Schedules of Controlled Substances: Removal of [123, 31521-31525 [2015-13455]
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Federal Register / Vol. 80, No. 106 / Wednesday, June 3, 2015 / Proposed Rules
I. Background
FDA is announcing the availability of
a draft revised GFI #120 entitled
‘‘Veterinary Feed Directive Regulation
Questions and Answers.’’ The audience
for this draft guidance is comprised of
veterinarians issuing VFD orders, feed
mills manufacturing VFD feeds and
other distributors, animal producers
who obtain VFD feeds for use in treating
their animals, and others. This draft
revised guidance reflects changes to the
VFD requirements under the VFD final
rule published elsewhere in this edition
of the Federal Register.
In 1996, Congress enacted the Animal
Drug Availability Act (ADAA) to
facilitate the approval and marketing of
new animal drugs and medicated feeds.
In passing the ADAA, Congress created
a new regulatory category for certain
animal drugs used in animal feed called
veterinary feed directive (VFD) drugs.
VFD drugs are new animal drugs
intended for use in or on animal feed
which are limited to use under the
professional supervision of a licensed
veterinarian. FDA published final
regulations implementing the VFDrelated provisions of the ADAA in 2000.
Elsewhere in this edition of the
Federal Register, FDA is publishing a
VFD final rule that revises those VFD
regulations and introduces clarifying
changes to specified definitions. This
draft revised guidance includes
revisions that are consistent with the
requirements in that final rule.
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II. Significance of Guidance
This level 1 draft guidance is being
issued consistent with FDA’s good
guidance practices regulation (21 CFR
10.115). The draft guidance, when
finalized, will represent the Agency’s
current thinking on this topic. It does
not establish any rights for or on any
person and does is not binding on FDA
or the public. An alternative approach
may be used if such approach satisfies
the requirements of the applicable
statutes and regulations.
III. Paperwork Reduction Act of 1995
This draft guidance refers to
previously approved collections of
information found in FDA regulations.
These collections of information are
subject to review by the Office of
Management and Budget (OMB) under
the Paperwork Reduction Act of 1995
(44 U.S.C. 3501–3520). The collections
of information in 21 CFR 558.6 have
been approved under OMB control
number 0910–0363.
IV. Comments
Interested persons may submit either
electronic comments regarding this
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document to https://www.regulations.gov
or written comments to the Division of
Dockets Management (see ADDRESSES). It
is only necessary to send one set of
comments. Identify comments with the
docket number found in brackets in the
heading of this document. Received
comments may be seen in the Division
of Dockets Management between 9 a.m.
and 4 p.m., Monday through Friday, and
will be posted to the docket at https://
www.regulations.gov.
V. Electronic Access
Persons with access to the Internet
may obtain the draft guidance at either
https://www.fda.gov/AnimalVeterinary/
GuidanceComplianceEnforcement/
GuidanceforIndustry/default.htm or
https://www.regulations.gov.
Dated: May 28, 2015.
Leslie Kux,
Associate Commissioner for Policy.
[FR Doc. 2015–13394 Filed 6–2–15; 8:45 am]
BILLING CODE 4164–01–P
DEPARTMENT OF JUSTICE
Drug Enforcement Administration
21 CFR Part 1308
[Docket No. DEA–415]
Schedules of Controlled Substances:
Removal of [123I]Ioflupane From
Schedule II of the Controlled
Substances Act
Drug Enforcement
Administration, Department of Justice.
ACTION: Notice of proposed rulemaking.
AGENCY:
The Drug Enforcement
Administration proposes to remove
[123I]ioflupane from the schedules of the
Controlled Substances Act. This action
is pursuant to the Controlled Substances
Act which requires that such actions be
made on the record after an opportunity
for a hearing through formal
rulemaking. [123I]Ioflupane is, by
definition, a schedule II controlled
substance because it is derived from
cocaine via ecgonine, both of which are
schedule II controlled substances. This
action would remove the regulatory
controls and administrative, civil, and
criminal sanctions applicable to
controlled substances, including those
specific to schedule II controlled
substances, on persons who handle
(manufacture, distribute, reverse
distribute, dispense, conduct research,
import, export, or conduct chemical
analysis) or propose to handle
[123I]ioflupane.
SUMMARY:
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31521
Interested persons may file
written comments on this proposal in
accordance with 21 CFR 1308.43(g).
Electronic comments must be
submitted, and written comments must
be postmarked, on or before July 6,
2015. Commenters should be aware that
the electronic Federal Docket
Management System will not accept
comments after 11:59 p.m. Eastern Time
on the last day of the comment period.
Interested persons, defined at 21 CFR
1300.01 as those ‘‘adversely affected or
aggrieved by any rule or proposed rule
issuable pursuant to section 201 of the
Act (21 U.S.C. 811)’’, may file a request
for hearing or waiver of participation
pursuant to 21 CFR 1308.44 and in
accordance with 21 CFR 1316.45,
1316.47, 1316.48, or 1316.49, as
applicable. Requests for hearing, notices
of appearance, and waivers of an
opportunity for a hearing or to
participate in a hearing must be
received on or before July 6, 2015.
ADDRESSES: To ensure proper handling
of comments, please reference ‘‘Docket
No. DEA–415’’ on all correspondence,
including any attachments.
• Electronic comments: The DEA
encourages that all comments be
submitted through the Federal
eRulemaking Portal, which provides the
ability to type short comments directly
into the comment field on the Web page
or to attach a file for lengthier
comments. Please go to https://
www.regulations.gov and follow the
online instructions at that site for
submitting comments. Upon completion
of your submission you will receive a
Comment Tracking Number for your
comment. Please be aware that
submitted comments are not
instantaneously available for public
view on Regulations.gov. If you have
received a Comment Tracking Number,
your comment has been successfully
submitted and there is no need to
resubmit the same comment.
• Paper comments: Paper comments
that duplicate an electronic submission
are not necessary and are discouraged.
Should you wish to mail a comment in
lieu of submitting a comment online, it
should be sent via regular or express
mail to: Drug Enforcement
Administration, Attention: DEA Federal
Register Representative/ODXL, 8701
Morrissette Drive, Springfield, Virginia
22152.
• Hearing requests: All requests for
hearing must be sent to: DEA Federal
Register Representative/ODL, 8701
Morrissette Drive, Springfield, Virginia
22152.
FOR FURTHER INFORMATION CONTACT: John
R. Scherbenske, Office of Diversion
DATES:
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Control, Drug Enforcement
Administration; Mailing Address: 8701
Morrissette Drive, Springfield, Virginia
22152; Telephone: (202) 598–6812.
SUPPLEMENTARY INFORMATION:
Posting of Public Comments
Please note that all comments
received in response to this docket are
considered part of the public record.
They will, unless reasonable cause is
given, be made available by the DEA for
public inspection online at https://
www.regulations.gov. Such information
includes personal identifying
information (such as your name,
address, etc.) voluntarily submitted by
the commenter. The Freedom of
Information Act (FOIA) applies to all
comments received. If you want to
submit personal identifying information
(such as your name, address, etc.) as
part of your comment, but do not want
it to be made publicly available, you
must include the phrase ‘‘PERSONAL
IDENTIFYING INFORMATION’’ in the
first paragraph of your comment. You
must also place the personal identifying
information you do not want made
publicly available in the first paragraph
of your comment and identify what
information you want redacted.
If you want to submit confidential
business information as part of your
comment, but do not want it to be made
publicly available, you must include the
phrase ‘‘CONFIDENTIAL BUSINESS
INFORMATION’’ in the first paragraph
of your comment. You must also
prominently identify confidential
business information to be redacted
within the comment.
