Orphan Drug Regulations, 64868-64879 [2011-27037]
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Federal Register / Vol. 76, No. 202 / Wednesday, October 19, 2011 / Proposed Rules
• How can we modify, streamline, or
expand our regulatory review process?
d. Prioritization
• How should we prioritize rules that
are to be reviewed (e.g., chronologically;
based on rules where the greatest impact
could be made from potential changes;
rules with potential to have greatest
savings in costs or paperwork/reporting
burdens; rules with most potential for
changes to enhance safety)?
3. Substance of Review
• Should the review include any or
all of the considerations in RFA reviews
(i.e., continued need for the rule; nature
of complaints or comments concerning
the rule; complexity of the rule; extent
of overlap or conflicts with other federal
(and possibly state and local) rules; and
length of time since the rule has been
evaluated; or extent of change in
technology, economic conditions, or
other factors)?
• Should we conduct cost-benefit
analyses with every rule we review or
only for significant rules as anticipated
by the Executive Orders? Please explain
your reasoning. Do commenters have
suggestions for how we might develop
our analysis of costs and benefits for
rules under consideration for
retrospective review?
Dated: October 12, 2011.
Todd A. Stevenson,
Secretary, Consumer Product Safety
Commission.
[FR Doc. 2011–26820 Filed 10–18–11; 8:45 am]
BILLING CODE 6355–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Food and Drug Administration
21 CFR Part 316
[Docket No. FDA–2011–N–0583]
RIN 0910–AG72
Orphan Drug Regulations
AGENCY:
Food and Drug Administration,
HHS.
ACTION:
Proposed rule.
The Food and Drug
Administration (FDA) is proposing to
amend the 1992 Orphan Drug
Regulations issued to implement the
Orphan Drug Act. These amendments
are intended to clarify regulatory
provisions and make minor
improvements to address issues that
have arisen since those regulations were
issued.
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SUMMARY:
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Submit either electronic or
written comments on the proposed rule
by January 17, 2012. Submit comments
on information collection issues under
the Paperwork Reduction Act of 1995 by
November 18, 2011 (see the ‘‘Paperwork
Reduction Act of 1995’’ section of this
document).
ADDRESSES: You may submit comments,
identified by Docket No. FDA–2011–N–
0583 and/or RIN number 0910–AG72,
by any of the following methods, except
that comments on information
collection issues under the Paperwork
Reduction Act of 1995 must be
submitted to the Office of Regulatory
Affairs, Office of Management and
Budget (OMB) (see the ‘‘Paperwork
Reduction Act of 1995’’ section of this
document).
DATES:
Electronic Submissions
Submit electronic comments in the
following way:
• Federal eRulemaking Portal: https://
www.regulations.gov. Follow the
instructions for submitting comments.
Written Submissions
Submit written submissions in the
following ways:
• Fax: 301–827–6870.
• Mail/Hand delivery/Courier (for
paper, disk, or CD–ROM submissions):
Division of Dockets Management (HFA–
305), Food and Drug Administration,
5630 Fishers Lane, rm. 1061, Rockville,
MD 20852.
Instructions: All submissions received
must include the Agency name and
Docket No. FDA–2011–N–0583 and
Regulatory Information Number (RIN)
0910–AG72 for this rulemaking. All
comments received may be posted
without change to https://
www.regulations.gov, including any
personal information provided. For
additional information on submitting
comments, see the ‘‘Comments’’ heading
of the SUPPLEMENTARY INFORMATION
section of this document.
Docket: For access to the docket to
read background documents or
comments received, go to https://
www.regulations.gov and insert the
docket number, found in brackets in the
heading of this document, into the
‘‘Search’’ box and follow the prompts
and/or go to the Division of Dockets
Management, 5630 Fishers Lane, rm.
1061, Rockville, MD 20852.
FOR FURTHER INFORMATION CONTACT:
Erica K. McNeilly, Office of Orphan
Products Development, Food and Drug
Administration, 10903 New Hampshire
Ave., Bldg. 32, rm. 5271, Silver Spring,
MD 20993, 301–796–8660.
SUPPLEMENTARY INFORMATION:
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Table of Contents
I. Background
II. Description of the Proposed Changes
A. Demonstration of an ‘‘Orphan Subset’’
of a Disease or Condition
B. Eligibility for Orphan-Drug Designation
of a Drug That Was Previously Approved
for the Orphan Indication
C. Eligibility for Multiple Orphan-Drug
Exclusive Approvals
D. Demonstration of Clinical Superiority
E. Name of the Drug
F. Required Drug Description and
Scientific Rationale in a Request for
Orphan-Drug Designation
G. Removal of Requirement To Submit
Statement as to Whether Sponsor
Submitting the Request Is the Real Party
in Interest
H. Timing of Request for Orphan-Drug
Designation
I. Responding to a Deficiency Letter From
FDA on an Orphan-Drug Designation
Request
J. Publication of Orphan-Drug Designations
K. FDA Recognition of Orphan-Drug
Exclusive Approval
L. Miscellaneous Terminology Changes
M. Address Change
III. Environmental Impact
IV. Legal Authority
V. Proposed Implementation Plan
VI. Executive Order 13132: Federalism
VII. Paperwork Reduction Act of 1995
VIII. Analysis of Impacts
A. Background
B. Benefits and Costs of the Proposed Rule
C. Small Business Analysis
IX. Request for Comments
I. Background
Since the publication of the Orphan
Drug Regulations in the Federal
Register of December 29, 1992 (57 FR
62076), FDA has reviewed over 3,350
requests for orphan-drug designation of
drugs for rare diseases and conditions.
Based on these experiences, FDA
believes it is useful to clarify certain
regulatory language in the current
orphan drug regulations and to propose
areas of minor improvement. These
amendments are intended to assist
sponsors who are seeking and who have
obtained orphan-drug designation of
their drugs, as well as FDA in
administering the orphan drug program.
These amendments are consistent with
the Orphan Drug Act (Pub. L. 97–414)
and continue to provide incentives for
the development of potentially
promising orphan drugs that otherwise
would not be developed for rare
diseases and conditions.
The specific issues addressed in this
proposal include: (1) Demonstration of
an appropriate ‘‘orphan subset’’ of
persons with a particular disease or
condition that otherwise affects 200,000
or more persons in the United States, for
the purpose of designating a drug for
use in that subset; (2) eligibility for
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orphan-drug designation of a drug that
is otherwise the same drug for the same
orphan indication as a previously
approved drug; (3) eligibility for
multiple orphan-drug exclusive
approvals when a designated orphan
drug is separately approved for use in
different subsets of the rare disease or
condition; (4) requirement for
demonstrating clinical superiority for
the purpose of orphan-drug exclusive
approval; (5) requirement for submitting
the name of the drug in an orphan-drug
designation request; (6) required drug
description and scientific rationale in a
designation request; (7) required
information in a designation request
relating to the sponsor’s interest in the
drug; (8) timing of a request for orphandrug designation; (9) responding to a
deficiency letter from FDA on an
orphan-drug designation request; (10)
FDA publication of information
regarding designated orphan drugs; (11)
FDA recognition of orphan-drug
exclusive approval; (12) miscellaneous
terminology changes; and (13) an
address change.
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II. Description of the Proposed Changes
A. Demonstration of an ‘‘Orphan
Subset’’ of a Disease or Condition
As set forth in part 316 (21 CFR part
316), a sponsor may request orphandrug designation of a drug for use in
persons with a rare disease or condition
or, in some special circumstances, a
subset of persons with a disease or
condition that may not otherwise be rare
(hereinafter, a ‘‘non-rare’’ disease or
condition). With respect to the latter,
§ 316.20(b)(6) stipulates that when a
drug is to be developed for only a subset
of persons with a particular disease or
condition, the sponsor must provide ‘‘a
demonstration that the subset is
medically plausible.’’ This concept has
been the subject of some confusion, and
FDA has received requests for further
clarification.
The term ‘‘medically plausible’’
subset used in § 316.20(b)(6) refers to a
regulatory concept specific to the
orphan drug regulations. The
applicability of this regulatory concept
is explained in section II.B of the
preamble to the notice of proposed rule
making (NPRM) entitled ‘‘Orphan Drug
Regulations’’ published in the Federal
Register of January 29, 1991 (56 FR 3338
at 3339). Because the term ‘‘medically
plausible’’ has not been further clarified
through regulations or guidance, it has
been misinterpreted to mean any
medically recognizable or any clinically
distinguishable subset of persons with a
particular disease or condition.
Inappropriate application of the concept
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of a ‘‘medically plausible’’ subset could
result in the creation of subsets of nonrare diseases or conditions that are
artificially narrow. This result would be
inconsistent with the purpose of the
Orphan Drug Act.
For example, some requests for
orphan-drug designation have been for
use of a drug in a subset of persons with
a particular pathohistologic grade or
clinical stage of a specific malignancy,
but without a plausible argument why
the drug could not be used to safely
treat all persons with the malignancy,
regardless of disease grade or stage.
Another example of misinterpretation of
the term ‘‘medically plausible’’ has been
its application to a select group of
persons with a disease or condition who
are eligible to enroll in a clinical trial to
support a specific indication for use of
a drug when there is no scientific reason
to preclude investigational use of the
drug in other persons with the disease
or condition. Patients who meet
inclusion and exclusion criteria for a
trial do not automatically qualify as a
‘‘medically plausible’’ subset because it
could be medically appropriate to
evaluate the same drug for use in the
remaining persons with the same
disease or condition. Similarly, a
sponsor’s intention to use or study a
drug in a certain limited group of
persons with a non-rare disease or
condition does not necessarily qualify
that group as a ‘‘medically plausible’’
subset.
Any of the interpretations described
in the previous paragraphs would
permit a non-rare disease or condition
to be artificially subdivided into smaller
groups for the purpose of establishing
subsets that are under the prevalence
limit for orphan-drug designation. FDA
does not believe that such an approach
serves the intent of the Orphan Drug
Act, because it would permit the
creation of artificial ‘‘orphan’’
populations. Designation of drugs for
use in such artificial ‘‘orphan’’
populations could encourage sponsors
to study and seek approval for the use
of a drug in the narrowest patient group
possible, in order to avail themselves of
the orphan-drug incentives, including
tax benefits and orphan-drug exclusive
approval. In addition, use of such
artificial orphan populations to obtain
orphan designation and its related
benefits could divert resources away
from research and development of drugs
for true orphan diseases and conditions.
To limit the confusion arising from
the use of the term ‘‘medically
plausible,’’ FDA proposes to remove the
term ‘‘medically plausible’’ in
§ 316.20(b)(6) and instead provide a
description of how an appropriate
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subset may be identified for the purpose
of orphan-drug designation (‘‘orphan
subset’’). The process for identifying an
orphan subset remains the same as has
been used by FDA for identifying a
medically plausible subset under the
regulations currently in effect.
For a subset of persons with a nonrare disease or condition to be
considered an orphan subset for the
purpose of orphan-drug designation, the
subset cannot be arbitrarily chosen
simply to reduce the prevalence
numbers to qualify a drug to treat that
population as an orphan drug. One way
for a sponsor to demonstrate that the
proposed subset rests on a non-arbitrary
foundation is to show that there is a
reasonable scientific or medical
rationale for limiting the investigation
and potential use of the drug to only the
subset of interest. When a sponsor has
established that the selected population
constitutes a non-arbitrary subset, e.g.,
by describing the scientific or medical
basis for limiting the potential use of the
drug to that population and
demonstrating that such scientific or
medical basis is reasonable, the target
population is an acceptable orphan
subset of persons with the particular
disease or condition for the drug of
interest.
For example, it might not be
appropriate to treat all persons with a
non-rare disease or condition with a
drug that is highly toxic; however, those
patients who are refractory to, or
intolerant of, other less toxic drugs
might be reasonable candidates for
treatment with the drug. Therefore,
those patients who are refractory to, or
intolerant of, other less toxic drugs may
be considered an appropriate orphan
subset for purposes of orphan-drug
designation of the highly toxic drug. In
addition, other inherent properties of a
drug, such as its pharmacologic or
biopharmaceutical characteristics, may
provide a reasonable basis upon which
to identify a subset of patients to whom
it would be appropriate to limit
treatment and who thus would qualify
as an orphan subset of a non-rare
disease or condition. Likewise,
characteristics of the drug that have
been demonstrated through previous
clinical experiences may be used to
identify an appropriate orphan subset.
Examples of such characteristics
include:
• Pharmacological Property: The
mechanism of action is a common
principle for limiting the investigation
and use of a drug to a subset of patients.
For example, it is reasonable to expect
that use of a monoclonal antibody
directed against a specific surface
antigen would be restricted to treatment
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of subtypes of tumors that possess that
specific antigen, and not subtypes of
tumors that lack the antigen.
• Previous Clinical Experience:
Information on the drug’s activity
available from completed trials or
published in clinical literature may be
used to establish an orphan subset. If,
for example, relevant data show that the
drug has no significant activity in the
remaining subset of patients with highgrade tumors, then patients with lowgrade tumors may constitute an orphan
subset.
FDA recommends that the following
practical questions be asked when
assessing whether a subset of a non-rare
disease or condition is an appropriate
orphan subset:
• Is the intended subset artificially
restricted in any way with respect to the
use of the drug to treat the disease or
condition?
• Given that the drug may potentially
benefit this particular subset of persons,
is there a reasonable scientific or
medical basis for believing that the drug
would also potentially benefit the
remaining population with the non-rare
disease or condition or a larger subset of
that population? If not, why not?
These questions serve to test whether
a subset of patients with a disease or
condition that otherwise affects 200,000
or more persons in the United States can
be considered an appropriate orphan
subset for the purpose of orphan-drug
designation.1
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B. Eligibility for Orphan-Drug
Designation of a Drug That Was
Previously Approved for the Orphan
Indication
According to §§ 316.20(a) and
316.25(a)(3), a sponsor of a subsequent
drug that is otherwise the same drug as
an already approved orphan drug may
seek and obtain orphan-drug
designation of its drug for the same rare
disease or condition, provided that it
can present a plausible hypothesis that
the subsequent drug may be clinically
superior to the approved orphan drug.
In the absence of a clinical superiority
hypothesis, the Agency does not
interpret the orphan-drug regulations to
permit orphan designation of a drug that
is otherwise the same as a drug that is
already approved for the orphan use,
1 In this proposed rule, FDA is not proposing to
change the current regulatory provisions allowing
sponsors to obtain orphan-drug designation for a
drug intended for a disease or condition affecting
200,000 or more people, or for a vaccine, diagnostic
drug, or preventive drug to be administered to
200,000 or more people per year, if there is no
reasonable expectation that research and drug
development costs can be recovered by sales of the
drug in the United States (§§ 316.20(b)(8)(ii) and
316.21(c)).
