Applications for Food and Drug Administration Approval To Market a New Drug; Revision of Postmarketing Reporting Requirements-Discontinuance, 78530-78540 [2011-32354]
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Federal Register / Vol. 76, No. 243 / Monday, December 19, 2011 / Rules and Regulations
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[Docket No. FDA–2011–N–0898]
Applications for Food and Drug
Administration Approval To Market a
New Drug; Revision of Postmarketing
Reporting Requirements—
Discontinuance
AGENCY:
Food and Drug Administration,
HHS.
Interim final rule; request for
comments.
ACTION:
The Food and Drug
Administration (FDA or the Agency) is
issuing an interim final rule amending
its postmarketing reporting regulations
implementing certain provisions of the
Federal Food, Drug and Cosmetic Act.
The provisions of the Federal Food,
Drug and Cosmetic Act require
manufacturers who are the sole
manufacturers of certain drug products
to notify FDA at least 6 months before
discontinuance of manufacture of the
products. This interim final rule
modifies the term ‘‘discontinuance’’ and
clarifies the term ‘‘sole manufacturer’’
with respect to notification of
discontinuance requirements. The
broader reporting resulting from these
changes will enable FDA to improve its
collection and distribution of drug
shortage information to physician and
patient organizations and to work with
manufacturers and other stakeholders to
respond to potential drug shortages.
DATES: This interim final rule is
effective January 18, 2012. Submit either
electronic or written comments on the
provisions of this interim final rule by
February 17, 2012. Submit comments on
the information collection requirements
under the Paperwork Reduction Act of
1995 by January 3, 2012 (see the
‘‘Paperwork Reduction Act of 1995’’
section of this document).
ADDRESSES: You may submit comments,
identified by Docket No. FDA–2011–N–
0898 by any of the following methods,
except that comments on information
collection issues under the Paperwork
Reduction Act of 1995 must be
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SUMMARY:
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SUPPLEMENTARY INFORMATION:
I. Background
In the Federal Register of October 18,
2007 (72 FR 58993), we (FDA) issued a
final rule to revise our postmarketing
reporting requirements to implement
section 506C of the Federal Food, Drug,
and Cosmetic Act (21 U.S.C. 356c).
Section 506C of the Federal Food, Drug,
and Cosmetic Act (section 506C)
requires manufacturers who are the sole
manufacturers of certain drug products
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to notify us at least 6 months before
discontinuance of manufacture of the
products. Section 506C applies to sole
manufacturers of products that meet the
following three criteria:
1. The products are life supporting,
life sustaining, or intended for use in
the prevention of a debilitating disease
or condition;
2. The products are approved under
section 505(b) or (j) of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C.
355(b) or (j)); and
3. The products are not originally
derived from human tissue and replaced
by a recombinant product.
These three criteria are statutory
requirements. FDA assesses whether a
drug is ‘‘life supporting, life sustaining,
or intended for use in the prevention of
a debilitating disease or condition’’ on
a case-by-case basis, but intends to
provide further guidance on this issue
in the near future.
Section 506C also requires us to
distribute certain information about
covered discontinuances to appropriate
physician and patient organizations.
Under section 506C, FDA may reduce
the 6-month notification period if we
find good cause exists for the reduction.
Recent experience with drug
shortages in the United States has
shown the serious and immediate
impacts they can have on patients and
healthcare providers, particularly those
shortages involving drugs that are
manufactured by a small number of
firms and for which there are no good
therapeutic substitutes available. The
number of drug shortages annually has
tripled from 61 in 2005 to 178 in 2010.
Some shortages delay or deny needed
care for patients, because they involve
critical drugs used to treat cancer, to
provide required parenteral nutrition, or
to address other serious medical
conditions. Other shortages can result in
providers prescribing second-line
alternatives, which may be less effective
and higher risk than first-line therapies.
A survey of 1,800 health practitioners
conducted by the Institute for Safe
Medication Practices (ISMP) concluded
that drug shortages could lead to
medication errors and poor patient
outcomes because shortages can result
in the use of secondary alternative
therapies (Ref. 1).
In light of increasing concerns about
the impact of drug shortages on health
care in the United States, on October 31,
2011, the President issued Executive
Order 13588 directing the FDA to ‘‘take
steps that will help to prevent and
reduce current and future disruptions in
the supply of lifesaving medicines’’ and
noting that ‘‘one important step is
ensuring that the FDA and the public
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receive adequate advance notice of
shortages whenever possible’’ (Ref. 2).
In response to the Executive Order’s
directive to address the growing drug
shortage problem, this rule modifies the
regulation at § 314.81(b)(3)(iii) (21 CFR
314.81(b)(3)(iii)), which, in addition to
§ 314.91 (21 CFR 314.91), implements
section 506C of the Federal Food, Drug,
and Cosmetic Act.
II. Overview of the Interim Final Rule
This interim final rule adds two
definitions to § 314.81(b)(3)(iii)—a
definition of ‘‘discontinuance’’ and a
definition of ‘‘sole manufacturer.’’
Although these terms were discussed in
the preamble to the final rule issuing
§ 314.81(b)(3)(iii) published on October
18, 2007 (72 FR 58993) (2007 Preamble),
and have been used in various
documents informally expressing the
Agency’s interpretation of section 506C
and its implementing regulations (see,
for example, the Center for Drug
Evaluation and Research (CDER)
Manual of Policies and Procedures
6003.1, Drug Shortage Management (Ref.
3)), these terms were not defined in the
regulation. Given the serious and
growing threat to public health due to
drug shortages, the Agency believes it is
appropriate at this time to codify
definitions of these terms. This
modification and clarification of our
existing regulations will further the
public health objective of the Federal
Food, Drug, and Cosmetic Act as a
whole, and section 506C specifically by
increasing the scope of information that
FDA receives regarding
discontinuances. This will enable the
Agency to: (1) Expand collection and
distribution of information on the
discontinuance of certain drugs to
appropriate physician and patient
organizations as required by section
506C(c); and (2) work with
manufacturers and other stakeholders to
implement appropriate strategies to
reduce, to the greatest extent possible,
the public health impact of
discontinuances of products that can
lead to drug shortages. We believe that
clarification of terminology will also
improve statutory compliance.
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A. Discontinuance
The Agency is revising an earlier
policy position and defining the term
‘‘discontinuance’’ in the regulation to
include both permanent and temporary
interruptions in the manufacturing of a
drug product, if the interruption could
lead to a disruption in supply of the
product. This interpretation of the
statutory language best achieves the
public health purpose of section 506C
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and the Federal Food, Drug, and
Cosmetic Act as a whole.
Under section 506C, sole
manufacturers are required to notify
FDA of a ‘‘discontinuance’’ of a drug
product subject to section 506C. In the
2007 Preamble, in response to a
comment on the meaning of the term
discontinuance, we indicated that a
discontinuance did not include planned
or unplanned temporary manufacturing
cessations (72 FR 58993 at 58995,
response to comment 4). At that time,
we stated that only manufacturers who
intended to permanently discontinue
manufacture and marketing of the drug
product were subject to mandatory
reporting requirements under section
506C. In our response to the comment
in the 2007 Preamble, however, we did
request that manufacturers who
experience an unplanned temporary
manufacturing cessation keep the
Agency informed of the status of the
shutdown because ‘‘the duration of an
unplanned shutdown may be
unpredictable and could affect the
availability of needed therapy for
patients.’’
FDA no longer believes that this
narrow policy position regarding the
term ‘‘discontinuance’’ serves the public
health need that the Federal Food, Drug,
and Cosmetic Act was intended to
address. In 2007, the Agency believed
that the supply of drug product
available to patients during a temporary
manufacturing cessation, particularly
one that was planned, would not be
greatly affected during the interruption
in manufacturing. However, subsequent
experience has shown that even
temporary discontinuances of
manufacturing can have a significant
impact on patient access to drug
products. For example, if an equipment
failure necessitates an unexpected
temporary interruption in
manufacturing of a drug product subject
to section 506C, this discontinuance
could have serious implications for
patient access to the product.
Notification to FDA of such
discontinuances will expand FDA’s
ability to distribute information on the
discontinuance of certain drugs to
physician and patient organizations and
enable FDA to work with manufacturers
and other stakeholders to respond to
potential drug shortages.
The interim final rule therefore adds
§ 314.81(b)(3)(iii)(d) to provide that
‘‘discontinuance’’ means ‘‘any
interruption of manufacturing of a drug
product described in paragraph
(b)(3)(iii)(a) for sale in the United States
that could lead to a potential disruption
in supply of the drug product, whether
the interruption is intended to be
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temporary or permanent.’’ Thus the
term ‘‘discontinuance’’ now includes
both temporary and permanent
interruptions in manufacturing, if the
interruption could lead to a disruption
in supply of the product. This
interpretation of ‘‘discontinuance’’ is
consistent with Webster’s Third New
International Dictionary, which defines
the term to mean ‘‘cessation, shutdown,
closure; interruption’’ (Ref. 4). The
dictionary definition indicates that a
discontinuance can be interpreted to
include both situations that are
permanent (cessation, shutdown,
closure) and those that are temporary
(interruption).
Any permanent discontinuance of
manufacturing by a sole manufacturer
will lead, per se, to a disruption in
supply of the product; thus, all
permanent discontinuances must
continue to be reported. Temporary
discontinuances must be reported to the
Agency under this interim final rule
only if the discontinuance could lead to
a disruption in supply of the product.
We understand that a manufacturer
may be unable to report some temporary
discontinuances 6 months before the
discontinuance, as required by statute.
When notification at least 6 months
prior to the discontinuance is
impossible because it was unforeseen,
the manufacturer must notify the
Agency as soon as possible after it
knows that a discontinuance will occur.
For example, if a contamination
problem requires immediate shut down
of a manufacturing plant for a drug
product subject to section 506C, the
manufacturer will not be able to provide
the FDA with 6 months prior
notification, but would be required to
notify FDA as soon as the manufacturer
becomes aware that the contamination
necessitates a temporary discontinuance
of manufacture of the product.
Other circumstances that would
trigger notification to the FDA of a
discontinuance of a drug product
subject to section 506C include:
• A business decision to permanently
discontinue manufacture of a drug
product;
• A delay in acquiring active
pharmaceutical ingredients or inactive
ingredients that leads to, or could lead
to, a temporary interruption in
manufacturing of a drug product while
alternative suppliers are located;
• Equipment failure or contamination
affecting the quality of a drug product
that necessitates an interruption in
manufacturing while the equipment is
repaired or the contamination issue is
addressed;
• Manufacturing shut-downs for
maintenance or other routine matters, if
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the shut-down extends for longer than
anticipated or otherwise could disrupt
supply of a drug product;
Conversely, a manufacturer is not
required to notify FDA if a
discontinuance is part of the normal
manufacturing schedule and is not
expected to lead to a disruption in
supply of a drug product subject to
506C. For example, FDA need not be
notified in the following circumstances:
• The manufacturer uses the same
manufacturing plant to manufacture two
drug products, one of which (Product A)
is subject to section 506C. From January
to June of each year the manufacturer
uses the plant to produce Product A.
From July to December of each year the
manufacturer uses the plant to produce
Product B. Although this could be
considered a temporary discontinuance
of Product A from July to December,
because this is the usual manufacturing
schedule and should not therefore result
in a disruption in the supply of Product
A, the manufacturer need not notify the
Agency of the annual, temporary
discontinuance of Product A.
• A manufacturer of a drug product
implements a scheduled shutdown of its
manufacturing facility each year for
routine maintenance. The annual
shutdown is anticipated and planned
for in advance; therefore, it is not
expected to disrupt supply of a drug
product subject to 506C. The shutdown
does not need to be reported to the
Agency under section 506C.
• A manufacturer of a drug product
subject to 506C experiences an
unexpected power outage that results in
an unscheduled interruption in
manufacturing. The manufacturer
expects to resume normal operations
within a relatively short timeframe and
does not expect a disruption in the
supply of the drug product. The
shutdown does not need to be reported
to the Agency under section 506C.
If any of the circumstances described
above do lead to a disruption in supply
of the drug product, even if
unanticipated, then it becomes a
reportable discontinuance under this
rule and the manufacturer would be
required to notify FDA of a
discontinuance of the product.
In addition to revising the definition
of ‘‘discontinuance,’’ this interim final
rule makes a minor conforming change
by striking the phrase ‘‘discontinuing
manufacture’’ in the first sentence of
§ 314.81(b)(3)(iii)(a) and replacing it
with the phrase ‘‘discontinuance of
manufacture.’’ This change ensures that
the regulations contain an appropriate
cross-reference to the revised definition
of discontinuance.
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The interim final rule also makes a
minor change to the procedures in
§ 314.81(b)(3)(iii)(b) for reporting
notices of discontinuances to the
Agency. The interim final rule requires
manufacturers to report a notice of a
discontinuance to FDA either
electronically or by telephone according
to instructions on the FDA’s Drug
Shortages Web site at https://
www.fda.gov/Drugs/DrugSafety/
DrugShortages. Products regulated by
CDER must be reported to the CDER
Drug Shortages Coordinator. Products
regulated by the Center for Biologics
Evaluation and Research (CBER) must
be reported to the CBER Products
Shortage Coordinator. This change
ensures that the appropriate offices are
timely notified of all relevant
discontinuances. It also reflects existing
practice for submitting notices of
discontinuance, and reduces the burden
on industry to submit multiple copies of
the notification.
