get a general—rather than a precise—
sense of how active IRBs are and to
assign our limited inspectional
resources more efficiently and
effectively. We recognize that there are
different types of IRB review and that
changes in an IRB’s workload could
make an IRB’s protocol estimate
outdated or obsolete at a later point in
time. However, given the protocol
ranges were created simply to give us an
idea about an IRB’s activity, we have
revised the rule to eliminate the
‘‘small,’’ ‘‘medium,’’ and ‘‘large’’ ranges.
Instead, the final rule requires an
approximate number of active protocols
reviewed, but we neither expect nor
want IRBs to constantly change or
update their protocol numbers
whenever their protocol numbers
fluctuate. If the approximate number of
protocols changes after initial IRB
registration, the IRB should report the
new protocol number as part of the reregistration process which takes place
every 3 years.
As for compliance activities, we
believe the comment may have
misinterpreted the preamble to the
proposed rule. We did not state that we
would base inspections solely on an
IRB’s self-reported level of ‘‘small,’’
‘‘medium,’’ or ‘‘large’’ numbers of
protocols reviewed. We simply said that
the information would help us assign
inspection resources based on IRB
activity levels.
To put it another way, we have
limited inspectional resources, and our
field staffs that inspect IRBs are also
responsible for many other types of
inspections and activities. We must
prioritize our routine IRB inspections in
some manner to make the most efficient
use of our resources. Such prioritization
of IRB inspections is not tantamount to
declaring, as the comment suggests, that
IRBs reviewing ‘‘small’’ or ‘‘medium’’
numbers of protocols do not have to
comply with FDA regulations or that we
enforce our requirements differently
depending on whether an IRB reviews a
‘‘small,’’ ‘‘medium,’’ or ‘‘large’’ number
of protocols. Nevertheless, given that
the final rule does not contain the
‘‘small,’’ ‘‘medium,’’ or ‘‘large’’ protocol
ranges, the issue is largely moot.
(Comment 10) Proposed § 56.106(b)(4)
would require IRBs to describe the types
of FDA-regulated products, such as
biological products, color additives,
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food additives, human drugs, or medical
devices, involved in the protocols that
they review.
Two comments addressed this
provision. One comment stated that it
had no objection to the requirement
provided that the description could be
simple or generic without numerical
ranges associated with each product
type. Another comment said the
descriptions would be appropriate only
if we used the information for purposes
of sending useful and targeted
information to IRBs. The comment also
said that the description should be
generic and without numerical ranges
associated with product types.
(Response) We agree with the
comments. Section 56.106(b)(4) merely
seeks a generic description of the FDAregulated products in the protocols
reviewed by the IRB. So, for example, if
the IRB reviews protocols for human
drug studies, the description, to satisfy
§ 56.106(b)(4), could simply be ‘‘human
drugs.’’ If the IRB reviews protocols for
human drug and medical device studies,
the description would be ‘‘human
drugs’’ and ‘‘medical devices.’’ We also
note that the electronic registration
system will list the types of FDAregulated products and allow
individuals to check the appropriate
boxes relating to those products and to
check ‘‘other’’ and explain what the
‘‘other’’ FDA-regulated products are.
Furthermore, § 56.106(b)(4) does not
require IRBs to assign numerical values
to the FDA-regulated product types. As
the comments noted, our intent is to use
this information to send productspecific information to IRBs, and we can
do so with a simple description of
product types.
(Comment 11) Proposed § 56.106(b)(5)
would require an indication whether the
IRB is accredited and, if so, the date of
the last accreditation and the name of
the accrediting body or organization.
The preamble to the proposed rule
stated that we recognized that IRB
accreditation is a developing concept
and invited comment on ‘‘the perceived
value of collecting information on the
accreditation status of IRBs’’ (see 69 FR
40556 at 40558).
We received more than 10 comments
on IRB accreditation issues, and the
comments reflected a considerable
difference of opinion regarding IRB
accreditation and whether we should
require information about such
accreditation. In brief, the comments
stated:
• IRB accreditation information may
give FDA useful information in deciding
which IRBs to inspect and may help us
decide whether to focus educational
activities on certain areas. One comment
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added that accreditation information
would help us evaluate the value of IRB
accreditation. In contrast, one comment
said that IRB accreditation information
will not give FDA new information that
will be useful in assessing
accreditation’s value;
• FDA should refer to accreditation of
human research protection programs
rather than accreditation of IRBs;
• FDA should require information
about the name of the accrediting
organization under which the IRB
functions or collect information about
accreditation type or level. One
comment explained that one body has
two different accreditation categories;
• The additional reporting burden
should not be passed on to the
institution;
• FDA should delete the provision
because accreditation information can
be collected without the need for a
regulation or is publicly available from
accrediting organizations. One comment
added that accreditation information, if
it were part of the IRB registration
requirement, might be unreliable
because our rule would require reregistration every 3 years; and
• Accreditation does not accurately
represent a measure of compliance with
human subject protection requirements.
Similarly, an IRB’s lack of accreditation
could be misconstrued as reflecting on
the quality of the IRB’s human subject
protection program. In contrast, one
comment strongly encouraged IRBs to
become accredited, and another
comment said that accreditation implies
that a certain standard has been
achieved.
(Response) The final rule omits
accreditation information from the IRB
registration requirements. We agree that,
if necessary, we can obtain accreditation
information from the accreditation
organizations themselves and that the
resulting information may be more
reliable or accurate, given that the rule
does not require certain registration
information to be updated until reregistration. We also agree that, as a
general matter, accreditation does not
ensure or demonstrate that a particular
action was done correctly; instead,
accreditation may increase one’s
confidence that the accredited body is
capable of performing a particular
action correctly.
Furthermore, we continue to believe
that accreditation, insofar as human
subject protection is concerned, is still
a developing concept. Consequently, we
will continue to follow such
accreditation activities, but will not
require accreditation information as part
of IRB registration.
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Finally, because the final rule does
not require accreditation information,
the comment regarding reporting
burdens is moot.
D. When Must an IRB Register? (Section
56.106(c))
Proposed § 56.106(c) would have IRBs
register once and to renew their
registrations every 3 years. Initial IRB
registration would occur within 30 days
before the date when the IRB intends to
review clinical investigations regulated
by FDA. IRB registration would become
effective upon HHS posting of the
registration information on its Web site.
(Comment 12) One comment would
have us consider IRBs to be registered
as soon as they complete submitting the
registration information regardless of
whether the IRB submitted the
information electronically or in writing.
Another comment suggested that the
electronic registration system
acknowledge or document that the IRB
has registered. Another comment stated
that, if IRB registration is to identify
IRBs for future inspections, there is no
need for a 30-day ‘‘waiting’’ period.
A different comment said that the 30day time period might interfere with
IRB review, particularly expedited
reviews and full IRB reviews that take
less than 30 days. The comment
suggested that we revise the rule so that
IRBs may not issue a determination on
FDA-regulated research until they have
registered.
Another comment asked us to clarify
when IRBs must register. The comment
explained that the codified provision
directed IRBs to submit an initial
registration within 30 days before the
date when the IRB intends to review
clinical investigations regulated by
FDA. The comment said that the word
‘‘within’’ could mean that an IRB could
register ‘‘anytime between one and 30
days before reviewing a protocol,’’ but
that the preamble to the proposed rule
interpreted proposed § 56.106(c) as
requiring registration at least 30 days
before reviewing the protocol. The
comment preferred giving IRBs the
ability to register any time between 1
and 30 days before reviewing protocols
in FDA-regulated research.
(Response) We agree, in part, with the
comments. For IRBs that register
electronically, the registration system
will notify them that they are registered.
This notification will be sent to the
electronic mail address that the IRB
provides as part of the registration
process. The IRB’s registration will be
effective after review and acceptance by
HHS. We have amended § 56.106(c)
regarding the time at which IRB
registration becomes effective to
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correspond to changes made by OHRP
in its final rule which is published
elsewhere in this issue of the Federal
Register. OHRP revised a comparable
provision in its rule to clarify when IRB
registration would become effective.
For IRBs that submit their registration
information in writing, our experience
with written forms in other contexts
suggests that some individuals will not
complete the forms or omit required
information. As a result, we may need
to contact individuals to obtain the
missing information. Therefore, it
would be more practical for us to
consider IRBs who submit their
registration information in writing to be
registered only after they have
submitted all required registration
information, we have entered that
information into the electronic
registration system, and the information
is reviewed and accepted by HHS.
As for the comments concerning the
30-day timeframe and the suggestion
that we amend the rule so that IRBs
cannot issue decisions on FDAregulated research until they have
registered, we have decided to eliminate
the 30-day timeframe from the final
rule. We note that IRB registration,
alone, does not address issues regarding
an IRB’s competence or expertise, nor
does it require IRBs to meet a particular
standard in order to conduct a review.
However, because it is important to FDA
to assemble an accurate IRB database,
we have revised § 56.106(c) to state that:
‘‘Each IRB must submit an initial
registration. The initial registration must
occur before the IRB begins to review a
clinical investigation described in
paragraph (a) of this section. Each IRB
must renew its registration every 3
years. IRB registration becomes effective
after review and acceptance by HHS.’’
(Comment 13) One comment would
require IRBs to renew their registration
every year instead of every 3 years. The
comment said that 3 years would be too
long a time period.
(Response) We decline to revise the
rule as suggested by the comment. IRB
registration does not confer any
particular status on IRBs, nor does
registration, alone, reflect upon an IRB’s
competence or capabilities. Moreover,
given that the information we seek
through IRB registration is quite basic
(as in names and addresses) and that
§ 56.106(e) describes how and when
IRBs are to revise their registration
information, annual registration would
not appear to confer any advantages or
make registration information more
accurate or reliable. Consequently, we
decline to require IRBs to register
annually.
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2363
E. Where Can an IRB Register? (Section
56.106(e))
Proposed § 56.106(e) would direct
IRBs to register at a specific Internet
address or, if an IRB lacked the ability
to register electronically, to send its
registration information to a specific
mail address. We indicated that we
would provide the Internet address and
mail address in the final rule. We also
invited comment on whether we should
discontinue written IRB registration
procedures after some time period has
elapsed, because we did not know how
widespread Internet access is among
IRBs (see 69 FR 40556 at 40558).
(Comment 14) Several comments
pertained to the registration site(s). One
comment said we should maintain one
common registration site with OHRP
and that the registration system should
automatically include currently
registered IRBs. The comment said the
registration system should also allow
such IRBs to retain their assigned
numbers. The comment acknowledged
the intent to create a single registration
site, but implied that the proposed
rule’s omission of a specific Internet
address created concern. Another
comment supported creation of a
simple, electronic registration system.
(Response) We agree that a single
Internet registration site should be used
for electronic registrations and have
always worked with OHRP towards that
end. We were unable to provide a
specific Internet address at the time of
the proposed rule because the electronic
registration system was still under
development. The final rule now states
that the Internet registration address is
https://ohrp.cit.nih.gov/efile.
Additionally, as we stated in the
preamble to the proposed rule, OHRP
will continue to recognize previous IRB
registrations (see 69 FR 40556 at 40558).
(Comment 15) One comment asked
whether entities that have more than
one IRB at the same location need to
register more than once or whether they
could register once and provide
multiple pieces of information in
connection with a single registration.
(Response) The electronic registration
system will assign an organization
number to each entity, and this will
enable the entity to register several IRBs
without having to enter the same data
repeatedly for each IRB.
(Comment 16) Two comments
encouraged us to have the electronic
registration system consider IRBs to be
registered automatically once an IRB
completes the electronic registration
process or to send acknowledgements to
the IRBs once they complete the
electronic registration process.
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(Response) As we stated in our
response to comment 12 of this
document, when an IRB completes the
electronic registration process and HHS
has reviewed and accepted the
information, the electronic registration
system will notify IRBs that they are
registered.