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either where the approved drug received
orphan-drug exclusive approval (even
after such drug’s exclusivity period has
run out) or where the approved drug
was not previously designated as an
orphan drug and thus did not receive
orphan exclusive approval. If the same
drug has already been approved for the
orphan disease or condition, with or
without orphan exclusivity, designation
would be inappropriate because it
would be inconsistent with the primary
purpose of the Orphan Drug Act, which
is to provide incentives to develop
promising drugs for rare diseases or
conditions that would not otherwise be
developed and approved. Furthermore,
permitting orphan-drug designation of a
drug that is already approved for the
orphan indication could permit
inappropriate ‘‘evergreening’’ of
exclusive approval periods. For
example, a sponsor might obtain
approval and 5-year new chemical
entity exclusivity as described in
§ 314.108 (21 CFR 314.108) for a drug
product and then, once that 5-year
exclusivity period is expiring, seek
orphan-drug designation and exclusive
approval for a drug that is the same as
the drug (e.g., in a new dosage form) for
the same indication that was previously
approved. This outcome would be
inconsistent with the provisions of the
Orphan Drug Act, which provide that
exclusive approval for a drug for an
orphan disease or condition runs for 7
years from the date of approval of the
application for the drug (21 U.S.C.
360cc(a)).
Accordingly, FDA proposes to delete
the word ‘‘orphan’’ in the phrase
‘‘approved orphan drug’’ in
§§ 316.3(b)(3), 316.20(a), and
316.20(b)(5), to clarify that these
provisions would be applicable to a
drug that is otherwise the same drug as
any previously approved drug for the
same orphan disease or condition,
regardless of whether such drug was
designated as an orphan drug. FDA
proposes that the text of § 316.25(a)(3)
be revised. FDA is not changing its
position that, as described in the NPRM
preamble (56 FR 3338), section II.E,
paragraph 8, ‘‘even a drug considered
the ‘same’ drug structurally could
become a ‘different’ drug * * * by
showing clinical superiority.’’ In section
II.I, comment 77, of the preamble to the
final rule, ‘‘Orphan Drug Regulations’’
(57 FR 62076 at 62084), FDA reiterated
that it would ‘‘designate a structurally
identical subsequent drug as an orphan
drug, even in the face of a holder’s
exclusive marketing rights, if the
subsequent sponsor advances a
plausible basis on which to conclude
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that its product may be proven
‘clinically superior.’ ’’ FDA believes that
permitting a sponsor to receive orphandrug designation of a potentially
clinically superior drug that is
otherwise the same drug as an already
approved drug promotes development
of potentially superior drugs to the
benefit of persons with rare diseases or
conditions.
C. Eligibility for Multiple Orphan-Drug
Exclusive Approvals
When FDA designates an orphan
drug, it generally designates the drug for
use by all persons with the rare disease
or condition and expects that a sponsor
will seek approval of the drug for all
persons with the rare disease or
condition designated. The uses for
which a drug will be approved,
however, are those for which there is
adequate data and information to
support approval, and may be limited to
subsets of patients with the orphan
disease or condition. As new data
emerge, FDA may approve the drug for
use in additional subsets of the disease
or condition for which the drug was
designated.
The scope of orphan exclusive
approval for a designated drug is limited
to the approved indication or use, even
if the underlying orphan designation is
broader. If the sponsor who originally
obtained orphan exclusive approval of
the drug for only a subset of the orphan
disease or condition for which the drug
was designated subsequently obtains
approval of the drug for one or more
additional subsets of that orphan
disease or condition, FDA will
recognize orphan-drug exclusive
approval, as appropriate, for those
additional subsets from the date of such
additional marketing approval(s). Before
obtaining such additional marketing
approval(s), the sponsor in this instance
would not need to have obtained
additional orphan designation for the
additional subset(s) of the orphan
disease or condition.
If, before approval of the drug for any
subset of the disease or condition for
which it was designated, a subsequent
sponsor also obtained designation for
the same orphan disease or condition,
each sponsor may be eligible for orphandrug exclusive approval for the
respective subset(s) for which each first
obtains marketing approval. For
example, if the first sponsor receives
approval for one subset of the orphan
disease or condition and the subsequent
sponsor receives approval for a different
subset, FDA will recognize orphan-drug
exclusive approval for each sponsor’s
drug, as appropriate, from the date of
each drug’s marketing approval.
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After approval of the drug for one or
more subsets of the orphan disease or
condition, a subsequent sponsor may,
without submitting a plausible
hypothesis of clinical superiority, seek
designation of the drug for the subset(s)
of the orphan disease or condition for
which the drug has not yet been
approved. FDA may designate the drug
for use in the remaining subset(s)
without requiring a postulation of
clinical superiority. To obtain such a
designation, however, the sponsor must
demonstrate that, at the time of its
designation request, the entire
population with the orphan disease or
condition, not just the remaining
subset(s) of the population, is under the
prevalence limit, unless the sponsor can
demonstrate that the remaining subset(s)
is an orphan subset in accordance with
§ 316.20(b)(6).
This approach would permit multiple
orphan-drug exclusive approvals for
multiple subsets of the same underlying
orphan disease or condition. For
example, a drug could be designated for
the treatment of T-cell non-Hodgkin’s
lymphoma (assuming that, at the time of
designation, the drug’s sponsor
otherwise met all the other statutory and
regulatory requirements for obtaining an
orphan designation). However, the data
submitted may only support approval of
the treatment of cutaneous
manifestations in patients with
cutaneous T-cell lymphoma.
Subsequently, on the basis of additional
data, the same drug could be approved
for other subsets of T-cell nonHodgkin’s lymphomas, such as
anaplastic large cell lymphoma or
angioimmunoblastic T-cell lymphoma.
If the same sponsor, or a different
sponsor with orphan designation,
obtained approval for the use of the
drug in one or more of the remaining
subsets of T-cell non-Hodgkin’s
lymphomas, that sponsor would be
eligible for orphan-drug exclusive
approval for the use of the drug in those
subsets from the date of approval of the
drug for use in those subsets.
Accordingly, FDA proposes to add
provisions to § 316.31.
FDA believes that this proposal is
consistent with the purpose of the
Orphan Drug Act because it provides an
important incentive for one or more
sponsors to develop, or to continue to
develop, a potentially promising drug
for use in all persons affected by a rare
disease or condition, rather than in just
a subset of that orphan population, even
after the drug has been approved for a
different subset of the population with
the disease or condition.
This provision is applicable only in
situations where the underlying disease
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or condition for which the drug was
designated is an orphan disease or
condition at the time designation is
requested.
D. Demonstration of Clinical Superiority
FDA believes that granting orphandrug designation to a subsequent drug
that is otherwise the same as a
previously approved drug for the same
orphan disease or indication on the
basis of hypothetical plausibility of
clinical superiority is the best tool for
giving effect to the intent of Congress to
provide incentives for sponsors to
develop potentially safer and more
effective orphan drugs. It is possible,
however, that a sponsor that has
obtained designation of its drug on the
basis of a hypothesis that the drug will
be clinically superior will be unable,
upon submission of the marketing
application, to demonstrate that the
drug is clinically superior to the
previously approved drug. In that case,
if the already approved drug has
remaining exclusive approval, the
subsequent drug would not itself be
eligible for approval, because it is the
same drug as the drug with exclusive
approval. If the approved drug does not
have exclusive approval, the subsequent
drug may be approved, but would not
itself be eligible for orphan-drug
exclusive approval.
As described in § 316.3(b)(3)(i) and
(b)(3)(ii), a drug that is otherwise the
same drug as a previously approved
drug, and for which a clear showing of
greater effectiveness or greater safety has
not been made, may still be considered
clinically superior within the meaning
of § 316.3(b)(3)(iii) if it makes a major
contribution to patient care. FDA
believes that such clinical superiority is
meaningful only when the subsequent
drug provides safety or effectiveness
comparable to the approved drug. For
example, to claim that a drug makes a
major contribution to patient care
through a new formulation or a different
route of administration, the sponsor
must also address whether the change
renders the drug less safe or less
effective than the approved drug. For
these reasons, FDA proposes that
§ 316.3(b)(3)(iii) be revised.
E. Name of the Drug
As provided in § 316.20(b)(2),
requests for orphan designation must
include the generic and trade name, if
any, of the drug. For some products,
however, neither a generic, nor trade
name may be available, for example, for
some large and complicated biological
products or for any molecule for which
the sponsor has not yet obtained a trade
name. FDA is proposing to revise
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§ 316.20(b)(2) so that, if neither such
name is available, requests for
designation include a chemical name or
a meaningful descriptive name (i.e., one
that would be meaningful to the public
if published). By providing such
information in the request for
designation, sponsors would help
ensure that the name that FDA
ultimately publishes under § 316.28
upon designation of the product is
accurate and meaningful.
F. Required Drug Description and
Scientific Rationale in a Request for
Orphan-Drug Designation
FDA needs adequate information on
the drug to conduct the review of a
request for orphan-drug designation.
The identity of the active moiety or
principal molecular structural features
is of particular importance because such
information is critical in determining
whether various drugs are the same
within the meaning of § 316.3(b)(13).
FDA notes that a number of sponsors
have omitted such information in their
designation requests. Without such
information, FDA cannot determine
whether the drug is the same as one
already approved and so cannot render
a decision on the request.
FDA further notes that some sponsors
have included in their designation
requests only theories, unsupported by
data, as to why the drug may be used
in a particular disease or condition,
which does not constitute an adequate
scientific rationale for the use of the
drug for the rare disease or condition.
Other sponsors, by contrast, have
included all available data about a drug,
rather than just the data pertinent to
demonstrating a scientific rationale to
establish a medically plausible basis for
the use of the drug for the rare disease
or condition. Among the data pertinent
to a request that should be included are
in vitro data, preclinical efficacy data of
the drug from studies conducted in a
relevant animal model for the human
disease or condition, and clinical data
from use of the drug in the rare disease
or condition. Animal toxicology studies
are generally not relevant to a request
for orphan-drug designation. To ensure
that an adequate drug description and
scientific rationale are provided in a
request, along with the necessary
supporting data (whether positive,
negative, or inconclusive), FDA
proposes to revise § 316.20(b)(4).
G. Removal of Requirement To Submit
Statement as to Whether Sponsor
Submitting the Request Is the Real Party
in Interest
FDA regulations at § 316.20(b)(9)
currently require that requests for
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orphan-drug designations include a
statement as to whether the sponsor
submitting the request is the real party
in interest of the development and the
intended or actual production and sales
of the product. FDA is proposing to
remove this requirement because it has
proven to be of marginal if any utility
in applications, has caused confusion
for sponsors, and has had the effect of
discouraging agents of sponsors (e.g., a
sponsor’s lawyer) from submitting
requests on the sponsor’s behalf.
Accordingly, FDA proposes to remove
§ 316.20(b)(9).
srobinson on DSK4SPTVN1PROD with PROPOSALS
H. Timing of Request for Orphan-Drug
Designation
FDA regulations at § 316.23(a) state
that a sponsor may request orphan-drug
designation at any time in the drug
development process prior to the
submission of a marketing application
for the drug product for the orphan
indication. FDA is aware that this
language has been the subject of
different interpretations by sponsors. To
clarify the requirements regarding the
timing of a designation request, FDA
proposes to revise § 316.23(a) to indicate
that a sponsor may request orphan-drug
designation at any time in its drug
development process prior to the time
that sponsor submits a marketing
application for the drug for the rare
disease or condition. This is intended to
clarify that a sponsor may not submit an
orphan-drug designation request after it
has submitted a marketing application
for the drug for that use. This revision
is also intended to clarify that
submission by a sponsor of a marketing
application for the drug for the orphan
indication does not prevent another
sponsor from submitting a request for
orphan designation of the same drug for
the same orphan use. Permitting
designation of the subsequent drug in
this situation, where there is no
certainty that the previous marketing
application will be approved promptly,
if at all, would be consistent with the
purpose of the Orphan Drug Act to
provide incentives to develop and
obtain approval for promising drugs for
rare diseases or conditions. Once any
sponsor’s marketing application for the
orphan indication has been approved,
with or without orphan exclusive
approval, another sponsor may not
obtain orphan-drug designation for the
same drug and the same orphan
indication or use for which the approval
was granted absent a plausible
hypothesis of clinical superiority.
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I. Responding to a Deficiency Letter
From FDA on an Orphan-Drug
Designation Request
FDA regulations are currently silent
on when sponsors must respond to a
deficiency letter from FDA on an
orphan-drug designation request. FDA
sends such deficiency letters when a
request lacks necessary information or
contains inaccurate information, for
example, a miscalculated prevalence
estimate. FDA has observed that some
sponsors respond promptly to such
deficiency letters, providing the
requested information, whereas other
sponsors may take several years or more
to respond without sending any interim
communication to FDA. In FDA’s
experience, when a period of several
years or more elapses between the
sponsor’s initial request and the
sponsor’s deficiency response, the very
basis for the orphan request may no
longer hold in some circumstances. One
example is if the initial request lacks an
accurate prevalence estimate and the
sponsor takes several years or more to
submit a revised prevalence estimate
keyed to the time of submission of the
initial request, several years prior. In
some circumstances, the actual
prevalence for the disease or condition
in question may have grown in the
intervening years to exceed the
prevalence limit of under 200,000.
Because orphan designation eligibility
in terms of prevalence is evaluated at
the time of the submission of the request
(see § 316.21(b)), the drug may be
granted orphan-drug designation despite
this prevalence increase, without any
justification that there is no reasonable
expectation of cost recovery (see
§§ 316.20(b)(8)(ii) and 316.21(c)). FDA
believes that such designations may be
inconsistent with the purpose of the
Orphan Drug Act, to provide incentives
for the development of drugs for ‘‘rare
diseases or conditions’’ as defined in
section 526 of the Federal Food, Drug,
and Cosmetic Act (FD&C Act) (21 U.S.C.
360bb).
To address this issue, FDA is
proposing to require that sponsors
respond to a deficiency letter within 1
year after issuance of the letter, unless
within that timeframe the sponsor
requests in writing an extension of time
to respond. Such a request would
specify both the reason(s) for the
requested extension and the length of
time of the requested extension. FDA
will grant all reasonable requests for an
extension. In some cases, FDA may
grant a repeat request for an extension
if, before expiration of the deadline as
originally extended, the sponsor
submits a new extension request, stating
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both the reason(s) for the request and
the requested length of time of the
extension.
In the event the sponsor fails to
respond to the deficiency letter or to
request an extension of time within a
year, FDA may consider the designation
request voluntarily withdrawn at the
conclusion of the 1-year period, unless
notified sooner by the sponsor that the
request is withdrawn. FDA encourages
sponsors to notify the Agency as soon as
possible after receipt of a deficiency
letter in the event the sponsor decides
not to pursue the designation request.
Should FDA deny a request for an
extension of time, FDA may likewise
consider the designation request
voluntarily withdrawn and will so
notify the sponsor in writing.
In FDA’s experience, some
deficiencies may be less suitable to
extension requests than others. For
example, FDA generally expects that
deficiencies involving an inaccurate or
incomplete prevalence estimate will be
readily addressed within 1 year. Other
types of deficiencies, however, may take
longer to address. For example,
deficiencies involving the scientific or
medical rationale supporting a
designation request for only a subset of
persons with a particular disease or
condition may require sponsors to
conduct research and develop
additional data, which may take several
years or more. For the latter types of
deficiencies, FDA generally anticipates
granting extension requests to allow
sponsors to develop necessary
supporting data and information.