Comments containing personal
identifying information and confidential
business information identified as
directed above will generally be made
publicly available in redacted form. If a
comment has so much confidential
business information or personal
identifying information that it cannot be
effectively redacted, all or part of that
comment may not be made publicly
available. Comments posted to https://
www.regulations.gov may include any
personal identifying information (such
as name, address, and phone number)
included in the text of your online
submission that is not identified as
directed above as confidential.
An electronic copy of this document
and supplemental information to this
proposed rule are available at https://
www.regulations.gov for easy reference.
Request for Hearing, Notice of
Appearance at or Waiver of
Participation in Hearing
Pursuant to 21 U.S.C. 811(a), this
action is a formal rulemaking ‘‘on the
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record after opportunity for a hearing.’’
Such proceedings are conducted
pursuant to the provisions of the
Administrative Procedure Act (APA) (5
U.S.C. 551–559). 21 CFR 1308.41–
1308.45, and 21 CFR part 1316 subpart
D. In accordance with 21 CFR 1308.44
(a)–(c), requests for hearing, notices of
appearance, and waivers of an
opportunity for a hearing or to
participate in a hearing may be
submitted only by interested persons,
defined as those ‘‘adversely affected or
aggrieved by any rule or proposed rule
issuable pursuant to section 201 of the
Act (21 U.S.C. 811).’’ 21 CFR 1300.01.
Such requests or notices must conform
to the requirements of 21 CFR 1308.44
(a) or (b), and 1316.47 or 1316.48, as
applicable, and include a statement of
the interest of the person in the
proceeding and the objections or issues,
if any, concerning which the person
desires to be heard. Any waiver must
conform to the requirements of 21 CFR
1308.44(c) and 1316.49, including a
written statement regarding the
interested person’s position on the
matters of fact and law involved in any
hearing.
Legal Authority
The Drug Enforcement
Administration (DEA) implements and
enforces titles II and III of the
Comprehensive Drug Abuse Prevention
and Control Act of 1970, as amended. 21
U.S.C. 801–971. Titles II and III are
referred to as the ‘‘Controlled
Substances Act’’ and the ‘‘Controlled
Substances Import and Export Act,’’
respectively, but they are collectively
referred to as the ‘‘Controlled
Substances Act’’ or the ‘‘CSA’’ for the
purposes of this action. The DEA
publishes the implementing regulations
for these statutes in title 21 of the Code
of Federal Regulations (CFR), chapter II.
The CSA and its implementing
regulations are designed to prevent,
detect, and eliminate the diversion of
controlled substances and listed
chemicals into the illicit market while
ensuring an adequate supply is available
for the legitimate medical, scientific,
research, and industrial needs of the
United States. Controlled substances
have the potential for abuse and
dependence and are controlled to
protect the public health and safety.
Under the CSA, each controlled
substance is classified into one of five
schedules based upon its potential for
abuse, its currently accepted medical
use in treatment in the United States,
and the degree of dependence the drug
or other substance may cause. 21 U.S.C.
812. The initial schedules of controlled
substances established by Congress are
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found at 21 U.S.C. 812(c) and the
current list of scheduled substances is
published at 21 CFR part 1308.
Pursuant to 21 U.S.C. 811(a)(2), the
Attorney General may, by rule, ‘‘remove
any drug or other substance from the
schedules if he [or she] finds that the
drug or other substance does not meet
the requirements for inclusion in any
schedule.’’ The Attorney General has
delegated scheduling authority under 21
U.S.C. 811 to the Administrator of the
DEA, 28 CFR 0.100.
The CSA provides that proceedings
for the issuance, amendment, or repeal
of the scheduling of any drug or other
substance may be initiated by the
Attorney General (1) on his or her own
motion, (2) at the request of the
Secretary of the Department of Health
and Human Services,1 or (3) on the
petition of any interested party. 21
U.S.C. 811(a). This action was initiated
at the request of the Assistant Secretary
for Health of the HHS, and is supported
by an evaluation of all relevant data by
the HHS and the DEA. This action
would remove the regulatory controls
and administrative, civil, and criminal
sanctions applicable to controlled
substances, including those specific to
schedule II controlled substances, on
persons who handle or propose to
handle [123I]ioflupane.
Background
DaTscan is a single-dose, injectable
diagnostic radiopharmaceutical for use
in hospital settings with specialized
gamma cameras. It was developed as a
diagnostic tool for visualization of
dopamine transporters (DAT) by using
single photon emission computed
tomography (SPECT) brain imaging. The
Food and Drug Administration (FDA)
approved the New Drug Application
(NDA) for DaTscan on January 14, 2011,
for the indication of visualizing striatal
DATs in the brains of adult patients
with suspected Parkinsonian syndromes
(PS). [123I]Ioflupane is the active
pharmaceutical ingredient (API) in
DaTscan and it is a new molecular
entity. However, [123I]Ioflupane is, by
definition, a schedule II controlled
substance because it is derived from
cocaine, a schedule II substance, via
ecgonine (a schedule II substance). See
21 U.S.C. 812(c), Schedule II, (a)(4).
1 As discussed in a memorandum of
understanding entered into by the Food and Drug
Administration (FDA) and the National Institute on
Drug Abuse (NIDA), the FDA acts as the lead agency
within the HHS in carrying out the Secretary’s
scheduling responsibilities under the CSA, with the
concurrence of NIDA. 50 FR 9518, Mar. 8, 1985.
The Secretary of the HHS has delegated to the
Assistant Secretary for Health of the HHS the
authority to make domestic drug scheduling
recommendations. 58 FR 35460, July 1, 1993.
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Each vial of DaTscan contains 0.325
micrograms (mg) of [123I]ioflupane per
2.5 milliliters (ml). The average and
maximum amounts of non-radioactive
ioflupane in each DaTscan vial are
estimated to be between 0.21 mg and
0.31 mg. Although ioflupane, the nonradiolabeled API of the drug product
DaTscan, binds to DAT and elicits
behavioral effects similar to that of
cocaine, based upon the available
information and DaTscan’s unique
formulation-specific properties,
DaTscan itself presents no practical
possibility of abuse, misuse, diversion
or clandestine production.
Proposed Determination To Decontrol
[123I]Ioflupane
Pursuant to 21 U.S.C. 811(b), (c), and
(f), the HHS recommended to the DEA
on November 2, 2010, that FDAapproved products containing
[123I]ioflupane be removed from
schedule II of the CSA. HHS provided
to DEA a scientific and medical
evaluation document entitled ‘‘Basis for
the Recommendation to Remove FDA
Approved Products Containing
[123I]Ioflupane from Schedule II of the
Controlled Substances Act (CSA).’’
Pursuant to 21 U.S.C. 811(b), this
document contained an eight-factor
analysis of FDA-approved products
containing [123I]ioflupane, along with
the HHS’s recommendation to remove
FDA-approved products containing
[123I]ioflupane from the schedules of the
CSA.
In response, the DEA reviewed the
scientific and medical evaluation and
scheduling recommendation provided
by the HHS, and all other relevant data.
The DEA and HHS collaborated further
regarding the available information. By
letter dated February 2, 2015, the HHS
provided detailed responses to specific
inquiries from the DEA (submitted by
letter dated September 16, 2014). Upon
further review of all of the available
information, the DEA completed its own
eight-factor review document on FDAapproved diagnostic products
containing [123I]ioflupane (currently,
only DaTscan) pursuant to 21 U.S.C.
811(c). The FDA-approved diagnostic
product, DaTscan, was used as the basis
for the scientific and medical evaluation
of FDA-approved diagnostic products
containing [123I]ioflupane for both the
HHS and DEA eight-factor analysis.