(Comment 17) Several comments
responded to our question whether we
should discontinue written IRB
registrations after some time period has
elapsed. One comment supported
conversion to electronic registration as
soon as possible, but said it is important
to allow small organizations the time to
acquire the necessary technology. The
comment agreed that not all institutions
have electronic capabilities or Internet
access.
Another comment supported giving
IRBs the option to submit registration
information in writing for a
predetermined period of time, but did
not suggest any time period. A different
comment also supported the written
registration option, but suggested that it
be available only for 2 years.
Another comment opposed
discontinuing written IRB registration.
The comment said that there are adverse
consequences to both the IRB and any
sponsor or investigator that might use
an unregistered IRB (which appeared to
be a reference to a later discussion, in
the preamble to the proposed rule, about
‘‘What Happens if an IRB Does Not
Register?’’ (see 69 FR 40556 at 40559)),
so we should continue to make written
IRB registration possible.
(Response) While we continue to
believe that most IRBs will use the
electronic registration system, we do not
know how many IRBs will use the
written registration option, and the
administrative record for this
rulemaking does not give us sufficient
basis to set a deadline at which we
would end the written registration
option. (We realize that one comment
suggested a 2-year period, but, given
that IRBs have 3 years to renew
registrations, discontinuing written
registrations after 2 years would not give
IRBs the opportunity to renew their
registrations in writing.) Consequently,
until we become more experienced with
IRB registrations, we will continue to
offer written registration as an
alternative to electronic registration, and
the final rule states that IRBs that lack
the ability to register electronically must
send their registration information, in
writing, to the Good Clinical Practice
Program (HF–34), Office of Science and
Health Coordination, Food and Drug
Administration, 5600 Fishers Lane,
Rockville, MD 20857.
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F. How Does an IRB Revise Its
Registration Information? (Section
56.106(e))
Proposed § 56.106(e) would have IRBs
revise their registration information
within specific timeframes if certain
changes occurred. For example, if the
IRB’s contact or chair person
information changes, proposed
§ 56.106(e) would require the IRB to
change its registration information
within 90 days of the change. If the IRB
decided to disband or to discontinue
reviewing FDA-regulated clinical
investigations, it would report that
change within 30 days. All other
information changes would be reported
when the IRB renews its registration.
(Comment 18) Two comments pointed
out a discrepancy between the proposed
rule and its preamble. The comments
noted that the preamble to the proposed
rule said that if an IRB reviews new
types of FDA-regulated products, it
would revise its registration information
within 30 days (see 69 FR 40556 at
40559), yet proposed § 56.106(e) was
silent regarding such changes. The
comments suggested that we reconcile
the codified text with the preamble.
(Response) The comments were
correct. We inadvertently omitted
changes in the IRB’s review of FDAregulated research from proposed
§ 56.106(e), and we have revised the
rule so that IRBs must revise their
registration information within 30 days
if they review new types of FDAregulated products. Additionally, on our
own initiative, we have added a
parenthetical phrase to clarify that a
decision to review ‘‘new types of FDAregulated products’’ should be
interpreted as a decision to review a
different category of FDA-regulated
products, such as a decision to review
studies pertaining to food additives
when the IRB previously reviewed
studies pertaining to drug products. We
do not want IRBs to revise their
registration information if they decide to
review studies pertaining to
subcategories within the same class of
FDA-regulated products; for example, if
an IRB previously reviewed studies
pertaining to drugs intended to treat
cardiac conditions and then decided to
review studies pertaining to drugs
intended to treat cancer, both types of
studies would still pertain to drug
products, so there would be no ‘‘new
type’’ of FDA-regulated product within
§ 56.106(e).
(Comment 19) One comment
addressed IRBs that have decided to
disband. The comment said that the
process of closing an IRB may take
longer than 30 days, so requiring IRBs
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to revise their registration information
within 30 days of a decision to disband
would put an ‘‘undue burden’’ on IRBs
and the institutions responsible for the
IRBs.
(Response) We agree in part, and
disagree in part with the comment. We
agree that, in some cases, closing an IRB
may take more than 30 days, but, in
other cases, the process may take less
time. In other words, IRBs vary in size,
resources, organization, and complexity,
and, as a result, different IRBs will take
different amounts of time to perform the
same or similar functions.
The comment also may have
misinterpreted the proposed rule.
Proposed § 56.106(e) stated that an IRB’s
decision to disband or to discontinue
reviewing FDA-regulated clinical
investigations is a change that must be
reported within 30 days of that change;
thus, the proposal would begin the time
period when IRB decides to close, not
when the IRB finally closes.
Nevertheless, for consistency with
OHRP’s final rule (which appears
elsewhere in this issue of the Federal
Register), we have revised § 56.106(e) to
state that an IRB’s decision to disband
is a change that must be reported
‘‘within 30 days of permanent cessation
of the IRB’s review of research.’’ In the
preamble to the OHRP final rule, OHRP
states that ‘‘the date of permanent
cessation of the IRB’s review of * * *
research would occur on or after the
IRB’s decision to disband, but not before
the IRB’s decision to disband was
made.’’
Furthermore, given the simplicity of
the electronic registration system, we do
not believe that IRBs or their
institutions will find it ‘‘unduly’’
burdensome to report the IRB’s decision
to disband.
(Comment 20) One comment would
shorten the time period for reporting
changes in the IRB’s contact or chair
person information from 90 days to 60
days.
(Response) We decline to revise the
rule as suggested by the comment. The
comment did not identify any advantage
in shortening the timeframe, and we do
not believe that reducing the timeframe
by 30 days will confer any significant
benefit.
G. What Other Comments Did We
Receive?
1. What Information Will Be Publicly
Available?
The preamble to the proposed rule
referred to the OHRP proposal for
information regarding public disclosure
of IRB registration information, the
Freedom of Information Act (FOIA), and
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the Privacy Act of 1974 (see 69 FR
40556 at 40557). It also stated that,
insofar as FDA’s registration system was
concerned, the name of the institution
operating the IRB and the IRB’s name
will be publicly accessible, and all other
IRB registration information would be
subject to public disclosure under FOIA
and our public information regulations
at part 20 (21 CFR part 20) (see id.).
(Comment 21) One comment said
that, in addition to the institution’s
name and the IRB’s name, we should
make the following information publicly
available:
• The name, address, and telephone
number of the IRB contact; and
• For accredited IRBs, information
relating to that accreditation.
Another comment asked us to clarify
what information would be publicly
available under FOIA.
(Response) All registration
information required under this rule
will be subject to FOIA and any other
applicable statutes and regulations
pertaining to public disclosure. Please
note that certain information may be
withheld from public disclosure or may
require an individual’s consent to
public disclosure (see, e.g., § 20.63(e)
(stating that a request for all records
relating to a specific individual will be
denied as a clearly unwarranted
invasion of personal privacy unless
accompanied by the written consent of
the individual named)).
As for accreditation information,
accreditation status is not required
under the final rule, so that information
will not be publicly available from us or
from OHRP.
(Comment 22) One comment
suggested that sponsors and
investigators have access to the IRB
registration database. The comment said
that sponsors and investigators
currently have access to Federal-wide
assurances data and suggested that, if
sponsors and investigators could not
have access to the IRB registration
database, we or OHRP should issue a
report of IRB registrations or issue
certificates to individual IRBs.
(Response) OHRP currently posts all
registered IRBs on its Web site,
including the name and location of the
organization operating the IRB(s) and
the name and location of each IRB.
We decline to issue reports on IRB
registration or certificates to show that
an IRB is registered. As we stated in our
response to comment 12 of this
document, IRB registration, alone, does
not address issues regarding an IRB’s
competence or expertise, nor does it
require IRBs to meet a particular
standard in order to conduct a review.
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(Comment 23) One comment said we
should establish a link to the publicly
available IRB registration information
from the portion of our own Web site
that pertains to ‘‘Good Clinical Practices
in FDA-Regulated Clinical Trials,’’
located at https://www.fda.gov/oc/gcp/
default.htm.
(Response) We agree with the
comment and have modified our Web
site accordingly.
2. What Happens if an IRB Does Not
Register?
The preamble to the proposed rule
stated that sponsors and investigators
who used unregistered IRBs might be
using IRBs that ‘‘would not have had the
benefit of receiving educational
materials from FDA and would not have
been identified on an FDA IRB
registration list for future inspection’’
(see 69 FR 40556 at 40559). Thus, the
preamble to the proposed rule added
that, ‘‘to the extent that any existing
FDA regulation requires a sponsor or
investigator to comply with [part 56] or
to use an IRB that complies with part
56, FDA will consider sponsors and
investigators using an unregistered IRB
to be in conflict with their regulatory
obligations’’ (id.).
The preamble to the proposed rule
also noted how we considered other
options to require sponsors and
investigators to use only registered IRBs,
such as refusing to consider information
from an application for a research
permit for a clinical investigation that is
reviewed or is to be reviewed by an
unregistered IRB (id.). The preamble to
the proposed rule also invited comment
on what sanctions or administrative
mechanisms, if any, should or might be
used against sponsors and investigators
who use unregistered IRBs and whether
any additional changes to our
regulations were necessary.
(Comment 24) We received many
comments relating to sanctions, other
regulatory changes, and ensuring that
sponsors and investigators use only
registered IRBs. The comments reflected
a considerable difference of opinion. For
example:
• One comment said we should
impose and enforce ‘‘high fines’’ for
failure to follow human subject
protection regulations;
• Several comments said that the
forms investigators currently use (Form
FDA 1572) could be used to reinforce or
otherwise highlight the need to use only
registered IRBs, but the comments
differed as to whether investigators
should be subject to any sanctions if
they use an unregistered IRB. For
example, one comment said failure to
use a registered IRB should be treated
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2365
the same as any other breach of an
investigator’s responsibilities, but others
said that IRBs, rather than sponsors or
investigators, should be responsible for
any failure to register. One comment
also opposed placing an investigation
on clinical hold because, the comment
argued, clinical holds are appropriate
when the rights and/or safety of human
subjects are in jeopardy or other
material, noncompliance concerns are
evident; the comment said that failure to
register does not mean improper
oversight by the IRB or by the sponsor.
Some comments argued that sponsors
and investigators should not be obliged
to monitor an IRB’s registration status.
In contrast, one comment would have us
amend the investigational new drug
(IND) application regulations to
authorize us to place a study on clinical
hold if the sponsor or investigator uses
an unregistered IRB. The same comment
suggested that we consider additional
enforcement options, such as ‘‘refusing
to consider information from an
application for a research permit for a
clinical investigation that is reviewed or
is to be reviewed by an unregistered
IRB.’’
• Several comments, mostly from
pharmaceutical firms or trade
associations, opposed any changes
outside the IRB regulations. The
comments, in general, felt that the
existing IND regulations were sufficient
and clear regarding a sponsor’s or
investigator’s obligation to use IRBs that
comply with part 56. Some comments
said we should not expend resources on
revising the IND regulations but should
promote awareness of the IRB
registration requirements instead.
Another comment, from an association
of medical colleges, also opposed
revisions to the IND regulations, stating
that clinical holds would be unworkable
because, if an unregistered IRB had
reviewed a clinical study and the
clinical study had proceeded,
retroactive review of the study would be
impermissible. The comment said we
should refuse to consider information
from an application for a research
permit that is reviewed or is to be
reviewed by an unregistered IRB.
• One comment suggested a
‘‘flexible’’ approach whereby we would
start by sending a certified letter to an
unregistered IRB regarding its failure to
register and include registration
instructions. If the IRB remained
unregistered, the comment suggested
that we inspect the IRB. The comment
said that this approach would allow us
to take appropriate action against
unregistered IRBs without
‘‘unnecessarily penalizing’’ sponsors
and investigators who have attempted to
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follow our regulations in good faith.
Similarly, another comment advocated
sending letters to IRBs or notices to
sponsors rather than imposing
sanctions.