B. Sole Manufacturer
To best achieve the public health
purposes of the Federal Food, Drug, and
Cosmetic Act, and section 506C, the
Agency is clarifying the term sole
manufacturer to ensure that we receive
timely reports of all discontinuances of
drug products subject to section 506C,
including where other strengths, dosage
forms, or routes of administration of the
same drug product are marketed. The
clarification is intended to improve
statutory compliance and to minimize
instances where manufacturers fail to
make reports to the Agency as required
by section 506C. This clarification of the
statutory language best achieves the
purpose of section 506C and the Federal
Food, Drug, and Cosmetic Act as a
whole.
Section 314.81(b)(3)(iii) currently
does not include a definition of the term
‘‘sole manufacturer.’’ In the 2007
Preamble, we rejected a suggestion to
rely on the ‘‘Orange Book’’ (FDA’s
publication on ‘‘Approved Drug
Products with Therapeutic Equivalence
Evaluations’’) as the source for
determining whether an entity is a sole
manufacturer (72 FR 58993 at 58995,
comment 3). The comment to the
proposed rule had expressed concern
that, although the Orange Book lists all
drug products with approved new drug
applications (NDA) and abbreviated
new drug applications (ANDA), it is not
possible to determine whether the listed
approved products are, in fact, being
manufactured. The comment requested
that we define sole manufacturer as ‘‘an
applicant listed in the Orange Book who
is the holder of the only listed approved
application under section 505(b) or (j) of
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the [FD&C] Act.’’ We declined to accept
this definition of sole manufacturer, and
reliance on the Orange Book, to
determine whether an applicant was a
sole manufacturer for several reasons in
2007, including the following: (1) There
may be delays in updating the Orange
Book, rendering it temporarily
inaccurate; (2) the suggested definition
could create potential confusion
because some drugs are approved but
not marketed and are therefore placed in
the ‘‘discontinued’’ section of the
Orange Book; and (3) there are other
generally reliable sources for obtaining
commercial manufacturing information
to assist in determining whether an
applicant is a sole manufacturer.
We continue to believe that reference
to the Orange Book is not the
appropriate way to identify a ‘‘sole
manufacturer’’ for purposes of
implementing section 506C. In addition,
we believe there has been some
confusion as to the scope of the term.
Accordingly, the interim final rule adds
§ 314.81(b)(3)(iii)(d) to define ‘‘sole
manufacturer’’ in the regulation to mean
‘‘an applicant that is the only entity
currently manufacturing a drug product
of a specific strength, dosage form, or
route of administration for sale in the
United States, whether the product is
manufactured by the applicant or for the
applicant under contract with one or
more different entities.’’
The definition in this interim final
rule is intended to clarify that a sole
manufacturer means the only applicant
currently supplying the U.S. market
with the drug product. It does not mean
sole NDA or ANDA holder. A
manufacturer is considered a sole
manufacturer even if other
manufacturers hold an approved NDA
or ANDA for the same product, if the
other applicants are no longer
manufacturing (or have never
manufactured) the product for sale in
the United States. For example,
Company A holds an NDA for a drug
product subject to section 506C and
manufactures and sells that product in
the United States. Company B holds an
ANDA for the drug product, but does
not manufacture or sell the product in
the United States. Company A would be
considered a sole manufacturer of the
drug product for purposes of reporting
a discontinuance of the drug product
under section 506C. If Company B began
manufacturing and selling the drug
product in the United States, then
Company A would no longer be
considered a sole manufacturer. A
manufacturer is responsible for
determining if it is a sole manufacturer
under this regulation. There is
commercial information available to
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help with this determination. If an
applicant is unsure if it is a sole
manufacturer of a drug product subject
to section 506C, FDA’s drugs shortages
staff may be able to work with it to help
it determine whether it is or is not the
sole manufacturer of the drug.
The interim final rule also clarifies
that the specific strength, dosage form,
and route of administration of the
product are critical in determining if a
manufacturer is a sole manufacturer. For
example, if a company manufacturers
for sale in the United States an
injectable dosage form of a drug product
subject to section 506C, that company is
considered a sole manufacturer of that
drug product, even if a second company
manufactures and sells in the United
States an oral dosage form of the same
drug product for the same indication. In
this example, if the second company
was the only applicant manufacturing
and selling the oral dosage form in the
United States, both companies would be
considered sole manufacturers for
purposes of section 506C.
It is important that an entity currently
manufacturing a drug product of a
specific strength, dosage form, or route
of administration for sale in the United
States report a discontinuance to FDA
because that specific strength, dosage
form, or route of administration may be
critical for the targeted needs of
particular patients. To enable the
Agency to fully distribute information
under section 506C(c), and to work most
effectively with manufacturers and
other stakeholders to implement
appropriate strategies to reduce, to the
greatest extent possible, the public
health impact of drug shortages,
discontinuances of a specific strength,
dosage form, or route of administration
of drug products subject to section 506C
must be reported to us. Moreover, recent
experience has shown that
discontinuances of a specific strength,
dosage form, or route of administration
of a drug product may lead to a shortage
of another strength, dosage form, or
route of administration of the product,
compounding patient difficulties in
obtaining the drug product.
Finally, the new definition in the
interim final rule clarifies who bears the
responsibility for reporting to FDA a
discontinuance of a drug product
subject to section 506C. The inclusion of
‘‘whether the product is manufactured
by the applicant or for the applicant
under contract with one or more
different entities’’ in the definition
makes clear that the application holder
must report a discontinuance to FDA.
For purposes of section 506C, an
application holder will be considered a
‘‘manufacturer’’ even if the application
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holder contracts that function out to
another entity. The application holder is
responsible for establishing a process
with any relevant contract manufacturer
that ensures the application holder’s
compliance with this rule. This could
include contractual terms between the
application holder and the contract
manufacturer, as well as monitoring. For
example, Company X holds an NDA for
a drug product subject to section 506C.
Company X contracts with Company Y
to manufacture the drug product for the
purposes of marketing and selling the
drug product in the United States.
Company X would be considered the
‘‘sole manufacturer’’ in the above
situation, and is required to establish a
process with Company Y that ensures
Company X’s ability to report a
discontinuance of the drug product to
FDA.
III. Legal Authority
FDA is amending its postmarketing
reporting regulations implementing
section 506C of the Federal Food, Drug,
and Cosmetic Act (21 U.S.C. 356c).
Section 506C requires manufacturers
who are the sole manufacturers of
certain drug products to notify us at
least 6 months before discontinuance of
manufacture of the drug products. This
interim final rule modifies the term
‘‘discontinuance’’ and clarifies the term
‘‘sole manufacturer’’ with respect to
section 506C notification requirements.
FDA’s authority for this rule also
derives from section 701(a) of the
Federal Food, Drug, and Cosmetic Act
(21 U.S.C. 371(a)).
The Administrative Procedure Act
permits an agency to promulgate a rule
without notice and comment procedures
when an agency for ‘‘good cause finds
(and incorporates the finding and a brief
statement of reasons therefor in the
rules issued) that notice and public
procedure thereon are impracticable,
unnecessary, or contrary to the public
interest’’ (5 U.S.C. 553(b); 21 CFR
10.40(e)). FDA has determined that good
cause exists for this interim final rule
and that notice and comment
procedures are contrary to the public
interest given the serious and growing
threat to public health due to drug
shortages.
Recent experience with drug
shortages in the United States has
shown serious and immediate impacts
on patients and healthcare providers,
particularly those shortages involving
drugs that are manufactured by a small
number of firms and for which there are
no good therapeutic substitutes
available. Some shortages delay or deny
needed care for patients, because they
involve critical drugs used to treat
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78533
cancer, to provide required parenteral
nutrition, or to address other serious
medical conditions. Other shortages can
result in providers prescribing secondline alternatives, which may be less
effective and higher risk than first-line
therapies. The number of drug shortages
annually has tripled from 61 in 2005 to
178 in 2010. New shortages are
occurring at the present time.
The scope of information FDA
receives under the current regulations
has not adequately enabled the Agency
to distribute information on the
discontinuance of certain drugs to
physician and patient organizations as
required by section 506C(c) and to work
with manufacturers and other
stakeholders to respond to potential
drug shortages. There are significant
non-quantifiable benefits of reporting
information about discontinuances to
FDA, including better enabling the
Agency, manufacturers, healthcare
providers, and patients to monitor and
evaluate these discontinuances to
mitigate or prevent potential drug
shortages that can arise as a result of
these discontinuances and that could
otherwise lead to serious and
widespread adverse health
consequences. Any delay in the
implementation of this rule would limit
the ability of healthcare providers to
respond to potential and actual
shortages, and would reduce the ability
of FDA to work with manufacturers and
other stakeholders to prevent and
mitigate drug shortages. In this instance,
FDA has determined that an interim
final rule is legally permissible and in
the public’s interest.
IV. Analysis of Impacts
A. Introduction and Summary
1. Introduction
FDA has examined the impacts of the
interim final 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). This interim final
rule is a significant regulatory action as
defined by Executive Order 12866 and
accordingly has been reviewed by the
Office of Management and Budget.
The Regulatory Flexibility Act
requires agencies to analyze regulatory
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A survey conducted by the American
Hospital Association (AHA) concluded
that drug shortages are experienced by
hospitals. For example, almost 100
percent of the 820 hospitals surveyed
had experienced at least one drug
shortage in the 6 months preceding the
survey (Ref. 6). Another survey of 1,800
health practitioners conducted by the
ISMP suggested that because drug
shortages often result in the need for
physicians to prescribe alternative
therapies which may be less effective
and higher risk than first-line
treatments, drug shortages can lead to
the potential for medication errors and
poor patient outcomes as well as higher
costs (Refs. 1 and 7).
The interim final rule is intended to
increase the scope of information that
FDA receives, enabling the Agency to:
(1) Expand distribution of information
on the discontinuance of certain drugs
to appropriate physician and patient
organizations as required by section
506C(c); and (2) work with
manufacturers and other stakeholders to
implement appropriate strategies to
reduce, to the greatest extent possible,
the public health impact of
discontinuances of products that can
lead to drug shortages. The public
health purpose of section 506C and the
Federal Food, Drug, and Cosmetic Act
as a whole are best achieved with this
modification to our existing regulations.
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$15,064 in total. Non-quantifiable
benefits include the value of the
reported information about
discontinuances in helping FDA,
manufacturers, healthcare providers,
and patients to monitor and evaluate
these discontinuances to mitigate or
prevent potential drug shortages that
can arise as a result of these
discontinuances and that could
otherwise lead to serious and
widespread adverse health
consequences.
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ER19DE11.002
2. Summary
The interim final rule modifies the
term ‘‘discontinuance’’ and clarifies the
term ‘‘sole manufacturer’’ with respect
to notifications of discontinuance of
products that are life supporting, life
sustaining, or intended for use in the
prevention of a debilitating disease or
condition. The interim final rule will
impose annual reporting costs of up to
B. Objective of and Need for the Interim
Final Rule
Current regulations require that a sole
manufacturer of a drug product that is:
(1) Life supporting, life sustaining, or
intended for use in the prevention of a
debilitating disease or condition; (2)
approved under section 505(b) or 505(j)
of the Federal Food, Drug, and Cosmetic
Act; and (3) not a product that was
originally derived from human tissue
and was replaced by a recombinant
product report permanent
discontinuances to FDA at least 6
months prior to the discontinuance.
FDA can reduce the 6-month
notification period if the applicant
submits a certification of good cause,
and the Agency finds good cause.
The purpose of the interim final rule
is to define the terms ‘‘discontinuance’’
and ‘‘sole manufacturer.’’ In the interim
final rule, ‘‘discontinuance’’ is defined
as ‘‘any interruption in manufacturing
of a drug product described in
paragraph (b)(3)(iii)(a) for sale in the
United States that could lead to a
potential disruption in supply of the
drug product, whether the interruption
is intended to be temporary or
permanent.’’ ‘‘Sole manufacturer’’ is
defined as ‘‘an applicant that is the only
entity currently manufacturing a drug
product of a specific strength, dosage
form, or route of administration for sale
in the United States, whether the
product is manufactured by the
applicant or for the applicant under
contract with one or more different
entities.’’ These definitions will require
additional manufacturers to report to
FDA a wider range of discontinuances
that could potentially lead to a drug
shortage than under the current, existing
regulations.
While existing regulations require that
only permanent discontinuances be
reported to FDA, in practice, some
manufacturers voluntarily notify FDA
about temporary discontinuances. In the
past 2 years, such notifications have
enabled FDA to prevent 233 drug
shortages by expediting review of new
manufacturing sites, new suppliers, and
specification changes. Nonetheless,
recent data from FDA’s Drug Shortages
Program (DSP) indicate that the number
of drug shortages has tripled from 2005
to 2010 (see figure 1 below, Ref. 5).
options that would minimize any
significant impact of a rule on small
entities. The Agency projects that the
interim final rule will not likely have a
significant economic impact on a
substantial number of small entities, but
seeks comments on its analysis below.
Section 202(a) of the Unfunded
Mandates Reform Act of 1995 requires
that Agencies prepare a written
statement, which includes an
assessment of anticipated costs and
benefits, before proposing ‘‘any rule that
includes any Federal mandate that may
result in the expenditure by State, local,
and tribal governments, in the aggregate,
or by the private sector, of $100,000,000
or more (adjusted annually for inflation)
in any one year.’’ The current threshold
after adjustment for inflation is $136
million, using the most current (2010)
Implicit Price Deflator for the Gross
Domestic Product. FDA does not expect
this interim final rule to result in any 1year expenditure that would meet or
exceed this amount.
Federal Register / Vol. 76, No. 243 / Monday, December 19, 2011 / Rules and Regulations
Currently it appears that some
manufacturers may lack sufficient
incentives to either take steps to prevent
certain shortages or to notify FDA early
enough for the Agency to act (Ref. 7). By
providing clear definitions, the interim
final rule will address this concern and
require all applicants to report
appropriate information to the Agency
in a timely manner.