Included below is a brief summary of
each factor as analyzed by the HHS and
the DEA, and as considered by the DEA
in this proposed rule to remove
[123I]ioflupane from the schedules of the
CSA. Please note that both the DEA and
HHS analyses and other relevant
documents are available in their entirety
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under ‘‘Supporting and Related
Material’’ of the public docket for this
rule at https://www.regulations.gov
under docket number DEA–415.
1. The Drug’s Actual or Relative
Potential for Abuse
According to HHS and the DEA, there
are no data demonstrating that
individuals are administering quantities
of DaTscan sufficient to create a hazard
to their health or to the safety of other
individuals or to the community. In
clinical studies, DaTscan, due to its low
concentrations of [123I]ioflupane lacked,
central nervous activity (CNS) in
humans.
According to HHS review of
Sponsor’s calculation regarding
psychoactive doses of DaTscan,
approximately 6,000 vials of DaTscan
would be required to produce a
subjective ‘‘high’’ in humans from
exposure to [123I]ioflupane in this
product. The volume of 6,000 vials is
about 15 liters (L) of fluid, an amount
that would be lethal if administered
intravenously (i.v.). The short half-life
of DaTscan (due to its radioactive decay)
will prevent its extended storage for
future use at the manufacturing,
distributing, or radiopharmacy site;
thereby limiting the amount available
for diversion. It is highly unlikely that
individuals will administer DaTscan on
their own initiative since DaTscan has
a very dilute and small dose of
[123I]ioflupane, and possesses
radioactivity. As a result, DaTscan will
not have significant capability of
creating hazards to the health of the user
or to the safety of the community.
2. Scientific Evidence of the Drug’s
Pharmacological Effects, If Known
DaTscan blocks monoamine
transporters, such as DAT and other
monoamine transporters such as
serotonin transporters. Ioflupane, the
active pharmaceutical ingredient in
DaTscan, was demonstrated to have an
affinity to DAT that was approximately
10- and 100-fold greater than cocaine in
rodent brain homogenates or in cells
transfected with rat DAT (Neumeyer et
al., 1996; Okada et al., 1998; Scheffel et
al., 1997). As reported by HHS, nonradiolabeled ioflupane at doses >0.1 mg/
kg, i.v. was able to substitute for cocaine
in cocaine-trained rats (10 mg/kg,
intraperitoneal administration) using a
drug discrimination protocol which is
predictive of subjective behavioral
effects in humans.
HHS reviewed data from eight human
clinical trials involving 942 subjects and
nine years of post-approval use in
Europe and found that there was not
any clinical evidence of
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31523
pharmacological effects resulting from
DaTscan administration. The maximum
dose of [123I]ioflupane in DaTscan that
is administered to the patient prior to
undergoing an imaging procedure is
0.325 mg (0.13 mg/ml). HHS extrapolated
from the locomotor study and drug
discrimination study on nonradiolabeled ioflupane and estimated
that the lowest active dose of DaTscan
for a 60 kg (132.2 lb) human to achieve
a pharmacologic effect would be 288 mg
or 886 vials of DaTscan. In addition, the
recreational dose of DaTscan is
estimated as 1921 mg or 5,910 vials.
Although [123I]ioflupane would be
expected to have a pharmacological
profile nearly identical to its nonradioactive form, its unique properties
(i.e., manufacturing limits and
radioactive properties) pose practical
barriers to its abuse. Furthermore,
according to HHS, the amount of
[123I]ioflupane in DaTscan is
significantly less than the amounts of
ioflupane used to elicit the
pharmacological response in preclinical
studies with this compound.
3. The State of Current Scientific
Knowledge Regarding the Drug or Other
Substance
The international non-proprietary
name of [123I]ioflupane is methyl(1R,
2S, 3S, 5S)-8-(3-fluoropropyl)-3-(4[123I]iodophenyl)-8-azabicyclo[3,2,1]
octane-2-carboxylate. The molecular
formula of [123I]ioflupane is
C18H23F[123I]NO2 and the molecular
weight is 427.28 g/mol. [123I]Ioflupane
is a clear, colorless solution and is only
present in a solution of ethanol and
sodium acetate buffer. Non-radioactive
ioflupane is a white solid with a melting
point of 83 °C to 87 °C and soluble in
water (less than 0.1 mg/ml), sodium
acetate buffer (pH 7.4; 16 mg/ml), and
ethanol (27 mg/ml).
HHS states that meaningful extraction
of [123I]ioflupane from DaTscan would
be impossible due to its limited
production and availability and because
extraction is technically complex and
would require advanced equipment not
available to the general public.
Importantly, if extraction of ioflupane
from [123I]ioflupane is accomplished,
the ioflupane would be subject to
schedule II controls under the CSA.
According to HHS, the retrosynthesis of
DaTscan to cocaine and ecgonine would
be difficult. Production of DaTscan is
technically complex as it requires
specialized equipment, facilities,
scientific training and expertise, making
clandestine manufacturing particularly
difficult. HHS indicated that the nonradiolabeled precursors needed for the
synthesis of [123I]ioflupane (and
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DaTscan) are abusable. In addition, the
non-radiolabeled precursors derived
from cocaine or ecgonine are also
schedule II controlled substances.
However, even if an individual obtained
the precursors, it is impractical and
highly unlikely that they would
synthesize the abusable compound into
a radiolabeled formulation with a
limited storage life that is not desired by
drug users.
On January 14, 2011, FDA approved
the NDA for DaTscan with the
indication of visualizing striatal
dopamine transporters in the brains of
adult patients with suspected
Parkinsonian syndromes using SPECT
imaging. As such, any FDA-approved
diagnostic product containing
[123I]ioflupane has a currently accepted
medical use in the United States.
4. Its History and Current Pattern of
Abuse
According to HHS, there have been no
reports of abuse of [123I]ioflupane. Over
168,000 doses of DaTscan have been
administered to patients worldwide,
and no pharmacological effects have
been noted. Further, according to HHS,
no single user has received more than
10 vials of DaTscan in a single day.
5. The Scope, Duration, and
Significance of Abuse
There have been no reports of abuse
of [123I]ioflupane. According to the
National Forensic Laboratory
Information System (NFLIS) 2 and the
System to Retrieve Information from
Drug Evidence (STRIDE) 3, there have
been no reports of [123I]ioflupane
seizures during the time period January
2010 to February 2015.
6. What, If Any, Risk There Is to the
Public Health
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According to the HHS, because of the
limited amounts of manufactured
DaTscan, the low concentration of
[123I]ioflupane per vial, and the
existence of stringent regulatory
controls (controls other than those
imposed by the CSA and its
implementing regulations, including
regulation by the United States Nuclear
Regulatory Commission under 10 CFR
2 NFLIS is a program of the DEA that collects drug
identification results from drug cases analyzed by
other Federal, State, and local forensic laboratories.
NFLIS was queried on April 16, 2015.
3 STRIDE collected the results of drug evidence
analyzed at DEA laboratories and reflects evidence
submitted by the DEA, other Federal law
enforcement agencies, and some local law
enforcement agencies. STRIDE data was queried by
date submitted to Federal forensic laboratories. On
October 1, 2014, STARLiMS replaced STRIDE as
the DEA laboratory drug evidence data system of
record.
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part 35 and/or by states) 4 on the
manufacturing and handling of
DaTscan, abuse of DaTscan is not
possible as a practical matter. Thus,
there is little to no practical risk to
public health from DaTscan abuse.
7. Its Psychic or Physiological
Dependence Liability
As reviewed by HHS, nonradiolabeled ioflupane has cocaine-like
properties. In a drug discrimination
study in cocaine-trained rats, nonradiolabeled ioflupane produced
cocaine-appropriate responding, which
suggests that non-radiolabeled ioflupane
may produce cocaine-like subjective
effects in humans (HHS, 2010).