To implement this policy, FDA
proposes to add new language to
§ 316.24(a). FDA proposes to change the
title of this section to, ‘‘Deficiency
letters and granting orphan-drug
designation.’’ The existing paragraphs
(a) and (b) would be redesignated (b)
and (c), respectively.
J. Publication of Orphan-Drug
Designations
Section 316.28 requires that FDA
publish a monthly updated list of
designated drugs in addition to placing
on file at the FDA Division of Dockets
Management an annual cumulative list
of all designated drugs. FDA currently
makes available a cumulative list of all
designated drugs to date and a
cumulative list of designated drugs in
the current year on its Web site at http:
//www.fda.gov/orphan/. These lists are
updated monthly.
To identify a drug in these lists and
in the docket, FDA publishes its generic
name and trade name, if any. If neither
name is available, FDA publishes the
chemical name or a meaningful
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descriptive name of the drug (i.e., a
name that would be meaningful to the
public). Internal business codes or other
similar identifiers do not suffice for
publication purposes, because they do
not provide meaningful notice to the
public of a designation. The Orphan
Drug Act requires that notice respecting
designation of a drug be made available
to the public (section 526(c) of the FD&C
Act). Ensuring that notice is meaningful,
such that patients, health care
providers, sponsors, and other
stakeholders can identify which drug
has been designated as an orphan drug,
accords with both the language and the
purpose of this statutory provision.2
FDA proposes to revise § 316.28 to
reflect FDA’s existing publication
practices.
The presence of a drug on the list of
designated drugs does not necessarily
mean the sponsor is actively developing
the drug for the orphan disease or
indication. Holders of orphan-drug
designations are required by § 316.30 to
submit an annual progress report on
their designated drugs. It has been the
Agency’s experience that a number of
holders of orphan-drug designations
have failed to submit annual reports as
required for the designated drug, and
some have terminated their orphan-drug
development program without notifying
FDA. The Agency is considering ways to
make available to the public information
about the status of development for
designated orphan drugs, including
whether to provide information to the
public on whether a sponsor has
submitted the required annual reports.
Although the failure of a sponsor to
submit an annual report does not
necessarily signal that the sponsor has
ceased development of the orphan drug,
this information could nevertheless
prove useful to patients, medical
practitioners, and the drug development
community, who may wish to obtain
additional information regarding the
status of drug development from the
sponsor of the designated drug.
Whether FDA will need to consider
making additional information about
designated drugs available through, for
example, publishing the status of annual
report submissions will depend in part
on the effect of recent and pending
changes in the availability of
information about clinical trials of
drugs. It is possible that expansion of
the public availability of clinical trial
2 In enacting and later amending the Orphan Drug
Act, Congress emphasized the importance of
effective public dissemination of orphan
designation and the need for certainty about an
orphan drug’s potential for exclusivity (see H.R.
Rep. No. 97–840, at 9 (1982), and H.R. Rep. No.
100–473, at 5–6 (1987)).
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information under section 801 of the
Food and Drug Administration
Amendments Act of 2007 (Pub. L. 110–
85) will provide the public additional
useful information on whether trials of
a designated drug are being undertaken
for the orphan indication. The
information derived from this clinical
trials database may be as useful, or even
more useful, to patients and other
interested parties as would information
on whether a sponsor had submitted an
annual report as required.
We are seeking comment on whether
it would be useful for the Agency to
make public information about whether
the sponsor of a designated drug has
submitted annual reports as required
under § 316.30. The Agency does not
contemplate disclosing the contents of
the annual report, only whether such
annual report has been submitted.
K. FDA Recognition of Orphan-Drug
Exclusive Approval
Under existing Agency practice, FDA
does not recognize orphan-drug
exclusive approval if the drug is
otherwise the same drug as one already
approved and the sponsor fails to
substantiate, in the application for
marketing approval, the hypothesis of
clinical superiority over the previously
approved drug that formed the basis for
designation. To clarify existing practice,
FDA proposes to add new language to
§ 316.34(c).
L. Miscellaneous Terminology Changes
FDA proposes to revise the following
terms throughout part 316 for the sake
of precision and internal consistency, so
that each term is used consistently
throughout this part: ‘‘drug product’’
versus ‘‘drug,’’ and ‘‘indication’’ and
‘‘indicated’’ versus ‘‘designation,’’
‘‘use,’’ ‘‘developed,’’ and ‘‘disease or
condition.’’
M. Address Change
FDA proposes to update the address
in § 316.4 to ‘‘Office of Orphan Products
Development, Food and Drug
Administration, 10903 New Hampshire
Ave., Bldg. 32, Rm. 5271, Silver Spring,
MD 20993.’’
III. Environmental Impact
FDA has determined under 21 CFR
25.30(h) and 25.31(a) 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.
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IV. Legal Authority
FDA is proposing this rule under the
authority granted it by the Orphan Drug
Act (Pub. L. 97–414). In enacting the
Orphan Drug Act, Congress required
FDA to issue regulations for the
implementation of sections 525 and 526
of the FD&C Act (21 U.S.C. 360aa and
360bb), relating to written FDA
recommendations on studies required
for approval of marketing applications
of orphan drugs and for the designation
of eligible drugs as orphan drugs. In the
Federal Register of December 29, 1992
(57 FR 62076) (1992 final rule), FDA
issued a final rule for the
implementation of these sections as well
as for the implementation of sections
527 and 528 of the FD&C Act (21 U.S.C.
360cc and 360dd), relating to exclusive
marketing for orphan drugs and the
encouragement of sponsors to make
orphan drugs available for treatment on
an ‘‘open protocol’’ basis before the drug
has been approved for general
marketing. Any final rule based on this
proposed rule would clarify regulatory
provisions in the 1992 final rule and
make minor improvements to address
issues that have arisen since that rule
took effect.
A final rule based on this proposal
would further the main purpose of the
Orphan Drug Act to provide incentives
to develop promising drugs for rare
diseases or conditions that would
otherwise not be developed and
approved. It would do so in several
ways: By enhancing clarity for sponsors
in seeking orphan-drug designations
and orphan-drug exclusive marketing
approval; by providing an important
incentive for one or more sponsors to
develop, or to continue to develop, a
potentially promising drug for use in all
persons affected by a rare disease or
condition, rather than in just a subset of
that orphan population, even after the
drug has been approved for a different
subset of the population with the
disease or condition; and by helping
ensure that the orphan designation
request, at the time it is granted, is
consistent with the purpose of the
Orphan Drug Act despite a lapse of time
between the date of submission of the
initial request and a sponsor’s response
to a deficiency letter from FDA.
An additional source of authority for
this proposed rule is section 701 of the
FD&C Act (21 U.S.C. 371). Under this
section, FDA is authorized to issue
regulations for the efficient enforcement
of the FD&C Act. Any final rule based
on this proposed rule would help the
efficient enforcement of the Orphan
Drug Act provisions by enhancing
clarity and certainty in FDA’s
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administration of the orphan drug
program.
V. Proposed Implementation Plan
FDA proposes that these regulatory
changes, where applicable, would
become effective 30 days after the date
of publication of the final rule. The final
rule would apply only to original
orphan-designation requests submitted
on or after the effective date of the final
rule. It would not apply to the
following: (1) Amendments submitted
on or after the effective date regarding
previously submitted designation
requests, or (2) responses to deficiency
letters submitted on or after the effective
date regarding previously submitted
requests. As proposed here, the final
rule would have no effect on the scope
of or eligibility for orphan-drug
exclusive approval because it merely
clarifies existing FDA practice.
srobinson on DSK4SPTVN1PROD with PROPOSALS
VI. Executive Order 13132: Federalism
FDA has analyzed this proposed rule
in accordance with the principles set
forth in Executive Order 13132. FDA
has determined that the proposed rule,
if finalized, would not contain policies
that have substantial direct effects on
the States, on the relationship between
the National Government and the States,
or on the distribution of power and
responsibilities among the various
levels of government. Accordingly, the
Agency tentatively concludes that the
rule does not contain policies that have
federalism implications as defined in
the Executive order and, consequently,
a federalism summary impact statement
is not required.
VII. Paperwork Reduction Act of 1995
This proposed rule contains
information collection provisions that
are subject to review by the Office of
Management and Budget (OMB) under
the Paperwork Reduction Act of 1995
(44 U.S.C. 3501–3520). A description of
these provisions is given in the
Description section of this document an
estimate of the annual reporting 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.
FDA invites comments on these
topics: (1) Whether the proposed
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collection of information is necessary
for the proper performance of FDA’s
functions, including whether the
information will have practical utility;
(2) the accuracy of FDA’s estimate of the
burden of the proposed collection of
information, including the validity of
the methodology and assumptions used;
(3) ways to enhance the quality, utility,
and clarity of the information to be
collected; and (4) ways to minimize the
burden of the collection of information
on respondents, including through the
use of automated collection techniques
and other forms of information
technology, when appropriate.
Title: Orphan Drug Regulations.
Description: FDA is proposing to
amend its regulations on orphan-drug
designation requests to clarify policy
and make minor improvements. The
proposed revisions are intended to
assist sponsors who are seeking and
who have obtained orphan-drug
designations, as well as FDA in its
administration of the orphan drug
program.
One proposed revision is a
requirement that sponsors include in
requests a chemical or meaningful
descriptive name of the drug, if neither
a trade name nor a generic name is
available. By providing such
information in the request for
designation, sponsors would help
ensure that the name that FDA
ultimately publishes under § 316.28
upon designation of the product is
accurate and meaningful to the public.
Because sponsors are already required
to include a description of the drug in
requests for designation, the proposed
requirement to include a chemical or
meaningful descriptive name is not
expected to require much additional
time or effort from sponsors.
Based on historical data concerning
the number of designation requests for
which neither a trade name nor a
generic name for the drug is available,
FDA expects that about 20 requests per
year would be affected by this
requirement. FDA estimates that it will
take approximately 0.2 hours, or 12
minutes, for sponsors to submit this
information. This estimate reflects both
the length of time likely required to
submit the chemical name of the drug
(less than 0.2 hours) and the length of
time likely required to submit a
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meaningful descriptive name if a
chemical name is not readily available
(more than 0.2 hours).
Another proposed revision is a
requirement that sponsors respond to
deficiency letters from FDA on
designation requests within 1 year of
issuance of the deficiency letter, unless
within that timeframe the sponsor
requests in writing an extension of time
to respond. FDA will grant all
reasonable requests for an extension. In
the event the sponsor fails to respond to
the deficiency or request an extension of
time to respond within the 1-year
timeframe, FDA may consider the
designation request voluntarily
withdrawn.
FDA believes this proposal is
necessary to ensure that designation
requests do not become ‘‘stale’’ by the
time they are granted, such that the
basis for the initial request may no
longer hold. Granting such designations
despite a lapse of years and change in
factual circumstances concerning the
disease or condition in question may
not serve the primary purpose of the
Orphan Drug Act to provide incentives
for the development of drug products
for ‘‘rare diseases or conditions’’ as
defined in section 526 of the FD&C Act.
Based on historical data concerning
the number of deficiency letters that
FDA has sent and the number of
sponsors who have taken longer than a
year to respond, FDA estimates that it
will receive approximately 10 written
requests each year for an extension of
time to respond. This number is likely
an overestimate, because it is based on
historical data in the absence of any
regulatory deadline for sponsors to
respond; FDA believes that at least some
of the sponsors who have taken longer
than a year to respond have been
capable of responding earlier, but did
not do so because they did not need to.
FDA estimates that it will take
approximately 2 hours to prepare and
submit each extension request,
including time to develop and articulate
a rationale for the requested extension
and to obtain internal approval of the
request before submission to FDA.
Description of Respondents: Persons
and businesses, including small
businesses and manufacturers.
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64875
TABLE 1—ESTIMATED ANNUAL REPORTING BURDEN 1
Number of
Respondents
21 CFR Section
Number of
Responses
per
Respondent
Total Annual
Responses
316.20(b)(2) .........................................................................
20
1
20
316.24(a) ..............................................................................
10
1
Total Burden Hours ......................................................
........................
........................
1 There
Total Hours
10
0.2
(12 minutes)
2
4
20
........................
........................
24
are no capital costs or operating and maintenance costs associated with this collection of information.
Except with respect to the proposed
revisions addressed in table 1 of this
document, the revisions in this
proposed rule clarify existing regulatory
language and do not constitute a
substantive or material modification to
the approved collections of information
in current part 316 (Cf. 5 CFR 1320.5(g)).
The collections of information in
current part 316 have been approved by
OMB in accordance with the Paperwork
Reduction Act of 1995 (44 U.S.C. 3501–
3520), under OMB control number
0910–0167.
To ensure that comments on
information collection are received,
OMB recommends that written
comments be faxed to the Office of
Information and Regulatory Affairs,
OMB, Attn: FDA Desk Officer, FAX:
202–395–6974, or e-mailed to
oira_submission@omb.eop.gov. All
comments should be identified with the
title ‘‘Orphan Drug Regulations.’’
In compliance with the Paperwork
Reduction Act of 1995 (44 U.S.C.
3407(d)), the Agency has submitted the
information collection provisions of this
proposed rule to OMB for review. These
requirements will not be effective until
FDA obtains OMB approval. FDA will
publish a notice concerning OMB
approval of these requirements in the
Federal Register.
srobinson on DSK4SPTVN1PROD with PROPOSALS
Average
Burden per
Response
VIII. Analysis of Impacts
FDA has examined the impacts of the
proposed rule under Executive Order
12866, Executive Order 13563, the
Regulatory Flexibility Act (5 U.S.C.
601–612), and the Unfunded Mandates
Reform Act of 1995 (Pub. L. 104–4).
Executive Orders 12866 and 13563
direct 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 proposed rule is not a
significant regulatory action as defined
by Executive Order 12866.
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The Regulatory Flexibility Act
requires Agencies to analyze regulatory
options that would minimize any
significant impact of a rule on small
entities. Because this proposed rule
primarily clarifies current practice and
any costs would be very small, the
Agency proposes to certify 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 1 year.’’
The current threshold after adjustment
for inflation is $136 million, using the
most current (2010) Implicit Price
Deflator for the Gross Domestic Product.
FDA does not expect this proposed rule
to result in any 1-year expenditure that
would meet or exceed this amount.
A. Background
Our experience with orphan-drug
designation requests over many years
has led us to conclude that sponsors are
confused by some portions of the
current regulatory language. The Agency
receives dozens of requests for orphandrug designation each year that are
deficient in some way that would
prevent designation. We observe the
same types of deficiencies suggesting
some problematic areas in our
regulations.
Of the 324 requests for orphan-drug
designation we received in 2010, 124
were denied or placed in abeyance so
that the sponsor could submit
additional material to respond to the
deficiencies. Of these, 79 were deficient
because they did not identify an
appropriate ‘‘medically plausible
subset’’ of a population with a non-rare
disease or condition. That nearly a
quarter of the designation requests were
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Fmt 4702
Sfmt 4702
deficient in the subset analysis, and that
problems with population subsets
constituted over half of the deficiencies,
highlights the need to clarify existing
regulatory language regarding subsets.
