Public Meeting on Pre-Market Evaluation of Abuse-Deterrent Properties of Opioid Drug Products, 69532-69535 [2016-24234]
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69532
Federal Register / Vol. 81, No. 194 / Thursday, October 6, 2016 / Notices
Leroy A. Richardson
Chief, Information Collection Review Office,
Office of Scientific Integrity, Office of the
Associate Director for Science, Office of the
Director, Centers for Disease Control and
Prevention.
[FR Doc. 2016–24132 Filed 10–5–16; 8:45 am]
BILLING CODE 4163–18–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Food and Drug Administration
[Docket No. FDA–2016–N–2896]
Public Meeting on Pre-Market
Evaluation of Abuse-Deterrent
Properties of Opioid Drug Products
AGENCY:
Food and Drug Administration,
HHS.
Notice of public meeting;
request for comments.
ACTION:
The Food and Drug
Administration (FDA) is announcing a
public meeting to discuss scientific and
technical issues relating to formulation
development and pre-market evaluation
of opioid drug products with abusedeterrent properties. The meeting is
intended to give FDA the opportunity to
discuss, and seek public input from
stakeholders on, the approach to testing
FDA recommended in its draft guidance
‘‘General Principles for Evaluating the
Abuse Deterrence of Generic Solid Oral
Opioid Drug Products.’’ The meeting
will also provide an opportunity to
discuss FDA’s efforts to develop
standardized in vitro testing
methodologies for evaluating the abuse
deterrence of opioid drug products. FDA
is seeking input from all stakeholders,
including patients, health care
providers, health care payers, the
pharmaceutical industry, patient
advocates, academics, researchers, and
other government entities.
FDA may hold one or more additional
meetings in the future to discuss the
risk-benefit paradigm for opioid drug
products to ensure that FDA is
appropriately considering the full
public health impact of prescription
opioid drug products and the postmarket impact (‘‘real world effects’’) of
abuse-deterrent opioid drug products.
DATES: The public meeting will be held
on October 31, 2016, from 8:30 a.m. to
4:30 p.m. and November 1, 2016, from
8:30 a.m. to 4 p.m. The meeting may be
extended or end early depending on the
level of public participation. Individuals
seeking to attend or to present at the
meeting must register by October 17,
2016. Please register here for the
meeting: https://www.cvent.com/d/
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SUMMARY:
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wvq0sm/4W. Electronic or written
comments regarding scientific and
technical issues relating to formulation
development and pre-market evaluation
of abuse-deterrent properties of opioid
drug products will be accepted until
December 1, 2016.
ADDRESSES: The public meeting will be
held at College Park Marriott Hotel and
Conference Center, 3501 University
Blvd. East, Hyattsville, MD 20783.
You may submit comments as
follows:
Electronic Submissions
Submit electronic comments in the
following way:
• Federal eRulemaking Portal: https://
www.regulations.gov. Follow the
instructions for submitting comments.
Comments submitted electronically,
including attachments, to https://
www.regulations.gov will be posted to
the docket unchanged. Because your
comment will be made public, you are
solely responsible for ensuring that your
comment does not include any
confidential information that you or a
third party may not wish to be posted,
such as medical information, your or
anyone else’s Social Security number, or
confidential business information, such
as a manufacturing process. Please note
that if you include your name, contact
information, or other information that
identifies you in the body of your
comments, that information will be
posted on https://www.regulations.gov.
• If you want to submit a comment
with confidential information that you
do not wish to be made available to the
public, submit the comment as a
written/paper submission and in the
manner detailed (see ‘‘Written/Paper
Submissions’’ and ‘‘Instructions’’).
Written/Paper Submissions
Submit written/paper submissions as
follows:
• Mail/Hand delivery/Courier (for
written/paper submissions): Division of
Dockets Management (HFA–305), Food
and Drug Administration, 5630 Fishers
Lane, Rm. 1061, Rockville, MD 20852.
• For written/paper comments
submitted to the Division of Dockets
Management, FDA will post your
comment, as well as any attachments,
except for information submitted,
marked and identified, as confidential,
if submitted as detailed in
‘‘Instructions.’’