C. Benefits
The interim final rule modifies the
term ‘‘discontinuance’’ and clarifies the
term ‘‘sole manufacturer’’ with respect
to postmarketing reporting requirements
of products subject to section 506C. The
clarification in terminology captures
additional manufacturers as ‘‘sole
manufacturers’’ by explicitly linking the
definition of sole manufacturer to a
specific strength, dosage form, or route
of administration of a drug product.
Requiring notification of temporary
discontinuances and clarifying the term
sole manufacturer will result in FDA
receiving better and more timely
information on a wider range of
discontinuances. This increased
reporting will enable FDA to distribute
information on discontinuances to
appropriate physician and patient
organizations and to work with
manufactures and other stakeholders to
try to prevent a discontinuance from
leading to a drug shortage, or to mitigate
the impacts of an unavoidable drug
shortage on patients and healthcare
providers.
There is evidence that the negative
impact of drug shortages could be
significant. For instance, the American
Society of Health System Pharmacists
(ASHP) reported that annual labor costs
to manage drug shortages are
approximately $216 million in the
United States (Ref. 7). Moreover, drugs
in several major therapeutic classes are
in shortage, including oncology
products, antibiotics, and electrolyte/
nutrition products. For example,
statistics indicate that cancer alone
affects more than 11 million people in
the United States (Ref. 8). Therefore, the
potential benefits of the interim final
rule as a result of prevention or
mitigation of these drug shortages could
be substantial from both an economic
and public health viewpoint. Because
the shortage of even one critical drug
can impact a large number of patients
and healthcare providers, the potential
benefits could be substantial even if the
interim final rule only results in a small
number of additional notifications of
discontinuances to the Agency.
D. Costs
Currently, FDA receives one
mandatory notification that meets the
statutory and regulatory criteria of a
section 506C discontinuance per year
and zero certifications of good cause. In
addition, there are several dozen
voluntary submissions of information to
FDA that are related to section 506C
discontinuances but do not meet the
applicable statutory criteria, as
implemented by the current regulation.
We note that as a result of FDA’s letter
to industry (Ref. 10), FDA has
experienced a significant increase in the
number of notifications. We estimate
that the total number of manufacturers
who would be required to notify us of
a discontinuance under the interim final
rule would be 80 per year.1 However,
the impact of the interim final rule
represents the incremental impact,
which is the difference between the
total number of reports required by the
interim final rule and the baseline, i.e.,
the estimated number of reports that we
would receive without the interim final
rule. We estimate that as a result of the
interim final rule, we will receive an
78535
additional 9 to 24 notifications of
section 506C discontinuances (both
temporary and permanent
discontinuances) and 2 to 5 associated
certifications of good cause. In the 2007
Preamble, we estimated that it would
take two hours to prepare a notification
of discontinuance and 16 hours to
prepare a certification of good cause (72
FR 58993 at 58999). Since neither the
format nor the content of these
submissions will change as a result of
the interim final rule, we continue to
estimate that it will take two hours to
prepare a notification of discontinuance
and 16 hours to prepare a certification
of good cause. We estimate that it will
take longer to prepare a certification of
good cause than a notification of
discontinuance because preparing a
certification of good cause requires a
detailed narrative justifying a reduction
in the notification period, which is more
labor intensive than the simpler
notification of discontinuance.
Notifications are generally prepared
and submitted by a regulatory affairs
manager. Thus, labor hours are valued
using the median hourly wage for
Management Occupations (occupation
code 11–0000) in Pharmaceutical and
Medicine Manufacturing (North
American Industry Notification, NAICS,
code 325400) as reported by the Bureau
of Labor Statistics 2010 Employment
Occupational Statistics (Ref. 9). The
median hourly wage is $117, which is
adjusted for benefits and overhead.
The estimated cost is $234 ($117 × 2
hours) per notification of
discontinuance, and $1,872 ($117 × 16
hours) per certification of good cause. In
table 1 below we present the estimated
costs. The estimated annual cost of the
interim final rule is between $5,850 and
$15,064.
TABLE 1—ESTIMATED ADDITIONAL ANNUAL REPORTING COSTS OF THE INTERIM FINAL RULE
Number of
additional
responses
Type of response
Hours per
response
Cost per
response
Total estimated
cost
9–24
2–5
2
16
$234
$1,872
$2,106–$5,704
$3,744–9,360
Total ................................................................................................................
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Notification of Discontinuance (§ 314.81(b)(3)(iii)) ................................................
Certification of Good Cause (§ 314.91) .................................................................
....................
....................
....................
$5,850–$15,064
E. Analysis of Regulatory Alternatives
The interim final rule will result in
the submission of additional
notifications to FDA of a discontinuance
of a drug product subject to section
506C. As noted in FDA’s recent report
on medical product shortages (Ref. 5),
any system that increases reporting
must ensure that, in the pursuit of more
‘‘signal,’’ FDA is not overwhelmed with
‘‘noise.’’ We welcome comments on
how the notifications can be designed in
line with this principle. Such an
approach is consistent with Section 4 of
Executive Order 13563, which calls
1 The total is estimated based on 220 shortages
tracked by FDA’s CDER Drug Shortages Coordinator
from January through October of 2011, of which we
estimate 30 percent would relate to discontinuances
subject to mandatory reporting under section 506C
and this interim final rule. The estimated number
of discontinuances subject to mandatory reporting
(220 × 30 percent) is then adjusted to include two
additional months of reporting.
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Federal Register / Vol. 76, No. 243 / Monday, December 19, 2011 / Rules and Regulations
upon agencies ‘‘to identify and consider
regulatory approaches that reduce
burdens and maintain flexibility and
freedom of choice for the public.’’ FDA
identified the following alternatives to
the interim final rule: (1) No change in
regulation; and (2) publish guidance
that encourages sole manufacturers
(including manufacturers of specific
strengths, dosage forms, and routes of
administration) to notify FDA about
temporary discontinuances of drug
products subject to the rule, and (3)
provide incentives for voluntary
reporting.
1. Alternative 1: No Change in
Regulation
A simple alternative would be to
leave the current regulation unchanged.
While this alternative may not impose
additional costs on sole manufacturers
of drug products subject to section
506C, the benefits of this option would
be uncertain and would not provide any
additional tools to reduce the number of
product shortages.
2. Alternative 2: Publish Guidance
FDA could draft additional guidance
to encourage voluntary notification of
upcoming discontinuances. A recent
example is a FDA’s letter to industry
(Ref. 10). However, such
communications and guidance cannot
impose new regulatory requirements.
Without this regulation defining which
manufacturers are required to notify
FDA about both temporary and
permanent discontinuances of drug
products subject to section 506C, FDA
may not have adequate information to
distribute to physician and patient
organizations and to work effectively
with manufacturers and other
stakeholders to better prevent and
mitigate drug shortages.
3. Alternative 3: Provide Incentives for
Voluntary Reporting
It may be possible to develop a system
of incentives to encourage increased
reporting on a voluntary basis. FDA
welcomes comments from the public on
how such a system could be
implemented, including the types of
incentives that would advance the
FDA’s mission to protect the public
health while encouraging additional
reporting.
F. Regulatory Flexibility Analysis
FDA has examined the economic
implications of the interim final rule as
required by the Regulatory Flexibility
Act. The Agency projects that the
interim final rule will not likely have a
significant economic impact on a
substantial number of small entities, but
seeks comment on its analysis below.
1. Economic Effect on Small Entities
The Small Business Administration
(SBA) uses different definitions of what
a small entity is for different industries.
Using SBA standard size definitions, a
firm categorized in NAICS code 315412
(Pharmaceutical Preparations) or NAICS
code 325414 (Biological Products) is
considered small if it employs fewer
than 750 or 500 people, respectively
(Ref. 11). The most currently available
data from the 2007 Economic Census
(Ref. 12) show that at least 92 percent
of these establishments would be
considered small by SBA standards.2
We note that using data at the
establishment level implicitly assumes
that the typical manufacturing
establishment is roughly equivalent to
the typical small manufacturing firm.
We estimate that the cost per response
as a percent of average sales for
manufacturers in NAICS code 325412
could represent up to 0.002 percent of
sales. The greatest impact is on
establishments hiring fewer than 10
employees, where the cost per response
as a percent of average sales ranges from
0.029 percent to 0.235 percent. The
analysis of the effect on small versus
large entities for NAICS 312314 is
limited by data restrictions imposed to
safeguard the confidentially of some
establishments. Consequently, for
NAICS code 312314 the average value of
shipments is only presented for all
establishments. We estimate that the
cost per response as a percent of average
sales in this industry is between 0.001
percent and 0.004 percent (see table 2).
Therefore, the Agency concludes that
this rule will not likely have a
significant impact on a substantial
number of small entities, but we request
comments on our analysis.
TABLE 2—ESTIMATED ECONOMIC IMPACT OF INTERIM FINAL RULE ON SMALL ENTITIES
Cost per response as a percent of average sales
Total value of
shipments ($000)
408
77
249
182
75
324,604
317,551
8,377,347
32,516,961
68,162,155
796
4,124
33,644
178,665
908,829
0.029
0.006
0.001
0.000
0.000
0.235
0.045
0.006
0.001
0.000
991
109,698,618
110,695
0.000
0.002
350
16,112,435
46,036
0.001
0.004
NAICS Code 325412:
0–9 .........................................................
10–19 ..............................................
20–99 ..............................................
100–499 ..........................................
500 and over ...................................
All .............................................
NAICS Code 325414:
All .............................................
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2. Additional Flexibility Identified
2 For NAICS code 325412, total value of
shipments data are not available for establishments
employing fewer than 750 employees. The
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($234 per response—notification of discontinuance)
(%)
($1,872 per response—certification of good
cause)
(%)
Alternative 1: Exempt Small-sized
Entities: Exempting small-sized
businesses from the interim final rule
would reduce the economic impact to
In this section, we identify
alternatives that would present
reductions in costs to small entities.
VerDate Mar<15>2010
Average value of
shipments
($1,000)
Number of establishments
Number of employees
small businesses by up to 0.235 percent
of average sales. However, not imposing
these notification requirements on drug
products subject to section 506C could
estimated percent of small establishments (92
percent) is based on the total number of
establishments with fewer than 500 employees. For
NAICS code 324514 the percent of establishments
with fewer than 750 employees is 96 percent.
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exacerbate the increasing trend in drug
shortages that affect a substantial
number of patients and healthcare
providers. Moreover, these reporting
requirements enable FDA to distribute
information to physician and patient
organizations, to assess potential drug
shortages, and to evaluate mitigation
strategies. Thus, exempting small
business entities may in the long-term
lead to high social costs associated with
outcomes such as worsening of
conditions for patients for whom these
products are necessary.
Alternative 2: Extend the Compliance
Period for Small Businesses: An
alternative to reduce costs would be to
extend the compliance period for smallsized entities. While a longer
compliance period may enable small
businesses to reduce labor costs, it
would delay FDA’s receipt of notices of
discontinuance and limit the Agency’s
ability to distribute information to
physician and patient organizations as
required by section 506C(c), to assess
potential drug shortages, and to work
with manufacturers and other
stakeholders to prevent or mitigate
shortages.
V. Paperwork Reduction Act of 1995
This interim final rule contains
information collection provisions that
are subject to review by OMB under the
Paperwork Reduction Act of 1995 (44
U.S.C. 3501–3520) (the PRA). The title,
description, and respondent description
of these provisions are shown below
with 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: (1)
Whether the proposed collections of
information are 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 collections 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 collections of information
on respondents, including through the
use of automated collection techniques,
when appropriate, or other forms of
information technology.
Title: Applications for Food and Drug
Administration Approval to Market a
New Drug; Revision of Postmarketing
Reporting Requirements—
Discontinuance.
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Description: Sections 314.81(b)(3)(iii)
and 314.91 of FDA’s regulations
(‘‘§ 314.81(b)(3)(iii)’’ and ‘‘§ 314.91’’,
respectively) implement section 506C.
Section 314.81(b)(3)(iii) requires entities
who are the sole manufacturers of
certain drug products to notify us at
least 6 months before discontinuance of
manufacture of the product. For the
regulations to apply, a product must
meet the following three criteria:
1. The product must be life
supporting, life sustaining, or intended
for use in the prevention of a
debilitating disease or condition;
2. The product must have been
approved by FDA under section 505(b)
or 505(j) of the Federal Food, Drug, and
Cosmetic Act; and
3. The product must not have been
originally derived from human tissue
and replaced by a recombinant product.
Under § 314.81(b)(3)(iii)(c), we will
publicly disclose information about
drug products subject to section 506C
that are to be discontinued. Section
314.91 allows us to reduce the 6-month
notification period if we find that good
cause exists for the reduction. A
manufacturer may request that we
reduce the notification period by
certifying that good cause for the
reduction exists.
In the October 18, 2007 final rule (72
FR 58993), we added §§ 314.81(b)(3)(iii)
and 314.91 to our regulations. Sections
314.81(b)(3)(iii) and 314.91 require two
new reporting requirements to FDA that
are subject to OMB approval under the
PRA: Notification of Discontinuance
and Certification of Good Cause. The
interim final rule adds two new
definitions to § 314.81(b)(3)(iii):
‘‘discontinuance’’ and ‘‘sole
manufacturer.’’ The interim final rule
clarifies the scope of manufacturers
required to report and expands the
range of circumstances required to be
reported to the Agency under
§ 314.81(b)(3)(iii), but does not change
the substantive content of the reports
required to be submitted to the Agency.