However, the available evidence
suggests that there is no psychic or
physiological dependence potential of
FDA-approved diagnostic products
containing [123I]ioflupane. The psychic
or physiological dependence potential
of FDA-approved diagnostic products is
currently expected to be very limited
due to the low exposure concentration
of [123I]ioflupane, the aforementioned
low potential for abuse (see Factor 1)
and the extremely high and lethal
quantities needed to achieve a
subjective ‘‘high.’’
8. Whether the Substance Is an
Immediate Precursor of a Substance
Already Controlled Under the CSA
[123I]Ioflupane is not an immediate
precursor of a substance already
controlled under the CSA.
Conclusion
Based on consideration of the
scientific and medical evaluation and
accompanying recommendation of the
HHS and based on the DEA’s
consideration of its own eight-factor
analysis, the DEA finds that the facts
and all available and relevant data
demonstrate that [123I]ioflupane does
not possess abuse or dependence
potential. Accordingly, the DEA finds
that [123I]ioflupane does not meet the
requirements for inclusion in any
schedule and should be removed from
control under the CSA.
Findings for Schedule Placement
Pursuant to 21 U.S.C. 812(b)
The CSA outlines the findings
required to place a drug or other
substance in any particular schedule (I,
II, III, IV, or V). 21 U.S.C. 812(b). The
Assistant Secretary for Health of the
HHS recommended removal of ‘‘FDA
approved products containing
4 There are Federal and state laws and regulations
which limit the public’s exposure to radioactivity
in radiopharmaceuticals, thus limiting the potential
for toxicity imposed on the public.
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[123I]ioflupane from schedule II of the’’
CSA. However, because the DEA finds
no basis to remove only FDA approved
products containing [123I]ioflupane from
the schedules, this action proposes to
remove the substance [123I]ioflupane
from the CSA schedules. Historically,
when new molecular entities are
removed from control, the substance
itself is removed from control rather
than the specific FDA-approved drug
product (e.g., naloxegol, 80 FR 3468;
naloxone, 39 FR 44392). As summarized
above, the data currently support
removal of substances that contain
[123I]ioflupane, primarily because
[123I]ioflupane itself has a lethal
radioactive barrier, and its
manufacturing process is highly
regulated and technically complex, thus
making abuse highly unlikely.
After consideration of the analyses
and recommendation of the Assistant
Secretary for Health of the HHS and
review of all relevant and available data,
the Administrator of the DEA, pursuant
to 21 U.S.C. 812(b)(5), finds that:
(1) [123I]Ioflupane has no comparable
potential for abuse relative to substances
in Schedule V.
(2) [123I]Ioflupane has a currently
accepted medical use in treatment in the
United States. FDA approved the New
Drug Application for DaTscan on
January 14, 2011, with the indication of
visualizing striatal dopamine
transporters in the brains of adult
patients with suspected Parkinsonian
syndromes using SPECT imaging.
(3) [123I]Ioflupane is not abusable,
therefore, its use is not likely to lead to
physical or psychological dependence.
Based on these findings, the
Administrator of the DEA concludes
that [123I]ioflupane does not warrant
control under the CSA.
Effect on Other Rulemakings
On November 25, 2014, DEA
published an interim final rule waiving
the requirement of DEA registration for
certain entities that are authorized
under other federal or state authorities
to administer DaTscan. 79 FR 70085. If
finalized, this proposal to remove
[123I]ioflupane from the schedules of
controlled substances would make such
waivers unnecessary. Therefore, if this
action is finalized, DEA intends to
withdraw the regulations established
through that interim final rule.
Regulatory Analyses
Executive Orders 12866 and 15363
In accordance with 21 U.S.C. 811(a),
this scheduling action is subject to
formal rulemaking procedures done ‘‘on
the record after opportunity for a
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03JNP1
Federal Register / Vol. 80, No. 106 / Wednesday, June 3, 2015 / Proposed Rules
hearing,’’ which are conducted pursuant
to the provisions of 5 U.S.C. 556 and
557. The CSA sets forth the criteria for
scheduling a drug or other substance
and for removing a drug or substance
from the schedules of controlled
substances. Such actions are exempt
from review by the Office of
Management and Budget (OMB)
pursuant to section 3(d)(1) of Executive
Order 12866 and the principles
reaffirmed in Executive Order 13563.
Executive Order 12988
This regulation meets the applicable
standards set forth in sections 3(a) and
3(b)(2) of Executive Order 12988 Civil
Justice Reform to eliminate drafting
errors and ambiguity, minimize
litigation, provide a clear legal standard
for affected conduct, and promote
simplification and burden reduction.
Executive Order 13132
This rulemaking does not have
federalism implications warranting the
application of Executive Order 13132.
The rule does not have substantial
direct effects on the States, on the
relationship between the Federal
Government and the States, or the
distribution of power and
responsibilities among the various
levels of government.
asabaliauskas on DSK5VPTVN1PROD with PROPOSALS
Executive Order 13175
This rule does not have tribal
implications warranting the application
of Executive Order 13175. This rule
does not have substantial direct effects
on one or more Indian tribes, on the
relationship between the Federal
Government and Indian tribes, or on the
distribution of power and
responsibilities between the Federal
Government and Indian tribes.
Regulatory Flexibility Act
The Administrator, in accordance
with the Regulatory Flexibility Act (5
U.S.C. 601–612) (RFA), has reviewed
this proposed rule and by approving it
certifies that it will not have a
significant economic impact on a
substantial number of small entities.
The purpose of this rule is to remove
[123I]ioflupane from the list of schedules
of the CSA. This action will remove
regulatory controls and administrative,
civil, and criminal sanctions applicable
to controlled substances for handlers
and proposed handlers of
[123I]ioflupane. Accordingly, it has the
potential for some economic impact in
the form of cost savings.
If finalized, the proposed rule will
affect all persons who would handle, or
propose to handle, [123I]ioflupane. Due
to the wide variety of unidentifiable and
VerDate Sep<11>2014
17:19 Jun 02, 2015
Jkt 235001
unquantifiable variables that potentially
could influence the distribution and
administration rates of new molecular
entities, the DEA is unable to determine
the number of entities and small entities
which might handle [123I]ioflupane.
Although the DEA does not have a
reliable basis to estimate the number of
affected entities and quantify the
economic impact of this proposed rule,
a qualitative analysis indicates that, if
finalized, this rule is likely to result in
some cost savings for the healthcare
industry. The affected entities will
continue to meet existing Federal and/
or state requirements applicable to those
who handle radiopharmaceutical
substances, including licensure,
security, recordkeeping, and reporting
requirements, which in many cases are
more stringent than the DEA’s
requirements. However, the DEA
estimates cost savings will be realized
from the removal of the administrative,
civil, and criminal sanctions for those
entities handling or proposing to handle
[123I]ioflupane, in the form of saved
registration fees, and the elimination of
additional physical security,
recordkeeping, and reporting
requirements.
Because of these facts, this rule will
not result in a significant economic
impact on a substantial number of small
entities.
Unfunded Mandates Reform Act of 1995
On the basis of information contained
in the ‘‘Regulatory Flexibility Act’’
section above, the DEA has determined
and certifies pursuant to the Unfunded
Mandates Reform Act of 1995 (UMRA),
2 U.S.C. 1501 et seq., that this action
would not result in 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 for
inflation) in any one year * * * .’’
Therefore, neither a Small Government
Agency Plan nor any other action is
required under provisions of UMRA.
Paperwork Reduction Act
This action does not impose a new
collection of information requirement
under the Paperwork Reduction Act, 44
U.S.C. 3501–3521. This action would
not impose recordkeeping or reporting
requirements on State or local
governments, individuals, businesses, or
organizations. 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.