• One comment agreed with us that
an IRB’s failure to register would not
justify disqualification of the IRB under
§ 56.121 absent the extreme
circumstances described in
§ 56.121(b)(1) (the IRB has refused or
repeatedly failed to comply with
regulatory requirements) or
§ 56.121(b)(2) (the noncompliance
adversely affects the rights or welfare of
the human subjects in a clinical
investigation).
(Response) We agree in part and
disagree in part with the comments. We
agree that the existing IND regulations,
as well as the IDE regulations, are
sufficient and clear regarding a
sponsor’s or investigator’s obligation to
use IRBs that comply with part 56. We
also agree that an IRB’s failure to
register, alone, should not lead to
disqualification proceedings under
§ 56.121 absent extreme circumstances.
We intend to educate IRBs, sponsors,
and investigators about the IRB
registration requirements and to
encourage sponsors and investigators to
use registered IRBs for the same reasons
we stated in the preamble to the
proposed rule.
Given the existing IND and IDE
regulations and our intent to pursue
educational efforts, we disagree with
those comments that would have us
impose fines or place clinical
investigations on clinical hold if the
sponsor or investigator used an
unregistered IRB. We believe that it
would be premature for us to consider
the use of such sanctions before we and
the regulated community have gained
sufficient experience with the IRB
registration program.
mstockstill on PROD1PC66 with RULES
3. What Other Issues Did the Comments
Raise?
Several comments addressed issues
that were either not part of the
rulemaking or not material to the
proposed codified text.
(Comment 25) One comment
disagreed with the preamble to the
proposed rule when we stated that our
knowledge about the identities and
numbers of IRBs reviewing FDAregulated clinical research is obsolete or
incomplete (see 69 FR 40556 at 40557).
The comment said that we require
sponsors to identify IRBs and that, for
20 years, OHRP has maintained a list of
IRBs that have filed assurances (under
45 CFR part 46). The comment said that
such past practices were apparently
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16:54 Jan 14, 2009
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sufficient for purposes of conducting
inspections.
(Response) We disagree with the
comment. As we stated in the preamble
to the proposed rule, existing FDA
regulations have required some, but not
all, clinical investigators and sponsors
to provide IRB names and addresses to
us, and those regulatory requirements
differ slightly (see 69 FR 40556 at
40557). Consequently, because of
differences within our own regulations,
we do not have a comprehensive list of
IRBs that review FDA-regulated
research. Additionally, because our preexisting regulations do not require
sponsors and investigators to revise or
update IRB information if and when the
IRB changes its address, contact person,
or chair person, or even, in some cases,
to provide addresses, contact
information, or chair person information
to us, the IRB information we do have
is not as detailed as the information we
seek under this rule.
As for institutions that have filed
assurances with OHRP under 45 CFR
part 46, the IRBs associated with such
institutions are not necessarily identical
to those that review FDA-regulated
research. OHRP’s regulations apply to
institutions that are engaged in human
subjects research conducted or
supported by HHS. In contrast, our IRB
regulations apply to clinical
investigations regulated by us,
regardless of whether those
investigations are conducted or
supported by HHS. Thus, the fact that
OHRP has operated an assurance system
for decades does not necessarily mean
that the OHRP list of institutions that
have filed assurances can serve as a list
of IRBs that review FDA-regulated
research.
(Comment 26) One comment said that
registration and re-registration fees
should be set at $5,000 to cover costs.
The comment said that taxpayers should
not have to pay the fees or fund the
costs of ‘‘profiteers,’’ and that
pharmaceutical companies should not
‘‘get away’’ with low fees when ‘‘they
can pay their executives $150,000,000 at
retirement.’’
(Response) We decline to revise the
rule as suggested by the comment. We
have no express authority to impose
registration or re-registration fees on
IRBs. Additionally, the rule is directed
at IRBs themselves rather than
pharmaceutical firms, so issues relating
to pharmaceutical executives’ salaries
are not relevant to this rulemaking.
(Comment 27) One comment asked us
to confirm that our IRB inspections will
adhere to the guidelines described in
the ‘‘Guidance for Institutional Review
Boards and Clinical Investigators.’’
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Frm 00074
Fmt 4700
Sfmt 4700
(Response) This rulemaking does not
affect how we conduct IRB inspections.
We may, however, use IRB registration
information to help us prioritize
inspections. Additionally, our receipt of
more accurate IRB addresses and
contact information due to IRB
registration should make it easier and
more efficient to schedule IRB
inspections.
H. What Other Amendment Did We
Propose?
The proposal would also make a nonsubstantive amendment to part 56. The
proposal would revise the definition of
‘‘An Application for an Investigational
Device Exemption,’’ at § 56.102(b)(12),
to eliminate its reference to 21 CFR part
813. The preamble to the proposed rule
explained that this change is necessary
because we removed the regulations at
part 813 (which had pertained to
intraocular lenses) in 1997 (see 62 FR
4164, January 29, 1997).
We received no comments on this
aspect of the proposal. Consequently,
the final rule deletes a reference to part
813.
III. Implementation
This rule is effective July 14, 2009.
This protracted effective date is
necessary to allow refinement of the
electronic registration system so that it
corresponds to this final rule and to
OHRP’s final rule.
IV. Legal Authority
In general, the act authorizes us to
issue regulations pertaining to
investigational uses of FDA-regulated
products (see, e.g., sections 409(j) (21
U.S.C. 348(j)) (investigations involving
food additives); 505(i) (investigations
involving human drugs); 520(g)
(investigations involving devices); and
721(f) (21 U.S.C. 379e(f)) of the act
(investigations involving color
additives)).
The act also requires the submission
of a petition or application to FDA (see,
e.g., sections 409(b) (food additive
petitions); 505(b) (new drug
applications); 505(j) (abbreviated new
drug applications); 513(f) (premarket
notification for devices); 515(c)
(premarket approval applications for
devices); 520(m) (humanitarian device
exemption applications); and 721(b) of
the act (color additive petitions)) before
marketing begins.
To implement these provisions of the
act, section 701(a) of the act gives us the
authority to issue regulations for the
efficient enforcement of the act. By
requiring IRB registration, the final rule
will aid in the efficient enforcement of
the act’s provisions regarding the
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Federal Register / Vol. 74, No. 10 / Thursday, January 15, 2009 / Rules and Regulations
investigational use of various FDAregulated products (because then we
would be able to conduct IRB
inspections more efficiently) as well as
those provisions regarding marketing
applications (because marketing
applications usually depend on clinical
investigations involving human
subjects, and IRBs are supposed to
provide protections for the rights and
welfare of such human subjects).
Moreover, by requiring IRBs to register,
the final rule will enable FDA to contact
IRBs more quickly and efficiently on
various issues, such as adverse reactions
that may be attributed to a particular
product, new regulatory requirements or
policies, or problems associated with a
particular protocol or clinical
investigator. Consequently, we conclude
that we have sufficient legal authority to
issue the final rule.
V. Economic Impact Analysis
We have examined the impacts of the
final rule under Executive Order 12866,
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 as defined
by the Executive Order.
The Regulatory Flexibility Act
requires agencies to analyze regulatory
options that would minimize any
significant impact of a rule on small
entities. Because the required
registration information is minimal and
the costs associated with registration are
low, 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 final rule requires most IRBs to
register with FDA. The information
sought through the registration process
is minimal, consisting largely of names
and addresses for a contact person, the
institution operating the IRB (if an
institution exists), the head of the
institution, the IRB, and the IRB
chairperson. The registration would also
indicate the approximate number of
active protocols reviewed and the types
of FDA-regulated products involved. We
estimate that initial IRB registration may
require 1 hour. The average loaded wage
rate for administrators at public
institutions is about $44 per hour.1 This
means that each IRB would spend $44
for an initial registration ($44 per hour
x 1 hour per initial registration).
We estimate that re-registration would
require less time, especially if the IRB
verifies existing information. If reregistration requires 30 minutes, then
the cost of re-registration to each IRB
would be approximately $22 ($44 per
hour x 0.5 hours per re-registration).
Revising an IRB’s registration
information would probably involve
costs similar to re-registration costs. If
the revision requires 30 minutes, then
the cost of revising an IRB’s registration
information would be approximately
$22 per IRB.
Given the minimal registration
information that would be required and
the low costs associated with
registration, this final rule is not a
significant regulatory action, and we
certify that the final rule does not have
a significant economic impact on a
2367
substantial number of small entities.
Therefore, the rule is not a ‘‘significant
regulatory action’’ under Executive
Order 12866 and does not require a
Regulatory Flexibility Act analysis.
Additionally, assuming that an
estimated 5,000 IRBs would register, the
final rule will result in a 1-year
expenditure of $220,000 (5,000 IRBs x
$44 registration wage costs per IRB).
Because the total expenditure under the
rule will not result in a 1-year
expenditure of $100 million or more, we
are not required to perform a costbenefit analysis under the Unfunded
Mandates Reform Act.
VI. Environmental Impact
We have 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 the human
environment. Therefore, neither an
environmental assessment nor an
environmental impact statement is
required.
VII. Paperwork Reduction Act of 1990
This rule contains information
collection requirements that are subject
to review by the Office of Management
and Budget (OMB) under the Paperwork
Reduction Act of 1995 (PRA) (44 U.S.C.
3501–3520). The title, description, and
respondent description of the
information collection provisions are
shown below with an estimate of the
annual reporting and recordkeeping
burden. Included in the estimate is the
time for reviewing instructions,
searching existing data sources,
gathering and maintaining the data
needed, and completing and reviewing
each collection of information.
Title: Institutional Review Boards:
Registration Requirements.
Description: The final rule requires
IRBs to register with FDA.
Description of Respondents:
Businesses and individuals.
The estimated burden associated with
the information collection requirements
of this rule is 8,750 hours.
We estimate the burden of this
collection of information as follows:
TABLE 1.—ESTIMATED ANNUAL REPORTING BURDEN1
No. of
Respondents
21 CFR Section
Annual Frequency
per Response
Total Annual
Responses
Hours per
Response
Total Hours
mstockstill on PROD1PC66 with RULES
56.106(c) (initial registration)
5,000
1
5,000
1
5,000
56.106(c) (re-registration)
2,500
1
2,500
0.5
1,250
1 Source: United States Department of Labor,
Bureau of Labor Statistics; National Compensation
Survey, June 2005. Overall hourly rate in the United
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16:54 Jan 14, 2009
Jkt 217001
States for administrators and officials, public
administration, is $31.54. To account for benefits,
the hourly rate was increased by 40 percent and
PO 00000
Frm 00075
Fmt 4700
Sfmt 4700
rounded to the nearest whole dollar. Data accessed
on August 31, 2006, at https://data.bls.gov.
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TABLE 1.—ESTIMATED ANNUAL REPORTING BURDEN1—Continued
No. of
Respondents
21 CFR Section
56.106(e)
Annual Frequency
per Response
5,000
Total Annual
Responses
1
5,000
Total
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1 There
Hours per
Response
0.5
Total Hours
2,500
8,750
are no capital costs or operating and maintenance costs associated with this collection of information.
Our estimates are based on the
following considerations. According to a
1998 OIG report, there are 3,000 to 5,000
IRBs in the United States, and most are
associated with hospitals and academic
centers (see Department of Health and
Human Services, Office of the Inspector
General, Institutional Review Boards: A
Time for Reform, page 3, June 8, 1998).
While not all IRBs are involved in
clinical investigations regulated by
FDA, for purposes of the PRA, we will
use 5,000 as the maximum number of
IRBs subject to the final rule.
Additionally, because the final rule
requires basic information about an IRB
(such as names and addresses) and
because registration would, in most
cases, be done electronically, we will
assume that registration will take only 1
hour per IRB. Thus, the total burden
hours would be 5,000 hours (5,000 IRBs
x 1 hour per IRB).