This PRA analysis covers the
information collection resulting from
the October 18, 2007 final rule and also
includes our estimates of how the
number of Notifications of
Discontinuance and Certifications of
Good Cause may increase as a result of
this interim final rule. Accordingly, the
estimates included in the Analysis of
Impacts will not directly match the
estimates in the PRA analysis because
the PRA analysis represents an estimate
of the total reporting burden under
§§ 314.81(b)(3)(iii) and 314.91, while the
Analysis of Impacts examines only the
increased costs and benefits as a result
of the interim final rule.
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78537
A. Notification of Discontinuance
Under § 314.81(b)(3)(iii), at least 6
months before a sole manufacturer
intends to discontinue manufacture of a
drug product subject to section 506C,
the manufacturer must send us
notification of the discontinuance. The
notification of discontinuance generally
contains the name of the manufacturer,
the name of the product to be
discontinued, the reason for the
discontinuance, and the date of
discontinuance. We will work with
relevant manufacturers during the 6month notification period to help
minimize the effect of the
discontinuance on patients and health
care providers, and to distribute
appropriate information about the
discontinuance to physician and patient
organizations. The interim final rule
adds definitions of ‘‘discontinuance’’
and ‘‘sole manufacturer’’ to
§ 314.81(b)(3)(iii). The inclusion of these
definitions expands notification
requirements under § 314.81(b)(3)(iii) to
additional discontinuance
circumstances and clarifies the scope of
manufacturers who must report
discontinuances. The interim final rule
also requires that notifications of
discontinuance be submitted either
electronically or by telephone according
to instructions on FDA’s Drug Shortage
Web site at https://www.fda.gov/Drugs/
DrugSafety/DrugShortages. This change
ensures that the appropriate offices are
timely notified of all relevant
discontinuances. It also reflects existing
practice for submitting notices of
discontinuance, and reduces the burden
on industry to submit multiple copies of
the notification.
B. Certification of Good Cause
We may reduce the 6-month
notification period if we find good cause
for the reduction. As described in
§ 314.91, a manufacturer can request a
reduction in the notification period by
submitting written certification that
good cause exists to the following
designated offices: (1) The CDER Drug
Shortage Coordinator at the address of
the Director of CDER; (2) the CDER Drug
Registration and Listing Team, Division
of Compliance Risk Management and
Surveillance in CDER; and (3) the
director of either the CDER division or
the CBER office that is responsible for
reviewing the application. The
following circumstances may establish
good cause:
• A public health problem may result
from continuation of manufacturing for
the 6-month period (§ 314.91(d)(1));
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Federal Register / Vol. 76, No. 243 / Monday, December 19, 2011 / Rules and Regulations
• A biomaterials shortage prevents
the continuation of manufacturing for
the 6-month period (§ 314.91(d)(2));
• A liability problem may exist for
the manufacturer if the manufacturing is
continued for the 6-month period
(§ 314.91(d)(3));
• Continuation of the manufacturing
for the 6-month period may cause
substantial economic hardship for the
manufacturer (§ 314.91(d)(4));
• The manufacturer has filed for
bankruptcy under chapter 7 or 11 of title
11, United States Code (§ 314.91(d)(5));
• The manufacturer can stop making
the product but still distribute it to
satisfy existing market need for 6
months (§ 314.91(d)(6)); or
• Other good cause exists for a
reduction in the notification period
(§ 314.91(d)(7)).
With each certification described
previously, the manufacturer must
describe in detail the basis for its
conclusion that such circumstances
exist. We require that the written
certification that good cause exists be
submitted to the offices identified
previously to ensure that our efforts to
address the discontinuance take place in
a timely manner. The interim final rule
makes no changes to the requirements
or process for certification of good
cause.
Description of Respondents: An
applicant that is the sole manufacturer
and who is discontinuing manufacture
of a drug product that meets the
following criteria: (1) Is life supporting,
life sustaining, or intended for use in
the prevention of a debilitating disease
or condition; (2) was approved by FDA
under section 505(b) or (j) of the Federal
Food, Drug, and Cosmetic Act; and (3)
was not originally derived from human
tissue and replaced by a recombinant
product.
Burden Estimate: Table 3 of this
document provides an estimate of the
annual reporting burden for notification
of a product discontinuance and
certification of good cause under
§§ 314.81(b)(3)(iii) and 314.91, as
amended by this interim final rule.
Notification of Discontinuance: Based
on data collected from the CDER Drug
Shortage Coordinator since December
17, 2007, when §§ 314.81(b)(3)(iii) and
314.91 went into effect, one
manufacturer during each year reported
to FDA a discontinuance of one drug
product meeting the criteria of section
506C and its implementing regulations
(i.e., the drug product was approved
under section 505(b) or (j) of the Federal
Food, Drug, and Cosmetic Act, the drug
product was ‘‘life-supporting, lifesustaining or intended for use in the
prevention of a debilitating disease or
condition,’’ the drug product was
produced by a sole manufacturer, and
the drug product was permanently
discontinued). CDER’s Drug Shortages
Coordinator tracked 220 drug shortages
between January and October of 2011.
The Agency estimates that 30 percent
(66) of these shortages would relate to
discontinuances subject to mandatory
reporting under section 506C as a result
of the interim final rule. Adjusting to
include an additional two months of
reporting (November and December), we
estimate that FDA will receive a total of
80 notifications of a discontinuance per
year under section 506C, as amended by
the interim final rule. Based on
experience, a manufacturer submits
only one notification of a
discontinuance per year, thus the total
number of manufacturers who would be
required to notify us of a discontinuance
would be 80. Therefore, the number of
respondents is estimated to be 80. The
hours per response is the estimated
number of hours that a respondent
would spend preparing the information
to be submitted with a notification of
product discontinuance, including the
time it takes to gather and copy the
statement. Based on experience in
working with manufacturers to submit
notifications under § 314.81(b)(3)(iii),
we estimate that approximately 2 hours
on average are needed per response. We
do not expect the changes in the interim
final rule to affect the number of hours
per response. Therefore, we estimate
that respondents will spend 160 hours
per year notifying us of a product
discontinuance under these regulations.
Certification of Good Cause: Based on
data collected from the CDER drug
shortage coordinator since 2007, one
manufacturer each year reported a
discontinuance of one drug product
under section 506C and its
implementing regulations. Each
manufacturer has the opportunity under
§ 314.91 to request a reduction in the 6month notification period by certifying
to us that good cause exists for the
reduction. The Agency has received no
certifications of good cause since 2007.
Although we expect we will receive an
increase in the number of reports of
discontinuances as a result of the
changes in the interim final rule,
because of the limited circumstances
under which good cause can be
requested or would be appropriately
granted, we do not expect a
correspondingly large increase in the
number of manufacturers requesting a
certification of good cause. We estimate
that only 5 manufacturers will request a
certification of good cause each year.
Therefore, the number of respondents is
estimated to be 5. The total annual
responses are the total number of
certifications of good cause that are
expected to be submitted to us in a year.
We estimate that the total annual
responses will remain small, averaging
one response per respondent. The hours
per response is the estimated number of
hours that a respondent spends
preparing the detailed information
certifying that good cause exists for a
reduction in the notification period,
including the time it takes to gather and
copy the documents. We estimate that
approximately 16 hours on average are
needed per response. Therefore, we
estimate that 80 hours will be spent per
year by respondents certifying that good
cause exists for a reduction in the 6month notification period under
§ 314.91.
TABLE 3—ESTIMATED ANNUAL REPORTING BURDEN 1
Number of respondents
Number of responses per
respondent
Notification of Discontinuance .............................................
(314.81(b)(3)(iii)) ..................................................................
Certification of Good Cause (314.91) ..................................
80
5
1
1
Total ..............................................................................
240
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21 CFR Section
1 There
Total annual
responses
80
5
are no capital costs or operating and maintenance costs associated with this collection of information.
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Hours per response
2
16
Total hours
160
80
Federal Register / Vol. 76, No. 243 / Monday, December 19, 2011 / Rules and Regulations
The information collection provisions
for this interim final rule have been
submitted to OMB for emergency review
under the Paperwork Reduction Act of
1995. An agency may not conduct or
sponsor, and a person is not required to
respond to, a collection of information
unless it displays a currently valid OMB
control number.
Interested persons are requested to fax
comments regarding the information
collection to the Office of Information
and Regulatory Affairs, OMB. To ensure
that comments on the 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) 395–5806, or
emailed to
OIRA_submission@omb.eop.gov. All
comments should be identified with the
title, ‘‘Applications for Food and Drug
Administration Approval to Market a
New Drug; Revision of Postmarketing
Reporting Requirements—
Discontinuance.’’
VI. Federalism
FDA has analyzed this interim final
rule in accordance with the principles
set forth in Executive Order 13132. FDA
has determined that the rule does not
contain policies that have substantial
direct effects on the States, on the
relationship between the National
Government and the States, or on the
distribution of power and
responsibilities among the various
levels of government. Accordingly, the
Agency has concluded that the rule does
not contain policies that have
federalism implications as defined in
the Executive order and, consequently,
a federalism summary impact statement
is not required.
srobinson on DSK4SPTVN1PROD with RULES
VII. Environmental Impact
The Agency has determined under 21
CFR 25.30(h) that this action is of a type
that does not individually or
cumulatively have a significant effect on
the human environment. Therefore,
neither an environmental assessment
nor an environmental impact statement
is required.
VIII. Comments
Interested persons may submit to the
Division of Dockets Management (see
ADDRESSES) either electronic or written
comments regarding this document. 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
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of Dockets Management between 9 a.m.
and 4 p.m., Monday through Friday.
IX. References
The following references are on
display in the Division of Dockets
Management (see ADDRESSES) and may
be seen by interested persons between 9
a.m. and 4 p.m., Monday through
Friday. (FDA has verified all Web site
addresses, but FDA is not responsible
for any subsequent changes to the Web
site after this document publishes in the
Federal Register).
1. Institute for Safe Medication Practices.
Drug Shortages: National Survey Reveals
High Level of Frustration, Low Level of
Safety. ISMP Medication Safety Alert. Sept
23, 2010, available at https://www.ismp.org/
newsletters/acutecare/articles/20100923.asp,
accessed December 2011.
2. Executive Order 13588, Reducing
Prescription Drug Shortages, October 31,
2011, available at https://www.gpo.gov/fdsys/
pkg/FR-2011-11-03/pdf/2011-28728.pdf
accessed December 2011.
3. Center for Drug Evaluation and
Research, Manual of Policies and Procedures
6003.1, Drug Shortage Management,
September 26, 2006, available at https://
www.fda.gov/downloads/AboutFDA/
CentersOffices/CDER/
ManualofPoliciesProcedures/ucm079936.pdf,
accessed December 2011.
4. Webster’s Third New International
Dictionary of the English Language
Unabridged, 2002, defining
‘‘discontinuance.’’
5. Food and Drug Administration. A
Review of FDA’s Approach to Medical
Product Shortage, October 31, 2011, available
at https://www.fda.gov/AboutFDA/
ReportsManualsForms/Reports/
ucm275051.htm, accessed December 2011.
6. American Hospital Association. AHA
Survey on Drug Shortages, available at
https://www.aha.org/aha/content/2011/pdf/
drugshortagesurvey.pdf, accessed December
2011.
7. Department of Health and Human
Services. Assistant Secretary for Planning
and Evaluation. Economic Analysis of the
Causes of Drug Shortages, October 2011,
available at https://aspe.hhs.gov/sp/reports/
2011/DrugShortages/ib.shtml, accessed
December 2011.
8. American Cancer Society. Cancer Facts
& Figures 2011. Atlanta: American Cancer
Society; 2011, available at https://
www.cancer.org/acs/groups/content/
@epidemiologysurveilance/documents/
document/acspc-029771.pdf, accessed
December 2011.
9. Bureau of Labor Statistics. National
Occupational Employment and Wage
Estimates. Occupational Employment
Statistics, May 2010, available at https://
www.bls.gov/oes/current/oes_nat.htm,
accessed December 2011.
10. Food and Drug Administration. Letter
to Industry, October 31, 2011, available at
https://www.fda.gov/Drugs/DrugSafety/
DrugShortages/ucm277675.htm, accessed
December 2011.
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78539
11. Small Business Administration. Table
of Small Business Size Standards Matched to
North American Industry Classification
System Codes. November 2010, available at
https://www.sba.gov/sites/default/files/
Size_Standards_Table.pdf, accessed
December 2011.
12. United States Census Bureau. 2007
Economic Census. Sector 31: Manufacturing:
General Summary: Industry Statistics for
Subsectors and Industries by Employment
Size: 2007, available at https://
factfinder.census.gov/servlet/IBQTable?_
bm=y&-geo_id=&-fds_name=EC0700A1&-ds_
name=EC0731SG3&-_lang=en, accessed
December 2011.
List of Subjects in 21 CFR Part 314
Administrative practice and
procedure, Confidential business
information, Drugs, Reporting and
recordkeeping requirements.
Therefore, under the Federal Food,
Drug, and Cosmetic Act, the Public
Health Service Act, and under authority
delegated to the Commissioner of Food
and Drugs, 21 CFR part 314 is amended
as follows:
PART 314—APPLICATIONS FOR FDA
APPROVAL TO MARKET A NEW DRUG
1. The authority citation for 21 CFR
part 314 continues to read as follows:
■
Authority: 21 U.S.C. 321, 331, 351, 352,
353, 355, 356, 356a, 356b, 356c, 371, 374,
379e.
2. In § 314.81, paragraph (b)(3)(iii)(a)
is amended by removing the phrase
‘‘discontinuing manufacture’’ and
adding in its place the phrase
‘‘discontinuance of manufacture’’; by
revising paragraph (b)(3)(iii)(b); and by
adding new paragraph (b)(3)(iii)(d) to
read as follows:
■
§ 314.81
Other postmarketing reports.