Instructions: All submissions received
must include the Docket No. FDA–
2016–N–2896 for ‘‘Public Meeting on
Pre-Market Evaluation of AbuseDeterrent Properties of Opioid Drug
Products.’’ Received comments will be
placed in the docket and, except for
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those submitted as ‘‘Confidential
Submissions,’’ publicly viewable at
https://www.regulations.gov or at the
Division of Dockets Management
between 9 a.m. and 4 p.m., Monday
through Friday.
• Confidential Submissions—To
submit a comment with confidential
information that you do not wish to be
made publicly available, submit your
comments only as a written/paper
submission. You should submit two
copies total. One copy will include the
information you claim to be confidential
with a heading or cover note that states
‘‘THIS DOCUMENT CONTAINS
CONFIDENTIAL INFORMATION.’’ The
Agency will review this copy, including
the claimed confidential information, in
its consideration of comments. The
second copy, which will have the
claimed confidential information
redacted/blacked out, will be available
for public viewing and posted on https://
www.regulations.gov. Submit both
copies to the Division of Dockets
Management. If you do not wish your
name and contact information to be
made publicly available, you can
provide this information on the cover
sheet and not in the body of your
comments and you must identify this
information as ‘‘confidential.’’ Any
information marked as ‘‘confidential’’
will not be disclosed except in
accordance with 21 CFR 10.20 and other
applicable disclosure law. For more
information about FDA’s posting of
comments to public dockets, see 80 FR
56469, September 18, 2015, or access
the information at: https://www.fda.gov/
regulatoryinformation/dockets/
default.htm.
Docket: For access to the docket to
read background documents or the
electronic and written/paper 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.
FDA will post the agenda
approximately 3 days before the public
meeting at: https://www.fda.gov/Drugs/
NewsEvents/ucm509853.htm. FDA will
also post a link to the live Webcast of
this public meeting on the day of the
public meeting.
FOR FURTHER INFORMATION CONTACT:
Michelle Eby, Center for Drug
Evaluation and Research, Food and
Drug Administration, 10903 New
Hampshire Ave., Bldg. 51, Rm. 6184,
Silver Spring, MD 20993, 301–796–
4714, Michelle.Eby@fda.hhs.gov.
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SUPPLEMENTARY INFORMATION:
I. Background
Prescription opioid analgesics are an
important component of modern pain
management. Prescription opioid
analgesic products such as oxycodone,
hydrocodone, and morphine, are widely
prescribed for the treatment of pain, and
certain opioid drug products are also
used in opioid dependence treatment
programs. When used properly, opioid
drug products can provide significant
benefits for patients. Unfortunately,
misuse and abuse of opioid drug
products is a serious public health
problem.
When misused or abused, opioid drug
products can cause serious harm,
including addiction, overdose, and
death. According to the Centers for
Disease Control and Prevention (CDC),
prescription opioid drug products were
involved in over 14,000 deaths in 2014.1
FDA is determined to help defeat this
epidemic through an adaptive, sciencebased approach.
In February 2016, FDA announced a
comprehensive action plan to take
concrete steps toward reducing the
impact of opioid abuse on families and
communities.2 As part of this plan, FDA
strongly supports the development of,
and transition to use of, opioid drug
products with meaningful abusedeterrent formulations. FDA has taken
and is continuing to take steps to
incentivize and support the
development of opioid drug products
with progressively better abusedeterrent properties. These steps
include working with individual
sponsors on promising abuse-deterrent
technologies, publishing guidance on
the evaluation and labeling of abusedeterrent drug products, and conducting
and supporting research in developing
appropriate pre-market testing
methodologies for evaluating the abuse
deterrence of both innovator and generic
drugs.
FDA believes abuse-deterrent
technologies can and will improve
substantially and can make a real
impact in the fight against prescription
opioid abuse. FDA hopes that as the
market transitions to abuse-deterrent
formulations, abuse rates will decrease
and the most significant consequences
of that abuse (addiction, overdose, and
death) will diminish. To that end,
fostering the development, marketing,
and iterative improvement of abusedeterrent formulations of opioid drug
1 Wide-Ranging Online Data for Epidemiologic
Research (WONDER), National Center for Health
Statistics; available at https://wonder.cdc.gov.