Re-registration and revisions to
existing registration information should
require less time than initial
registration. We will assume that reregistration and revisions will take only
30 minutes per IRB. We will also
assume, based on OHRP’s experience
with its IRB registration program, that
50 percent of IRBs (2,500) will reregister and that all (5,000) will revise
their registration information. Therefore,
the total burden hours for re-registration
will be 1,250 hours (2,500 IRBs x 0.5
hours per IRB), and the total burden
hours for revisions will be 2,500 hours
(5,000 IRBs x 0.5 hours per IRB).
Prior to the effective date of this final
rule, FDA will publish a notice in the
Federal Register announcing OMB’s
decision to approve, modify, or
disapprove the information collection
provisions in this final rule. In
compliance with the PRA (44 U.S.C.
3507(d)), we have submitted the
information collection requirements of
this rule to OMB for review. An agency
may not conduct or sponsor, and a
person is not required to respond to, a
collection of information unless it
displays a currently valid OMB control
number.
VIII. Federalism
We have analyzed this final rule in
accordance with the principles set forth
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16:54 Jan 14, 2009
Jkt 217001
in Executive Order 13132. We have
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, we
have concluded that the rule does not
contain policies that have federalism
implications as defined in the order
and, consequently, a federalism
summary impact statement isnot
required.
List of Subjects in 21 CFR Part 56
Human research subjects, Reporting
and recordkeeping requirements, Safety.
■ Therefore, under the Federal Food,
Drug, and Cosmetic Act and under
authority delegated to the
Commissioner, part 56 is amended as
follows:
PART 56—INSTITUTIONAL REVIEW
BOARDS
1. The authority citation for 21 CFR
part 10 continues to read as follows:
■
Authority: 21 U.S.C. 321, 343, 346, 346a,
348, 350a, 350b, 351, 352, 353, 355, 360,
360c–360f, 360h–360j, 371, 379e, 381; 42
U.S.C. 216, 241, 262, 263b–263n.
§ 56.102
[Amended]
2. Amend § 56.102 in paragraph
(b)(12) by removing the phrase ‘‘parts
812 and 813’’ and by adding in its place
the phrase ‘‘part 812’’.
■ 3. Add § 56.106 to subpart A to read
as follows:
■
§ 56.106
Registration.
(a) Who must register? Each IRB in the
United States that reviews clinical
investigations regulated by FDA under
sections 505(i) or 520(g) of the act and
each IRB in the United States that
reviews clinical investigations that are
intended to support applications for
research or marketing permits for FDAregulated products must register at a site
maintained by the Department of Health
and Human Services (HHS). (A research
permit under section 505(i) of the act is
usually known as an investigational
new drug application (IND), while a
research permit under section 520(g) of
PO 00000
Frm 00076
Fmt 4700
Sfmt 4700
the act is usually known as an
investigational device exemption (IDE).)
An individual authorized to act on the
IRB’s behalf must submit the
registration information. All other IRBs
may register voluntarily.
(b) What information must an IRB
register? Each IRB must provide the
following information:
(1) The name, mailing address, and
street address (if different from the
mailing address) of the institution
operating the IRB and the name, mailing
address, phone number, facsimile
number, and electronic mail address of
the senior officer of that institution who
is responsible for overseeing activities
performed by the IRB;
(2) The IRB’s name, mailing address,
street address (if different from the
mailing address), phone number,
facsimile number, and electronic mail
address; each IRB chairperson’s name,
phone number, and electronic mail
address; and the name, mailing address,
phone number, facsimile number, and
electronic mail address of the contact
person providing the registration
information.
(3) The approximate number of active
protocols involving FDA-regulated
products reviewed. For purposes of this
rule, an ‘‘active protocol’’ is any
protocol for which an IRB conducted an
initial review or a continuing review at
a convened meeting or under an
expedited review procedure during the
preceding 12 months; and
(4) A description of the types of FDAregulated products (such as biological
products, color additives, food
additives, human drugs, or medical
devices) involved in the protocols that
the IRB reviews.
(c) When must an IRB register? Each
IRB must submit an initial registration.
The initial registration must occur
before the IRB begins to review a
clinical investigation described in
paragraph (a) of this section. Each IRB
must renew its registration every 3
years. IRB registration becomes effective
after review and acceptance by HHS.
(d) Where can an IRB register? Each
IRB may register electronically through
https://ohrp.cit.nih.gov/efile. If an IRB
lacks the ability to register
electronically, it must send its
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Federal Register / Vol. 74, No. 10 / Thursday, January 15, 2009 / Rules and Regulations
registration information, in writing, to
the Good Clinical Practice Program (HF–
34), Office of Science and Health
Coordination, Food and Drug
Administration, 5600 Fishers Lane,
Rockville, MD 20857.
(e) How does an IRB revise its
registration information? If an IRB’s
contact or chair person information
changes, the IRB must revise its
registration information by submitting
any changes in that information within
90 days of the change. An IRB’s decision
to review new types of FDA-regulated
products (such as a decision to review
studies pertaining to food additives
whereas the IRB previously reviewed
studies pertaining to drug products), or
to discontinue reviewing clinical
investigations regulated by FDA is a
change that must be reported within 30
days of the change. An IRB’s decision to
disband is a change that must be
reported within 30 days of permanent
cessation of the IRB’s review of
research. All other information changes
may be reported when the IRB renews
its registration. The revised information
must be sent to FDA either
electronically or in writing in
accordance with paragraph (d) of this
section.
Dated: January 7, 2009.
Jeffrey Shuren,
Associate Commissioner for Policy and
Planning.
[FR Doc. E9–682 Filed 1–14–09; 8:45 am]
DATES: Effective Date: This rule is
effective on January 15, 2009.
DEPARTMENT OF HOUSING AND
URBAN DEVELOPMENT
FOR FURTHER INFORMATION CONTACT:
Lauren Prosnik, Legislation and
Regulations Division, Visa Services,
Department of State, Washington, DC
20520–0106, (202) 663–1202, e-mail
(prosnikla@state.gov).
24 CFR Parts 203 and 3500
SUPPLEMENTARY INFORMATION:
Why is the Department promulgating
this rule?
The Department published an interim
rule, Public Notice 4446 at 68 FR 49353,
Aug. 18, 2003, with a request for
comments. The comment period expired
on October 17, 2003. No public
comments were received during the
comment period.
What did the rule do?
The rule amended the Department’s
regulations at 22 CFR 42.33 to establish
an entirely electronic system utilizing a
specifically designated Internet Web
site, by which aliens can petition for the
opportunity to participate in the
Diversity Visa Program.
Why was the petitioning process
changed?
There are three main benefits to
changing the mail-in process to an
electronic format. First, it helps
eliminate multiple applications,
prohibited under INA Section
204(a)(1)(I). Secondly, it greatly reduces
the cost of administering the system.
Finally, it benefits the petitioners by
immediately notifying them of the
receipt of the petition, impossible under
the mail-in system.
BILLING CODE 4160–01–S
DEPARTMENT OF STATE
22 CFR Part 42
[Public Notice: 6457]
RIN 1400–AB84
Visas: Documentation of Immigrants
Under the Immigration and Nationality
Act, as Amended: Electronic Petition
for Diversity Immigrant Status
State Department.
Final rule.
mstockstill on PROD1PC66 with RULES
ACTION:
SUMMARY: This rule makes final an
interim rule published in the Federal
Register on August 18, 2003, amending
the Department’s regulations pertaining
to the manner in which aliens may
petition for the opportunity to
participate in the Diversity Visa
Program. The rule changed the standard
mail-in system previously used to an
entirely electronic system for the
purpose of making the process less
prone to fraud, improve efficiency and
significantly reduce the processing costs
to the Government.
VerDate Nov<24>2008
16:54 Jan 14, 2009
PART 42—VISAS: DOCUMENTATION
OF IMMIGRANTS UNDER THE
IMMIGRATION AND NATIONALITY
ACT, AS AMENDED
Accordingly, the interim rule
amending 22 CFR part 42 which was
published at 68 FR 49353 on August 18,
2003, is adopted as final without
change.
■
AGENCY:
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2369
Dated: January 2, 2009.
Janice L. Jacobs,
Assistant Secretary for Consular Affairs,
Department of State.
[FR Doc. E9–698 Filed 1–14–09; 8:45 am]
BILLING CODE 4710–06–P
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Fmt 4700
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[Docket No. FR–5180–F–04]
RIN 2502–AI61
Real Estate Settlement Procedures Act
(RESPA): Rule To Simplify and
Improve the Process of Obtaining
Mortgages and Reduce Consumer
Settlement Costs; Deferred
Applicability Date for the Revised
Definition of ‘‘Required Use’’
AGENCY: Office of the Assistant
Secretary for Housing-Federal Housing
Commissioner, HUD.
ACTION: Final rule.
SUMMARY: This final rule delays the
effective date of the definition of
‘‘required use’’ as revised by HUD’s
November 17, 2008, final rule amending
its RESPA regulations. The November
17, 2008, final rule provides that the
revised definition is applicable
commencing January 16, 2009, the
effective date of the final rule. As a
result of recently initiated litigation,
HUD has determined to delay the
effective date of the revised definition of
‘‘Required use’’ until April 16, 2009.
DATES: This correction is effective
January 16, 2009, The definition of
‘‘Required use’’ in § 3500.2, as revised
by HUD’s final rule published on
November 17, 2008, at 73 FR 68204, is
delayed until April 16, 2009.
FOR FURTHER INFORMATION CONTACT: Ivy
Jackson, Director, or Barton Shapiro,
Deputy Director, Office of RESPA and
Interstate Land Sales, Office of Housing,
Department of Housing and Urban
Development, 451 7th Street, SW.,
Room 9158, Washington, DC 20410–
8000; telephone 202–708–0502 (this is
not a toll-free telephone number).
Persons with hearing or speech
impairments may access this number
through TTY by calling the toll-free
Federal Information Relay Service at
800–877–8339.
SUPPLEMENTARY INFORMATION: On
November 17, 2008 (73 FR 68204), HUD
published a final rule amending its
regulations to further the purposes of
the Real Estate Settlement Procedures
Act (12 U.S.C. 2601–2617) by requiring
more timely and effective disclosures
related to mortgage settlement costs for
federally related mortgage loans to
consumers. The final rule followed
publication of a March 14, 2008,
proposed rule (73 FR 14030) and made
changes in response to public comment
and in further consideration of certain
issues by HUD. Additional information
E:\FR\FM\15JAR1.SGM
15JAR1
Agencies
[Federal Register Volume 74, Number 10 (Thursday, January 15, 2009)]
[Rules and Regulations]
[Pages 2358-2369]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E9-682]
=======================================================================
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Food and Drug Administration
21 CFR Part 56
[Docket No. FDA-2004-N-0117] (formerly Docket No. 2004N-0242)
RIN 0910-AB88
Institutional Review Boards; Registration Requirements
AGENCY: Food and Drug Administration, HHS.
ACTION: Final rule.
-----------------------------------------------------------------------
SUMMARY: The Food and Drug Administration (FDA, we) is issuing a final
rule to require institutional review boards (IRBs) to register through
a system maintained by the Department of Health and Human Services
(HHS). The registration information includes contact information (such
as addresses and telephone numbers), the number of active protocols
involving FDA-regulated products reviewed during the preceding 12
months, and a description of the types of FDA-regulated products
involved in the protocols reviewed. The IRB registration requirements
will make it easier for FDA to inspect IRBs and to convey information
to IRBs.
DATES: This rule is effective July 14, 2009. This effective date is
necessary to allow refinement of the electronic
[[Page 2359]]
registration system so that it corresponds to this final rule. All IRBs
must comply with the initial registration requirement and, if
necessary, make required revisions to their registrations by September
14, 2009.
FOR FURTHER INFORMATION CONTACT: Erik Mettler, Office of Policy,
Planning and Preparedness, Food and Drug Administration, WO1, rm. 4324,
Silver Spring, MD 20993-0002, 301-796-4830.
SUPPLEMENTARY INFORMATION:
I. Introduction
What Led Us to Issue This Rule?