*
*
*
*
*
(b) * * *
(3) * * *
(iii) * * *
(b) Notifications required by
paragraph (b)(3)(iii)(a) of this section
must be submitted to FDA either
electronically or by phone according to
instructions on FDA’s Drug Shortages
Web site at: https://www.fda.gov/Drugs/
DrugSafety/DrugShortages.
*
*
*
*
*
(d) For purposes of this section and
§ 314.91, the terms ‘‘discontinuance’’
and ‘‘sole manufacturer’’ are defined as
follows:
Discontinuance means any
interruption in manufacturing of a drug
product described in paragraph
(b)(3)(iii)(a) of this section for sale in the
United States that could lead to a
potential disruption in supply of the
drug product, whether the interruption
E:\FR\FM\19DER1.SGM
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Federal Register / Vol. 76, No. 243 / Monday, December 19, 2011 / Rules and Regulations
is intended to be temporary or
permanent.
Sole manufacturer means an
applicant that is the only entity
currently manufacturing a drug product
of a specific strength, dosage form, or
route of administration for sale in the
United States, whether the product is
manufactured by the applicant or for the
applicant under contract with one or
more different entities.
*
*
*
*
*
Dated: December 13, 2011.
Leslie Kux,
Acting Assistant Commissioner for Policy.
[FR Doc. 2011–32354 Filed 12–15–11; 8:45 am]
BILLING CODE 4160–01–P
DEPARTMENT OF THE TREASURY
Internal Revenue Service
26 CFR Part 1
[TD 9565]
RIN 1545–BG15
Corporate Reorganizations; Guidance
on the Measurement of Continuity of
Interest
Internal Revenue Service (IRS),
Treasury.
ACTION: Final regulations and removal of
temporary regulations.
AGENCY:
This document contains final
regulations that provide guidance
regarding the continuity of interest
requirement for corporate
reorganizations. The guidance is
necessary to establish the date upon
which continuity of interest is
measured. These regulations affect
corporations and their shareholders.
DATES: Effective Date: These regulations
are effective on December 19, 2011.
Applicability Date: For dates of
applicability, see § 1.368–1(e)(9)(ii).
FOR FURTHER INFORMATION CONTACT:
Richard Starke at (202) 622–7790 (not a
toll-free number).
SUPPLEMENTARY INFORMATION:
SUMMARY:
srobinson on DSK4SPTVN1PROD with RULES
Background
The Internal Revenue Code of 1986
(Code) provides for general nonrecognition treatment for
reorganizations described in section 368
of the Code. In addition to satisfying the
statutory requirements of a
reorganization, a transaction also must
satisfy certain non-statutory
requirements, such as continuity of
interest (COI). COI requires that, in
substance, a substantial part of the value
of the proprietary interests in the target
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18:16 Dec 16, 2011
Jkt 226001
corporation be preserved in the
reorganization. A proprietary interest in
the target corporation is preserved if, in
a potential reorganization, it is
exchanged for a proprietary interest in
the issuing corporation, it is exchanged
by the acquiring corporation for a direct
interest in the target corporation
enterprise, or it otherwise continues as
a proprietary interest in the target
corporation. See § 1.368–1(e)(1)(i).
On August 10, 2004, the IRS and the
Treasury Department published a notice
of proposed rulemaking (REG–129706–
04, 2004–2 CB 479) in the Federal
Register (69 FR 48429) (2004 proposed
regulations) identifying certain
circumstances in which the
determination of whether a proprietary
interest in the target corporation is
preserved would be made by reference
to the value of the issuing corporation’s
stock on the day before there is an
agreement to effect the potential
reorganization. Specifically, the 2004
proposed regulations provided that, in
determining whether a proprietary
interest in the target corporation is
preserved, the consideration to be
exchanged for the proprietary interests
in the target corporation pursuant to a
contract to effect the potential
reorganization is valued on the last
business day before the first date such
contract is a binding contract (the PreSigning Date), if such consideration was
fixed at the signing date (the signing
date rule). On September 16, 2005, the
IRS and the Treasury Department
published final regulations (TD 9225,
2005–2 CB 716) in the Federal Register
(70 FR 54631) (2005 final regulations)
that retained the general framework of
the 2004 proposed regulations but made
several modifications in response to
comments received regarding the
proposed regulations. After
consideration of comments relating to
the 2005 final regulations, the IRS and
the Treasury Department published
temporary (TD 9316, 2007–1 CB 962)
and proposed (REG–146247–06, 2007–1
CB 977) regulations in the Federal
Register (72 FR 12974 and 72 FR 13058
respectively) (the 2007 temporary
regulations). The 2007 temporary
regulations generally narrowed the
definition of fixed consideration, and
accordingly, limited the application of
the signing date rule. The preamble
explained that the signing date rule is
based on the principle that, where a
binding contract provides for fixed
consideration, the target corporation
shareholders can generally be viewed as
being subject to the economic fortunes
of the issuing corporation as of the
signing date. However, if the contract
PO 00000
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Fmt 4700
Sfmt 4700
does not provide for fixed
consideration, the signing date value of
the issuing corporation stock is not
relevant for purposes of determining the
extent to which a proprietary interest in
the target corporation is preserved.
On March 17, 2010, the IRS released
Notice 2010–25 (the Notice), 2010–1 CB
527. Notice 2010–25 acknowledged that
the 2007 temporary regulations would,
as required by sunset provisions of
section 7805(e)(2), expire on March 19,
2010. It also noted that proposed
regulations (REG–146247–06, 2007–1
CB 977) previously published in the
Federal Register (72 FR 13058) had the
same text as the expiring temporary
regulations and would remain
outstanding after that expiration. The
Notice provided that, until the issuance
of new regulations, taxpayers could
choose, as long as a specified condition
of consistency among parties was
satisfied, to apply the rules in the
proposed regulations. The ability of
taxpayers to elect to apply the rules of
the proposed regulations, as provided in
the Notice, is incorporated into § 1.368–
1(e)(9)(ii), the effective/applicability
date of these final regulations. See
§ 601.601(d)(2)(ii)(b).
Explanation of Revisions
These final regulations adopt the 2007
temporary regulations with only minor
changes. First, questions were raised
concerning whether a contract can
provide for fixed consideration under
the general definition of fixed
consideration if the contract provides
for a shareholder election. These final
regulations clarify that a shareholder
election does not prevent a contract
from satisfying the general definition of
fixed consideration if that requirement
is otherwise met. Second, Example 9 is
modified to address a more typical fact
pattern.
In response to comments regarding
the application of the signing date rule
and after further consideration of the
purpose and operation of that rule, the
IRS and the Treasury Department have
proposed a regulation, published
elsewhere in this issue of the Federal
Register, under which application of the
signing date principles would be
expanded. That notice of proposed
rulemaking (REG–124627–11) also
requests comments regarding the
propriety of applying signing date
principles more generally to
transactions in which the target
corporation shareholders, pursuant to a
binding contract to effect a potential
reorganization, become subject to the
economic fortunes of issuing
corporation consideration between the
signing date and the closing date. In
E:\FR\FM\19DER1.SGM
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Agencies
[Federal Register Volume 76, Number 243 (Monday, December 19, 2011)]
[Rules and Regulations]
[Pages 78530-78540]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2011-32354]
=======================================================================
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Food and Drug Administration
21 CFR Part 314
[Docket No. FDA-2011-N-0898]
Applications for Food and Drug Administration Approval To Market
a New Drug; Revision of Postmarketing Reporting Requirements--
Discontinuance
AGENCY: Food and Drug Administration, HHS.
ACTION: Interim final rule; request for comments.
-----------------------------------------------------------------------
SUMMARY: The Food and Drug Administration (FDA or the Agency) is
issuing an interim final rule amending its postmarketing reporting
regulations implementing certain provisions of the Federal Food, Drug
and Cosmetic Act. The provisions of the Federal Food, Drug and Cosmetic
Act require manufacturers who are the sole manufacturers of certain
drug products to notify FDA at least 6 months before discontinuance of
manufacture of the products. This interim final rule modifies the term
``discontinuance'' and clarifies the term ``sole manufacturer'' with
respect to notification of discontinuance requirements. The broader
reporting resulting from these changes will enable FDA to improve its
collection and distribution of drug shortage information to physician
and patient organizations and to work with manufacturers and other
stakeholders to respond to potential drug shortages.
DATES: This interim final rule is effective January 18, 2012. Submit
either electronic or written comments on the provisions of this interim
final rule by February 17, 2012. Submit comments on the information
collection requirements under the Paperwork Reduction Act of 1995 by
January 3, 2012 (see the ``Paperwork Reduction Act of 1995'' section of
this document).
ADDRESSES: You may submit comments, identified by Docket No. FDA-2011-
N-0898 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-0898 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: Kalah Auchincloss, Center for Drug
Evaluation and Research, Food and Drug Administration, 10903 New
Hampshire Ave., Silver Spring, MD 20993, (301) 796-0659, or Stephen
Ripley, Center for Biologics Evaluation and Research, Food and Drug
Administration, 1401 Rockville Pike, Rockville, MD 20852-1448, (301)
827-6210.
SUPPLEMENTARY INFORMATION:
I. Background
In the Federal Register of October 18, 2007 (72 FR 58993), we (FDA)
issued a final rule to revise our postmarketing reporting requirements
to implement section 506C of the Federal Food, Drug, and Cosmetic Act
(21 U.S.C. 356c). Section 506C of the Federal Food, Drug, and Cosmetic
Act (section 506C) requires manufacturers who are the sole
manufacturers of certain drug products to notify us at least 6 months
before discontinuance of manufacture of the products. Section 506C
applies to sole manufacturers of products that meet the following three
criteria:
1. The products are life supporting, life sustaining, or intended
for use in the prevention of a debilitating disease or condition;
2. The products are approved under section 505(b) or (j) of the
Federal Food, Drug, and Cosmetic Act (21 U.S.C. 355(b) or (j)); and
3. The products are not originally derived from human tissue and
replaced by a recombinant product.
These three criteria are statutory requirements. FDA assesses
whether a drug is ``life supporting, life sustaining, or intended for
use in the prevention of a debilitating disease or condition'' on a
case-by-case basis, but intends to provide further guidance on this
issue in the near future.
Section 506C also requires us to distribute certain information
about covered discontinuances to appropriate physician and patient
organizations. Under section 506C, FDA may reduce the 6-month
notification period if we find good cause exists for the reduction.
Recent experience with drug shortages in the United States has
shown the serious and immediate impacts they can have on patients and
healthcare providers, particularly those shortages involving drugs that
are manufactured by a small number of firms and for which there are no
good therapeutic substitutes available. The number of drug shortages
annually has tripled from 61 in 2005 to 178 in 2010. Some shortages
delay or deny needed care for patients, because they involve critical
drugs used to treat cancer, to provide required parenteral nutrition,
or to address other serious medical conditions. Other shortages can
result in providers prescribing second-line alternatives, which may be
less effective and higher risk than first-line therapies. A survey of
1,800 health practitioners conducted by the Institute for Safe
Medication Practices (ISMP) concluded that drug shortages could lead to
medication errors and poor patient outcomes because shortages can
result in the use of secondary alternative therapies (Ref. 1).
In light of increasing concerns about the impact of drug shortages
on health care in the United States, on October 31, 2011, the President
issued Executive Order 13588 directing the FDA to ``take steps that
will help to prevent and reduce current and future disruptions in the
supply of lifesaving medicines'' and noting that ``one important step
is ensuring that the FDA and the public
[[Page 78531]]
receive adequate advance notice of shortages whenever possible'' (Ref.
2). In response to the Executive Order's directive to address the
growing drug shortage problem, this rule modifies the regulation at
Sec. 314.81(b)(3)(iii) (21 CFR 314.81(b)(3)(iii)), which, in addition
to Sec. 314.91 (21 CFR 314.91), implements section 506C of the Federal
Food, Drug, and Cosmetic Act.
II. Overview of the Interim Final Rule
This interim final rule adds two definitions to Sec.
314.81(b)(3)(iii)--a definition of ``discontinuance'' and a definition
of ``sole manufacturer.'' Although these terms were discussed in the
preamble to the final rule issuing Sec. 314.81(b)(3)(iii) published on
October 18, 2007 (72 FR 58993) (2007 Preamble), and have been used in
various documents informally expressing the Agency's interpretation of
section 506C and its implementing regulations (see, for example, the
Center for Drug Evaluation and Research (CDER) Manual of Policies and
Procedures 6003.1, Drug Shortage Management (Ref. 3)), these terms were
not defined in the regulation. Given the serious and growing threat to
public health due to drug shortages, the Agency believes it is
appropriate at this time to codify definitions of these terms. This
modification and clarification of our existing regulations will further
the public health objective of the Federal Food, Drug, and Cosmetic Act
as a whole, and section 506C specifically by increasing the scope of
information that FDA receives regarding discontinuances. This will
enable the Agency to: (1) Expand collection and distribution of
information on the discontinuance of certain drugs to appropriate
physician and patient organizations as required by section 506C(c); and
(2) work with manufacturers and other stakeholders to implement
appropriate strategies to reduce, to the greatest extent possible, the
public health impact of discontinuances of products that can lead to
drug shortages. We believe that clarification of terminology will also
improve statutory compliance.
A. Discontinuance
The Agency is revising an earlier policy position and defining the
term ``discontinuance'' in the regulation to include both permanent and
temporary interruptions in the manufacturing of a drug product, if the
interruption could lead to a disruption in supply of the product. This
interpretation of the statutory language best achieves the public
health purpose of section 506C and the Federal Food, Drug, and Cosmetic
Act as a whole.