PO 00000
Frm 00039
Fmt 4702
Sfmt 4702
31525
List of Subjects in 21 CFR part 1308
Administrative practice and
procedure, Drug traffic control,
Reporting and recordkeeping
requirements.
For the reasons set out above, 21 CFR
part 1308 is proposed to be amended to
read as follows:
PART 1308—SCHEDULES OF
CONTROLLED SUBSTANCES
1. The authority citation for 21 CFR
part 1308 continues to read as follows:
■
Authority: 21 U.S.C. 811, 812, 871(b),
unless otherwise noted.
2. In § 1308.12, revise paragraph (b)(4)
to read as follows:
■
§ 1308.12
Schedule II.
*
*
*
*
*
(b) * * *
(4) Coca leaves (9040) and any salt,
compound, derivative or preparation of
coca leaves (including cocaine (9041)
and ecgonine (9180) and their salts,
isomers, derivatives and salts of isomers
and derivatives), and any salt,
compound, derivative, or preparation
thereof which is chemically equivalent
or identical with any of these
substances, except that the substances
shall not include:
(i) Decocainized coca leaves or
extraction of coca leaves, which
extractions do not contain cocaine or
ecgonine; or
(ii) [123I]ioflupane.
*
*
*
*
*
Dated: May 6, 2015.
Michele M. Leonhart,
Administrator.
[FR Doc. 2015–13455 Filed 6–2–15; 8:45 am]
BILLING CODE 4410–09–P
DEPARTMENT OF STATE
22 CFR Parts 120, 123, 125, and 127
[Public Notice 9149]
RIN 1400–AD70
International Traffic in Arms: Revisions
to Definitions of Defense Services,
Technical Data, and Public Domain;
Definition of Product of Fundamental
Research; Electronic Transmission
and Storage of Technical Data; and
Related Definitions
Department of State.
Proposed rule.
AGENCY:
ACTION:
As part of the President’s
Export Control Reform (ECR) initiative,
the Department of State proposes to
amend the International Traffic in Arms
SUMMARY:
E:\FR\FM\03JNP1.SGM
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Agencies
[Federal Register Volume 80, Number 106 (Wednesday, June 3, 2015)]
[Proposed Rules]
[Pages 31521-31525]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-13455]
=======================================================================
-----------------------------------------------------------------------
DEPARTMENT OF JUSTICE
Drug Enforcement Administration
21 CFR Part 1308
[Docket No. DEA-415]
Schedules of Controlled Substances: Removal of [\123\I]Ioflupane
From Schedule II of the Controlled Substances Act
AGENCY: Drug Enforcement Administration, Department of Justice.
ACTION: Notice of proposed rulemaking.
-----------------------------------------------------------------------
SUMMARY: The Drug Enforcement Administration proposes to remove
[\123\I]ioflupane from the schedules of the Controlled Substances Act.
This action is pursuant to the Controlled Substances Act which requires
that such actions be made on the record after an opportunity for a
hearing through formal rulemaking. [\123\I]Ioflupane is, by definition,
a schedule II controlled substance because it is derived from cocaine
via ecgonine, both of which are schedule II controlled substances. This
action would remove the regulatory controls and administrative, civil,
and criminal sanctions applicable to controlled substances, including
those specific to schedule II controlled substances, on persons who
handle (manufacture, distribute, reverse distribute, dispense, conduct
research, import, export, or conduct chemical analysis) or propose to
handle [\123\I]ioflupane.
DATES: Interested persons may file written comments on this proposal in
accordance with 21 CFR 1308.43(g). Electronic comments must be
submitted, and written comments must be postmarked, on or before July
6, 2015. Commenters should be aware that the electronic Federal Docket
Management System will not accept comments after 11:59 p.m. Eastern
Time on the last day of the comment period.
Interested persons, defined at 21 CFR 1300.01 as those ``adversely
affected or aggrieved by any rule or proposed rule issuable pursuant to
section 201 of the Act (21 U.S.C. 811)'', may file a request for
hearing or waiver of participation pursuant to 21 CFR 1308.44 and in
accordance with 21 CFR 1316.45, 1316.47, 1316.48, or 1316.49, as
applicable. Requests for hearing, notices of appearance, and waivers of
an opportunity for a hearing or to participate in a hearing must be
received on or before July 6, 2015.
ADDRESSES: To ensure proper handling of comments, please reference
``Docket No. DEA-415'' on all correspondence, including any
attachments.
Electronic comments: The DEA encourages that all comments
be submitted through the Federal eRulemaking Portal, which provides the
ability to type short comments directly into the comment field on the
Web page or to attach a file for lengthier comments. Please go to
https://www.regulations.gov and follow the online instructions at that
site for submitting comments. Upon completion of your submission you
will receive a Comment Tracking Number for your comment. Please be
aware that submitted comments are not instantaneously available for
public view on Regulations.gov. If you have received a Comment Tracking
Number, your comment has been successfully submitted and there is no
need to resubmit the same comment.
Paper comments: Paper comments that duplicate an
electronic submission are not necessary and are discouraged. Should you
wish to mail a comment in lieu of submitting a comment online, it
should be sent via regular or express mail to: Drug Enforcement
Administration, Attention: DEA Federal Register Representative/ODXL,
8701 Morrissette Drive, Springfield, Virginia 22152.
Hearing requests: All requests for hearing must be sent
to: DEA Federal Register Representative/ODL, 8701 Morrissette Drive,
Springfield, Virginia 22152.
FOR FURTHER INFORMATION CONTACT: John R. Scherbenske, Office of
Diversion
[[Page 31522]]
Control, Drug Enforcement Administration; Mailing Address: 8701
Morrissette Drive, Springfield, Virginia 22152; Telephone: (202) 598-
6812.
SUPPLEMENTARY INFORMATION:
Posting of Public Comments
Please note that all comments received in response to this docket
are considered part of the public record. They will, unless reasonable
cause is given, be made available by the DEA for public inspection
online at https://www.regulations.gov. Such information includes
personal identifying information (such as your name, address, etc.)
voluntarily submitted by the commenter. The Freedom of Information Act
(FOIA) applies to all comments received. If you want to submit personal
identifying information (such as your name, address, etc.) as part of
your comment, but do not want it to be made publicly available, you
must include the phrase ``PERSONAL IDENTIFYING INFORMATION'' in the
first paragraph of your comment. You must also place the personal
identifying information you do not want made publicly available in the
first paragraph of your comment and identify what information you want
redacted.
If you want to submit confidential business information as part of
your comment, but do not want it to be made publicly available, you
must include the phrase ``CONFIDENTIAL BUSINESS INFORMATION'' in the
first paragraph of your comment. You must also prominently identify
confidential business information to be redacted within the comment.
Comments containing personal identifying information and
confidential business information identified as directed above will
generally be made publicly available in redacted form. If a comment has
so much confidential business information or personal identifying
information that it cannot be effectively redacted, all or part of that
comment may not be made publicly available. Comments posted to https://www.regulations.gov may include any personal identifying information
(such as name, address, and phone number) included in the text of your
online submission that is not identified as directed above as
confidential.
An electronic copy of this document and supplemental information to
this proposed rule are available at https://www.regulations.gov for easy
reference.