IRBs are ``boards, committees, or groups formally designated by an
institution to review, to approve the initiation of, and to conduct
periodic review of, biomedical research involving human subjects'' (see
21 CFR 56.102(g)). An IRB's primary purpose during such reviews is to
assure the protection of the rights and welfare of human subjects
(id.). FDA's general regulations pertaining to IRBs are at part 56 (21
CFR part 56). (While section 520(g) of the Federal Food, Drug, and
Cosmetic Act (``the act'') (21 U.S.C. 360j(g)) refers to
``institutional review committees'' rather than IRBs, FDA considers
institutional review committees to be IRBs and to be subject to the IRB
regulations.)
Even though IRBs play an important role in the conduct of clinical
investigations regulated by FDA, we have never compiled a comprehensive
list of IRBs involved in reviewing clinical investigations regulated by
FDA. Existing FDA regulations have required some, but not all, clinical
investigators or sponsors of clinical investigations to provide IRB
names and addresses to FDA, and the requirements differ slightly among
the different types of products regulated by FDA. For example, for
human drug products, the sponsor must disclose the name and address of
``each reviewing'' IRB (see 21 CFR 312.23(a)(6)(iii)(b)). For medical
devices, the sponsor must disclose the names and addresses of IRBs that
``have been asked or will be asked'' to review the investigation (see
21 CFR 812.20(b)(7)) (emphasis added). For other types of clinical
investigations regulated by FDA (such as food additive studies
involving human subjects), the regulations do not expressly require the
sponsor or the clinical investigator to disclose or keep records
showing an IRB's name and address, and they make no distinction between
``reviewing IRBs'' and IRBs that have been asked or will be asked to
review a study.
In 1998, the Department of Health and Human Services' Office of the
Inspector General (OIG) issued several reports on IRBs. The OIG sought
to identify the challenges facing IRBs and to make recommendations on
improving Federal oversight of IRBs. One recommendation was that all
IRBs should register with the Federal Government on a regular basis as
part of an effort to develop more streamlined, coordinated, and probing
means of assessing IRB performance and to enhance the Federal
Government's ability to identify and respond to emerging problems
before they result in ``serious transgressions'' (see Office of the
Inspector General, Department of Health and Human Services,
Institutional Review Boards: a Time for Reform, pages 20 and 21, June
1998).
After reviewing the OIG's recommendation, we concluded that IRB
registration would serve several important goals. IRB registration
would:
Enable us to identify more precisely those IRBs reviewing
clinical investigations regulated by FDA. At present, much of our
knowledge about the identities and numbers of IRBs reviewing clinical
investigations regulated by FDA is based on information from persons
conducting or sponsoring clinical investigations rather than from IRBs
themselves. This information may be obsolete (because there may be no
obligation to update the information) or incomplete (because the
requirements to report the names and addresses of IRBs are not uniform
across all FDA-regulated products);
Enable us to send educational information and other
information to IRBs. Because we lack an accurate list of IRBs, our
outreach and educational efforts are not as efficient as they might be.
Changes in IRB addresses result in returned mail, and newly formed IRBs
may not appear in FDA's mailing lists; and
Help us identify IRBs for inspection, because we would
have a more accurate list of IRBs.
Consequently, FDA, in consultation with the Department of Health
and Human Services, Office for Human Research Protections (OHRP),
published a proposed rule in the Federal Register of July 6, 2004 (69
FR 40556), that would require IRB registration for IRBs reviewing
clinical investigations involving FDA-regulated products. OHRP issued a
companion proposed rule which appeared in the Federal Register of July
6, 2004 (69 FR 40584) that would require registration for IRBs
reviewing federally supported research. The final OHRP IRB registration
rule is published elsewhere in this issue of the Federal Register.
The goal of the two rules is to create a simple, electronic
registration system that all IRBs, regardless of whether they review
clinical investigations regulated by FDA or federally supported
research, can use.
II. What Comments Did We Receive?
A. How Many Comments Did We Receive, and Who Submitted Comments?
We received over 15 comments in response to the proposed rule.
Individuals, IRB members, IRB associations, an IRB accreditation
association, government, health, academic or trade associations, a
university system, and drug companies submitted comments. In general,
the comments supported IRB registration, although some disagreed with
specific aspects of the proposal or with other issues that were
discussed in the preamble to the proposed rule. To make it easier to
identify comments and our responses, the word ``Comment,'' in
parentheses, will appear before the comment's description, and the word
``Response,'' in parentheses, will appear before our response. We have
also numbered each comment to help distinguish between different
comments. The number assigned to each comment is purely for
organizational purposes and does not signify the comment's value or
importance or the order in which it was received.
B. Who Must Register? (Section 56.106(a))
Proposed Sec. 56.106(a) would require the following IRBs to
register:
Each IRB in the United States that reviews clinical
investigations regulated by FDA under sections 505(i) (21 U.S.C.
355(i)) or 520(g) of the act; and
Each IRB in the United States that reviews clinical
investigations that are intended to support applications for research
or marketing permits for FDA-regulated products.
The preamble to the proposed rule invited comment on whether there
are circumstances in which foreign IRBs should be required or invited
to register (see 69 FR 40556 at 40558).
(Comment 1) One comment stated that foreign IRBs are not needed in
America.
(Response) The comment may have misinterpreted the preamble. The
issue is not whether foreign IRBs should or should not review studies,
but rather whether foreign IRBs should be included in the IRB
registration system.
(Comment 2) Several comments differed as to whether foreign IRBs
should have to register. One comment would require foreign IRBs to
register if they review research conducted in the
[[Page 2360]]
United States; the same comment would give foreign IRBs the option to
register if they review research conducted outside the United States
that may be used to support a future marketing application in the
United States.
Several comments would allow for voluntary registration of foreign
IRBs or ethical review committees. Two comments explained that
registering foreign IRBs would enable them to have access to
educational materials and other information. However, one comment would
limit such registration to foreign IRBs reviewing research conducted in
the United States, and another comment noted that local privacy laws in
foreign countries might affect a foreign IRB's ability to provide
certain registration information.
In contrast, one comment said that we should respect oversight of
ethical review committees by foreign authorities and that we should not
impose ``additional bureaucracy.'' Similarly, another comment opposed
registering foreign IRBs, stating that such registration could pose
``significant difficulties'' for clinical investigators and sponsors
and that foreign laws and regulations might make it difficult for
foreign IRBs to register.
(Response) We agree in part with the comments. We agree that
foreign IRBs would benefit from educational and other materials that
would be sent to registered IRBs. Therefore, we have revised Sec.
56.106(a) to allow for voluntary registration by foreign IRBs and by
any domestic IRB that is not otherwise required to register.
We decline to require registration by foreign IRBs that review
research to be conducted in the United States. We do not believe a
significant number of foreign IRBs review research that is to be
conducted in the United States. Furthermore, requiring registration by
foreign IRBs that review research conducted in the United States could
lead to arguments over the validity of our regulatory authority when
applied to actions occurring in a foreign country.
As for possible problems foreign IRBs might encounter in
registering information due to foreign laws and regulations, the
comments did not identify specific registration elements that would be
a problem. Consequently, we lack sufficient information to determine
whether we should modify certain IRB registration elements to
accommodate foreign IRBs.
(Comment 3) One comment asked us to clarify whether the reference
to section 520(g) of the act was limited to research done under an
investigational device exemption (IDE) or encompassed all
investigational devices in a clinical investigation.
(Response) The reference to section 520(g) of the act encompasses
all investigational devices in a clinical investigation, regardless of
whether FDA approval of an IDE is needed in accordance with 21 CFR part
812 for the clinical investigation.
(Comment 4) One comment asked us to clarify whether the rule
applied to ``non-local'' or ``commercial'' IRBs.
(Response) The comment did not explain what it meant by the terms
``non-local'' or ``commercial'' IRB. For purposes of this response, we
will assume that a ``non-local'' IRB is one that is physically located
away from the clinical trial site(s) and that a ``commercial'' IRB is
one that is paid to review research.
If the ``non-local'' or ``commercial'' IRB is located in the United
States and:
Reviews clinical investigations regulated by FDA under
sections 505(i) or 520(g) of the act; or
Reviews clinical investigations that are intended to
support applications for research or marketing permits for FDA-
regulated products, then the non-local or commercial IRB must register
under Sec. 56.106(a). If the non-local or commercial IRB does not
perform any of the reviews described immediately above or is outside
the United States, then it may register voluntarily.
C. What Information Must an IRB Register? (Section 56.106(b))
Proposed Sec. 56.106(b) would describe the information that IRBs
would provide as part of the registration process. For example,
proposed Sec. 56.106(b)(1) would require the name and mailing address
of the institution operating the IRB and the name, mailing address,
phone number, facsimile number, and electronic mail address of the
senior officer of that institution who is responsible for overseeing
the IRB's activities. (A facsimile number also is known more commonly
as a ``fax number.'')
(Comment 5) Several comments addressed the registration information
in proposed Sec. 56.106(b) generally. Two comments said that the
registration information that OHRP and FDA would require should either
be the same or that information required by OHRP, but not by FDA,
should be clearly delineated and marked as optional for IRBs that are
subject to FDA regulation. Similarly, one comment said that questions
relating to research funded by HHS, which were part of OHRP's proposed
registration system, should be identified clearly so IRBs that do not
review HHS-funded research are not obliged to answer those questions.
Another comment said the proposed registration information is
appropriate.
One comment urged us to reexamine the registration information to
assure that the information is necessary to support the rule's stated
goals.
(Response) We coordinated our rule with OHRP and tailored our
respective registration information elements to be as consistent as
possible and to use the same internet-based registration system.
We agree that the IRB registration system should specify whether
certain registration information is optional or not required for IRBs
subject only to our jurisdiction. The preamble to the proposed rule
stated that, ``In those instances where the Internet registration site
would seek more information than FDA would require under this proposal,
the site would clarify that IRBs regulated solely by FDA may, but are
not required to, provide the additional information'' (69 FR 40556 at
40558). The Internet registration site will be structured so that
required information will be identified or marked as such, and IRBs
indicating that they are registering pursuant to FDA's regulation also
will be directed to questions requesting information required only
under FDA's regulation.
(Comment 6) Proposed Sec. 56.106(b)(1) would require IRBs to
provide the name and mailing address of the institution operating the
IRB and the name, mailing address, phone number, facsimile number, and
electronic mail address of the ``senior officer of that institution who
is responsible for overseeing activities performed by the IRB.'' The
preamble to the proposed rule explained that the senior officer ``must
not be an IRB member, IRB staff, or a sponsor or investigator
participating in an investigation under review by that IRB'' (see 69 FR
40556 at 40558).
Several comments addressed this provision. Two comments supported
the proposed requirement, but two other comments stated that our
interpretation of ``senior officer'' was too prohibitive or too
restrictive. These comments said that if a senior officer is on the
IRB, his or her membership should not invalidate registration or
subject the IRB to enforcement action.
Another comment questioned what we meant when we referred to ``IRB
staff.'' The comment said that some IRBs distinguish staff from IRB
members to ensure the IRB's integrity and independence. The comment
suggested that we list persons who cannot be a ``senior officer'' and
that we delete ``IRB staff'' from that list.
(Response) We agree, in part, with the comments. We recognize that,
in some cases, it may not be feasible to identify
[[Page 2361]]
a ``senior officer'' who is not also an IRB member or IRB staff.
However, our experience indicates that IRBs sometimes form
subcommittees or other groups and that the institutions overseeing the
IRBs may not be aware of these subcommittees or other groups. Thus,
when we said that the ``senior officer'' should not be an IRB member or
IRB staffer, our goal was to ensure that the institution overseeing the
IRB's activities is truly aware of those activities. For these reasons,
where feasible, we recommend that the senior officer not be an IRB
member or an IRB staffer.