The confusion about regulatory
language is not limited to issues
regarding population subsets. Many
designation requests are deficient
because the submitted drug description
is not adequate to establish whether the
drug is the same as one that has already
been approved. There are continuing
problems with requests for drugs that
are in fact the same as drugs already
approved but lack necessary
information regarding clinical
superiority. Other requests lack the data
to support the scientific rationale for the
use of the drug in a rare disease or
condition. Addressing these deficiencies
and resolving sponsor inquiries
consumes sponsor and FDA resources
and extends the orphan-drug
designation process. The process would
be less costly to sponsors and FDA if
sponsors had an authoritative source of
information about basic program
requirements.
Basic program requirements are part
of Federal regulation; clarifying
regulatory language to reduce costly
confusion would have to be done
through rulemaking at the Federal level.
This proposed rule would clarify
regulatory language to reduce sponsor
and FDA costs and streamline the
orphan-drug designation process.
B. Benefits and Costs of the Proposed
Rule
This proposed rule would reduce
costs to sponsors who might otherwise
submit deficient orphan-drug
designation requests or face additional
costs to determine program
requirements. It would benefit sponsors
and promote public health by clarifying
requirements for sponsors who would
otherwise be discouraged from
submitting designation requests when
their drug is in fact eligible for orphandrug designation. The proposed rule
would also reduce costs to FDA of
responding to sponsor inquiries and
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deficient designation requests. There
would be small costs associated with
the requirement that sponsors either
respond to deficiency letters within a
year or obtain an extension of time to
respond. The proposed rule has several
elements, which we address in the order
presented earlier in this document.
We propose to clarify what
population or disease subsets may be
eligible for orphan-drug designation
(§ 316.20(b)(6)). This action merely
clarifies longstanding policy but should
reduce uncertainty about the
requirements for orphan-drug
designation and result in fewer requests
that cannot be designated. With the
improved information about
requirements for establishing
population subsets, some sponsors may
realize that their drug is not eligible for
orphan designation and they would save
the cost they would have otherwise
incurred submitting a request. FDA has
recently estimated a burden of 150
hours to complete a designation request
(76 FR 3910 at 3911, January 21, 2011).
At a benefit-adjusted hourly wage of
about $46 for a regulatory affairs official,
sponsors who do not submit a request
that cannot be granted would avoid
$6,900 in labor costs.3 Under this
proposed rule, other sponsors would
avoid the cost they would have
otherwise incurred addressing the
subset deficiency. We do not have a
precise estimate of the time required to
respond to a deficiency letter; using 40
hours as a rough estimate implies
$1,840 in avoided labor costs. We do not
possess a reliable estimate for the
number of avoided deficiency letters,
but assuming FDA receives 79 subsetdeficient requests each year and onehalf would not occur with the clarified
regulatory language, sponsors would
avoid $72,680 in additional labor costs.
FDA would also avoid costs from
responding to these requests.
It is longstanding FDA policy that a
designation request for a drug that is
otherwise the same as a drug previously
approved for the same disease or
condition must include a plausible
hypothesis of clinical superiority,
regardless of whether the already
approved drug was designated as an
orphan. FDA continues to receive
requests that cannot be designated
because this policy is not explicit in
current regulation. This proposed rule
3 2010 National Industry-Specific Occupational
Employment and Wage Estimates, U.S. Department
of Labor Statistics, last modified May 17, 2011
(https://www.bls.gov/oes/current/
naics4_325400.htm); mean compliance officer wage
rate of $35.28 for pharmaceutical and medicine
manufacturing (NAICS 325400) plus a 30-percent
increase for benefits.
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would make this policy explicit,
reducing costs to sponsors and FDA by
reducing the number of deficient
orphan-drug designation requests.
FDA’s longstanding practice has been
that if a drug is approved for only a
subset of patients with a rare disease or
condition, FDA may grant orphan-drug
designation and orphan-drug exclusive
approval for use of the drug in one or
more of the remaining subsets of
patients with the rare disease or
condition. Current § 316.31 does not
explicitly mention subsets, which could
deter confused sponsors from pursuing
designation for use of the drug in
remaining subsets for which the drug
has not yet been approved. Clarifying
this provision would not change Agency
policy but would benefit sponsors and
public health by reducing the risk of a
sponsor failing to pursue designation
when it would otherwise do so.
We propose to clarify the definition of
clinical superiority to make explicit that
a drug shown to be clinically superior
to an approved drug for making a major
contribution to patient care would also
have to be demonstrated to provide
safety and effectiveness comparable to
the approved drug (§ 316.3(b)(3)(iii)).
This revision is consistent with
longstanding policy and would impose
no new costs. Benefits from a minor
clarification to a requirement that
applies only under unusual
circumstances would be too small to
reliably estimate.
We propose to modify and clarify our
requirements for the drug name. Current
regulations require the sponsor to
submit the generic and trade name of
the drug, but do not specify how to
name a drug for which there is no
generic name or trade name. In the past,
sponsors have provided FDA with their
internal business codes, which are
meaningless to the general public. We
propose to require that a drug that has
neither a generic nor a trade name be
identified according to its chemical
name or a meaningful descriptive name
(i.e., one that would be meaningful to
the public if published). Descriptive
names are readily accessible to the
sponsor and could be included in a
designation request as easily as an
internal business code and any costs
would be too small to meaningfully
quantify.
We propose to clarify our
requirements for the drug description
and for the data to support a drug’s
scientific rationale in an orphan-drug
designation request. Some requests for
orphan-drug designation cannot be
acted upon because the drug
descriptions are not adequate to
determine whether the drug in the
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Sfmt 4702
submission is the same as a previously
approved drug. This proposed rule
would clarify the required drug
description in § 316.20(b)(4), reducing
the frequency of deficient requests.
Some requests lack the data to support
a scientific rationale, while others
include substantial additional data not
needed to obtain designation. In both
situations, sponsors incur costs that
could be avoided with clearer
requirements. We do not know the
frequency of these data problems nor do
we know the costs associated with
them, but this proposal would reduce
sponsor and FDA costs.
We propose to eliminate
§ 316.20(b)(9), which requires that the
sponsor submitting the request state
whether it is the real party in interest of
the development and the intended or
actual production and sales of the
product. This provision merely obtains
information from the sponsor; it does
not provide a basis to disqualify any
entity from pursuing orphan-drug
designation. There is no known use for
the information and it is our
understanding that this provision may
be discouraging sponsors from using
agents to submit requests on their
behalf, potentially increasing the cost to
obtain orphan-drug designation. We do
not possess a reliable estimate for this
cost. Eliminating this provision would
clarify our longstanding policy to accept
submissions from agents, which may
reduce sponsor costs. Halting the
collection of information for which
there is no known purpose would not
negatively impact public health.
We propose to clarify the requirement
regarding the timing of orphan-drug
designation requests (§ 316.23(a)). A
sponsor may not submit an orphan-drug
designation request after it has
submitted a marketing application for
the drug for that use. It is not clear in
the current regulatory language that one
sponsor’s marketing application would
not prevent a different sponsor from
submitting a request for orphan
designation for the same drug for the
same orphan use and that this
subsequent sponsor would not have to
submit a plausible hypothesis of clinical
superiority. Clarifying current policy
would benefit sponsors and public
health by reducing the likelihood of a
confused sponsor failing to seek orphandrug designation for an eligible product.
We propose a 1-year time limit for
sponsors to respond to deficiency letters
or obtain a time extension (§ 316.24(a)).
Based on our experience with the time
required to address particular
submission deficiencies and the
observed variation in time for sponsors
to respond, some submission requests
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do not appear to be part of an active
effort to obtain orphan-drug designation.
We know of no public health benefit
from open inactive designation requests.
We do not know if they exist because
sponsors gain nothing from the cost of
formally withdrawing a request or
because there may be a strategic
advantage to an inactive request for
designation. Current regulations do not
impose time limits on sponsors replying
to FDA deficiency letters and we have
no mechanism to encourage sponsors to
continue to actively pursue designation.
Sponsors who would otherwise respond
to a deficiency letter within 1 year
would be unaffected by this proposal.
Sponsors actively pursuing designation
but needing more than 1 year to respond
to a deficiency letter would be expected
to submit a time extension request to
FDA. We assume approval for all
extension requests from sponsors
actively pursuing orphan-drug
designation and estimate a request
would require 2 hours of time from a
regulatory affairs specialist. At a benefitadjusted hourly wage of $46, the cost to
submit an extension request is $92.
Based on our experience with
deficiency letters and the frequency of
responses requiring more than 1 year,
we estimate 10 requests for additional
time each year. The estimated annual
cost of this provision is $920. We
assume sponsors not actively pursuing
designation would not obtain extensions
and their requests would be considered
to be withdrawn 1 year after the
deficiency letter. We do not possess a
reliable estimate of the number of
designation requests that would be
withdrawn under this proposal.
Withdrawing inactive designation
requests would improve information
about potential future orphan drugs,
which would be beneficial to potential
sponsors and to the general public.
There is at least a potential for a cost to
some sponsors, as we cannot rule out
the possibility of some small advantage
to holding an inactive designation
request. Nevertheless, we estimate the
cost of a withdrawal in this case to be
very small and to be extremely small
relative to the benefits of improved
public information and the streamlined
orphan-drug designation process.
According to longstanding policy,
FDA does not recognize orphan-drug
exclusive approval when the sponsor of
a drug that is otherwise the same as a
drug already approved fails to
demonstrate clinical superiority in its
marketing application. We propose to
make this policy explicit by adding
proposed § 316.34(c). This clarification
applies to a rare set of circumstances
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and benefits would be too small to
reliably estimate.
We do not possess a single bottom
line estimate for the total monetized
benefit of this proposed rule. Avoiding
half of the designation requests that are
deficient because of problems
establishing population subsets would
save sponsors an estimated $73,000
annually. Subset problems account for
more than half of all deficiencies, so we
estimate the other clarifications to
reduce deficient requests would reduce
sponsor costs by an additional amount
less than $73,000. The total estimated
cost of this proposed rule is an annual
$920, attributable to the submission of
requests for additional time to respond
to deficiency letters.
C. Small Business Analysis
This proposed rule would apply to
the sponsors of orphan-drug designation
requests. According to the Table of
Small Business Size Standards, the U.S.
Small Business Administration (SBA)
considers pharmaceutical preparation
manufacturing entities (NAICS 325412)
with 750 or fewer employees and
biological product (except diagnostic)
manufacturing entities (NAICS 325414)
with 500 or fewer employees to be
small.4 According to the 2007 Economic
Census, annual shipments for the 284
establishments in NAICS 325412 with 0
to 4 employees are $240 million, which
is $840,000 per establishment. Total
annual shipments for the 250
establishments in NAICS 325414 with 0
to 49 employees (the smallest group
with value of shipment data) are $720
million, which is $2.9 million per
establishment.
Most of the provisions of this
proposed rule would clarify regulatory
language consistent with current
practice, imposing no new costs. The
proposal to create a 1-year time limit to
respond to FDA deficiency letters would
result in estimated costs of $92 per
extension request. Costs from the
withdrawal of inactive submissions
would be too small to reliably quantify.
A common threshold for determining a
significant impact is 1 percent of annual
shipments. Because the estimated cost
of this proposed rule would be
approximately 1/100 of 1 percent of
annual shipments for the smallest
affected establishments, we conclude
this proposed rule, if finalized, would
not constitute a significant impact on a
substantial number of small entities.
4 U.S. Small Business Administration, ‘‘Table of
Small Business Size Standards Matched to North
American Industry Classification System Codes,’’
November 5, 2010, https://www.sba.gov/sites/
default/files/Size_Standards_Table.pdf.
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IX. Request for Comments
Interested persons may submit to the
Division of Dockets Management (see
ADDRESSES) either electronic or written
comments regarding this document. As
noted previously in this document, if
you have comments on specific
provisions of the proposed regulation,
we request that you identify these
provisions in your comments. In
addition, if you have concerns that
would be addressed by alternative text
for the regulation, we request that you
provide this alternative text in your
comments. It is only necessary to send
one set of comments. It is no longer
necessary to send two copies of mailed
comments. Identify comments with the
docket number found in brackets in the
heading of this document. Received
comments may be seen in the Division
of Dockets Management between 9 a.m.
and 4 p.m., Monday through Friday.
List of Subjects in 21 CFR Part 316
Administrative practice and
procedure, Drugs, Investigations,
Medical research, Orphan drugs,
Reporting and recordkeeping
requirements.
Therefore, under the Federal Food,
Drug, and Cosmetic Act and under
authority delegated to the Commissioner
of Food and Drugs, 21 CFR part 316 is
proposed to be amended as follows:
PART 316—ORPHAN DRUGS
1. The authority citation for 21 CFR
part 316 continues to read as follows:
Authority: 21 U.S.C. 360aa, 360bb, 360cc,
360dd, 371.
2. Section 316.1 is amended by
revising paragraphs (a)(1)(iii) and (a)(2)
to read as follows:
§ 316.1
Scope of this part.
(a) * * *
(1) * * *
(iii) Requests for gaining exclusive
approval for a drug for a rare disease or
condition.
(2) Allowing a sponsor to provide an
investigational drug under a treatment
protocol to patients who need the drug
for treatment of a rare disease or
condition.
*
*
*
*
*
3. Section 316.3 is amended by
revising paragraphs (b)(3) introductory
text, (b)(3)(i), (b)(3)(iii), and (b)(12) to
read as follows:
§ 316.3
Definitions.
*
*
*
*
*
(b) * * *
(3) Clinically superior means that a
drug is shown to provide a significant
therapeutic advantage over and above
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that provided by an approved drug (that
is otherwise the same drug) in one or
more of the following ways:
(i) Greater effectiveness than an
approved drug (as assessed by effect on
a clinically meaningful endpoint in
adequate and well controlled clinical
trials). Generally, this would represent
the same kind of evidence needed to
support a comparative effectiveness
claim for two different drugs; in most
cases, direct comparative clinical trials
would be necessary; or
*
*
*
*
*
(iii) In unusual cases, where neither
greater safety nor greater effectiveness
has been shown, a demonstration that
the drug provides safety and
effectiveness comparable to the
approved drug and otherwise makes a
major contribution to patient care.
*
*
*
*
*
(12) Orphan-drug exclusive approval
or exclusive approval means that,
effective on the date of FDA approval as
stated in the approval letter of a
marketing application for a sponsor of a
designated orphan drug, no approval
will be given to a subsequent sponsor of
the same drug for the same use for 7
years, except as otherwise provided by
law or in this part.
*
*
*
*
*
4. Section 316.4 is revised to read as
follows:
§ 316.4
Address for submissions.
All correspondence and requests for
FDA action pursuant to the provisions
of this rule should be addressed as
follows: Office of Orphan Products
Development, Food and Drug
Administration, 10903 New Hampshire
Ave., Bldg. 32, rm. 5271, Silver Spring,
MD 20993.