Under section 506C, sole manufacturers are required to notify FDA
of a ``discontinuance'' of a drug product subject to section 506C. In
the 2007 Preamble, in response to a comment on the meaning of the term
discontinuance, we indicated that a discontinuance did not include
planned or unplanned temporary manufacturing cessations (72 FR 58993 at
58995, response to comment 4). At that time, we stated that only
manufacturers who intended to permanently discontinue manufacture and
marketing of the drug product were subject to mandatory reporting
requirements under section 506C. In our response to the comment in the
2007 Preamble, however, we did request that manufacturers who
experience an unplanned temporary manufacturing cessation keep the
Agency informed of the status of the shutdown because ``the duration of
an unplanned shutdown may be unpredictable and could affect the
availability of needed therapy for patients.''
FDA no longer believes that this narrow policy position regarding
the term ``discontinuance'' serves the public health need that the
Federal Food, Drug, and Cosmetic Act was intended to address. In 2007,
the Agency believed that the supply of drug product available to
patients during a temporary manufacturing cessation, particularly one
that was planned, would not be greatly affected during the interruption
in manufacturing. However, subsequent experience has shown that even
temporary discontinuances of manufacturing can have a significant
impact on patient access to drug products. For example, if an equipment
failure necessitates an unexpected temporary interruption in
manufacturing of a drug product subject to section 506C, this
discontinuance could have serious implications for patient access to
the product. Notification to FDA of such discontinuances will expand
FDA's ability to distribute information on the discontinuance of
certain drugs to physician and patient organizations and enable FDA to
work with manufacturers and other stakeholders to respond to potential
drug shortages.
The interim final rule therefore adds Sec. 314.81(b)(3)(iii)(d) to
provide that ``discontinuance'' means ``any interruption of
manufacturing of a drug product described in paragraph (b)(3)(iii)(a)
for sale in the United States that could lead to a potential disruption
in supply of the drug product, whether the interruption is intended to
be temporary or permanent.'' Thus the term ``discontinuance'' now
includes both temporary and permanent interruptions in manufacturing,
if the interruption could lead to a disruption in supply of the
product. This interpretation of ``discontinuance'' is consistent with
Webster's Third New International Dictionary, which defines the term to
mean ``cessation, shutdown, closure; interruption'' (Ref. 4). The
dictionary definition indicates that a discontinuance can be
interpreted to include both situations that are permanent (cessation,
shutdown, closure) and those that are temporary (interruption).
Any permanent discontinuance of manufacturing by a sole
manufacturer will lead, per se, to a disruption in supply of the
product; thus, all permanent discontinuances must continue to be
reported. Temporary discontinuances must be reported to the Agency
under this interim final rule only if the discontinuance could lead to
a disruption in supply of the product.
We understand that a manufacturer may be unable to report some
temporary discontinuances 6 months before the discontinuance, as
required by statute. When notification at least 6 months prior to the
discontinuance is impossible because it was unforeseen, the
manufacturer must notify the Agency as soon as possible after it knows
that a discontinuance will occur. For example, if a contamination
problem requires immediate shut down of a manufacturing plant for a
drug product subject to section 506C, the manufacturer will not be able
to provide the FDA with 6 months prior notification, but would be
required to notify FDA as soon as the manufacturer becomes aware that
the contamination necessitates a temporary discontinuance of
manufacture of the product.
Other circumstances that would trigger notification to the FDA of a
discontinuance of a drug product subject to section 506C include:
A business decision to permanently discontinue manufacture
of a drug product;
A delay in acquiring active pharmaceutical ingredients or
inactive ingredients that leads to, or could lead to, a temporary
interruption in manufacturing of a drug product while alternative
suppliers are located;
Equipment failure or contamination affecting the quality
of a drug product that necessitates an interruption in manufacturing
while the equipment is repaired or the contamination issue is
addressed;
Manufacturing shut-downs for maintenance or other routine
matters, if
[[Page 78532]]
the shut-down extends for longer than anticipated or otherwise could
disrupt supply of a drug product;
Conversely, a manufacturer is not required to notify FDA if a
discontinuance is part of the normal manufacturing schedule and is not
expected to lead to a disruption in supply of a drug product subject to
506C. For example, FDA need not be notified in the following
circumstances:
The manufacturer uses the same manufacturing plant to
manufacture two drug products, one of which (Product A) is subject to
section 506C. From January to June of each year the manufacturer uses
the plant to produce Product A. From July to December of each year the
manufacturer uses the plant to produce Product B. Although this could
be considered a temporary discontinuance of Product A from July to
December, because this is the usual manufacturing schedule and should
not therefore result in a disruption in the supply of Product A, the
manufacturer need not notify the Agency of the annual, temporary
discontinuance of Product A.
A manufacturer of a drug product implements a scheduled
shutdown of its manufacturing facility each year for routine
maintenance. The annual shutdown is anticipated and planned for in
advance; therefore, it is not expected to disrupt supply of a drug
product subject to 506C. The shutdown does not need to be reported to
the Agency under section 506C.
A manufacturer of a drug product subject to 506C
experiences an unexpected power outage that results in an unscheduled
interruption in manufacturing. The manufacturer expects to resume
normal operations within a relatively short timeframe and does not
expect a disruption in the supply of the drug product. The shutdown
does not need to be reported to the Agency under section 506C.
If any of the circumstances described above do lead to a disruption
in supply of the drug product, even if unanticipated, then it becomes a
reportable discontinuance under this rule and the manufacturer would be
required to notify FDA of a discontinuance of the product.
In addition to revising the definition of ``discontinuance,'' this
interim final rule makes a minor conforming change by striking the
phrase ``discontinuing manufacture'' in the first sentence of Sec.
314.81(b)(3)(iii)(a) and replacing it with the phrase ``discontinuance
of manufacture.'' This change ensures that the regulations contain an
appropriate cross-reference to the revised definition of
discontinuance.
The interim final rule also makes a minor change to the procedures
in Sec. 314.81(b)(3)(iii)(b) for reporting notices of discontinuances
to the Agency. The interim final rule requires manufacturers to report
a notice of a discontinuance to FDA either electronically or by
telephone according to instructions on the FDA's Drug Shortages Web
site at https://www.fda.gov/Drugs/DrugSafety/DrugShortages. Products
regulated by CDER must be reported to the CDER Drug Shortages
Coordinator. Products regulated by the Center for Biologics Evaluation
and Research (CBER) must be reported to the CBER Products Shortage
Coordinator. This change ensures that the appropriate offices are
timely notified of all relevant discontinuances. It also reflects
existing practice for submitting notices of discontinuance, and reduces
the burden on industry to submit multiple copies of the notification.
B. Sole Manufacturer
To best achieve the public health purposes of the Federal Food,
Drug, and Cosmetic Act, and section 506C, the Agency is clarifying the
term sole manufacturer to ensure that we receive timely reports of all
discontinuances of drug products subject to section 506C, including
where other strengths, dosage forms, or routes of administration of the
same drug product are marketed. The clarification is intended to
improve statutory compliance and to minimize instances where
manufacturers fail to make reports to the Agency as required by section
506C. This clarification of the statutory language best achieves the
purpose of section 506C and the Federal Food, Drug, and Cosmetic Act as
a whole.
Section 314.81(b)(3)(iii) currently does not include a definition
of the term ``sole manufacturer.'' In the 2007 Preamble, we rejected a
suggestion to rely on the ``Orange Book'' (FDA's publication on
``Approved Drug Products with Therapeutic Equivalence Evaluations'') as
the source for determining whether an entity is a sole manufacturer (72
FR 58993 at 58995, comment 3). The comment to the proposed rule had
expressed concern that, although the Orange Book lists all drug
products with approved new drug applications (NDA) and abbreviated new
drug applications (ANDA), it is not possible to determine whether the
listed approved products are, in fact, being manufactured. The comment
requested that we define sole manufacturer as ``an applicant listed in
the Orange Book who is the holder of the only listed approved
application under section 505(b) or (j) of the [FD&C] Act.'' We
declined to accept this definition of sole manufacturer, and reliance
on the Orange Book, to determine whether an applicant was a sole
manufacturer for several reasons in 2007, including the following: (1)
There may be delays in updating the Orange Book, rendering it
temporarily inaccurate; (2) the suggested definition could create
potential confusion because some drugs are approved but not marketed
and are therefore placed in the ``discontinued'' section of the Orange
Book; and (3) there are other generally reliable sources for obtaining
commercial manufacturing information to assist in determining whether
an applicant is a sole manufacturer.
We continue to believe that reference to the Orange Book is not the
appropriate way to identify a ``sole manufacturer'' for purposes of
implementing section 506C. In addition, we believe there has been some
confusion as to the scope of the term. Accordingly, the interim final
rule adds Sec. 314.81(b)(3)(iii)(d) to define ``sole manufacturer'' in
the regulation to mean ``an applicant that is the only entity currently
manufacturing a drug product of a specific strength, dosage form, or
route of administration for sale in the United States, whether the
product is manufactured by the applicant or for the applicant under
contract with one or more different entities.''
The definition in this interim final rule is intended to clarify
that a sole manufacturer means the only applicant currently supplying
the U.S. market with the drug product. It does not mean sole NDA or
ANDA holder. A manufacturer is considered a sole manufacturer even if
other manufacturers hold an approved NDA or ANDA for the same product,
if the other applicants are no longer manufacturing (or have never
manufactured) the product for sale in the United States. For example,
Company A holds an NDA for a drug product subject to section 506C and
manufactures and sells that product in the United States. Company B
holds an ANDA for the drug product, but does not manufacture or sell
the product in the United States. Company A would be considered a sole
manufacturer of the drug product for purposes of reporting a
discontinuance of the drug product under section 506C. If Company B
began manufacturing and selling the drug product in the United States,
then Company A would no longer be considered a sole manufacturer. A
manufacturer is responsible for determining if it is a sole
manufacturer under this regulation. There is commercial information
available to
[[Page 78533]]
help with this determination. If an applicant is unsure if it is a sole
manufacturer of a drug product subject to section 506C, FDA's drugs
shortages staff may be able to work with it to help it determine
whether it is or is not the sole manufacturer of the drug.
The interim final rule also clarifies that the specific strength,
dosage form, and route of administration of the product are critical in
determining if a manufacturer is a sole manufacturer. For example, if a
company manufacturers for sale in the United States an injectable
dosage form of a drug product subject to section 506C, that company is
considered a sole manufacturer of that drug product, even if a second
company manufactures and sells in the United States an oral dosage form
of the same drug product for the same indication. In this example, if
the second company was the only applicant manufacturing and selling the
oral dosage form in the United States, both companies would be
considered sole manufacturers for purposes of section 506C.
It is important that an entity currently manufacturing a drug
product of a specific strength, dosage form, or route of administration
for sale in the United States report a discontinuance to FDA because
that specific strength, dosage form, or route of administration may be
critical for the targeted needs of particular patients. To enable the
Agency to fully distribute information under section 506C(c), and to
work most effectively with manufacturers and other stakeholders to
implement appropriate strategies to reduce, to the greatest extent
possible, the public health impact of drug shortages, discontinuances
of a specific strength, dosage form, or route of administration of drug
products subject to section 506C must be reported to us. Moreover,
recent experience has shown that discontinuances of a specific
strength, dosage form, or route of administration of a drug product may
lead to a shortage of another strength, dosage form, or route of
administration of the product, compounding patient difficulties in
obtaining the drug product.
Finally, the new definition in the interim final rule clarifies who
bears the responsibility for reporting to FDA a discontinuance of a
drug product subject to section 506C. The inclusion of ``whether the
product is manufactured by the applicant or for the applicant under
contract with one or more different entities'' in the definition makes
clear that the application holder must report a discontinuance to FDA.
For purposes of section 506C, an application holder will be considered
a ``manufacturer'' even if the application holder contracts that
function out to another entity. The application holder is responsible
for establishing a process with any relevant contract manufacturer that
ensures the application holder's compliance with this rule. This could
include contractual terms between the application holder and the
contract manufacturer, as well as monitoring. For example, Company X
holds an NDA for a drug product subject to section 506C. Company X
contracts with Company Y to manufacture the drug product for the
purposes of marketing and selling the drug product in the United
States. Company X would be considered the ``sole manufacturer'' in the
above situation, and is required to establish a process with Company Y
that ensures Company X's ability to report a discontinuance of the drug
product to FDA.
III. Legal Authority
FDA is amending its postmarketing reporting regulations
implementing section 506C of the Federal Food, Drug, and Cosmetic Act
(21 U.S.C. 356c). Section 506C requires manufacturers who are the sole
manufacturers of certain drug products to notify us at least 6 months
before discontinuance of manufacture of the drug products. This interim
final rule modifies the term ``discontinuance'' and clarifies the term
``sole manufacturer'' with respect to section 506C notification
requirements. FDA's authority for this rule also derives from section
701(a) of the Federal Food, Drug, and Cosmetic Act (21 U.S.C. 371(a)).
The Administrative Procedure Act permits an agency to promulgate a
rule without notice and comment procedures when an agency for ``good
cause finds (and incorporates the finding and a brief statement of
reasons therefor in the rules issued) that notice and public procedure
thereon are impracticable, unnecessary, or contrary to the public
interest'' (5 U.S.C. 553(b); 21 CFR 10.40(e)). FDA has determined that
good cause exists for this interim final rule and that notice and
comment procedures are contrary to the public interest given the
serious and growing threat to public health due to drug shortages.