Additionally, as the preamble to the proposed rule stated,
information regarding the institution will enable us to identify the
institution and to determine whether problems that might exist for one
IRB at that institution exist at other IRBs affiliated with that
institution (see 69 FR 40556 at 40558).
Additionally, on our own initiative, we have revised Sec.
56.106(b)(1) to require the street address for the institution if the
street address is different from the institution's mailing address.
(Comment 7) One comment said we should ensure that any addresses
and telephone numbers are current and are kept current. The comment
suggested that we issue fines and penalties if IRBs fail to keep such
information current.
(Response) Section 56.106(e) requires IRBs to revise their
registration information within 90 days if a contact person or
chairperson information changes; this would encompass changes in the
contact person's or chairperson's telephone number.
As for the comment's suggestion of imposing fines and penalties, we
do not have legal authority to impose fines for failure to maintain IRB
registration information. As for other penalties, we discuss the
consequences of failing to register in comment 24 of this document.
(Comment 8) Proposed Sec. 56.106(b)(2) would require IRBs to
provide the IRB's name, the names of each IRB chair person and each
contact person (if one exists) for the IRB, and the IRB's mailing
address, street address (if different from the mailing address), phone
number, facsimile number, and electronic mail address.
One comment supported the proposal. However, another comment noted
that the OHRP proposal would require IRBs to provide the name, gender,
degree, scientific or nonscientific specialty, and affiliation of each
IRB member and suggested that we revise our rule to require the same
information as the OHRP rule.
(Response) We agree, in part, and disagree, in part, with the
comment's suggestion that we require the same information as OHRP's
rule. We decline to revise the rule as requested by the comment. Unlike
OHRP, we have never required IRBs to give us the names, educational
background, and qualifications of all IRB members. Our rule does not
include this information because our regulatory emphasis has been on
the IRB's overall composition. Consequently, our final rule does not
require such information about individual IRB members.
We have, however, revised Sec. 56.106(b)(2) to replace ``chair
person'' with ``chairperson.'' This change reflects the common spelling
for this noun and does not alter the application or interpretation of
Sec. 56.106(b)(2). Additionally, we have revised Sec. 56.106(b)(2) to
require the phone number and electronic mail address for the IRB
chairperson; this will enable us to communicate with the IRB
chairperson quickly if such a need arises.
On our own initiative, we have revised Sec. 56.106(b)(2) to delete
the parenthetical of ``(if one exists)'' after ``the contact person's
name'' and to require and the name, mailing address, phone number,
facsimile number, and electronic mail address of the contact person
providing the registration information. This information will enable us
to communicate with the contact person if any questions arise regarding
the IRB or its registration information, and the information now
required is similar to that required for the contact person under
OHRP's rule. We also have reorganized the provision to make it easier
to understand what information is required.
(Comment 9) Proposed Sec. 56.106(b)(3) would require IRBs to
provide the ``number of active protocols (small, medium, or large)
involving FDA-regulated products reviewed.'' The proposal explained
that a ``small'' number of protocols is 1 to 25 protocols; ``medium''
is 26 to 499 protocols, and ``large'' is 500 protocols or more.
Several comments interpreted this provision in different ways or
sought clarification as to its meaning. In brief:
One comment asked us to define ``protocol'' because it
said questions would arise regarding multi-site studies involving a
single protocol.
Another comment would redefine the numerical ranges so
that ``small'' would be 1 to 99 protocols, ``medium'' would be 100 to
499 protocols, ``large'' would be 500 to 1,999 protocols, and ``very
large,'' a new category, would be 2,000 protocols or more. The comment
explained that a ``substantial number'' of organizations oversee
thousands of protocols and that these organizations operate differently
compared to those that review 500 protocols.
Another comment expressed concern about the protocol
numbers, stating that it was unclear how useful or accurate the data
would be due to complexities in IRB review and ``protocol driven
research activities,'' the level of IRB review (such as full IRB review
or expedited review), and frequent or daily changes in protocol review
numbers.
Similarly, another comment stated that protocols are neither
uniform nor uniformly complex, so that protocol activity is not a
reasonable basis for determining IRB activity. A third comment said
that we should consider the protocol ranges to be only approximations
of IRB workloads and use the information carefully and cautiously in
evaluating or characterizing IRBs.
Another comment disputed the need for protocol review
information, arguing that compliance with regulatory requirements is an
issue regardless of the number of protocols reviewed by an IRB.
(Response) The preamble to the proposed rule explained that
information regarding the number of protocols reviewed would enable us
to determine how active an IRB is and to assign our inspection
resources based on IRB activity levels (see 69 FR 40556 at 40558). Our
intent was not to get an exact or precise figure, and the proposal's
use of ``small,'' ``medium,'' and ``large'' protocol ranges reflected
that intent.
Consequently, we decline to revise the rule to define ``protocol''
in the final rule. Webster's II--New Riverside University Dictionary
defines ``protocol,'' in relevant part, as ``the plan for a scientific
experiment or treatment'' (see Webster's II--New Riverside University
Dictionary at page 947 (1988)). Thus, in the comment's scenario, if an
IRB conducts one review for a multi-site study, that single review
could be considered as one ``protocol.'' If an IRB conducts separate
reviews for individual study sites, then it conceivably could have
reviewed multiple ``protocols'' notwithstanding the fact that the study
plan remains essentially the same for all sites.
However, on our own initiative, we have amended Sec. 56.106(b)(3)
to define what the term ``active protocol'' means. The final rule
defines ``active protocol'' as ``any protocol for which an IRB
conducted an initial review or a continuing review at a convened
[[Page 2362]]
meeting or under an expedited review procedure during the preceding 12
months.'' We have made this change to be consistent with changes made
by OHRP in its final rule.
With respect to the proposal's numerical ranges and their
usefulness to us, we reiterate that our intent was to get a general--
rather than a precise--sense of how active IRBs are and to assign our
limited inspectional resources more efficiently and effectively. We
recognize that there are different types of IRB review and that changes
in an IRB's workload could make an IRB's protocol estimate outdated or
obsolete at a later point in time. However, given the protocol ranges
were created simply to give us an idea about an IRB's activity, we have
revised the rule to eliminate the ``small,'' ``medium,'' and ``large''
ranges. Instead, the final rule requires an approximate number of
active protocols reviewed, but we neither expect nor want IRBs to
constantly change or update their protocol numbers whenever their
protocol numbers fluctuate. If the approximate number of protocols
changes after initial IRB registration, the IRB should report the new
protocol number as part of the re-registration process which takes
place every 3 years.
As for compliance activities, we believe the comment may have
misinterpreted the preamble to the proposed rule. We did not state that
we would base inspections solely on an IRB's self-reported level of
``small,'' ``medium,'' or ``large'' numbers of protocols reviewed. We
simply said that the information would help us assign inspection
resources based on IRB activity levels.
To put it another way, we have limited inspectional resources, and
our field staffs that inspect IRBs are also responsible for many other
types of inspections and activities. We must prioritize our routine IRB
inspections in some manner to make the most efficient use of our
resources. Such prioritization of IRB inspections is not tantamount to
declaring, as the comment suggests, that IRBs reviewing ``small'' or
``medium'' numbers of protocols do not have to comply with FDA
regulations or that we enforce our requirements differently depending
on whether an IRB reviews a ``small,'' ``medium,'' or ``large'' number
of protocols. Nevertheless, given that the final rule does not contain
the ``small,'' ``medium,'' or ``large'' protocol ranges, the issue is
largely moot.
(Comment 10) Proposed Sec. 56.106(b)(4) would require IRBs to
describe the types of FDA-regulated products, such as biological
products, color additives, food additives, human drugs, or medical
devices, involved in the protocols that they review.
Two comments addressed this provision. One comment stated that it
had no objection to the requirement provided that the description could
be simple or generic without numerical ranges associated with each
product type. Another comment said the descriptions would be
appropriate only if we used the information for purposes of sending
useful and targeted information to IRBs. The comment also said that the
description should be generic and without numerical ranges associated
with product types.
(Response) We agree with the comments. Section 56.106(b)(4) merely
seeks a generic description of the FDA-regulated products in the
protocols reviewed by the IRB. So, for example, if the IRB reviews
protocols for human drug studies, the description, to satisfy Sec.
56.106(b)(4), could simply be ``human drugs.'' If the IRB reviews
protocols for human drug and medical device studies, the description
would be ``human drugs'' and ``medical devices.'' We also note that the
electronic registration system will list the types of FDA-regulated
products and allow individuals to check the appropriate boxes relating
to those products and to check ``other'' and explain what the ``other''
FDA-regulated products are.
Furthermore, Sec. 56.106(b)(4) does not require IRBs to assign
numerical values to the FDA-regulated product types. As the comments
noted, our intent is to use this information to send product-specific
information to IRBs, and we can do so with a simple description of
product types.
(Comment 11) Proposed Sec. 56.106(b)(5) would require an
indication whether the IRB is accredited and, if so, the date of the
last accreditation and the name of the accrediting body or
organization. The preamble to the proposed rule stated that we
recognized that IRB accreditation is a developing concept and invited
comment on ``the perceived value of collecting information on the
accreditation status of IRBs'' (see 69 FR 40556 at 40558).
We received more than 10 comments on IRB accreditation issues, and
the comments reflected a considerable difference of opinion regarding
IRB accreditation and whether we should require information about such
accreditation. In brief, the comments stated:
IRB accreditation information may give FDA useful
information in deciding which IRBs to inspect and may help us decide
whether to focus educational activities on certain areas. One comment
added that accreditation information would help us evaluate the value
of IRB accreditation. In contrast, one comment said that IRB
accreditation information will not give FDA new information that will
be useful in assessing accreditation's value;
FDA should refer to accreditation of human research
protection programs rather than accreditation of IRBs;
FDA should require information about the name of the
accrediting organization under which the IRB functions or collect
information about accreditation type or level. One comment explained
that one body has two different accreditation categories;
The additional reporting burden should not be passed on to
the institution;
FDA should delete the provision because accreditation
information can be collected without the need for a regulation or is
publicly available from accrediting organizations. One comment added
that accreditation information, if it were part of the IRB registration
requirement, might be unreliable because our rule would require re-
registration every 3 years; and
Accreditation does not accurately represent a measure of
compliance with human subject protection requirements. Similarly, an
IRB's lack of accreditation could be misconstrued as reflecting on the
quality of the IRB's human subject protection program. In contrast, one
comment strongly encouraged IRBs to become accredited, and another
comment said that accreditation implies that a certain standard has
been achieved.
(Response) The final rule omits accreditation information from the
IRB registration requirements. We agree that, if necessary, we can
obtain accreditation information from the accreditation organizations
themselves and that the resulting information may be more reliable or
accurate, given that the rule does not require certain registration
information to be updated until re-registration. We also agree that, as
a general matter, accreditation does not ensure or demonstrate that a
particular action was done correctly; instead, accreditation may
increase one's confidence that the accredited body is capable of
performing a particular action correctly.
Furthermore, we continue to believe that accreditation, insofar as
human subject protection is concerned, is still a developing concept.
Consequently, we will continue to follow such accreditation activities,
but will not require accreditation information as part of IRB
registration.
[[Page 2363]]
Finally, because the final rule does not require accreditation
information, the comment regarding reporting burdens is moot.
D. When Must an IRB Register? (Section 56.106(c))
Proposed Sec. 56.106(c) would have IRBs register once and to renew
their registrations every 3 years. Initial IRB registration would occur
within 30 days before the date when the IRB intends to review clinical
investigations regulated by FDA. IRB registration would become
effective upon HHS posting of the registration information on its Web
site.
(Comment 12) One comment would have us consider IRBs to be
registered as soon as they complete submitting the registration
information regardless of whether the IRB submitted the information
electronically or in writing. Another comment suggested that the
electronic registration system acknowledge or document that the IRB has
registered. Another comment stated that, if IRB registration is to
identify IRBs for future inspections, there is no need for a 30-day
``waiting'' period.