Request for Hearing, Notice of Appearance at or Waiver of Participation
in Hearing
Pursuant to 21 U.S.C. 811(a), this action is a formal rulemaking
``on the record after opportunity for a hearing.'' Such proceedings are
conducted pursuant to the provisions of the Administrative Procedure
Act (APA) (5 U.S.C. 551-559). 21 CFR 1308.41-1308.45, and 21 CFR part
1316 subpart D. In accordance with 21 CFR 1308.44 (a)-(c), requests for
hearing, notices of appearance, and waivers of an opportunity for a
hearing or to participate in a hearing may be submitted only by
interested persons, defined as those ``adversely affected or aggrieved
by any rule or proposed rule issuable pursuant to section 201 of the
Act (21 U.S.C. 811).'' 21 CFR 1300.01. Such requests or notices must
conform to the requirements of 21 CFR 1308.44 (a) or (b), and 1316.47
or 1316.48, as applicable, and include a statement of the interest of
the person in the proceeding and the objections or issues, if any,
concerning which the person desires to be heard. Any waiver must
conform to the requirements of 21 CFR 1308.44(c) and 1316.49, including
a written statement regarding the interested person's position on the
matters of fact and law involved in any hearing.
Legal Authority
The Drug Enforcement Administration (DEA) implements and enforces
titles II and III of the Comprehensive Drug Abuse Prevention and
Control Act of 1970, as amended. 21 U.S.C. 801-971. Titles II and III
are referred to as the ``Controlled Substances Act'' and the
``Controlled Substances Import and Export Act,'' respectively, but they
are collectively referred to as the ``Controlled Substances Act'' or
the ``CSA'' for the purposes of this action. The DEA publishes the
implementing regulations for these statutes in title 21 of the Code of
Federal Regulations (CFR), chapter II. The CSA and its implementing
regulations are designed to prevent, detect, and eliminate the
diversion of controlled substances and listed chemicals into the
illicit market while ensuring an adequate supply is available for the
legitimate medical, scientific, research, and industrial needs of the
United States. Controlled substances have the potential for abuse and
dependence and are controlled to protect the public health and safety.
Under the CSA, each controlled substance is classified into one of
five schedules based upon its potential for abuse, its currently
accepted medical use in treatment in the United States, and the degree
of dependence the drug or other substance may cause. 21 U.S.C. 812. The
initial schedules of controlled substances established by Congress are
found at 21 U.S.C. 812(c) and the current list of scheduled substances
is published at 21 CFR part 1308.
Pursuant to 21 U.S.C. 811(a)(2), the Attorney General may, by rule,
``remove any drug or other substance from the schedules if he [or she]
finds that the drug or other substance does not meet the requirements
for inclusion in any schedule.'' The Attorney General has delegated
scheduling authority under 21 U.S.C. 811 to the Administrator of the
DEA, 28 CFR 0.100.
The CSA provides that proceedings for the issuance, amendment, or
repeal of the scheduling of any drug or other substance may be
initiated by the Attorney General (1) on his or her own motion, (2) at
the request of the Secretary of the Department of Health and Human
Services,\1\ or (3) on the petition of any interested party. 21 U.S.C.
811(a). This action was initiated at the request of the Assistant
Secretary for Health of the HHS, and is supported by an evaluation of
all relevant data by the HHS and the DEA. This action would remove the
regulatory controls and administrative, civil, and criminal sanctions
applicable to controlled substances, including those specific to
schedule II controlled substances, on persons who handle or propose to
handle [\123\I]ioflupane.
---------------------------------------------------------------------------
\1\ As discussed in a memorandum of understanding entered into
by the Food and Drug Administration (FDA) and the National Institute
on Drug Abuse (NIDA), the FDA acts as the lead agency within the HHS
in carrying out the Secretary's scheduling responsibilities under
the CSA, with the concurrence of NIDA. 50 FR 9518, Mar. 8, 1985. The
Secretary of the HHS has delegated to the Assistant Secretary for
Health of the HHS the authority to make domestic drug scheduling
recommendations. 58 FR 35460, July 1, 1993.
---------------------------------------------------------------------------
Background
DaTscan is a single-dose, injectable diagnostic radiopharmaceutical
for use in hospital settings with specialized gamma cameras. It was
developed as a diagnostic tool for visualization of dopamine
transporters (DAT) by using single photon emission computed tomography
(SPECT) brain imaging. The Food and Drug Administration (FDA) approved
the New Drug Application (NDA) for DaTscan on January 14, 2011, for the
indication of visualizing striatal DATs in the brains of adult patients
with suspected Parkinsonian syndromes (PS). [\123\I]Ioflupane is the
active pharmaceutical ingredient (API) in DaTscan and it is a new
molecular entity. However, [\123\I]Ioflupane is, by definition, a
schedule II controlled substance because it is derived from cocaine, a
schedule II substance, via ecgonine (a schedule II substance). See 21
U.S.C. 812(c), Schedule II, (a)(4).
[[Page 31523]]
Each vial of DaTscan contains 0.325 micrograms ([mu]g) of
[\123\I]ioflupane per 2.5 milliliters (ml). The average and maximum
amounts of non-radioactive ioflupane in each DaTscan vial are estimated
to be between 0.21 [mu]g and 0.31 [mu]g. Although ioflupane, the non-
radiolabeled API of the drug product DaTscan, binds to DAT and elicits
behavioral effects similar to that of cocaine, based upon the available
information and DaTscan's unique formulation-specific properties,
DaTscan itself presents no practical possibility of abuse, misuse,
diversion or clandestine production.
Proposed Determination To Decontrol [\123\I]Ioflupane
Pursuant to 21 U.S.C. 811(b), (c), and (f), the HHS recommended to
the DEA on November 2, 2010, that FDA-approved products containing
[\123\I]ioflupane be removed from schedule II of the CSA. HHS provided
to DEA a scientific and medical evaluation document entitled ``Basis
for the Recommendation to Remove FDA Approved Products Containing
[\123\I]Ioflupane from Schedule II of the Controlled Substances Act
(CSA).'' Pursuant to 21 U.S.C. 811(b), this document contained an
eight-factor analysis of FDA-approved products containing
[\123\I]ioflupane, along with the HHS's recommendation to remove FDA-
approved products containing [\123\I]ioflupane from the schedules of
the CSA.
In response, the DEA reviewed the scientific and medical evaluation
and scheduling recommendation provided by the HHS, and all other
relevant data. The DEA and HHS collaborated further regarding the
available information. By letter dated February 2, 2015, the HHS
provided detailed responses to specific inquiries from the DEA
(submitted by letter dated September 16, 2014). Upon further review of
all of the available information, the DEA completed its own eight-
factor review document on FDA-approved diagnostic products containing
[\123\I]ioflupane (currently, only DaTscan) pursuant to 21 U.S.C.
811(c). The FDA-approved diagnostic product, DaTscan, was used as the
basis for the scientific and medical evaluation of FDA-approved
diagnostic products containing [\123\I]ioflupane for both the HHS and
DEA eight-factor analysis. Included below is a brief summary of each
factor as analyzed by the HHS and the DEA, and as considered by the DEA
in this proposed rule to remove [\123\I]ioflupane from the schedules of
the CSA. Please note that both the DEA and HHS analyses and other
relevant documents are available in their entirety under ``Supporting
and Related Material'' of the public docket for this rule at https://www.regulations.gov under docket number DEA-415.
1. The Drug's Actual or Relative Potential for Abuse
According to HHS and the DEA, there are no data demonstrating that
individuals are administering quantities of DaTscan sufficient to
create a hazard to their health or to the safety of other individuals
or to the community. In clinical studies, DaTscan, due to its low
concentrations of [\123\I]ioflupane lacked, central nervous activity
(CNS) in humans.