Recent experience with drug shortages in the United States has
shown serious and immediate impacts on patients and healthcare
providers, particularly those shortages involving drugs that are
manufactured by a small number of firms and for which there are no good
therapeutic substitutes available. Some shortages delay or deny needed
care for patients, because they involve critical drugs used to treat
cancer, to provide required parenteral nutrition, or to address other
serious medical conditions. Other shortages can result in providers
prescribing second-line alternatives, which may be less effective and
higher risk than first-line therapies. The number of drug shortages
annually has tripled from 61 in 2005 to 178 in 2010. New shortages are
occurring at the present time.
The scope of information FDA receives under the current regulations
has not adequately enabled the Agency to distribute information on the
discontinuance of certain drugs to physician and patient organizations
as required by section 506C(c) and to work with manufacturers and other
stakeholders to respond to potential drug shortages. There are
significant non-quantifiable benefits of reporting information about
discontinuances to FDA, including better enabling the Agency,
manufacturers, healthcare providers, and patients to monitor and
evaluate these discontinuances to mitigate or prevent potential drug
shortages that can arise as a result of these discontinuances and that
could otherwise lead to serious and widespread adverse health
consequences. Any delay in the implementation of this rule would limit
the ability of healthcare providers to respond to potential and actual
shortages, and would reduce the ability of FDA to work with
manufacturers and other stakeholders to prevent and mitigate drug
shortages. In this instance, FDA has determined that an interim final
rule is legally permissible and in the public's interest.
IV. Analysis of Impacts
A. Introduction and Summary
1. Introduction
FDA has examined the impacts of the interim final 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). This interim final rule is a
significant regulatory action as defined by Executive Order 12866 and
accordingly has been reviewed by the Office of Management and Budget.
The Regulatory Flexibility Act requires agencies to analyze
regulatory
[[Page 78534]]
options that would minimize any significant impact of a rule on small
entities. The Agency projects that the interim final rule will not
likely have a significant economic impact on a substantial number of
small entities, but seeks comments on its analysis below.
Section 202(a) of the Unfunded Mandates Reform Act of 1995 requires
that Agencies prepare a written statement, which includes an assessment
of anticipated costs and benefits, before proposing ``any rule that
includes any Federal mandate that may result in the expenditure by
State, local, and tribal governments, in the aggregate, or by the
private sector, of $100,000,000 or more (adjusted annually for
inflation) in any one year.'' The current threshold after adjustment
for inflation is $136 million, using the most current (2010) Implicit
Price Deflator for the Gross Domestic Product. FDA does not expect this
interim final rule to result in any 1-year expenditure that would meet
or exceed this amount.
2. Summary
The interim final rule modifies the term ``discontinuance'' and
clarifies the term ``sole manufacturer'' with respect to notifications
of discontinuance of products that are life supporting, life
sustaining, or intended for use in the prevention of a debilitating
disease or condition. The interim final rule will impose annual
reporting costs of up to $15,064 in total. Non-quantifiable benefits
include the value of the reported information about discontinuances in
helping FDA, manufacturers, healthcare providers, and patients to
monitor and evaluate these discontinuances to mitigate or prevent
potential drug shortages that can arise as a result of these
discontinuances and that could otherwise lead to serious and widespread
adverse health consequences.
B. Objective of and Need for the Interim Final Rule
Current regulations require that a sole manufacturer of a drug
product that is: (1) Life supporting, life sustaining, or intended for
use in the prevention of a debilitating disease or condition; (2)
approved under section 505(b) or 505(j) of the Federal Food, Drug, and
Cosmetic Act; and (3) not a product that was originally derived from
human tissue and was replaced by a recombinant product report permanent
discontinuances to FDA at least 6 months prior to the discontinuance.
FDA can reduce the 6-month notification period if the applicant submits
a certification of good cause, and the Agency finds good cause.
The purpose of the interim final rule is to define the terms
``discontinuance'' and ``sole manufacturer.'' In the interim final
rule, ``discontinuance'' is defined as ``any interruption in
manufacturing of a drug product described in paragraph (b)(3)(iii)(a)
for sale in the United States that could lead to a potential disruption
in supply of the drug product, whether the interruption is intended to
be temporary or permanent.'' ``Sole manufacturer'' is defined as ``an
applicant that is the only entity currently manufacturing a drug
product of a specific strength, dosage form, or route of administration
for sale in the United States, whether the product is manufactured by
the applicant or for the applicant under contract with one or more
different entities.'' These definitions will require additional
manufacturers to report to FDA a wider range of discontinuances that
could potentially lead to a drug shortage than under the current,
existing regulations.
While existing regulations require that only permanent
discontinuances be reported to FDA, in practice, some manufacturers
voluntarily notify FDA about temporary discontinuances. In the past 2
years, such notifications have enabled FDA to prevent 233 drug
shortages by expediting review of new manufacturing sites, new
suppliers, and specification changes. Nonetheless, recent data from
FDA's Drug Shortages Program (DSP) indicate that the number of drug
shortages has tripled from 2005 to 2010 (see figure 1 below, Ref. 5).
[GRAPHIC] [TIFF OMITTED] TR19DE11.002
A survey conducted by the American Hospital Association (AHA)
concluded that drug shortages are experienced by hospitals. For
example, almost 100 percent of the 820 hospitals surveyed had
experienced at least one drug shortage in the 6 months preceding the
survey (Ref. 6). Another survey of 1,800 health practitioners conducted
by the ISMP suggested that because drug shortages often result in the
need for physicians to prescribe alternative therapies which may be
less effective and higher risk than first-line treatments, drug
shortages can lead to the potential for medication errors and poor
patient outcomes as well as higher costs (Refs. 1 and 7).
The interim final rule is intended to increase the scope of
information that FDA receives, enabling the Agency to: (1) Expand
distribution of information on the discontinuance of certain drugs to
appropriate physician and patient organizations as required by section
506C(c); and (2) work with manufacturers and other stakeholders to
implement appropriate strategies to reduce, to the greatest extent
possible, the public health impact of discontinuances of products that
can lead to drug shortages. The public health purpose of section 506C
and the Federal Food, Drug, and Cosmetic Act as a whole are best
achieved with this modification to our existing regulations.
[[Page 78535]]
Currently it appears that some manufacturers may lack sufficient
incentives to either take steps to prevent certain shortages or to
notify FDA early enough for the Agency to act (Ref. 7). By providing
clear definitions, the interim final rule will address this concern and
require all applicants to report appropriate information to the Agency
in a timely manner.
C. Benefits
The interim final rule modifies the term ``discontinuance'' and
clarifies the term ``sole manufacturer'' with respect to postmarketing
reporting requirements of products subject to section 506C. The
clarification in terminology captures additional manufacturers as
``sole manufacturers'' by explicitly linking the definition of sole
manufacturer to a specific strength, dosage form, or route of
administration of a drug product. Requiring notification of temporary
discontinuances and clarifying the term sole manufacturer will result
in FDA receiving better and more timely information on a wider range of
discontinuances. This increased reporting will enable FDA to distribute
information on discontinuances to appropriate physician and patient
organizations and to work with manufactures and other stakeholders to
try to prevent a discontinuance from leading to a drug shortage, or to
mitigate the impacts of an unavoidable drug shortage on patients and
healthcare providers.
There is evidence that the negative impact of drug shortages could
be significant. For instance, the American Society of Health System
Pharmacists (ASHP) reported that annual labor costs to manage drug
shortages are approximately $216 million in the United States (Ref. 7).
Moreover, drugs in several major therapeutic classes are in shortage,
including oncology products, antibiotics, and electrolyte/nutrition
products. For example, statistics indicate that cancer alone affects
more than 11 million people in the United States (Ref. 8). Therefore,
the potential benefits of the interim final rule as a result of
prevention or mitigation of these drug shortages could be substantial
from both an economic and public health viewpoint. Because the shortage
of even one critical drug can impact a large number of patients and
healthcare providers, the potential benefits could be substantial even
if the interim final rule only results in a small number of additional
notifications of discontinuances to the Agency.
D. Costs
Currently, FDA receives one mandatory notification that meets the
statutory and regulatory criteria of a section 506C discontinuance per
year and zero certifications of good cause. In addition, there are
several dozen voluntary submissions of information to FDA that are
related to section 506C discontinuances but do not meet the applicable
statutory criteria, as implemented by the current regulation. We note
that as a result of FDA's letter to industry (Ref. 10), FDA has
experienced a significant increase in the number of notifications. We
estimate that the total number of manufacturers who would be required
to notify us of a discontinuance under the interim final rule would be
80 per year.\1\ However, the impact of the interim final rule
represents the incremental impact, which is the difference between the
total number of reports required by the interim final rule and the
baseline, i.e., the estimated number of reports that we would receive
without the interim final rule. We estimate that as a result of the
interim final rule, we will receive an additional 9 to 24 notifications
of section 506C discontinuances (both temporary and permanent
discontinuances) and 2 to 5 associated certifications of good cause. In
the 2007 Preamble, we estimated that it would take two hours to prepare
a notification of discontinuance and 16 hours to prepare a
certification of good cause (72 FR 58993 at 58999). Since neither the
format nor the content of these submissions will change as a result of
the interim final rule, we continue to estimate that it will take two
hours to prepare a notification of discontinuance and 16 hours to
prepare a certification of good cause. We estimate that it will take
longer to prepare a certification of good cause than a notification of
discontinuance because preparing a certification of good cause requires
a detailed narrative justifying a reduction in the notification period,
which is more labor intensive than the simpler notification of
discontinuance.
---------------------------------------------------------------------------
\1\ The total is estimated based on 220 shortages tracked by
FDA's CDER Drug Shortages Coordinator from January through October
of 2011, of which we estimate 30 percent would relate to
discontinuances subject to mandatory reporting under section 506C
and this interim final rule. The estimated number of discontinuances
subject to mandatory reporting (220 x 30 percent) is then adjusted
to include two additional months of reporting.
---------------------------------------------------------------------------
Notifications are generally prepared and submitted by a regulatory
affairs manager. Thus, labor hours are valued using the median hourly
wage for Management Occupations (occupation code 11-0000) in
Pharmaceutical and Medicine Manufacturing (North American Industry
Notification, NAICS, code 325400) as reported by the Bureau of Labor
Statistics 2010 Employment Occupational Statistics (Ref. 9). The median
hourly wage is $117, which is adjusted for benefits and overhead.
The estimated cost is $234 ($117 x 2 hours) per notification of
discontinuance, and $1,872 ($117 x 16 hours) per certification of good
cause. In table 1 below we present the estimated costs. The estimated
annual cost of the interim final rule is between $5,850 and $15,064.
Table 1--Estimated Additional Annual Reporting Costs of the Interim Final Rule
----------------------------------------------------------------------------------------------------------------
Number of
Type of response additional Hours per Cost per Total estimated
responses response response cost
----------------------------------------------------------------------------------------------------------------
Notification of Discontinuance (Sec. 9-24 2 $234 $2,106-$5,704
314.81(b)(3)(iii))...................................
Certification of Good Cause (Sec. 314.91)........... 2-5 16 $1,872 $3,744-9,360
---------------------------------------------------------
Total............................................. ........... ........... ........... $5,850-$15,064
----------------------------------------------------------------------------------------------------------------
E. Analysis of Regulatory Alternatives
The interim final rule will result in the submission of additional
notifications to FDA of a discontinuance of a drug product subject to
section 506C. As noted in FDA's recent report on medical product
shortages (Ref. 5), any system that increases reporting must ensure
that, in the pursuit of more ``signal,'' FDA is not overwhelmed with
``noise.'' We welcome comments on how the notifications can be designed
in line with this principle. Such an approach is consistent with
Section 4 of Executive Order 13563, which calls
[[Page 78536]]
upon agencies ``to identify and consider regulatory approaches that
reduce burdens and maintain flexibility and freedom of choice for the
public.'' FDA identified the following alternatives to the interim
final rule: (1) No change in regulation; and (2) publish guidance that
encourages sole manufacturers (including manufacturers of specific
strengths, dosage forms, and routes of administration) to notify FDA
about temporary discontinuances of drug products subject to the rule,
and (3) provide incentives for voluntary reporting.
1. Alternative 1: No Change in Regulation
A simple alternative would be to leave the current regulation
unchanged. While this alternative may not impose additional costs on
sole manufacturers of drug products subject to section 506C, the
benefits of this option would be uncertain and would not provide any
additional tools to reduce the number of product shortages.
2. Alternative 2: Publish Guidance
FDA could draft additional guidance to encourage voluntary
notification of upcoming discontinuances. A recent example is a FDA's
letter to industry (Ref. 10). However, such communications and guidance
cannot impose new regulatory requirements. Without this regulation
defining which manufacturers are required to notify FDA about both
temporary and permanent discontinuances of drug products subject to
section 506C, FDA may not have adequate information to distribute to
physician and patient organizations and to work effectively with
manufacturers and other stakeholders to better prevent and mitigate
drug shortages.
3. Alternative 3: Provide Incentives for Voluntary Reporting
It may be possible to develop a system of incentives to encourage
increased reporting on a voluntary basis. FDA welcomes comments from
the public on how such a system could be implemented, including the
types of incentives that would advance the FDA's mission to protect the
public health while encouraging additional reporting.
F. Regulatory Flexibility Analysis
FDA has examined the economic implications of the interim final
rule as required by the Regulatory Flexibility Act. The Agency projects
that the interim final rule will not likely have a significant economic
impact on a substantial number of small entities, but seeks comment on
its analysis below.