5. Section 316.20 is amended by
revising paragraphs (a), (b)(2) through
(b)(6), and by removing paragraph (b)(9),
to read as follows:
srobinson on DSK4SPTVN1PROD with PROPOSALS
§ 316.20 Content and format of a request
for orphan-drug designation.
(a) A sponsor that submits a request
for orphan-drug designation of a drug
for a specified rare disease or condition
shall submit each request in the form
and containing the information required
in paragraph (b) of this section. A
sponsor may request orphan-drug
designation of a previously unapproved
drug, or of a new use for an already
marketed drug. In addition, a sponsor of
a drug that is otherwise the same drug
as an already approved drug may seek
and obtain orphan-drug designation for
the subsequent drug for the same rare
disease or condition if it can present a
plausible hypothesis that its drug may
be clinically superior to the first drug.
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More than one sponsor may receive
orphan-drug designation of the same
drug for the same rare disease or
condition, but each sponsor seeking
orphan-drug designation must file a
complete request for designation as
provided in paragraph (b) of this
section.
(b) * * *
(2) The name and address of the
sponsor; the name of the sponsor’s
primary contact person and/or resident
agent including title, address, and
telephone number; the generic and trade
name, if any, of the drug, or, if neither
is available, the chemical name or a
meaningful descriptive name of the
drug; and the name and address of the
source of the drug if it is not
manufactured by the sponsor.
(3) A description of the rare disease or
condition for which the drug is being or
will be investigated, the proposed use of
the drug, and the reasons why such
therapy is needed.
(4) A description of the drug, to
include the identity of the active moiety
if it is a drug composed of small
molecules, or of the principal molecular
structural features if it is composed of
macromolecules; its physical and
chemical properties, if these
characteristics can be determined; and a
discussion of the scientific rationale to
establish a medically plausible basis for
the use of the drug for the rare disease
or condition, including all data from in
vitro laboratory studies, preclinical
efficacy studies conducted in an animal
model for the human disease or
condition, and clinical investigations of
the drug in the rare disease or condition
that are available to the sponsor,
whether positive, negative, or
inconclusive. Animal toxicology studies
are generally not relevant to a request
for orphan-drug designation. Copies of
pertinent unpublished and published
papers are also required.
(5) Where the sponsor of a drug that
is otherwise the same drug as an already
approved drug seeks orphan-drug
designation for the subsequent drug for
the same rare disease or condition, an
explanation of why the proposed
variation may be clinically superior to
the first drug.
(6) Where a drug is under
development for only a subset of
persons with a particular disease or
condition that otherwise affects 200,000
or more people, a demonstration that,
due to one or more properties of the
drug, the remaining persons with such
disease or condition would not be
appropriate candidates for use of the
drug.
*
*
*
*
*
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6. Section 316.21 is amended by
revising paragraph (a)(1) and the
introductory text of paragraph (b) to
read as follows:
§ 316.21
status.
Verification of orphan-drug
(a) * * *
(1) Documentation as described in
paragraph (b) of this section that the
number of people affected by the
disease or condition for which the drug
is to be developed is fewer than 200,000
persons; or
*
*
*
*
*
(b) For the purpose of documenting
that the number of people affected by
the disease or condition for which the
drug is to be developed is less than
200,000 persons, ‘‘prevalence’’ is
defined as the number of persons in the
United States who have been diagnosed
as having the disease or condition at the
time of the submission of the request for
orphan-drug designation. To document
the number of persons in the United
States who have the disease or
condition for which the drug is to be
developed, the sponsor shall submit to
FDA evidence showing:
*
*
*
*
*
7. Section 316.23 is revised to read as
follows:
§ 316.23 Timing of requests for orphandrug designation; designation of already
approved drugs.
(a) A sponsor may request orphandrug designation at any time in its drug
development process prior to the time
that sponsor submits a marketing
application for the drug for the same
rare disease or condition.
(b) A sponsor may request orphandrug designation of an already approved
drug for an unapproved use without
regard to whether the prior marketing
approval was for a rare disease or
condition.
8. Section 316.24 is amended by
revising the section heading;
redesignating paragraphs (a) and (b) as
(b) and (c), respectively; and adding a
new paragraph (a), to read as follows:
§ 316.24 Deficiency letters and granting
orphan-drug designation.
(a) FDA will send a deficiency letter
to the sponsor if the request for orphandrug designation lacks information
required under §§ 316.20 and 316.21, or
contains inaccurate or incomplete
information. FDA may consider a
designation request voluntarily
withdrawn if the sponsor fails to
respond to the deficiency letter within
1 year of issuance of the deficiency
letter, unless within that same
timeframe the sponsor requests in
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writing an extension of time to respond.
This request must include the reason(s)
for the requested extension and the
length of time of the requested
extension. FDA will grant all reasonable
requests for an extension. In the event
FDA denies a request for an extension
of time, FDA may consider the
designation request voluntarily
withdrawn and, if so, will notify the
sponsor in writing.
*
*
*
*
*
9. Section 316.25 is amended by
revising paragraphs (a)(1)(ii) and (a)(3)
to read as follows:
§ 316.25 Refusal to grant orphan-drug
designation.
(a) * * *
(1) * * *
(ii) Where the drug is intended for
prevention, diagnosis, or treatment of a
disease or condition affecting 200,000 or
more people in the United States, the
sponsor has failed to demonstrate that
there is no reasonable expectation that
development and production costs will
be recovered from sales of the drug for
such disease or condition in the United
States. A sponsor’s failure to comply
with § 316.21 shall constitute a failure
to make the demonstration required in
this paragraph.
*
*
*
*
*
(3) The drug is otherwise the same
drug as an already approved drug for the
same rare disease or condition and the
sponsor has not submitted a medically
plausible hypothesis for the possible
clinical superiority of the subsequent
drug.
*
*
*
*
*
10. Section 316.26 is revised to read
as follows:
srobinson on DSK4SPTVN1PROD with PROPOSALS
§ 316.26 Amendment to orphan-drug
designation.
(a) At any time prior to approval of a
marketing application for a designated
orphan drug, the sponsor holding
designation may apply for an
amendment to the designated use if the
proposed change is due to new and
unexpected findings in research on the
drug, information arising from FDA
recommendations, or unforeseen
developments in treatment or diagnosis
of the disease or condition.
(b) FDA will grant the amendment if
it finds that the initial designation
request was made in good faith and that
the amendment is intended to conform
the orphan-drug designation to the
results of unanticipated research
findings, to unforeseen developments in
the treatment or diagnosis of the disease
or condition, or to changes based on
FDA recommendations, and that, as of
the date of the submission of the
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amendment request, the amendment
would not result in exceeding the
prevalence or cost recovery thresholds
in § 316.21(a)(1) or (a)(2) upon which
the drug was originally designated.
11. Section 316.28 is revised to read
as follows:
§ 316.28 Publication of orphan-drug
designations.
Each month FDA will update a
publicly available cumulative list of all
drugs designated as orphan drugs. This
list will be made available on the
Agency’s Internet site. In addition, a
cumulative, annually updated list of all
designated drugs will be placed on file
at the FDA Division of Dockets
Management. These lists will contain
the following information:
(a) The name and address of the
sponsor;
(b) The generic name and trade name,
if any, or, if neither is available, the
chemical name or a meaningful
descriptive name of the drug;
(c) The date of the granting of orphandrug designation; and
(d) The designated use in the rare
disease or condition.
12. Section 316.31 is amended by
revising paragraph (a) introductory text,
by redesignating paragraph (b) as
paragraph (c), and by adding new
paragraph (b) to read as follows:
§ 316.31 Scope of orphan-drug exclusive
approval.
(a) After approval of a sponsor’s
marketing application for a designated
orphan drug for use in the rare disease
or condition, or a subset thereof,
concerning which orphan-drug
designation was granted, FDA will not
approve another sponsor’s marketing
application for the same drug for the
same use before the expiration of 7 years
from the date of such approval as stated
in the approval letter from FDA, except
that such a marketing application can be
approved sooner if, and at such time as,
any of the following occurs:
*
*
*
*
*
(b) Orphan-drug exclusive approval
protects only the approved indication or
use of a designated drug. If such
approved indication or use is limited to
a particular subset of persons with a rare
disease or condition, FDA may later
approve the drug for use in one or more
additional subsets and, if the sponsor
who obtains approval in the additional
subset(s) has orphan-drug designation
for the drug, FDA will recognize a new
orphan-drug exclusive approval for the
use in the new subset(s) of persons with
the rare disease or condition from the
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64879
date of approval of the drug for use in
the new subset(s).
*
*
*
*
*
13. Section 316.34 is amended by
adding paragraph (c) as follows:
§ 316.34 FDA recognition of exclusive
approval.
*
*
*
*
*
(c) If a drug is otherwise the same
drug as a previously approved drug,
FDA will not recognize orphan-drug
exclusive approval if the sponsor fails to
substantiate, at the time of marketing
approval, the hypothesis of clinical
superiority over the previously
approved drug that formed the basis for
designation.
Dated: October 13, 2011.
Leslie Kux,
Acting Assistant Commissioner for Policy.
[FR Doc. 2011–27037 Filed 10–18–11; 8:45 am]
BILLING CODE 4160–01–P
DEPARTMENT OF THE TREASURY
Internal Revenue Service
26 CFR Part 1
[REG–146297–09]
RIN 1545–BJ23
Deduction for Qualified Film and
Television Production Costs
Internal Revenue Service (IRS),
Treasury.
ACTION: Notice of proposed rulemaking
by cross reference to temporary
regulation.
AGENCY:
In the Rules and Regulations
section of this issue of the Federal
Register, the IRS is issuing temporary
regulations relating to deductions for
the costs of producing film and
television productions. Those temporary
regulations reflect changes to the law
made by the Tax Extenders and
Alternative Minimum Tax Relief Act of
2008, and affect taxpayers that produce
films and television productions within
the United States. The text of those
temporary regulations also serves as the
text of these proposed regulations.
DATES: Written comments and requests
for a public hearing must be received by
January 17, 2012.
ADDRESSES: Send submissions to:
CC:PA:LPD:PR (REG–146297–09), room
5205, Internal Revenue Service, P.O.
Box 7604, Ben Franklin Station,
Washington, DC 20044. Submissions
may be hand delivered Monday through
Friday between the hours of 8 a.m. and
4 p.m. to: CC:PA:LPD:PR (REG–146297–
SUMMARY:
E:\FR\FM\19OCP1.SGM
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Agencies
[Federal Register Volume 76, Number 202 (Wednesday, October 19, 2011)]
[Proposed Rules]
[Pages 64868-64879]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2011-27037]
=======================================================================
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Food and Drug Administration
21 CFR Part 316
[Docket No. FDA-2011-N-0583]
RIN 0910-AG72
Orphan Drug Regulations
AGENCY: Food and Drug Administration, HHS.
ACTION: Proposed rule.
-----------------------------------------------------------------------
SUMMARY: The Food and Drug Administration (FDA) is proposing to amend
the 1992 Orphan Drug Regulations issued to implement the Orphan Drug
Act. These amendments are intended to clarify regulatory provisions and
make minor improvements to address issues that have arisen since those
regulations were issued.
DATES: Submit either electronic or written comments on the proposed
rule by January 17, 2012. Submit comments on information collection
issues under the Paperwork Reduction Act of 1995 by November 18, 2011
(see the ``Paperwork Reduction Act of 1995'' section of this document).
ADDRESSES: You may submit comments, identified by Docket No. FDA-2011-
N-0583 and/or RIN number 0910-AG72, by any of the following methods,
except that comments on information collection issues under the
Paperwork Reduction Act of 1995 must be submitted to the Office of
Regulatory Affairs, Office of Management and Budget (OMB) (see the
``Paperwork Reduction Act of 1995'' section of this document).
Electronic Submissions
Submit electronic comments in the following way:
Federal eRulemaking Portal: https://www.regulations.gov.
Follow the instructions for submitting comments.
Written Submissions
Submit written submissions in the following ways:
Fax: 301-827-6870.
Mail/Hand delivery/Courier (for paper, disk, or CD-ROM
submissions): Division of Dockets Management (HFA-305), Food and Drug
Administration, 5630 Fishers Lane, rm. 1061, Rockville, MD 20852.
Instructions: All submissions received must include the Agency name
and Docket No. FDA-2011-N-0583 and Regulatory Information Number (RIN)
0910-AG72 for this rulemaking. All comments received may be posted
without change to https://www.regulations.gov, including any personal
information provided. For additional information on submitting
comments, see the ``Comments'' heading of the SUPPLEMENTARY INFORMATION
section of this document.
Docket: For access to the docket to read background documents or
comments received, go to https://www.regulations.gov and insert the
docket number, found in brackets in the heading of this document, into
the ``Search'' box and follow the prompts and/or go to the Division of
Dockets Management, 5630 Fishers Lane, rm. 1061, Rockville, MD 20852.
FOR FURTHER INFORMATION CONTACT: Erica K. McNeilly, Office of Orphan
Products Development, Food and Drug Administration, 10903 New Hampshire
Ave., Bldg. 32, rm. 5271, Silver Spring, MD 20993, 301-796-8660.
SUPPLEMENTARY INFORMATION:
Table of Contents
I. Background
II. Description of the Proposed Changes
A. Demonstration of an ``Orphan Subset'' of a Disease or
Condition
B. Eligibility for Orphan-Drug Designation of a Drug That Was
Previously Approved for the Orphan Indication
C. Eligibility for Multiple Orphan-Drug Exclusive Approvals
D. Demonstration of Clinical Superiority
E. Name of the Drug
F. Required Drug Description and Scientific Rationale in a
Request for Orphan-Drug Designation
G. Removal of Requirement To Submit Statement as to Whether
Sponsor Submitting the Request Is the Real Party in Interest
H. Timing of Request for Orphan-Drug Designation
I. Responding to a Deficiency Letter From FDA on an Orphan-Drug
Designation Request
J. Publication of Orphan-Drug Designations
K. FDA Recognition of Orphan-Drug Exclusive Approval
L. Miscellaneous Terminology Changes
M. Address Change
III. Environmental Impact
IV. Legal Authority
V. Proposed Implementation Plan
VI. Executive Order 13132: Federalism
VII. Paperwork Reduction Act of 1995
VIII. Analysis of Impacts
A. Background
B. Benefits and Costs of the Proposed Rule
C. Small Business Analysis
IX. Request for Comments
I. Background
Since the publication of the Orphan Drug Regulations in the Federal
Register of December 29, 1992 (57 FR 62076), FDA has reviewed over
3,350 requests for orphan-drug designation of drugs for rare diseases
and conditions. Based on these experiences, FDA believes it is useful
to clarify certain regulatory language in the current orphan drug
regulations and to propose areas of minor improvement. These amendments
are intended to assist sponsors who are seeking and who have obtained
orphan-drug designation of their drugs, as well as FDA in administering
the orphan drug program. These amendments are consistent with the
Orphan Drug Act (Pub. L. 97-414) and continue to provide incentives for
the development of potentially promising orphan drugs that otherwise
would not be developed for rare diseases and conditions.