According to HHS review of Sponsor's calculation regarding
psychoactive doses of DaTscan, approximately 6,000 vials of DaTscan
would be required to produce a subjective ``high'' in humans from
exposure to [\123\I]ioflupane in this product. The volume of 6,000
vials is about 15 liters (L) of fluid, an amount that would be lethal
if administered intravenously (i.v.). The short half-life of DaTscan
(due to its radioactive decay) will prevent its extended storage for
future use at the manufacturing, distributing, or radiopharmacy site;
thereby limiting the amount available for diversion. It is highly
unlikely that individuals will administer DaTscan on their own
initiative since DaTscan has a very dilute and small dose of
[\123\I]ioflupane, and possesses radioactivity. As a result, DaTscan
will not have significant capability of creating hazards to the health
of the user or to the safety of the community.
2. Scientific Evidence of the Drug's Pharmacological Effects, If Known
DaTscan blocks monoamine transporters, such as DAT and other
monoamine transporters such as serotonin transporters. Ioflupane, the
active pharmaceutical ingredient in DaTscan, was demonstrated to have
an affinity to DAT that was approximately 10- and 100-fold greater than
cocaine in rodent brain homogenates or in cells transfected with rat
DAT (Neumeyer et al., 1996; Okada et al., 1998; Scheffel et al., 1997).
As reported by HHS, non-radiolabeled ioflupane at doses >0.1 mg/kg,
i.v. was able to substitute for cocaine in cocaine-trained rats (10 mg/
kg, intraperitoneal administration) using a drug discrimination
protocol which is predictive of subjective behavioral effects in
humans.
HHS reviewed data from eight human clinical trials involving 942
subjects and nine years of post-approval use in Europe and found that
there was not any clinical evidence of pharmacological effects
resulting from DaTscan administration. The maximum dose of
[\123\I]ioflupane in DaTscan that is administered to the patient prior
to undergoing an imaging procedure is 0.325 [mu]g (0.13 [mu]g/ml). HHS
extrapolated from the locomotor study and drug discrimination study on
non-radiolabeled ioflupane and estimated that the lowest active dose of
DaTscan for a 60 kg (132.2 lb) human to achieve a pharmacologic effect
would be 288 [mu]g or 886 vials of DaTscan. In addition, the
recreational dose of DaTscan is estimated as 1921 [micro]g or 5,910
vials.
Although [\123\I]ioflupane would be expected to have a
pharmacological profile nearly identical to its non-radioactive form,
its unique properties (i.e., manufacturing limits and radioactive
properties) pose practical barriers to its abuse. Furthermore,
according to HHS, the amount of [\123\I]ioflupane in DaTscan is
significantly less than the amounts of ioflupane used to elicit the
pharmacological response in preclinical studies with this compound.
3. The State of Current Scientific Knowledge Regarding the Drug or
Other Substance
The international non-proprietary name of [\123\I]ioflupane is
methyl(1R, 2S, 3S, 5S)-8-(3-fluoropropyl)-3-(4-[\123\I]iodophenyl)-8-
azabicyclo[3,2,1] octane-2-carboxylate. The molecular formula of
[\123\I]ioflupane is
C18H23F[\123\I]NO2 and the molecular
weight is 427.28 g/mol. [\123\I]Ioflupane is a clear, colorless
solution and is only present in a solution of ethanol and sodium
acetate buffer. Non-radioactive ioflupane is a white solid with a
melting point of 83 [deg]C to 87 [deg]C and soluble in water (less than
0.1 mg/ml), sodium acetate buffer (pH 7.4; 16 mg/ml), and ethanol (27
mg/ml).
HHS states that meaningful extraction of [\123\I]ioflupane from
DaTscan would be impossible due to its limited production and
availability and because extraction is technically complex and would
require advanced equipment not available to the general public.
Importantly, if extraction of ioflupane from [\123\I]ioflupane is
accomplished, the ioflupane would be subject to schedule II controls
under the CSA. According to HHS, the retrosynthesis of DaTscan to
cocaine and ecgonine would be difficult. Production of DaTscan is
technically complex as it requires specialized equipment, facilities,
scientific training and expertise, making clandestine manufacturing
particularly difficult. HHS indicated that the non-radiolabeled
precursors needed for the synthesis of [\123\I]ioflupane (and
[[Page 31524]]
DaTscan) are abusable. In addition, the non-radiolabeled precursors
derived from cocaine or ecgonine are also schedule II controlled
substances. However, even if an individual obtained the precursors, it
is impractical and highly unlikely that they would synthesize the
abusable compound into a radiolabeled formulation with a limited
storage life that is not desired by drug users.
On January 14, 2011, FDA approved the NDA for DaTscan with the
indication of visualizing striatal dopamine transporters in the brains
of adult patients with suspected Parkinsonian syndromes using SPECT
imaging. As such, any FDA-approved diagnostic product containing
[\123\I]ioflupane has a currently accepted medical use in the United
States.
4. Its History and Current Pattern of Abuse
According to HHS, there have been no reports of abuse of
[\123\I]ioflupane. Over 168,000 doses of DaTscan have been administered
to patients worldwide, and no pharmacological effects have been noted.
Further, according to HHS, no single user has received more than 10
vials of DaTscan in a single day.
5. The Scope, Duration, and Significance of Abuse
There have been no reports of abuse of [\123\I]ioflupane. According
to the National Forensic Laboratory Information System (NFLIS) \2\ and
the System to Retrieve Information from Drug Evidence (STRIDE) \3\,
there have been no reports of [\123\I]ioflupane seizures during the
time period January 2010 to February 2015.
---------------------------------------------------------------------------
\2\ NFLIS is a program of the DEA that collects drug
identification results from drug cases analyzed by other Federal,
State, and local forensic laboratories. NFLIS was queried on April
16, 2015.
\3\ STRIDE collected the results of drug evidence analyzed at
DEA laboratories and reflects evidence submitted by the DEA, other
Federal law enforcement agencies, and some local law enforcement
agencies. STRIDE data was queried by date submitted to Federal
forensic laboratories. On October 1, 2014, STARLiMS replaced STRIDE
as the DEA laboratory drug evidence data system of record.
---------------------------------------------------------------------------
6. What, If Any, Risk There Is to the Public Health
According to the HHS, because of the limited amounts of
manufactured DaTscan, the low concentration of [\123\I]ioflupane per
vial, and the existence of stringent regulatory controls (controls
other than those imposed by the CSA and its implementing regulations,
including regulation by the United States Nuclear Regulatory Commission
under 10 CFR part 35 and/or by states) \4\ on the manufacturing and
handling of DaTscan, abuse of DaTscan is not possible as a practical
matter. Thus, there is little to no practical risk to public health
from DaTscan abuse.
---------------------------------------------------------------------------
\4\ There are Federal and state laws and regulations which limit
the public's exposure to radioactivity in radiopharmaceuticals, thus
limiting the potential for toxicity imposed on the public.
---------------------------------------------------------------------------
7. Its Psychic or Physiological Dependence Liability
As reviewed by HHS, non-radiolabeled ioflupane has cocaine-like
properties. In a drug discrimination study in cocaine-trained rats,
non-radiolabeled ioflupane produced cocaine-appropriate responding,
which suggests that non-radiolabeled ioflupane may produce cocaine-like
subjective effects in humans (HHS, 2010).
However, the available evidence suggests that there is no psychic
or physiological dependence potential of FDA-approved diagnostic
products containing [\123\I]ioflupane. The psychic or physiological
dependence potential of FDA-approved diagnostic products is currently
expected to be very limited due to the low exposure concentration of
[\123\I]ioflupane, the aforementioned low potential for abuse (see
Factor 1) and the extremely high and lethal quantities needed to
achieve a subjective ``high.''
8. Whether the Substance Is an Immediate Precursor of a Substance
Already Controlled Under the CSA
[\123\I]Ioflupane is not an immediate precursor of a substance
already controlled under the CSA.