2 https://www.fda.gov/NewsEvents/Newsroom/
FactSheets/ucm484714.htm.
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products, including generic opioid drug
products, is a top priority. It is
important that generic versions of
opioids that reference approved opioids
whose labeling describes abusedeterrent properties are available to help
ensure widespread access to safe and
effective analgesics for patients who
need them and to accelerate the
prescribing of abuse-deterrent opioids.
Such generic opioids should be no less
abuse-deterrent than the opioids they
reference; otherwise opioid abusers
could preferentially seek out and abuse
easier-to-abuse generics.
FDA’s work to date to support the
development, marketing, and iterative
improvement of abuse-deterrent
formulations includes:
• Holding a public meeting in
October 2014 to discuss the
‘‘Development and Regulation of AbuseDeterrent Formulations of Opioid
Medications;’’
• Issuing a final guidance in April
2015 on the ‘‘Abuse-Deterrent Opioids—
Evaluation and Labeling.’’ This
guidance explains FDA’s current
thinking about the studies, both preand post-marketing, that should be
conducted to demonstrate that a given
formulation for which a new drug
application (NDA) is submitted has
abuse-deterrent properties. It also makes
recommendations about how those
studies should be performed and
evaluated and what information about a
product’s abuse-deterrent properties
should be included in labeling;
• To date, approving seven opioid
analgesic drug products with labeling
describing abuse-deterrent properties 3
consistent with the final guidance on
evaluation and labeling of abusedeterrent opioids;
• Seeking guidance from outside
experts in the fields of pain
management and drug abuse. For
example, FDA has asked the National
Academies of Sciences, Engineering,
and Medicine to help develop a
framework for opioid drug product
review, approval, and monitoring that
balances individual needs for pain
control with the risk of addiction, as
well as the broader public health
consequences of opioid drug product
misuse and abuse;
• Conducting or supporting research
on opioid drug product formulations
designed to deter abuse. This includes
development of in vitro testing
methodologies to assess purportedly
abuse-deterrent formulations; and
3 A list of opioid medications with FDA-approved
labeling describing abuse-deterrent properties can
be found at https://www.fda.gov/NewsEvents/
Newsroom/FactSheets/ucm514939.htm.
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• Issuing a draft guidance on the
‘‘General Principles for Evaluating
Abuse Deterrence of Generic Solid Oral
Opioid Drug Products.’’
In the notice of availability for the
draft guidance on evaluating abuse
deterrence of generic opioid drug
products, FDA announced its intent to
hold a public meeting following the
close of the comment period to discuss
further the pre-market evaluation of the
abuse deterrence of generic opioid drug
products and related issues, as
appropriate. FDA is opening a docket
and holding this public meeting to
further discuss pre-market evaluation of
the abuse deterrence of generic opioid
drug products and the development of
standardized in vitro testing
methodologies for evaluating the abuse
deterrence of opioid drug products.
Day 1 of this meeting will focus on
scientific and technical issues related to
the pre-market evaluation of the abuse
deterrence of generic opioid drug
products. It is important to have a viable
pathway for approval of generic abusedeterrent opioid drug products to
further FDA’s goal to transition to
abuse-deterrent formulations as FDA
looks forward to a future in which all or
substantially all opioid medications are
less susceptible to abuse than the
formulations on the market today. The
availability of generic versions of opioid
drug products that reference listed drugs
whose labeling describes abusedeterrent properties can help to ensure
access to safe and effective, and
affordable, opioid analgesics for patients
who need them.
Day 2 will focus on FDA’s efforts to
develop standardized in vitro testing
methodologies for evaluating the abuse
deterrence of opioid drug products. In
vitro testing should, to the greatest
extent possible, provide information
sufficient to fully characterize a drug
product’s abuse-deterrent properties,
including the degree of effort required to
bypass or defeat those properties. In
vitro studies should assess each
potential route of abuse (including
ingestion, injection, insufflation, and
smoking) starting with simple and
gentle mechanical and chemical
manipulations progressing to complex
and more destructive manipulations
until a drug product’s abuse-deterrent
properties are defeated or compromised.