A different comment said that the 30-day time period might
interfere with IRB review, particularly expedited reviews and full IRB
reviews that take less than 30 days. The comment suggested that we
revise the rule so that IRBs may not issue a determination on FDA-
regulated research until they have registered.
Another comment asked us to clarify when IRBs must register. The
comment explained that the codified provision directed IRBs to submit
an initial registration within 30 days before the date when the IRB
intends to review clinical investigations regulated by FDA. The comment
said that the word ``within'' could mean that an IRB could register
``anytime between one and 30 days before reviewing a protocol,'' but
that the preamble to the proposed rule interpreted proposed Sec.
56.106(c) as requiring registration at least 30 days before reviewing
the protocol. The comment preferred giving IRBs the ability to register
any time between 1 and 30 days before reviewing protocols in FDA-
regulated research.
(Response) We agree, in part, with the comments. For IRBs that
register electronically, the registration system will notify them that
they are registered. This notification will be sent to the electronic
mail address that the IRB provides as part of the registration process.
The IRB's registration will be effective after review and acceptance by
HHS. We have amended Sec. 56.106(c) regarding the time at which IRB
registration becomes effective to correspond to changes made by OHRP in
its final rule which is published elsewhere in this issue of the
Federal Register. OHRP revised a comparable provision in its rule to
clarify when IRB registration would become effective.
For IRBs that submit their registration information in writing, our
experience with written forms in other contexts suggests that some
individuals will not complete the forms or omit required information.
As a result, we may need to contact individuals to obtain the missing
information. Therefore, it would be more practical for us to consider
IRBs who submit their registration information in writing to be
registered only after they have submitted all required registration
information, we have entered that information into the electronic
registration system, and the information is reviewed and accepted by
HHS.
As for the comments concerning the 30-day timeframe and the
suggestion that we amend the rule so that IRBs cannot issue decisions
on FDA-regulated research until they have registered, we have decided
to eliminate the 30-day timeframe from the final rule. We note that IRB
registration, alone, does not address issues regarding an IRB's
competence or expertise, nor does it require IRBs to meet a particular
standard in order to conduct a review. However, because it is important
to FDA to assemble an accurate IRB database, we have revised Sec.
56.106(c) to state that: ``Each IRB must submit an initial
registration. The initial registration must occur before the IRB begins
to review a clinical investigation described in paragraph (a) of this
section. Each IRB must renew its registration every 3 years. IRB
registration becomes effective after review and acceptance by HHS.''
(Comment 13) One comment would require IRBs to renew their
registration every year instead of every 3 years. The comment said that
3 years would be too long a time period.
(Response) We decline to revise the rule as suggested by the
comment. IRB registration does not confer any particular status on
IRBs, nor does registration, alone, reflect upon an IRB's competence or
capabilities. Moreover, given that the information we seek through IRB
registration is quite basic (as in names and addresses) and that Sec.
56.106(e) describes how and when IRBs are to revise their registration
information, annual registration would not appear to confer any
advantages or make registration information more accurate or reliable.
Consequently, we decline to require IRBs to register annually.
E. Where Can an IRB Register? (Section 56.106(e))
Proposed Sec. 56.106(e) would direct IRBs to register at a
specific Internet address or, if an IRB lacked the ability to register
electronically, to send its registration information to a specific mail
address. We indicated that we would provide the Internet address and
mail address in the final rule. We also invited comment on whether we
should discontinue written IRB registration procedures after some time
period has elapsed, because we did not know how widespread Internet
access is among IRBs (see 69 FR 40556 at 40558).
(Comment 14) Several comments pertained to the registration
site(s). One comment said we should maintain one common registration
site with OHRP and that the registration system should automatically
include currently registered IRBs. The comment said the registration
system should also allow such IRBs to retain their assigned numbers.
The comment acknowledged the intent to create a single registration
site, but implied that the proposed rule's omission of a specific
Internet address created concern. Another comment supported creation of
a simple, electronic registration system.
(Response) We agree that a single Internet registration site should
be used for electronic registrations and have always worked with OHRP
towards that end. We were unable to provide a specific Internet address
at the time of the proposed rule because the electronic registration
system was still under development. The final rule now states that the
Internet registration address is https://ohrp.cit.nih.gov/efile.
Additionally, as we stated in the preamble to the proposed rule,
OHRP will continue to recognize previous IRB registrations (see 69 FR
40556 at 40558).
(Comment 15) One comment asked whether entities that have more than
one IRB at the same location need to register more than once or whether
they could register once and provide multiple pieces of information in
connection with a single registration.
(Response) The electronic registration system will assign an
organization number to each entity, and this will enable the entity to
register several IRBs without having to enter the same data repeatedly
for each IRB.
(Comment 16) Two comments encouraged us to have the electronic
registration system consider IRBs to be registered automatically once
an IRB completes the electronic registration process or to send
acknowledgements to the IRBs once they complete the electronic
registration process.
[[Page 2364]]
(Response) As we stated in our response to comment 12 of this
document, when an IRB completes the electronic registration process and
HHS has reviewed and accepted the information, the electronic
registration system will notify IRBs that they are registered.
(Comment 17) Several comments responded to our question whether we
should discontinue written IRB registrations after some time period has
elapsed. One comment supported conversion to electronic registration as
soon as possible, but said it is important to allow small organizations
the time to acquire the necessary technology. The comment agreed that
not all institutions have electronic capabilities or Internet access.
Another comment supported giving IRBs the option to submit
registration information in writing for a predetermined period of time,
but did not suggest any time period. A different comment also supported
the written registration option, but suggested that it be available
only for 2 years.
Another comment opposed discontinuing written IRB registration. The
comment said that there are adverse consequences to both the IRB and
any sponsor or investigator that might use an unregistered IRB (which
appeared to be a reference to a later discussion, in the preamble to
the proposed rule, about ``What Happens if an IRB Does Not Register?''
(see 69 FR 40556 at 40559)), so we should continue to make written IRB
registration possible.
(Response) While we continue to believe that most IRBs will use the
electronic registration system, we do not know how many IRBs will use
the written registration option, and the administrative record for this
rulemaking does not give us sufficient basis to set a deadline at which
we would end the written registration option. (We realize that one
comment suggested a 2-year period, but, given that IRBs have 3 years to
renew registrations, discontinuing written registrations after 2 years
would not give IRBs the opportunity to renew their registrations in
writing.) Consequently, until we become more experienced with IRB
registrations, we will continue to offer written registration as an
alternative to electronic registration, and the final rule states that
IRBs that lack the ability to register electronically must send their
registration information, in writing, to the Good Clinical Practice
Program (HF-34), Office of Science and Health Coordination, Food and
Drug Administration, 5600 Fishers Lane, Rockville, MD 20857.
F. How Does an IRB Revise Its Registration Information? (Section
56.106(e))
Proposed Sec. 56.106(e) would have IRBs revise their registration
information within specific timeframes if certain changes occurred. For
example, if the IRB's contact or chair person information changes,
proposed Sec. 56.106(e) would require the IRB to change its
registration information within 90 days of the change. If the IRB
decided to disband or to discontinue reviewing FDA-regulated clinical
investigations, it would report that change within 30 days. All other
information changes would be reported when the IRB renews its
registration.
(Comment 18) Two comments pointed out a discrepancy between the
proposed rule and its preamble. The comments noted that the preamble to
the proposed rule said that if an IRB reviews new types of FDA-
regulated products, it would revise its registration information within
30 days (see 69 FR 40556 at 40559), yet proposed Sec. 56.106(e) was
silent regarding such changes. The comments suggested that we reconcile
the codified text with the preamble.
(Response) The comments were correct. We inadvertently omitted
changes in the IRB's review of FDA-regulated research from proposed
Sec. 56.106(e), and we have revised the rule so that IRBs must revise
their registration information within 30 days if they review new types
of FDA-regulated products. Additionally, on our own initiative, we have
added a parenthetical phrase to clarify that a decision to review ``new
types of FDA-regulated products'' should be interpreted as a decision
to review a different category of FDA-regulated products, such as a
decision to review studies pertaining to food additives when the IRB
previously reviewed studies pertaining to drug products. We do not want
IRBs to revise their registration information if they decide to review
studies pertaining to subcategories within the same class of FDA-
regulated products; for example, if an IRB previously reviewed studies
pertaining to drugs intended to treat cardiac conditions and then
decided to review studies pertaining to drugs intended to treat cancer,
both types of studies would still pertain to drug products, so there
would be no ``new type'' of FDA-regulated product within Sec.
56.106(e).
(Comment 19) One comment addressed IRBs that have decided to
disband. The comment said that the process of closing an IRB may take
longer than 30 days, so requiring IRBs to revise their registration
information within 30 days of a decision to disband would put an
``undue burden'' on IRBs and the institutions responsible for the IRBs.
(Response) We agree in part, and disagree in part with the comment.
We agree that, in some cases, closing an IRB may take more than 30
days, but, in other cases, the process may take less time. In other
words, IRBs vary in size, resources, organization, and complexity, and,
as a result, different IRBs will take different amounts of time to
perform the same or similar functions.
The comment also may have misinterpreted the proposed rule.
Proposed Sec. 56.106(e) stated that an IRB's decision to disband or to
discontinue reviewing FDA-regulated clinical investigations is a change
that must be reported within 30 days of that change; thus, the proposal
would begin the time period when IRB decides to close, not when the IRB
finally closes. Nevertheless, for consistency with OHRP's final rule
(which appears elsewhere in this issue of the Federal Register), we
have revised Sec. 56.106(e) to state that an IRB's decision to disband
is a change that must be reported ``within 30 days of permanent
cessation of the IRB's review of research.'' In the preamble to the
OHRP final rule, OHRP states that ``the date of permanent cessation of
the IRB's review of * * * research would occur on or after the IRB's
decision to disband, but not before the IRB's decision to disband was
made.''
Furthermore, given the simplicity of the electronic registration
system, we do not believe that IRBs or their institutions will find it
``unduly'' burdensome to report the IRB's decision to disband.
(Comment 20) One comment would shorten the time period for
reporting changes in the IRB's contact or chair person information from
90 days to 60 days.
(Response) We decline to revise the rule as suggested by the
comment. The comment did not identify any advantage in shortening the
timeframe, and we do not believe that reducing the timeframe by 30 days
will confer any significant benefit.
G. What Other Comments Did We Receive?
1. What Information Will Be Publicly Available?
The preamble to the proposed rule referred to the OHRP proposal for
information regarding public disclosure of IRB registration
information, the Freedom of Information Act (FOIA), and
[[Page 2365]]
the Privacy Act of 1974 (see 69 FR 40556 at 40557). It also stated
that, insofar as FDA's registration system was concerned, the name of
the institution operating the IRB and the IRB's name will be publicly
accessible, and all other IRB registration information would be subject
to public disclosure under FOIA and our public information regulations
at part 20 (21 CFR part 20) (see id.).
(Comment 21) One comment said that, in addition to the
institution's name and the IRB's name, we should make the following
information publicly available:
The name, address, and telephone number of the IRB
contact; and
For accredited IRBs, information relating to that
accreditation.
Another comment asked us to clarify what information would be
publicly available under FOIA.
(Response) All registration information required under this rule
will be subject to FOIA and any other applicable statutes and
regulations pertaining to public disclosure. Please note that certain
information may be withheld from public disclosure or may require an
individual's consent to public disclosure (see, e.g., Sec. 20.63(e)
(stating that a request for all records relating to a specific
individual will be denied as a clearly unwarranted invasion of personal
privacy unless accompanied by the written consent of the individual
named)).
As for accreditation information, accreditation status is not
required under the final rule, so that information will not be publicly
available from us or from OHRP.
(Comment 22) One comment suggested that sponsors and investigators
have access to the IRB registration database. The comment said that
sponsors and investigators currently have access to Federal-wide
assurances data and suggested that, if sponsors and investigators could
not have access to the IRB registration database, we or OHRP should
issue a report of IRB registrations or issue certificates to individual
IRBs.