Conclusion
Based on consideration of the scientific and medical evaluation and
accompanying recommendation of the HHS and based on the DEA's
consideration of its own eight-factor analysis, the DEA finds that the
facts and all available and relevant data demonstrate that
[\123\I]ioflupane does not possess abuse or dependence potential.
Accordingly, the DEA finds that [\123\I]ioflupane does not meet the
requirements for inclusion in any schedule and should be removed from
control under the CSA.
Findings for Schedule Placement Pursuant to 21 U.S.C. 812(b)
The CSA outlines the findings required to place a drug or other
substance in any particular schedule (I, II, III, IV, or V). 21 U.S.C.
812(b). The Assistant Secretary for Health of the HHS recommended
removal of ``FDA approved products containing [\123\I]ioflupane from
schedule II of the'' CSA. However, because the DEA finds no basis to
remove only FDA approved products containing [\123\I]ioflupane from the
schedules, this action proposes to remove the substance
[\123\I]ioflupane from the CSA schedules. Historically, when new
molecular entities are removed from control, the substance itself is
removed from control rather than the specific FDA-approved drug product
(e.g., naloxegol, 80 FR 3468; naloxone, 39 FR 44392). As summarized
above, the data currently support removal of substances that contain
[\123\I]ioflupane, primarily because [\123\I]ioflupane itself has a
lethal radioactive barrier, and its manufacturing process is highly
regulated and technically complex, thus making abuse highly unlikely.
After consideration of the analyses and recommendation of the
Assistant Secretary for Health of the HHS and review of all relevant
and available data, the Administrator of the DEA, pursuant to 21 U.S.C.
812(b)(5), finds that:
(1) [\123\I]Ioflupane has no comparable potential for abuse
relative to substances in Schedule V.
(2) [\123\I]Ioflupane has a currently accepted medical use in
treatment in the United States. FDA approved the New Drug Application
for DaTscan on January 14, 2011, with the indication of visualizing
striatal dopamine transporters in the brains of adult patients with
suspected Parkinsonian syndromes using SPECT imaging.
(3) [\123\I]Ioflupane is not abusable, therefore, its use is not
likely to lead to physical or psychological dependence.
Based on these findings, the Administrator of the DEA concludes
that [\123\I]ioflupane does not warrant control under the CSA.
Effect on Other Rulemakings
On November 25, 2014, DEA published an interim final rule waiving
the requirement of DEA registration for certain entities that are
authorized under other federal or state authorities to administer
DaTscan. 79 FR 70085. If finalized, this proposal to remove
[\123\I]ioflupane from the schedules of controlled substances would
make such waivers unnecessary. Therefore, if this action is finalized,
DEA intends to withdraw the regulations established through that
interim final rule.
Regulatory Analyses
Executive Orders 12866 and 15363
In accordance with 21 U.S.C. 811(a), this scheduling action is
subject to formal rulemaking procedures done ``on the record after
opportunity for a
[[Page 31525]]
hearing,'' which are conducted pursuant to the provisions of 5 U.S.C.
556 and 557. The CSA sets forth the criteria for scheduling a drug or
other substance and for removing a drug or substance from the schedules
of controlled substances. Such actions are exempt from review by the
Office of Management and Budget (OMB) pursuant to section 3(d)(1) of
Executive Order 12866 and the principles reaffirmed in Executive Order
13563.
Executive Order 12988
This regulation meets the applicable standards set forth in
sections 3(a) and 3(b)(2) of Executive Order 12988 Civil Justice Reform
to eliminate drafting errors and ambiguity, minimize litigation,
provide a clear legal standard for affected conduct, and promote
simplification and burden reduction.
Executive Order 13132
This rulemaking does not have federalism implications warranting
the application of Executive Order 13132. The rule does not have
substantial direct effects on the States, on the relationship between
the Federal Government and the States, or the distribution of power and
responsibilities among the various levels of government.
Executive Order 13175
This rule does not have tribal implications warranting the
application of Executive Order 13175. This rule does not have
substantial direct effects on one or more Indian tribes, on the
relationship between the Federal Government and Indian tribes, or on
the distribution of power and responsibilities between the Federal
Government and Indian tribes.
Regulatory Flexibility Act
The Administrator, in accordance with the Regulatory Flexibility
Act (5 U.S.C. 601-612) (RFA), has reviewed this proposed rule and by
approving it certifies that it will not have a significant economic
impact on a substantial number of small entities. The purpose of this
rule is to remove [\123\I]ioflupane from the list of schedules of the
CSA. This action will remove regulatory controls and administrative,
civil, and criminal sanctions applicable to controlled substances for
handlers and proposed handlers of [\123\I]ioflupane. Accordingly, it
has the potential for some economic impact in the form of cost savings.
If finalized, the proposed rule will affect all persons who would
handle, or propose to handle, [\123\I]ioflupane. Due to the wide
variety of unidentifiable and unquantifiable variables that potentially
could influence the distribution and administration rates of new
molecular entities, the DEA is unable to determine the number of
entities and small entities which might handle [\123\I]ioflupane.
Although the DEA does not have a reliable basis to estimate the
number of affected entities and quantify the economic impact of this
proposed rule, a qualitative analysis indicates that, if finalized,
this rule is likely to result in some cost savings for the healthcare
industry. The affected entities will continue to meet existing Federal
and/or state requirements applicable to those who handle
radiopharmaceutical substances, including licensure, security,
recordkeeping, and reporting requirements, which in many cases are more
stringent than the DEA's requirements. However, the DEA estimates cost
savings will be realized from the removal of the administrative, civil,
and criminal sanctions for those entities handling or proposing to
handle [\123\I]ioflupane, in the form of saved registration fees, and
the elimination of additional physical security, recordkeeping, and
reporting requirements.
Because of these facts, this rule will not result in a significant
economic impact on a substantial number of small entities.
Unfunded Mandates Reform Act of 1995
On the basis of information contained in the ``Regulatory
Flexibility Act'' section above, the DEA has determined and certifies
pursuant to the Unfunded Mandates Reform Act of 1995 (UMRA), 2 U.S.C.
1501 et seq., that this action would not result in 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 for inflation) in any one year * * * .''
Therefore, neither a Small Government Agency Plan nor any other action
is required under provisions of UMRA.
Paperwork Reduction Act
This action does not impose a new collection of information
requirement under the Paperwork Reduction Act, 44 U.S.C. 3501-3521.
This action would not impose recordkeeping or reporting requirements on
State or local governments, individuals, businesses, or organizations.
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.
List of Subjects in 21 CFR part 1308
Administrative practice and procedure, Drug traffic control,
Reporting and recordkeeping requirements.
For the reasons set out above, 21 CFR part 1308 is proposed to be
amended to read as follows:
PART 1308--SCHEDULES OF CONTROLLED SUBSTANCES
0
1. The authority citation for 21 CFR part 1308 continues to read as
follows:
Authority: 21 U.S.C. 811, 812, 871(b), unless otherwise noted.
0
2. In Sec. 1308.12, revise paragraph (b)(4) to read as follows:
Sec. 1308.12 Schedule II.
* * * * *
(b) * * *
(4) Coca leaves (9040) and any salt, compound, derivative or
preparation of coca leaves (including cocaine (9041) and ecgonine
(9180) and their salts, isomers, derivatives and salts of isomers and
derivatives), and any salt, compound, derivative, or preparation
thereof which is chemically equivalent or identical with any of these
substances, except that the substances shall not include:
(i) Decocainized coca leaves or extraction of coca leaves, which
extractions do not contain cocaine or ecgonine; or
(ii) [\123\I]ioflupane.
* * * * *
Dated: May 6, 2015.
Michele M. Leonhart,
Administrator.
[FR Doc. 2015-13455 Filed 6-2-15; 8:45 am]
BILLING CODE 4410-09-P