The specific issues addressed in this proposal include: (1)
Demonstration of an appropriate ``orphan subset'' of persons with a
particular disease or condition that otherwise affects 200,000 or more
persons in the United States, for the purpose of designating a drug for
use in that subset; (2) eligibility for
[[Page 64869]]
orphan-drug designation of a drug that is otherwise the same drug for
the same orphan indication as a previously approved drug; (3)
eligibility for multiple orphan-drug exclusive approvals when a
designated orphan drug is separately approved for use in different
subsets of the rare disease or condition; (4) requirement for
demonstrating clinical superiority for the purpose of orphan-drug
exclusive approval; (5) requirement for submitting the name of the drug
in an orphan-drug designation request; (6) required drug description
and scientific rationale in a designation request; (7) required
information in a designation request relating to the sponsor's interest
in the drug; (8) timing of a request for orphan-drug designation; (9)
responding to a deficiency letter from FDA on an orphan-drug
designation request; (10) FDA publication of information regarding
designated orphan drugs; (11) FDA recognition of orphan-drug exclusive
approval; (12) miscellaneous terminology changes; and (13) an address
change.
II. Description of the Proposed Changes
A. Demonstration of an ``Orphan Subset'' of a Disease or Condition
As set forth in part 316 (21 CFR part 316), a sponsor may request
orphan-drug designation of a drug for use in persons with a rare
disease or condition or, in some special circumstances, a subset of
persons with a disease or condition that may not otherwise be rare
(hereinafter, a ``non-rare'' disease or condition). With respect to the
latter, Sec. 316.20(b)(6) stipulates that when a drug is to be
developed for only a subset of persons with a particular disease or
condition, the sponsor must provide ``a demonstration that the subset
is medically plausible.'' This concept has been the subject of some
confusion, and FDA has received requests for further clarification.
The term ``medically plausible'' subset used in Sec. 316.20(b)(6)
refers to a regulatory concept specific to the orphan drug regulations.
The applicability of this regulatory concept is explained in section
II.B of the preamble to the notice of proposed rule making (NPRM)
entitled ``Orphan Drug Regulations'' published in the Federal Register
of January 29, 1991 (56 FR 3338 at 3339). Because the term ``medically
plausible'' has not been further clarified through regulations or
guidance, it has been misinterpreted to mean any medically recognizable
or any clinically distinguishable subset of persons with a particular
disease or condition. Inappropriate application of the concept of a
``medically plausible'' subset could result in the creation of subsets
of non-rare diseases or conditions that are artificially narrow. This
result would be inconsistent with the purpose of the Orphan Drug Act.
For example, some requests for orphan-drug designation have been
for use of a drug in a subset of persons with a particular
pathohistologic grade or clinical stage of a specific malignancy, but
without a plausible argument why the drug could not be used to safely
treat all persons with the malignancy, regardless of disease grade or
stage. Another example of misinterpretation of the term ``medically
plausible'' has been its application to a select group of persons with
a disease or condition who are eligible to enroll in a clinical trial
to support a specific indication for use of a drug when there is no
scientific reason to preclude investigational use of the drug in other
persons with the disease or condition. Patients who meet inclusion and
exclusion criteria for a trial do not automatically qualify as a
``medically plausible'' subset because it could be medically
appropriate to evaluate the same drug for use in the remaining persons
with the same disease or condition. Similarly, a sponsor's intention to
use or study a drug in a certain limited group of persons with a non-
rare disease or condition does not necessarily qualify that group as a
``medically plausible'' subset.
Any of the interpretations described in the previous paragraphs
would permit a non-rare disease or condition to be artificially
subdivided into smaller groups for the purpose of establishing subsets
that are under the prevalence limit for orphan-drug designation. FDA
does not believe that such an approach serves the intent of the Orphan
Drug Act, because it would permit the creation of artificial ``orphan''
populations. Designation of drugs for use in such artificial ``orphan''
populations could encourage sponsors to study and seek approval for the
use of a drug in the narrowest patient group possible, in order to
avail themselves of the orphan-drug incentives, including tax benefits
and orphan-drug exclusive approval. In addition, use of such artificial
orphan populations to obtain orphan designation and its related
benefits could divert resources away from research and development of
drugs for true orphan diseases and conditions.
To limit the confusion arising from the use of the term ``medically
plausible,'' FDA proposes to remove the term ``medically plausible'' in
Sec. 316.20(b)(6) and instead provide a description of how an
appropriate subset may be identified for the purpose of orphan-drug
designation (``orphan subset''). The process for identifying an orphan
subset remains the same as has been used by FDA for identifying a
medically plausible subset under the regulations currently in effect.
For a subset of persons with a non-rare disease or condition to be
considered an orphan subset for the purpose of orphan-drug designation,
the subset cannot be arbitrarily chosen simply to reduce the prevalence
numbers to qualify a drug to treat that population as an orphan drug.
One way for a sponsor to demonstrate that the proposed subset rests on
a non-arbitrary foundation is to show that there is a reasonable
scientific or medical rationale for limiting the investigation and
potential use of the drug to only the subset of interest. When a
sponsor has established that the selected population constitutes a non-
arbitrary subset, e.g., by describing the scientific or medical basis
for limiting the potential use of the drug to that population and
demonstrating that such scientific or medical basis is reasonable, the
target population is an acceptable orphan subset of persons with the
particular disease or condition for the drug of interest.
For example, it might not be appropriate to treat all persons with
a non-rare disease or condition with a drug that is highly toxic;
however, those patients who are refractory to, or intolerant of, other
less toxic drugs might be reasonable candidates for treatment with the
drug. Therefore, those patients who are refractory to, or intolerant
of, other less toxic drugs may be considered an appropriate orphan
subset for purposes of orphan-drug designation of the highly toxic
drug. In addition, other inherent properties of a drug, such as its
pharmacologic or biopharmaceutical characteristics, may provide a
reasonable basis upon which to identify a subset of patients to whom it
would be appropriate to limit treatment and who thus would qualify as
an orphan subset of a non-rare disease or condition. Likewise,
characteristics of the drug that have been demonstrated through
previous clinical experiences may be used to identify an appropriate
orphan subset. Examples of such characteristics include:
Pharmacological Property: The mechanism of action is a
common principle for limiting the investigation and use of a drug to a
subset of patients. For example, it is reasonable to expect that use of
a monoclonal antibody directed against a specific surface antigen would
be restricted to treatment
[[Page 64870]]
of subtypes of tumors that possess that specific antigen, and not
subtypes of tumors that lack the antigen.
Previous Clinical Experience: Information on the drug's
activity available from completed trials or published in clinical
literature may be used to establish an orphan subset. If, for example,
relevant data show that the drug has no significant activity in the
remaining subset of patients with high-grade tumors, then patients with
low-grade tumors may constitute an orphan subset.
FDA recommends that the following practical questions be asked when
assessing whether a subset of a non-rare disease or condition is an
appropriate orphan subset:
Is the intended subset artificially restricted in any way
with respect to the use of the drug to treat the disease or condition?
Given that the drug may potentially benefit this
particular subset of persons, is there a reasonable scientific or
medical basis for believing that the drug would also potentially
benefit the remaining population with the non-rare disease or condition
or a larger subset of that population? If not, why not?
These questions serve to test whether a subset of patients with a
disease or condition that otherwise affects 200,000 or more persons in
the United States can be considered an appropriate orphan subset for
the purpose of orphan-drug designation.\1\
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\1\ In this proposed rule, FDA is not proposing to change the
current regulatory provisions allowing sponsors to obtain orphan-
drug designation for a drug intended for a disease or condition
affecting 200,000 or more people, or for a vaccine, diagnostic drug,
or preventive drug to be administered to 200,000 or more people per
year, if there is no reasonable expectation that research and drug
development costs can be recovered by sales of the drug in the
United States (Sec. Sec. 316.20(b)(8)(ii) and 316.21(c)).
---------------------------------------------------------------------------
B. Eligibility for Orphan-Drug Designation of a Drug That Was
Previously Approved for the Orphan Indication
According to Sec. Sec. 316.20(a) and 316.25(a)(3), a sponsor of a
subsequent drug that is otherwise the same drug as an already approved
orphan drug may seek and obtain orphan-drug designation of its drug for
the same rare disease or condition, provided that it can present a
plausible hypothesis that the subsequent drug may be clinically
superior to the approved orphan drug. In the absence of a clinical
superiority hypothesis, the Agency does not interpret the orphan-drug
regulations to permit orphan designation of a drug that is otherwise
the same as a drug that is already approved for the orphan use, either
where the approved drug received orphan-drug exclusive approval (even
after such drug's exclusivity period has run out) or where the approved
drug was not previously designated as an orphan drug and thus did not
receive orphan exclusive approval. If the same drug has already been
approved for the orphan disease or condition, with or without orphan
exclusivity, designation would be inappropriate because it would be
inconsistent with the primary purpose of the Orphan Drug Act, which is
to provide incentives to develop promising drugs for rare diseases or
conditions that would not otherwise be developed and approved.
Furthermore, permitting orphan-drug designation of a drug that is
already approved for the orphan indication could permit inappropriate
``evergreening'' of exclusive approval periods. For example, a sponsor
might obtain approval and 5-year new chemical entity exclusivity as
described in Sec. 314.108 (21 CFR 314.108) for a drug product and
then, once that 5-year exclusivity period is expiring, seek orphan-drug
designation and exclusive approval for a drug that is the same as the
drug (e.g., in a new dosage form) for the same indication that was
previously approved. This outcome would be inconsistent with the
provisions of the Orphan Drug Act, which provide that exclusive
approval for a drug for an orphan disease or condition runs for 7 years
from the date of approval of the application for the drug (21 U.S.C.
360cc(a)).
Accordingly, FDA proposes to delete the word ``orphan'' in the
phrase ``approved orphan drug'' in Sec. Sec. 316.3(b)(3), 316.20(a),
and 316.20(b)(5), to clarify that these provisions would be applicable
to a drug that is otherwise the same drug as any previously approved
drug for the same orphan disease or condition, regardless of whether
such drug was designated as an orphan drug. FDA proposes that the text
of Sec. 316.25(a)(3) be revised. FDA is not changing its position
that, as described in the NPRM preamble (56 FR 3338), section II.E,
paragraph 8, ``even a drug considered the `same' drug structurally
could become a `different' drug * * * by showing clinical
superiority.'' In section II.I, comment 77, of the preamble to the
final rule, ``Orphan Drug Regulations'' (57 FR 62076 at 62084), FDA
reiterated that it would ``designate a structurally identical
subsequent drug as an orphan drug, even in the face of a holder's
exclusive marketing rights, if the subsequent sponsor advances a
plausible basis on which to conclude that its product may be proven
`clinically superior.' '' FDA believes that permitting a sponsor to
receive orphan-drug designation of a potentially clinically superior
drug that is otherwise the same drug as an already approved drug
promotes development of potentially superior drugs to the benefit of
persons with rare diseases or conditions.
C. Eligibility for Multiple Orphan-Drug Exclusive Approvals
When FDA designates an orphan drug, it generally designates the
drug for use by all persons with the rare disease or condition and
expects that a sponsor will seek approval of the drug for all persons
with the rare disease or condition designated. The uses for which a
drug will be approved, however, are those for which there is adequate
data and information to support approval, and may be limited to subsets
of patients with the orphan disease or condition. As new data emerge,
FDA may approve the drug for use in additional subsets of the disease
or condition for which the drug was designated.
The scope of orphan exclusive approval for a designated drug is
limited to the approved indication or use, even if the underlying
orphan designation is broader. If the sponsor who originally obtained
orphan exclusive approval of the drug for only a subset of the orphan
disease or condition for which the drug was designated subsequently
obtains approval of the drug for one or more additional subsets of that
orphan disease or condition, FDA will recognize orphan-drug exclusive
approval, as appropriate, for those additional subsets from the date of
such additional marketing approval(s). Before obtaining such additional
marketing approval(s), the sponsor in this instance would not need to
have obtained additional orphan designation for the additional
subset(s) of the orphan disease or condition.
If, before approval of the drug for any subset of the disease or
condition for which it was designated, a subsequent sponsor also
obtained designation for the same orphan disease or condition, each
sponsor may be eligible for orphan-drug exclusive approval for the
respective subset(s) for which each first obtains marketing approval.
For example, if the first sponsor receives approval for one subset of
the orphan disease or condition and the subsequent sponsor receives
approval for a different subset, FDA will recognize orphan-drug
exclusive approval for each sponsor's drug, as appropriate, from the
date of each drug's marketing approval.
[[Page 64871]]
After approval of the drug for one or more subsets of the orphan
disease or condition, a subsequent sponsor may, without submitting a
plausible hypothesis of clinical superiority, seek designation of the
drug for the subset(s) of the orphan disease or condition for which the
drug has not yet been approved. FDA may designate the drug for use in
the remaining subset(s) without requiring a postulation of clinical
superiority. To obtain such a designation, however, the sponsor must
demonstrate that, at the time of its designation request, the entire
population with the orphan disease or condition, not just the remaining
subset(s) of the population, is under the prevalence limit, unless the
sponsor can demonstrate that the remaining subset(s) is an orphan
subset in accordance with Sec. 316.20(b)(6).
This approach would permit multiple orphan-drug exclusive approvals
for multiple subsets of the same underlying orphan disease or
condition. For example, a drug could be designated for the treatment of
T-cell non-Hodgkin's lymphoma (assuming that, at the time of
designation, the drug's sponsor otherwise met all the other statutory
and regulatory requirements for obtaining an orphan designation).
However, the data submitted may only support approval of the treatment
of cutaneous manifestations in patients with cutaneous T-cell lymphoma.
Subsequently, on the basis of additional data, the same drug could be
approved for other subsets of T-cell non-Hodgkin's lymphomas, such as
anaplastic large cell lymphoma or angioimmunoblastic T-cell lymphoma.
If the same sponsor, or a different sponsor with orphan designation,
obtained approval for the use of the drug in one or more of the
remaining subsets of T-cell non-Hodgkin's lymphomas, that sponsor would
be eligible for orphan-drug exclusive approval for the use of the drug
in those subsets from the date of approval of the drug for use in those
subsets. Accordingly, FDA proposes to add provisions to Sec. 316.31.
FDA believes that this proposal is consistent with the purpose of
the Orphan Drug Act because it provides an important incentive for one
or more sponsors to develop, or to continue to develop, a potentially
promising drug for use in all persons affected by a rare disease or
condition, rather than in just a subset of that orphan population, even
after the drug has been approved for a different subset of the
population with the disease or condition.
This provision is applicable only in situations where the
underlying disease or condition for which the drug was designated is an
orphan disease or condition at the time designation is requested.