(Response) OHRP currently posts all registered IRBs on its Web
site, including the name and location of the organization operating the
IRB(s) and the name and location of each IRB.
We decline to issue reports on IRB registration or certificates to
show that an IRB is registered. As we stated in our response to comment
12 of this document, IRB registration, alone, does not address issues
regarding an IRB's competence or expertise, nor does it require IRBs to
meet a particular standard in order to conduct a review.
(Comment 23) One comment said we should establish a link to the
publicly available IRB registration information from the portion of our
own Web site that pertains to ``Good Clinical Practices in FDA-
Regulated Clinical Trials,'' located at https://www.fda.gov/oc/gcp/
default.htm.
(Response) We agree with the comment and have modified our Web site
accordingly.
2. What Happens if an IRB Does Not Register?
The preamble to the proposed rule stated that sponsors and
investigators who used unregistered IRBs might be using IRBs that
``would not have had the benefit of receiving educational materials
from FDA and would not have been identified on an FDA IRB registration
list for future inspection'' (see 69 FR 40556 at 40559). Thus, the
preamble to the proposed rule added that, ``to the extent that any
existing FDA regulation requires a sponsor or investigator to comply
with [part 56] or to use an IRB that complies with part 56, FDA will
consider sponsors and investigators using an unregistered IRB to be in
conflict with their regulatory obligations'' (id.).
The preamble to the proposed rule also noted how we considered
other options to require sponsors and investigators to use only
registered IRBs, such as refusing to consider information from an
application for a research permit for a clinical investigation that is
reviewed or is to be reviewed by an unregistered IRB (id.). The
preamble to the proposed rule also invited comment on what sanctions or
administrative mechanisms, if any, should or might be used against
sponsors and investigators who use unregistered IRBs and whether any
additional changes to our regulations were necessary.
(Comment 24) We received many comments relating to sanctions, other
regulatory changes, and ensuring that sponsors and investigators use
only registered IRBs. The comments reflected a considerable difference
of opinion. For example:
One comment said we should impose and enforce ``high
fines'' for failure to follow human subject protection regulations;
Several comments said that the forms investigators
currently use (Form FDA 1572) could be used to reinforce or otherwise
highlight the need to use only registered IRBs, but the comments
differed as to whether investigators should be subject to any sanctions
if they use an unregistered IRB. For example, one comment said failure
to use a registered IRB should be treated the same as any other breach
of an investigator's responsibilities, but others said that IRBs,
rather than sponsors or investigators, should be responsible for any
failure to register. One comment also opposed placing an investigation
on clinical hold because, the comment argued, clinical holds are
appropriate when the rights and/or safety of human subjects are in
jeopardy or other material, noncompliance concerns are evident; the
comment said that failure to register does not mean improper oversight
by the IRB or by the sponsor. Some comments argued that sponsors and
investigators should not be obliged to monitor an IRB's registration
status. In contrast, one comment would have us amend the
investigational new drug (IND) application regulations to authorize us
to place a study on clinical hold if the sponsor or investigator uses
an unregistered IRB. The same comment suggested that we consider
additional enforcement options, such as ``refusing to consider
information from an application for a research permit for a clinical
investigation that is reviewed or is to be reviewed by an unregistered
IRB.''
Several comments, mostly from pharmaceutical firms or
trade associations, opposed any changes outside the IRB regulations.
The comments, in general, felt that the existing IND regulations were
sufficient and clear regarding a sponsor's or investigator's obligation
to use IRBs that comply with part 56. Some comments said we should not
expend resources on revising the IND regulations but should promote
awareness of the IRB registration requirements instead. Another
comment, from an association of medical colleges, also opposed
revisions to the IND regulations, stating that clinical holds would be
unworkable because, if an unregistered IRB had reviewed a clinical
study and the clinical study had proceeded, retroactive review of the
study would be impermissible. The comment said we should refuse to
consider information from an application for a research permit that is
reviewed or is to be reviewed by an unregistered IRB.
One comment suggested a ``flexible'' approach whereby we
would start by sending a certified letter to an unregistered IRB
regarding its failure to register and include registration
instructions. If the IRB remained unregistered, the comment suggested
that we inspect the IRB. The comment said that this approach would
allow us to take appropriate action against unregistered IRBs without
``unnecessarily penalizing'' sponsors and investigators who have
attempted to
[[Page 2366]]
follow our regulations in good faith. Similarly, another comment
advocated sending letters to IRBs or notices to sponsors rather than
imposing sanctions.
One comment agreed with us that an IRB's failure to
register would not justify disqualification of the IRB under Sec.
56.121 absent the extreme circumstances described in Sec. 56.121(b)(1)
(the IRB has refused or repeatedly failed to comply with regulatory
requirements) or Sec. 56.121(b)(2) (the noncompliance adversely
affects the rights or welfare of the human subjects in a clinical
investigation).
(Response) We agree in part and disagree in part with the comments.
We agree that the existing IND regulations, as well as the IDE
regulations, are sufficient and clear regarding a sponsor's or
investigator's obligation to use IRBs that comply with part 56. We also
agree that an IRB's failure to register, alone, should not lead to
disqualification proceedings under Sec. 56.121 absent extreme
circumstances. We intend to educate IRBs, sponsors, and investigators
about the IRB registration requirements and to encourage sponsors and
investigators to use registered IRBs for the same reasons we stated in
the preamble to the proposed rule.
Given the existing IND and IDE regulations and our intent to pursue
educational efforts, we disagree with those comments that would have us
impose fines or place clinical investigations on clinical hold if the
sponsor or investigator used an unregistered IRB. We believe that it
would be premature for us to consider the use of such sanctions before
we and the regulated community have gained sufficient experience with
the IRB registration program.
3. What Other Issues Did the Comments Raise?
Several comments addressed issues that were either not part of the
rulemaking or not material to the proposed codified text.
(Comment 25) One comment disagreed with the preamble to the
proposed rule when we stated that our knowledge about the identities
and numbers of IRBs reviewing FDA-regulated clinical research is
obsolete or incomplete (see 69 FR 40556 at 40557). The comment said
that we require sponsors to identify IRBs and that, for 20 years, OHRP
has maintained a list of IRBs that have filed assurances (under 45 CFR
part 46). The comment said that such past practices were apparently
sufficient for purposes of conducting inspections.
(Response) We disagree with the comment. As we stated in the
preamble to the proposed rule, existing FDA regulations have required
some, but not all, clinical investigators and sponsors to provide IRB
names and addresses to us, and those regulatory requirements differ
slightly (see 69 FR 40556 at 40557). Consequently, because of
differences within our own regulations, we do not have a comprehensive
list of IRBs that review FDA-regulated research. Additionally, because
our pre-existing regulations do not require sponsors and investigators
to revise or update IRB information if and when the IRB changes its
address, contact person, or chair person, or even, in some cases, to
provide addresses, contact information, or chair person information to
us, the IRB information we do have is not as detailed as the
information we seek under this rule.
As for institutions that have filed assurances with OHRP under 45
CFR part 46, the IRBs associated with such institutions are not
necessarily identical to those that review FDA-regulated research.
OHRP's regulations apply to institutions that are engaged in human
subjects research conducted or supported by HHS. In contrast, our IRB
regulations apply to clinical investigations regulated by us,
regardless of whether those investigations are conducted or supported
by HHS. Thus, the fact that OHRP has operated an assurance system for
decades does not necessarily mean that the OHRP list of institutions
that have filed assurances can serve as a list of IRBs that review FDA-
regulated research.
(Comment 26) One comment said that registration and re-registration
fees should be set at $5,000 to cover costs. The comment said that
taxpayers should not have to pay the fees or fund the costs of
``profiteers,'' and that pharmaceutical companies should not ``get
away'' with low fees when ``they can pay their executives $150,000,000
at retirement.''
(Response) We decline to revise the rule as suggested by the
comment. We have no express authority to impose registration or re-
registration fees on IRBs. Additionally, the rule is directed at IRBs
themselves rather than pharmaceutical firms, so issues relating to
pharmaceutical executives' salaries are not relevant to this
rulemaking.
(Comment 27) One comment asked us to confirm that our IRB
inspections will adhere to the guidelines described in the ``Guidance
for Institutional Review Boards and Clinical Investigators.''
(Response) This rulemaking does not affect how we conduct IRB
inspections. We may, however, use IRB registration information to help
us prioritize inspections. Additionally, our receipt of more accurate
IRB addresses and contact information due to IRB registration should
make it easier and more efficient to schedule IRB inspections.
H. What Other Amendment Did We Propose?
The proposal would also make a non-substantive amendment to part
56. The proposal would revise the definition of ``An Application for an
Investigational Device Exemption,'' at Sec. 56.102(b)(12), to
eliminate its reference to 21 CFR part 813. The preamble to the
proposed rule explained that this change is necessary because we
removed the regulations at part 813 (which had pertained to intraocular
lenses) in 1997 (see 62 FR 4164, January 29, 1997).
We received no comments on this aspect of the proposal.
Consequently, the final rule deletes a reference to part 813.
III. Implementation
This rule is effective July 14, 2009. This protracted effective
date is necessary to allow refinement of the electronic registration
system so that it corresponds to this final rule and to OHRP's final
rule.
IV. Legal Authority
In general, the act authorizes us to issue regulations pertaining
to investigational uses of FDA-regulated products (see, e.g., sections
409(j) (21 U.S.C. 348(j)) (investigations involving food additives);
505(i) (investigations involving human drugs); 520(g) (investigations
involving devices); and 721(f) (21 U.S.C. 379e(f)) of the act
(investigations involving color additives)).
The act also requires the submission of a petition or application
to FDA (see, e.g., sections 409(b) (food additive petitions); 505(b)
(new drug applications); 505(j) (abbreviated new drug applications);
513(f) (premarket notification for devices); 515(c) (premarket approval
applications for devices); 520(m) (humanitarian device exemption
applications); and 721(b) of the act (color additive petitions)) before
marketing begins.
To implement these provisions of the act, section 701(a) of the act
gives us the authority to issue regulations for the efficient
enforcement of the act. By requiring IRB registration, the final rule
will aid in the efficient enforcement of the act's provisions regarding
the
[[Page 2367]]
investigational use of various FDA-regulated products (because then we
would be able to conduct IRB inspections more efficiently) as well as
those provisions regarding marketing applications (because marketing
applications usually depend on clinical investigations involving human
subjects, and IRBs are supposed to provide protections for the rights
and welfare of such human subjects). Moreover, by requiring IRBs to
register, the final rule will enable FDA to contact IRBs more quickly
and efficiently on various issues, such as adverse reactions that may
be attributed to a particular product, new regulatory requirements or
policies, or problems associated with a particular protocol or clinical
investigator. Consequently, we conclude that we have sufficient legal
authority to issue the final rule.
V. Economic Impact Analysis
We have examined the impacts of the final rule under Executive
Order 12866, 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 as defined by
the Executive Order.
The Regulatory Flexibility Act requires agencies to analyze
regulatory options that would minimize any significant impact of a rule
on small entities. Because the required registration information is
minimal and the costs associated with registration are low, 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 final rule requires most IRBs to register with FDA. The
information sought through the registration process is minimal,
consisting largely of names and addresses for a contact person, the
institution operating the IRB (if an institution exists), the head of
the institution, the IRB, and the IRB chairperson. The registration
would also indicate the approximate number of active protocols reviewed
and the types of FDA-regulated products involved. We estimate that
initial IRB registration may require 1 hour. The average loaded wage
rate for administrators at public institutions is about $44 per
hour.\1\ This means that each IRB would spend $44 for an initial
registration ($44 per hour x 1 hour per initial registration).
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\1\ Source: United States Department of Labor, Bureau of Labor
Statistics; National Compensation Survey, June 2005. Overall hourly
rate in the United States for administrators and officials, public
administration,