1. Economic Effect on Small Entities
The Small Business Administration (SBA) uses different definitions
of what a small entity is for different industries. Using SBA standard
size definitions, a firm categorized in NAICS code 315412
(Pharmaceutical Preparations) or NAICS code 325414 (Biological
Products) is considered small if it employs fewer than 750 or 500
people, respectively (Ref. 11). The most currently available data from
the 2007 Economic Census (Ref. 12) show that at least 92 percent of
these establishments would be considered small by SBA standards.\2\ We
note that using data at the establishment level implicitly assumes that
the typical manufacturing establishment is roughly equivalent to the
typical small manufacturing firm.
---------------------------------------------------------------------------
\2\ For NAICS code 325412, total value of shipments data are not
available for establishments employing fewer than 750 employees. The
estimated percent of small establishments (92 percent) is based on
the total number of establishments with fewer than 500 employees.
For NAICS code 324514 the percent of establishments with fewer than
750 employees is 96 percent.
---------------------------------------------------------------------------
We estimate that the cost per response as a percent of average
sales for manufacturers in NAICS code 325412 could represent up to
0.002 percent of sales. The greatest impact is on establishments hiring
fewer than 10 employees, where the cost per response as a percent of
average sales ranges from 0.029 percent to 0.235 percent. The analysis
of the effect on small versus large entities for NAICS 312314 is
limited by data restrictions imposed to safeguard the confidentially of
some establishments. Consequently, for NAICS code 312314 the average
value of shipments is only presented for all establishments. We
estimate that the cost per response as a percent of average sales in
this industry is between 0.001 percent and 0.004 percent (see table 2).
Therefore, the Agency concludes that this rule will not likely have a
significant impact on a substantial number of small entities, but we
request comments on our analysis.
Table 2--Estimated Economic Impact of Interim Final Rule on Small Entities
--------------------------------------------------------------------------------------------------------------------------------------------------------
Cost per response as a percent of average sales
Average value of ------------------------------------------------
Number of employees Number of Total value of shipments ($234 per response-- ($1,872 per response--
establishments shipments ($000) ($1,000) notification of certification of good
discontinuance) (%) cause) (%)
--------------------------------------------------------------------------------------------------------------------------------------------------------
NAICS Code 325412:
0-9........................................... 408 324,604 796 0.029 0.235
10-19..................................... 77 317,551 4,124 0.006 0.045
20-99..................................... 249 8,377,347 33,644 0.001 0.006
100-499................................... 182 32,516,961 178,665 0.000 0.001
500 and over.............................. 75 68,162,155 908,829 0.000 0.000
---------------------------------------------------------------------------------------------------------
All................................... 991 109,698,618 110,695 0.000 0.002
NAICS Code 325414:
All................................... 350 16,112,435 46,036 0.001 0.004
--------------------------------------------------------------------------------------------------------------------------------------------------------
2. Additional Flexibility Identified
In this section, we identify alternatives that would present
reductions in costs to small entities.
Alternative 1: Exempt Small-sized Entities: Exempting small-sized
businesses from the interim final rule would reduce the economic impact
to small businesses by up to 0.235 percent of average sales. However,
not imposing these notification requirements on drug products subject
to section 506C could
[[Page 78537]]
exacerbate the increasing trend in drug shortages that affect a
substantial number of patients and healthcare providers. Moreover,
these reporting requirements enable FDA to distribute information to
physician and patient organizations, to assess potential drug
shortages, and to evaluate mitigation strategies. Thus, exempting small
business entities may in the long-term lead to high social costs
associated with outcomes such as worsening of conditions for patients
for whom these products are necessary.
Alternative 2: Extend the Compliance Period for Small Businesses:
An alternative to reduce costs would be to extend the compliance period
for small-sized entities. While a longer compliance period may enable
small businesses to reduce labor costs, it would delay FDA's receipt of
notices of discontinuance and limit the Agency's ability to distribute
information to physician and patient organizations as required by
section 506C(c), to assess potential drug shortages, and to work with
manufacturers and other stakeholders to prevent or mitigate shortages.
V. Paperwork Reduction Act of 1995
This interim final rule contains information collection provisions
that are subject to review by OMB under the Paperwork Reduction Act of
1995 (44 U.S.C. 3501-3520) (the PRA). The title, description, and
respondent description of these provisions are shown below with 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: (1) Whether the proposed collections of
information are 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 collections 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 collections of information on respondents,
including through the use of automated collection techniques, when
appropriate, or other forms of information technology.
Title: Applications for Food and Drug Administration Approval to
Market a New Drug; Revision of Postmarketing Reporting Requirements--
Discontinuance.
Description: Sections 314.81(b)(3)(iii) and 314.91 of FDA's
regulations (``Sec. 314.81(b)(3)(iii)'' and ``Sec. 314.91'',
respectively) implement section 506C. Section 314.81(b)(3)(iii)
requires entities who are the sole manufacturers of certain drug
products to notify us at least 6 months before discontinuance of
manufacture of the product. For the regulations to apply, a product
must meet the following three criteria:
1. The product must be life supporting, life sustaining, or
intended for use in the prevention of a debilitating disease or
condition;
2. The product must have been approved by FDA under section 505(b)
or 505(j) of the Federal Food, Drug, and Cosmetic Act; and
3. The product must not have been originally derived from human
tissue and replaced by a recombinant product.
Under Sec. 314.81(b)(3)(iii)(c), we will publicly disclose
information about drug products subject to section 506C that are to be
discontinued. Section 314.91 allows us to reduce the 6-month
notification period if we find that good cause exists for the
reduction. A manufacturer may request that we reduce the notification
period by certifying that good cause for the reduction exists.
In the October 18, 2007 final rule (72 FR 58993), we added
Sec. Sec. 314.81(b)(3)(iii) and 314.91 to our regulations. Sections
314.81(b)(3)(iii) and 314.91 require two new reporting requirements to
FDA that are subject to OMB approval under the PRA: Notification of
Discontinuance and Certification of Good Cause. The interim final rule
adds two new definitions to Sec. 314.81(b)(3)(iii): ``discontinuance''
and ``sole manufacturer.'' The interim final rule clarifies the scope
of manufacturers required to report and expands the range of
circumstances required to be reported to the Agency under Sec.
314.81(b)(3)(iii), but does not change the substantive content of the
reports required to be submitted to the Agency. This PRA analysis
covers the information collection resulting from the October 18, 2007
final rule and also includes our estimates of how the number of
Notifications of Discontinuance and Certifications of Good Cause may
increase as a result of this interim final rule. Accordingly, the
estimates included in the Analysis of Impacts will not directly match
the estimates in the PRA analysis because the PRA analysis represents
an estimate of the total reporting burden under Sec. Sec.
314.81(b)(3)(iii) and 314.91, while the Analysis of Impacts examines
only the increased costs and benefits as a result of the interim final
rule.
A. Notification of Discontinuance
Under Sec. 314.81(b)(3)(iii), at least 6 months before a sole
manufacturer intends to discontinue manufacture of a drug product
subject to section 506C, the manufacturer must send us notification of
the discontinuance. The notification of discontinuance generally
contains the name of the manufacturer, the name of the product to be
discontinued, the reason for the discontinuance, and the date of
discontinuance. We will work with relevant manufacturers during the 6-
month notification period to help minimize the effect of the
discontinuance on patients and health care providers, and to distribute
appropriate information about the discontinuance to physician and
patient organizations. The interim final rule adds definitions of
``discontinuance'' and ``sole manufacturer'' to Sec.
314.81(b)(3)(iii). The inclusion of these definitions expands
notification requirements under Sec. 314.81(b)(3)(iii) to additional
discontinuance circumstances and clarifies the scope of manufacturers
who must report discontinuances. The interim final rule also requires
that notifications of discontinuance be submitted either electronically
or by telephone according to instructions on FDA's Drug Shortage Web
site at https://www.fda.gov/Drugs/DrugSafety/DrugShortages. This change
ensures that the appropriate offices are timely notified of all
relevant discontinuances. It also reflects existing practice for
submitting notices of discontinuance, and reduces the burden on
industry to submit multiple copies of the notification.
B. Certification of Good Cause
We may reduce the 6-month notification period if we find good cause
for the reduction. As described in Sec. 314.91, a manufacturer can
request a reduction in the notification period by submitting written
certification that good cause exists to the following designated
offices: (1) The CDER Drug Shortage Coordinator at the address of the
Director of CDER; (2) the CDER Drug Registration and Listing Team,
Division of Compliance Risk Management and Surveillance in CDER; and
(3) the director of either the CDER division or the CBER office that is
responsible for reviewing the application. The following circumstances
may establish good cause:
A public health problem may result from continuation of
manufacturing for the 6-month period (Sec. 314.91(d)(1));
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A biomaterials shortage prevents the continuation of
manufacturing for the 6-month period (Sec. 314.91(d)(2));
A liability problem may exist for the manufacturer if the
manufacturing is continued for the 6-month period (Sec. 314.91(d)(3));
Continuation of the manufacturing for the 6-month period
may cause substantial economic hardship for the manufacturer (Sec.
314.91(d)(4));
The manufacturer has filed for bankruptcy under chapter 7
or 11 of title 11, United States Code (Sec. 314.91(d)(5));
The manufacturer can stop making the product but still
distribute it to satisfy existing market need for 6 months (Sec.
314.91(d)(6)); or
Other good cause exists for a reduction in the
notification period (Sec. 314.91(d)(7)).
With each certification described previously, the manufacturer must
describe in detail the basis for its conclusion that such circumstances
exist. We require that the written certification that good cause exists
be submitted to the offices identified previously to ensure that our
efforts to address the discontinuance take place in a timely manner.
The interim final rule makes no changes to the requirements or process
for certification of good cause.
Description of Respondents: An applicant that is the sole
manufacturer and who is discontinuing manufacture of a drug product
that meets the following criteria: (1) Is life supporting, life
sustaining, or intended for use in the prevention of a debilitating
disease or condition; (2) was approved by FDA under section 505(b) or
(j) of the Federal Food, Drug, and Cosmetic Act; and (3) was not
originally derived from human tissue and replaced by a recombinant
product.
Burden Estimate: Table 3 of this document provides an estimate of
the annual reporting burden for notification of a product
discontinuance and certification of good cause under Sec. Sec.
314.81(b)(3)(iii) and 314.91, as amended by this interim final rule.
Notification of Discontinuance: Based on data collected from the
CDER Drug Shortage Coordinator since December 17, 2007, when Sec. Sec.
314.81(b)(3)(iii) and 314.91 went into effect, one manufacturer during
each year reported to FDA a discontinuance of one drug product meeting
the criteria of section 506C and its implementing regulations (i.e.,
the drug product was approved under section 505(b) or (j) of the
Federal Food, Drug, and Cosmetic Act, the drug product was ``life-
supporting, life-sustaining or intended for use in the prevention of a
debilitating disease or condition,'' the drug product was produced by a
sole manufacturer, and the drug product was permanently discontinued).
CDER's Drug Shortages Coordinator tracked 220 drug shortages between
January and October of 2011. The Agency estimates that 30 percent (66)
of these shortages would relate to discontinuances subject to mandatory
reporting under section 506C as a result of the interim final rule.
Adjusting to include an additional two months of reporting (November
and December), we estimate that FDA will receive a total of 80
notifications of a discontinuance per year under section 506C, as
amended by the interim final rule. Based on experience, a manufacturer
submits only one notification of a discontinuance per year, thus the
total number of manufacturers who would be required to notify us of a
discontinuance would be 80. Therefore, the number of respondents is
estimated to be 80. The hours per response is the estimated number of
hours that a respondent would spend preparing the information to be
submitted with a notification of product discontinuance, including the
time it takes to gather and copy the statement. Based on experience in
working with manufacturers to submit notifications under Sec.
314.81(b)(3)(iii), we estimate that approximately 2 hours on average
are needed per response. We do not expect the changes in the interim
final rule to affect the number of hours per response. Therefore, we
estimate that respondents will spend 160 hours per year notifying us of
a product discontinuance under these regulations.
Certification of Good Cause: Based on data collected from the CDER
drug shortage coordinator since 2007, one manufacturer each year
reported a discontinuance of one drug product under section 506C and
its implementing regulations. Each manufacturer has the opportunity
under Sec. 314.91 to request a reduction in the 6-month notification
period by certifying to us that good cause exists for the reduction.
The Agency has received no certifications of good cause since 2007.
Although we expect we will receive an increase in the number of reports
of discontinuances as a result of the changes in the interim final
rule, because of the limited circumstances under which good cause can
be requested or would be appropriately granted, we do not expect a
correspondingly large increase in the number of manufacturers
requesting a certification of good cause. We estimate that only 5
manufacturers will request a certification of good cause each year.
Therefore, the number of respondents is estimated to be 5. The total
annual responses are the total number of certifications of good cause
that are expected to be submitted to us in a year. We estimate that the
total annual responses will remain small, averaging one response per
respondent. The hours per response is the estimated number of hours
that a respondent spends preparing the detailed information certifying
that good cause exists for a reduction in the notification period,
including the time it takes to gather and copy the documents. We
estimate that approximately 16 hours on average are needed per
response. Therefore, we estimate that 80 hours will be spent per year
by respondents certifying that good cause exists for a reduction in the
6- month notification period under Sec. 314.91.
Table 3--Estimated Annual Reporting Burden \1\
----------------------------------------------------------------------------------------------------------------
Number of
21 CFR Section Number of responses per Total annual Hours per Total hours
respondents respondent responses response
----------------------------------------------------------------------------------------------------------------
Notification of Discontinuance.. 80 1 80 2 160
(314.81(b)(3)(iii)).............
Certification of Good Cause 5 1 5 16 80
(314.91).......................
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Total....................... 240
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\1\ There are no capital costs or operating and maintenance costs associated with this collection of
information.
[[Page 78539]]
The information collection pr