D. Demonstration of Clinical Superiority
FDA believes that granting orphan-drug designation to a subsequent
drug that is otherwise the same as a previously approved drug for the
same orphan disease or indication on the basis of hypothetical
plausibility of clinical superiority is the best tool for giving effect
to the intent of Congress to provide incentives for sponsors to develop
potentially safer and more effective orphan drugs. It is possible,
however, that a sponsor that has obtained designation of its drug on
the basis of a hypothesis that the drug will be clinically superior
will be unable, upon submission of the marketing application, to
demonstrate that the drug is clinically superior to the previously
approved drug. In that case, if the already approved drug has remaining
exclusive approval, the subsequent drug would not itself be eligible
for approval, because it is the same drug as the drug with exclusive
approval. If the approved drug does not have exclusive approval, the
subsequent drug may be approved, but would not itself be eligible for
orphan-drug exclusive approval.
As described in Sec. 316.3(b)(3)(i) and (b)(3)(ii), a drug that is
otherwise the same drug as a previously approved drug, and for which a
clear showing of greater effectiveness or greater safety has not been
made, may still be considered clinically superior within the meaning of
Sec. 316.3(b)(3)(iii) if it makes a major contribution to patient
care. FDA believes that such clinical superiority is meaningful only
when the subsequent drug provides safety or effectiveness comparable to
the approved drug. For example, to claim that a drug makes a major
contribution to patient care through a new formulation or a different
route of administration, the sponsor must also address whether the
change renders the drug less safe or less effective than the approved
drug. For these reasons, FDA proposes that Sec. 316.3(b)(3)(iii) be
revised.
E. Name of the Drug
As provided in Sec. 316.20(b)(2), requests for orphan designation
must include the generic and trade name, if any, of the drug. For some
products, however, neither a generic, nor trade name may be available,
for example, for some large and complicated biological products or for
any molecule for which the sponsor has not yet obtained a trade name.
FDA is proposing to revise Sec. 316.20(b)(2) so that, if neither such
name is available, requests for designation include a chemical name or
a meaningful descriptive name (i.e., one that would be meaningful to
the public if published). By providing such information in the request
for designation, sponsors would help ensure that the name that FDA
ultimately publishes under Sec. 316.28 upon designation of the product
is accurate and meaningful.
F. Required Drug Description and Scientific Rationale in a Request for
Orphan-Drug Designation
FDA needs adequate information on the drug to conduct the review of
a request for orphan-drug designation. The identity of the active
moiety or principal molecular structural features is of particular
importance because such information is critical in determining whether
various drugs are the same within the meaning of Sec. 316.3(b)(13).
FDA notes that a number of sponsors have omitted such information in
their designation requests. Without such information, FDA cannot
determine whether the drug is the same as one already approved and so
cannot render a decision on the request.
FDA further notes that some sponsors have included in their
designation requests only theories, unsupported by data, as to why the
drug may be used in a particular disease or condition, which does not
constitute an adequate scientific rationale for the use of the drug for
the rare disease or condition. Other sponsors, by contrast, have
included all available data about a drug, rather than just the data
pertinent to demonstrating a scientific rationale to establish a
medically plausible basis for the use of the drug for the rare disease
or condition. Among the data pertinent to a request that should be
included are in vitro data, preclinical efficacy data of the drug from
studies conducted in a relevant animal model for the human disease or
condition, and clinical data from use of the drug in the rare disease
or condition. Animal toxicology studies are generally not relevant to a
request for orphan-drug designation. To ensure that an adequate drug
description and scientific rationale are provided in a request, along
with the necessary supporting data (whether positive, negative, or
inconclusive), FDA proposes to revise Sec. 316.20(b)(4).
G. Removal of Requirement To Submit Statement as to Whether Sponsor
Submitting the Request Is the Real Party in Interest
FDA regulations at Sec. 316.20(b)(9) currently require that
requests for
[[Page 64872]]
orphan-drug designations include a statement as to whether the sponsor
submitting the request is the real party in interest of the development
and the intended or actual production and sales of the product. FDA is
proposing to remove this requirement because it has proven to be of
marginal if any utility in applications, has caused confusion for
sponsors, and has had the effect of discouraging agents of sponsors
(e.g., a sponsor's lawyer) from submitting requests on the sponsor's
behalf. Accordingly, FDA proposes to remove Sec. 316.20(b)(9).
H. Timing of Request for Orphan-Drug Designation
FDA regulations at Sec. 316.23(a) state that a sponsor may request
orphan-drug designation at any time in the drug development process
prior to the submission of a marketing application for the drug product
for the orphan indication. FDA is aware that this language has been the
subject of different interpretations by sponsors. To clarify the
requirements regarding the timing of a designation request, FDA
proposes to revise Sec. 316.23(a) to indicate that a sponsor may
request orphan-drug designation at any time in its drug development
process prior to the time that sponsor submits a marketing application
for the drug for the rare disease or condition. This is intended to
clarify that a sponsor may not submit an orphan-drug designation
request after it has submitted a marketing application for the drug for
that use. This revision is also intended to clarify that submission by
a sponsor of a marketing application for the drug for the orphan
indication does not prevent another sponsor from submitting a request
for orphan designation of the same drug for the same orphan use.
Permitting designation of the subsequent drug in this situation, where
there is no certainty that the previous marketing application will be
approved promptly, if at all, would be consistent with the purpose of
the Orphan Drug Act to provide incentives to develop and obtain
approval for promising drugs for rare diseases or conditions. Once any
sponsor's marketing application for the orphan indication has been
approved, with or without orphan exclusive approval, another sponsor
may not obtain orphan-drug designation for the same drug and the same
orphan indication or use for which the approval was granted absent a
plausible hypothesis of clinical superiority.
I. Responding to a Deficiency Letter From FDA on an Orphan-Drug
Designation Request
FDA regulations are currently silent on when sponsors must respond
to a deficiency letter from FDA on an orphan-drug designation request.
FDA sends such deficiency letters when a request lacks necessary
information or contains inaccurate information, for example, a
miscalculated prevalence estimate. FDA has observed that some sponsors
respond promptly to such deficiency letters, providing the requested
information, whereas other sponsors may take several years or more to
respond without sending any interim communication to FDA. In FDA's
experience, when a period of several years or more elapses between the
sponsor's initial request and the sponsor's deficiency response, the
very basis for the orphan request may no longer hold in some
circumstances. One example is if the initial request lacks an accurate
prevalence estimate and the sponsor takes several years or more to
submit a revised prevalence estimate keyed to the time of submission of
the initial request, several years prior. In some circumstances, the
actual prevalence for the disease or condition in question may have
grown in the intervening years to exceed the prevalence limit of under
200,000. Because orphan designation eligibility in terms of prevalence
is evaluated at the time of the submission of the request (see Sec.
316.21(b)), the drug may be granted orphan-drug designation despite
this prevalence increase, without any justification that there is no
reasonable expectation of cost recovery (see Sec. Sec.
316.20(b)(8)(ii) and 316.21(c)). FDA believes that such designations
may be inconsistent with the purpose of the Orphan Drug Act, to provide
incentives for the development of drugs for ``rare diseases or
conditions'' as defined in section 526 of the Federal Food, Drug, and
Cosmetic Act (FD&C Act) (21 U.S.C. 360bb).
To address this issue, FDA is proposing to require that sponsors
respond to a deficiency letter within 1 year after issuance of the
letter, unless within that timeframe the sponsor requests in writing an
extension of time to respond. Such a request would specify both the
reason(s) for the requested extension and the length of time of the
requested extension. FDA will grant all reasonable requests for an
extension. In some cases, FDA may grant a repeat request for an
extension if, before expiration of the deadline as originally extended,
the sponsor submits a new extension request, stating both the reason(s)
for the request and the requested length of time of the extension.
In the event the sponsor fails to respond to the deficiency letter
or to request an extension of time within a year, FDA may consider the
designation request voluntarily withdrawn at the conclusion of the 1-
year period, unless notified sooner by the sponsor that the request is
withdrawn. FDA encourages sponsors to notify the Agency as soon as
possible after receipt of a deficiency letter in the event the sponsor
decides not to pursue the designation request. Should FDA deny a
request for an extension of time, FDA may likewise consider the
designation request voluntarily withdrawn and will so notify the
sponsor in writing.
In FDA's experience, some deficiencies may be less suitable to
extension requests than others. For example, FDA generally expects that
deficiencies involving an inaccurate or incomplete prevalence estimate
will be readily addressed within 1 year. Other types of deficiencies,
however, may take longer to address. For example, deficiencies
involving the scientific or medical rationale supporting a designation
request for only a subset of persons with a particular disease or
condition may require sponsors to conduct research and develop
additional data, which may take several years or more. For the latter
types of deficiencies, FDA generally anticipates granting extension
requests to allow sponsors to develop necessary supporting data and
information.
To implement this policy, FDA proposes to add new language to Sec.
316.24(a). FDA proposes to change the title of this section to,
``Deficiency letters and granting orphan-drug designation.'' The
existing paragraphs (a) and (b) would be redesignated (b) and (c),
respectively.
J. Publication of Orphan-Drug Designations
Section 316.28 requires that FDA publish a monthly updated list of
designated drugs in addition to placing on file at the FDA Division of
Dockets Management an annual cumulative list of all designated drugs.
FDA currently makes available a cumulative list of all designated drugs
to date and a cumulative list of designated drugs in the current year
on its Web site at https://www.fda.gov/orphan/. These lists are updated
monthly.
To identify a drug in these lists and in the docket, FDA publishes
its generic name and trade name, if any. If neither name is available,
FDA publishes the chemical name or a meaningful
[[Page 64873]]
descriptive name of the drug (i.e., a name that would be meaningful to
the public). Internal business codes or other similar identifiers do
not suffice for publication purposes, because they do not provide
meaningful notice to the public of a designation. The Orphan Drug Act
requires that notice respecting designation of a drug be made available
to the public (section 526(c) of the FD&C Act). Ensuring that notice is
meaningful, such that patients, health care providers, sponsors, and
other stakeholders can identify which drug has been designated as an
orphan drug, accords with both the language and the purpose of this
statutory provision.\2\ FDA proposes to revise Sec. 316.28 to reflect
FDA's existing publication practices.
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\2\ In enacting and later amending the Orphan Drug Act, Congress
emphasized the importance of effective public dissemination of
orphan designation and the need for certainty about an orphan drug's
potential for exclusivity (see H.R. Rep. No. 97-840, at 9 (1982),
and H.R. Rep. No. 100-473, at 5-6 (1987)).
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The presence of a drug on the list of designated drugs does not
necessarily mean the sponsor is actively developing the drug for the
orphan disease or indication. Holders of orphan-drug designations are
required by Sec. 316.30 to submit an annual progress report on their
designated drugs. It has been the Agency's experience that a number of
holders of orphan-drug designations have failed to submit annual
reports as required for the designated drug, and some have terminated
their orphan-drug development program without notifying FDA. The Agency
is considering ways to make available to the public information about
the status of development for designated orphan drugs, including
whether to provide information to the public on whether a sponsor has
submitted the required annual reports. Although the failure of a
sponsor to submit an annual report does not necessarily signal that the
sponsor has ceased development of the orphan drug, this information
could nevertheless prove useful to patients, medical practitioners, and
the drug development community, who may wish to obtain additional
information regarding the status of drug development from the sponsor
of the designated drug.
Whether FDA will need to consider making additional information
about designated drugs available through, for example, publishing the
status of annual report submissions will depend in part on the effect
of recent and pending changes in the availability of information about
clinical trials of drugs. It is possible that expansion of the public
availability of clinical trial information under section 801 of the
Food and Drug Administration Amendments Act of 2007 (Pub. L. 110-85)
will provide the public additional useful information on whether trials
of a designated drug are being undertaken for the orphan indication.
The information derived from this clinical trials database may be as
useful, or even more useful, to patients and other interested parties
as would information on whether a sponsor had submitted an annual
report as required.
We are seeking comment on whether it would be useful for the Agency
to make public information about whether the sponsor of a designated
drug has submitted annual reports as required under Sec. 316.30. The
Agency does not contemplate disclosing the contents of the annual
report, only whether such annual report has been submitted.
K. FDA Recognition of Orphan-Drug Exclusive Approval
Under existing Agency practice, FDA does not recognize orphan-drug
exclusive approval if the drug is otherwise the same drug as one
already approved and the sponsor fails to substantiate, in the
application for marketing approval, the hypothesis of clinical
superiority over the previously approved drug that formed the basis for
designation. To clarify existing practice, FDA proposes to add new
language to Sec. 316.34(c).
L. Miscellaneous Terminology Changes
FDA proposes to revise the following terms throughout part 316 for
the sake of precision and internal consistency, so that each term is
used consistently throughout this part: ``drug product'' versus
``drug,'' and ``indication'' and ``indicated'' versus ``designation,''
``use,'' ``developed,'' and ``disease or condition.''
M. Address Change
FDA proposes to update the address in Sec. 316.4 to ``Office of
Orphan Products Development, Food and Drug Administration, 10903 New
Hampshire Ave., Bldg. 32, Rm. 5271, Silver Spring, MD 20993.''
III. Environmental Impact
FDA has determined under 21 CFR 25.30(h) and 25.31(a) 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.
IV. Legal Authority
FDA is proposing this rule under the authority granted it by the
Orphan Drug Act (Pub. L. 97-414). In enacting the Orphan Drug Act,
Congress required FDA to issue regulations for the implementation of
sections 525 and 526 of the FD&C Act (21 U.S.C. 360aa and 360bb),
relating to written FDA recommendations on studies required for
approval of marketing applications of orphan drugs and for the
designation of eligible drugs as orphan drugs. In the Federal Register
of December 29, 1992 (57 FR 62076) (1992 final rule), FDA issued a
final rule for the implementation of these sections as well as for the
implementation of sections 527 and 528 of the FD&C Act (21 U.S.C. 360cc
and 360dd), relating to exclusive marketing for orphan drugs and the
encouragement of sponsors to make orphan drugs available for treatment
on an ``open protocol'' basis before the drug has been approved for
general marketing. Any final rule based on this proposed rule would
clarify regulatory provisions in the 1992 final rule and make minor
improvements to address issues that have arisen since that rule took
effect.
A final rule based on this proposal would further the main purpose
of the Orphan Drug Act to provide incentives to develop promising drugs
for rare diseases or conditions that would otherwise not be developed
and approved. It would do so in several ways: By enhancing clarity for
sponsors in seeking orphan-drug designations and orphan-drug exclusive
marketing approval; by providing an important incentive for one or more
sponsors to develop, or to continue to develop, a potentially promising
drug for use in all persons affected by a rare disease or condition,
rather than in just a subset of that orphan population, even after the
drug has been approved for a different subset of the population with
the disease or condition; and by helping ensure that the orphan
designation request, at the time it is granted, is consistent with the
purpose of the Orphan Drug Act despite a lapse of time between the date
of submission of the initial request and a sponsor's response to a
deficiency letter from FDA.
An additional source of authority for this proposed rule is section
701 of the FD&C Act (21 U.S.C. 371). Under this section, FDA is
authorized to issue regulations for the efficient enforcement of the
FD&C Act. Any final rule based on this proposed rule would help the
efficient enforcement of the Orphan Drug Act provisions by enhancing
clarity and certainty in FDA's
[[Page 64874]]
administration of the orphan drug program.