To be sufficiently comprehensive, in
vitro testing should address both the
mechanisms by which abusers can be
expected to attempt to deliberately
overcome the abuse-deterrent properties
of the product as well as the ways that
patients may alter the formulation
(intentionally or unintentionally) that
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change the rate or amount of drug
released.
A. Day 1: FDA’s Evaluation of Generic
Abuse-Deterrent Opioids
Section 505(j) of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C.
355(j)) (FD&C Act) permits any person
to submit to the FDA an abbreviated
new drug application (ANDA) to seek
approval to market a generic version of
a previously approved drug product. To
obtain approval, an ANDA applicant is
not required to provide independent
evidence of the safety and effectiveness
of the proposed generic drug. Instead,
the applicant relies on FDA’s finding
that a previously approved drug
product, i.e, the reference listed drug
(RLD), is safe and effective, and must
demonstrate, among other things, that
the proposed generic drug is the ‘‘same’’
as the RLD in certain ways and is
bioequivalent.
For FDA to approve an ANDA, the
Agency must find, among other things,
that the generic drug product has the
same active ingredient(s), dosage form,
route of administration, strength,
conditions of use, and, with limited
exceptions, labeling as the RLD, is
bioequivalent to its RLD, that the
methods used in, or the facilities and
controls used for, the manufacture,
processing, and packing of the drug are
adequate to assure and preserve its
identity, strength, quality, and purity,
and that the inactive ingredients and
composition of the generic drug are not
unsafe under the conditions of use
prescribed, recommended, or suggested
in the labeling. See section 505(j)(2)(A)
and (j)(4) of the FD&C Act.
FDA classifies as ‘‘therapeutically
equivalent’’ those products that meet
the following general criteria: (1) They
are approved as safe and effective; (2)
they are pharmaceutical equivalents in
that they contain identical amounts of
the same active ingredient(s) with the
same route of administration and dosage
form and meet compendial or other
applicable standards of strength,
quality, purity, and identity; (3) they are
bioequivalent; (4) they are adequately
labeled; and (5) they are manufactured
in compliance with current good
manufacturing practices regulations. See
FDA’s ‘‘Approved Drug Products with
Therapeutic Equivalence Evaluations’’
(the Orange Book), Preface. FDA
believes that a product classified as
therapeutically equivalent can be
substituted with the full expectation
that the substituted product will
produce the same clinical effect and
safety profile as the reference product.
If the RLD’s labeling describes
properties that are expected to deter
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misuse or abuse then the potential
ANDA applicant should evaluate its
proposed generic drug product in
comparative in vitro studies and, in
some cases, in relevant pharmacokinetic
or other studies to show that it is no less
abuse-deterrent than the RLD with
respect to all potential routes of abuse.4
It is important that generic versions of
opioid drug products referencing opioid
drug products with FDA-approved
labeling describing abuse-deterrent
properties are available to help ensure
availability of analgesics for patients
who need them. FDA is interested in
supporting the submission of ANDAs
for which the RLD is an opioid drug
product whose labeling describes abusedeterrent properties and ensuring that
generic opioid drug products are no less
abuse-deterrent than the RLD in its
efforts to combat the opioid epidemic.
Topics for discussion during the open
public comment period on Day 1 and by
the panel:
• Based on any testing you have
attempted to perform or performed in
accordance with the March 2016 draft
guidance, are there any aspects of the
guidance that need clarification or
improvement?
• Are there any characteristics of the
currently approved abuse-deterrent
RLDs for which issuance of product
specific guidance, beyond what is
described in FDA’s March 2016 draft
guidance, would facilitate development
of abuse-deterrent generic opioid drug
products?
• Are there approaches or
technologies for evaluating the abuse
deterrence of generic opioid drug
products that were not included in the
March 2016 draft guidance that should
be?
• What additional actions could FDA
take to encourage the submission of
ANDAs that reference an opioid drug
product whose labeling describes abusedeterrent properties?
• Are there potential consequences of
the development and introduction of
abuse-deterrent opioid drug products
that warrant further consideration?
B. Day 2: Development of Standardized
In Vitro Testing To Evaluate Abuse
Deterrence
The Office of Pharmaceutical Quality
(OPQ) will discuss its vision for
standardizing in vitro testing
methodologies for evaluating
4 FDA’s current thinking regarding the labeling of
opioids is described in FDA’s guidance for industry
on ‘‘Abuse-Deterrent Opioids—Evaluation and
Labeling’’ (April 2015). Any data relating to abusedeterrent properties would be included in the
DRUG ABUSE AND DEPENDENCE section of
product labeling, 9.2 Abuse.
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purportedly abuse-deterrent
formulations of opioid drug products.
OPQ will also discuss the efforts being
made to standardize in vitro testing
conditions to apply to future products
and some of the challenges being
encountered. OPQ’s Office of Testing
and Research will then provide an
update on its testing of abuse-deterrent
formulations, including approaches
being taken to simulate the ways
individuals who abuse opioids
manipulate opioid drug products for
purposes of abuse (e.g., crushing,
heating, dissolving). FDA recognizes
that new technologies for deterring
abuse of oral opioid drug products are
rapidly evolving and is seeking public
input on novel mechanisms and
approaches being considered so that it
may further consider how testing could
be standardized.
FDA intends to issue a general
guidance describing FDA’s
recommendations for standardized in
vitro testing to evaluate purported
abuse-deterrent properties and
considerations for a potential applicant
as it develops an abuse-deterrent
formulation of an opioid drug product.
Building on the testing FDA has
conducted and other available
information including public input,
FDA may recommend common
protocols that incorporate standard test
conditions, specified performance
standards, control formulations and
provide a tiered approach for
determining when abuse-deterrent
properties have been defeated and how
that information may be used during
drug development and for other relevant
comparative situations. The guidance
also may describe lifecycle
considerations (e.g., the need for testing
abuse deterrence throughout shelf life to
determine if any product changes over
time affect abuse-deterrence
performance) and provide additional
guidance on evaluating novel
technological approaches used to deter
abuse of oral opioid drug products.
Topics for discussion during the open
public comment period on Day 2 and by
the panel:
• What technical and quantitative
issues should FDA consider as it
develops guidance to recommend
standardization of in vitro testing to
evaluate the abuse deterrence of opioid
drug product formulations for various
routes of abuse, including ingestion,
insufflation, injection, and smoking? For
example, what should FDA consider
with respect to mechanical
manipulations (e.g., equipment, amount
of effort, and time), chemical
manipulations (e.g., solvent choice and
availability), particle size distribution,
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and volume of solvent used for
extraction?
• How can FDA standardize in vitro
testing to help substantiate appropriate
and consistent product manufacture that
assures abuse deterrence at release and
through a drug product’s shelf life?
• How can performance attributes
measured by in vitro testing be
quantified and linked to their impact on
abuse deterrence? For example, discuss
what amount of time delay in defeating
an abuse-deterrent property should be
considered significant and the basis for
the recommendation.
• How can FDA build flexibility into
standardized testing so that it may be
suitable for application to emerging
technologies? Are there any specific
emerging technologies that might
require new types of testing?
II. Registration and Accommodations
Registration: Registration is free and
available on a first-come, first-served
basis. Persons interested in attending
this public meeting must register by
close of business on October 17, 2016.
If you need special accommodations
because of a disability, please contact
La’Shaune Morant, 240–316–3206,
email: lashaune@tepgevents.com no
later than October 12, 2016.
To register for the public meeting,
please visit https://www.cvent.com/d/
wvq0sm/4W (FDA has verified the Web
address, but FDA is not responsible for
subsequent changes to the Web site after
this document publishes in the Federal
Register) by October 17, 2016. Those
without Internet access may register by
contacting La’Shaune Morant, 240–316–
3206. Early registration is recommended
because facilities are limited and,
therefore, FDA may limit the number of
participants from each organization.
You will receive confirmation after you
have registered and been accepted or
you will be notified if you are on a
waiting list. FDA may allow onsite
registration if space is available. If
registration reaches maximum capacity,
FDA will post a notice closing
registration at https://www.fda.gov/
Drugs/NewsEvents/ucm509853.htm.