V. Proposed Implementation Plan
FDA proposes that these regulatory changes, where applicable, would
become effective 30 days after the date of publication of the final
rule. The final rule would apply only to original orphan-designation
requests submitted on or after the effective date of the final rule. It
would not apply to the following: (1) Amendments submitted on or after
the effective date regarding previously submitted designation requests,
or (2) responses to deficiency letters submitted on or after the
effective date regarding previously submitted requests. As proposed
here, the final rule would have no effect on the scope of or
eligibility for orphan-drug exclusive approval because it merely
clarifies existing FDA practice.
VI. Executive Order 13132: Federalism
FDA has analyzed this proposed rule in accordance with the
principles set forth in Executive Order 13132. FDA has determined that
the proposed rule, if finalized, would not contain policies that have
substantial direct effects on the States, on the relationship between
the National Government and the States, or on the distribution of power
and responsibilities among the various levels of government.
Accordingly, the Agency tentatively concludes that the rule does not
contain policies that have federalism implications as defined in the
Executive order and, consequently, a federalism summary impact
statement is not required.
VII. Paperwork Reduction Act of 1995
This proposed rule contains information collection provisions that
are subject to review by the Office of Management and Budget (OMB)
under the Paperwork Reduction Act of 1995 (44 U.S.C. 3501-3520). A
description of these provisions is given in the Description section of
this document an estimate of the annual reporting 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.
FDA invites comments on these topics: (1) Whether the proposed
collection of information is necessary for the proper performance of
FDA's functions, including whether the information will have practical
utility; (2) the accuracy of FDA's estimate of the burden of the
proposed collection of information, including the validity of the
methodology and assumptions used; (3) ways to enhance the quality,
utility, and clarity of the information to be collected; and (4) ways
to minimize the burden of the collection of information on respondents,
including through the use of automated collection techniques and other
forms of information technology, when appropriate.
Title: Orphan Drug Regulations.
Description: FDA is proposing to amend its regulations on orphan-
drug designation requests to clarify policy and make minor
improvements. The proposed revisions are intended to assist sponsors
who are seeking and who have obtained orphan-drug designations, as well
as FDA in its administration of the orphan drug program.
One proposed revision is a requirement that sponsors include in
requests a chemical or meaningful descriptive name of the drug, if
neither a trade name nor a generic name is available. By providing such
information in the request for designation, sponsors would help ensure
that the name that FDA ultimately publishes under Sec. 316.28 upon
designation of the product is accurate and meaningful to the public.
Because sponsors are already required to include a description of the
drug in requests for designation, the proposed requirement to include a
chemical or meaningful descriptive name is not expected to require much
additional time or effort from sponsors.
Based on historical data concerning the number of designation
requests for which neither a trade name nor a generic name for the drug
is available, FDA expects that about 20 requests per year would be
affected by this requirement. FDA estimates that it will take
approximately 0.2 hours, or 12 minutes, for sponsors to submit this
information. This estimate reflects both the length of time likely
required to submit the chemical name of the drug (less than 0.2 hours)
and the length of time likely required to submit a meaningful
descriptive name if a chemical name is not readily available (more than
0.2 hours).
Another proposed revision is a requirement that sponsors respond to
deficiency letters from FDA on designation requests within 1 year of
issuance of the deficiency letter, unless within that timeframe the
sponsor requests in writing an extension of time to respond. FDA will
grant all reasonable requests for an extension. In the event the
sponsor fails to respond to the deficiency or request an extension of
time to respond within the 1-year timeframe, FDA may consider the
designation request voluntarily withdrawn.
FDA believes this proposal is necessary to ensure that designation
requests do not become ``stale'' by the time they are granted, such
that the basis for the initial request may no longer hold. Granting
such designations despite a lapse of years and change in factual
circumstances concerning the disease or condition in question may not
serve the primary purpose of the Orphan Drug Act to provide incentives
for the development of drug products for ``rare diseases or
conditions'' as defined in section 526 of the FD&C Act.
Based on historical data concerning the number of deficiency
letters that FDA has sent and the number of sponsors who have taken
longer than a year to respond, FDA estimates that it will receive
approximately 10 written requests each year for an extension of time to
respond. This number is likely an overestimate, because it is based on
historical data in the absence of any regulatory deadline for sponsors
to respond; FDA believes that at least some of the sponsors who have
taken longer than a year to respond have been capable of responding
earlier, but did not do so because they did not need to. FDA estimates
that it will take approximately 2 hours to prepare and submit each
extension request, including time to develop and articulate a rationale
for the requested extension and to obtain internal approval of the
request before submission to FDA.
Description of Respondents: Persons and businesses, including small
businesses and manufacturers.
[[Page 64875]]
Table 1--Estimated Annual Reporting Burden \1\
----------------------------------------------------------------------------------------------------------------
Number of Average
21 CFR Section Number of Responses per Total Annual Burden per Total Hours
Respondents Respondent Responses Response
----------------------------------------------------------------------------------------------------------------
316.20(b)(2).................... 20 1 20 0.2 4
(12 minutes)
316.24(a)....................... 10 1 10 2 20
-------------------------------------------------------------------------------
Total Burden Hours.......... .............. .............. .............. .............. 24
----------------------------------------------------------------------------------------------------------------
\1\ There are no capital costs or operating and maintenance costs associated with this collection of
information.
Except with respect to the proposed revisions addressed in table 1
of this document, the revisions in this proposed rule clarify existing
regulatory language and do not constitute a substantive or material
modification to the approved collections of information in current part
316 (Cf. 5 CFR 1320.5(g)). The collections of information in current
part 316 have been approved by OMB in accordance with the Paperwork
Reduction Act of 1995 (44 U.S.C. 3501-3520), under OMB control number
0910-0167.
To ensure that comments on information collection are received, OMB
recommends that written comments be faxed to the Office of Information
and Regulatory Affairs, OMB, Attn: FDA Desk Officer, FAX: 202-395-6974,
or e-mailed to oira_submission@omb.eop.gov. All comments should be
identified with the title ``Orphan Drug Regulations.''
In compliance with the Paperwork Reduction Act of 1995 (44 U.S.C.
3407(d)), the Agency has submitted the information collection
provisions of this proposed rule to OMB for review. These requirements
will not be effective until FDA obtains OMB approval. FDA will publish
a notice concerning OMB approval of these requirements in the Federal
Register.
VIII. Analysis of Impacts
FDA has examined the impacts of the proposed rule under Executive
Order 12866, Executive Order 13563, the Regulatory Flexibility Act (5
U.S.C. 601-612), and the Unfunded Mandates Reform Act of 1995 (Pub. L.
104-4). Executive Orders 12866 and 13563 direct 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 proposed rule is not a
significant regulatory action as defined by Executive Order 12866.
The Regulatory Flexibility Act requires Agencies to analyze
regulatory options that would minimize any significant impact of a rule
on small entities. Because this proposed rule primarily clarifies
current practice and any costs would be very small, the Agency proposes
to certify 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 1 year.'' The current threshold after adjustment for
inflation is $136 million, using the most current (2010) Implicit Price
Deflator for the Gross Domestic Product. FDA does not expect this
proposed rule to result in any 1-year expenditure that would meet or
exceed this amount.
A. Background
Our experience with orphan-drug designation requests over many
years has led us to conclude that sponsors are confused by some
portions of the current regulatory language. The Agency receives dozens
of requests for orphan-drug designation each year that are deficient in
some way that would prevent designation. We observe the same types of
deficiencies suggesting some problematic areas in our regulations.
Of the 324 requests for orphan-drug designation we received in
2010, 124 were denied or placed in abeyance so that the sponsor could
submit additional material to respond to the deficiencies. Of these, 79
were deficient because they did not identify an appropriate ``medically
plausible subset'' of a population with a non-rare disease or
condition. That nearly a quarter of the designation requests were
deficient in the subset analysis, and that problems with population
subsets constituted over half of the deficiencies, highlights the need
to clarify existing regulatory language regarding subsets.
The confusion about regulatory language is not limited to issues
regarding population subsets. Many designation requests are deficient
because the submitted drug description is not adequate to establish
whether the drug is the same as one that has already been approved.
There are continuing problems with requests for drugs that are in fact
the same as drugs already approved but lack necessary information
regarding clinical superiority. Other requests lack the data to support
the scientific rationale for the use of the drug in a rare disease or
condition. Addressing these deficiencies and resolving sponsor
inquiries consumes sponsor and FDA resources and extends the orphan-
drug designation process. The process would be less costly to sponsors
and FDA if sponsors had an authoritative source of information about
basic program requirements.
Basic program requirements are part of Federal regulation;
clarifying regulatory language to reduce costly confusion would have to
be done through rulemaking at the Federal level. This proposed rule
would clarify regulatory language to reduce sponsor and FDA costs and
streamline the orphan-drug designation process.
B. Benefits and Costs of the Proposed Rule
This proposed rule would reduce costs to sponsors who might
otherwise submit deficient orphan-drug designation requests or face
additional costs to determine program requirements. It would benefit
sponsors and promote public health by clarifying requirements for
sponsors who would otherwise be discouraged from submitting designation
requests when their drug is in fact eligible for orphan-drug
designation. The proposed rule would also reduce costs to FDA of
responding to sponsor inquiries and
[[Page 64876]]
deficient designation requests. There would be small costs associated
with the requirement that sponsors either respond to deficiency letters
within a year or obtain an extension of time to respond. The proposed
rule has several elements, which we address in the order presented
earlier in this document.
We propose to clarify what population or disease subsets may be
eligible for orphan-drug designation (Sec. 316.20(b)(6)). This action
merely clarifies longstanding policy but should reduce uncertainty
about the requirements for orphan-drug designation and result in fewer
requests that cannot be designated. With the improved information about
requirements for establishing population subsets, some sponsors may
realize that their drug is not eligible for orphan designation and they
would save the cost they would have otherwise incurred submitting a
request. FDA has recently estimated a burden of 150 hours to complete a
designation request (76 FR 3910 at 3911, January 21, 2011). At a
benefit-adjusted hourly wage of about $46 for a regulatory affairs
official, sponsors who do not submit a request that cannot be granted
would avoid $6,900 in labor costs.\3\ Under this proposed rule, other
sponsors would avoid the cost they would have otherwise incurred
addressing the subset deficiency. We do not have a precise estimate of
the time required to respond to a deficiency letter; using 40 hours as
a rough estimate implies $1,840 in avoided labor costs. We do not
possess a reliable estimate for the number of avoided deficiency
letters, but assuming FDA receives 79 subset-deficient requests each
year and one-half would not occur with the clarified regulatory
language, sponsors would avoid $72,680 in additional labor costs. FDA
would also avoid costs from responding to these requests.
---------------------------------------------------------------------------
\3\ 2010 National Industry-Specific Occupational Employment and
Wage Estimates, U.S. Department of Labor Statistics, last modified
May 17, 2011 (https://www.bls.gov/oes/current/naics4_325400.htm);
mean compliance officer wage rate of $35.28 for pharmaceutical and
medicine manufacturing (NAICS 325400) plus a 30-percent increase for
benefits.
---------------------------------------------------------------------------
It is longstanding FDA policy that a designation request for a drug
that is otherwise the same as a drug previously approved for the same
disease or condition must include a plausible hypothesis of clinical
superiority, regardless of whether the already approved drug was
designated as an orphan. FDA continues to receive requests that cannot
be designated because this policy is not explicit in current
regulation. This proposed rule would make this policy explicit,
reducing costs to sponsors and FDA by reducing the number of deficient
orphan-drug designation requests.
FDA's longstanding practice has been that if a drug is approved for
only a subset of patients with a rare disease or condition, FDA may
grant orphan-drug designation and orphan-drug exclusive approval for
use of the drug in one or more of the remaining subsets of patients
with the rare disease or condition. Current Sec. 316.31 does not
explicitly mention subsets, which could deter confused sponsors from
pursuing designation for use of the drug in remaining subsets for which
the drug has not yet been approved. Clarifying this provision would not
change Agency policy but would benefit sponsors and public health by
reducing the risk of a sponsor failing to pursue designation when it
would otherwise do so.
We propose to clarify the definition of clinical superiority to
make explicit that a drug shown to be clinically superior to an
approved drug for making a major contribution to patient care would
also have to be demonstrated to provide safety and effectiveness
comparable to the approved drug (Sec. 316.3(b)(3)(iii)). This revision
is consistent with longstanding policy and would impose no new costs.
Benefits from a minor clarification to a requirement that applies only
under unusual circumstances would be too small to reliably estimate.
We propose to modify and clarify our requirements for the drug
name. Current regulations require the sponsor to submit the generic and
trade name of the drug, but do not specify how to name a drug for which
there is no generic name or trade name. In the past, sponsors have
provided FDA with their internal business codes, which are meaningless
to the general public. We propose to require that a drug that has
neither a generic nor a trade name be identified according to its
chemical name or a meaningful descriptive name (i.e., one that would be
meaningful to the public if published). Descriptive names are readily
accessible to the sponsor and could be included in a designation
request as easily as an internal business code and any costs would be
too small to meaningfully quantify.
We propose to clarify our requirements for the drug description and
for the data to support a drug's scientific rationale in an orphan-drug
designation request. Some requests for orphan-drug designation cannot
be acted upon because the drug descriptions are not adequate to
determine whether the drug in the submission is the same as a
previously approved drug. This proposed rule would clarify the required
drug description in Sec. 316.20(b)(4), reducing the frequency of
deficient requests. Some requests lack the data to support a scientific
rationale, while others include substantial additional data not needed
to obtain designation. In both situations, sponsors incur costs that
could be avoided with clearer requirements. We do not know the
frequency of these data problems nor do we know the costs associated
with them, but this proposal would reduce sponsor and FDA costs.
We propose to eliminate Sec. 316.20(b)(9), which requires that the
sponsor submitting the request state whether it is the real party in
interest of the development and the intended or actual production and
sales of the product. This provision merely obtains information from
the sponsor; it does not provide a basis to disqualify any entity from
pursuing orphan-drug designation. There is no known use for the
information and it is our understanding that this provision may be
discouraging sponsors from using agents to submit requests on their
behalf, potentially increasing the cost to obtain orphan-drug
designation. We do not possess a reliable estimate for this cost.
Eliminating this provision would clarify our longstanding policy to
accept submissions from agents, which may reduce sponsor costs. Halting
the collection of information for which there is no known purpose would
not negatively impact public health.
We propose to clarify the requirement regarding the timing of
orphan-drug designation requests (Sec. 316.23(a)). A sponsor may not
submit an orphan-drug designation request after it has submitted a
marketing application for the drug for that use. It is not clear in the
current regulatory language that one sponsor's marketing application
would not prevent a different sponsor from submitting a request for
orphan designation for the same drug for the same orphan use and that
this subsequent sponsor would not have to submit a plausible hypothesis
of clinical superiority. Clarifying current policy would benefit
sponsors and public health by reducing the likelihood of a confused
sponsor failing to seek orphan-drug d