Streaming Webcast of the Public
Meeting: The meeting will also be
Webcast. Persons interested in viewing
the Webcast must register online by
October 17, 2016. Early registration is
recommended because Webcast
connections may be limited.
Organizations are requested to register
all participants, but to view using one
connection per location. A link to the
live Webcast will be available at https://
www.fda.gov/Drugs/NewsEvents/
ucm509853.htm on the day of the public
meeting. A video record of the public
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meeting will be available at https://
www.fda.gov/Drugs/NewsEvents/
ucm509853.htm following the meeting.
FDA has verified the Web site
addresses, as of the date this document
publishes in the Federal Register, but
Web sites are subject to change over
time.
Requests for Oral Presentations: If you
wish to present at the public meeting,
you must register and indicate which
topic(s) you wish to address: approach
to testing FDA recommended in its draft
guidance ‘‘General Principles for
Evaluating the Abuse Deterrence of
Generic Solid Oral Opioid Drug
Products,’’ new technologies for
deterring abuse of oral opioid drug
products, or standardization of in vitro
testing methodologies for evaluating
purportedly abuse-deterrent
formulations of opioid drug products.
This will help FDA organize the
presentations. FDA will do its best to
accommodate requests to make public
comments. Individuals and
organizations with common interests are
urged to consolidate or coordinate their
presentations, and request time for a
joint presentation. Following the close
of the registration, FDA will determine
the amount of time allotted to each
presenter and the approximate time
each oral presentation is to begin, and
will select and notify participants by
October 24, 2016. All requests to make
oral presentations must be received by
the close of registration, October 17,
2016. If you are selected, any
presentation materials must be emailed
to Michelle Eby (see FOR FURTHER
INFORMATION CONTACT) no later than
October 27, 2016. No commercial or
promotional material will be permitted
to be presented or distributed at the
public meeting.
FDA is holding this public meeting to
obtain information on scientific and
technical issues relating to formulation
development and pre-market evaluation
of opioid drug products with abusedeterrent properties. In order to permit
the widest possible opportunity for
public comment, FDA is soliciting
either electronic or written comments
on all aspects of the public meeting
topics. The deadline for submitting
comments related to this public meeting
is December 1, 2016.
Accommodations: Attendees are
responsible for their own hotel
accommodations. Attendees making
reservations at the College Park Marriott
Hotel and Conference Center, 3501
University Blvd. East, Hyattsville, MD
20783, are eligible for a reduced rate of
$231/night, not including applicable
taxes. To receive the reduced rate,
please reference ‘‘FDA Opioid Drug
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69535
Meeting’’ if you make your reservation
by calling 1–800–676–6137, or book
your reservation at https://
www.marriott.com/meeting-eventhotels/group-corporate-travel/
groupCorp.mi?resLinkData
=FDA%20Opioid%20Drug%20Meeting
%5Ewasum%60FDGFD
GA%60231.00%60USD%60
false%602%6010/30/16%6011/1/
16%6010/12/16&app=resvlink&stop_
mobi=yes.
If you need special accommodations
because of a disability, please contact
La’Shaune Morant, 240–316–3206,
lashaune@tepgevents.com no later than
October 12, 2016.
III. Transcript Request
Transcripts of the meeting will be
available for review at the Division of
Dockets Management (HFA–305), Food
and Drug Administration, 5630 Fishers
Lane, Rm. 1061, Rockville, MD 20850,
and on the Internet at https://
www.regulations.gov approximately 30
days after the meeting. A transcript will
also be available in either hard copy or
on CD–ROM, after submission of a
Freedom of Information request. The
Freedom of Information office address is
available on the Agency’s Web site at
https://www.fda.gov.
Dated: September 30, 2016.
Leslie Kux,
Associate Commissioner for Policy.
[FR Doc. 2016–24234 Filed 10–5–16; 8:45 am]
BILLING CODE 4164–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Food and Drug Administration
[Docket No. FDA–2015–D–4561]
Head Lice Infestation: Developing
Drugs for Topical Treatment; Guidance
for Industry; Availability
AGENCY:
Food and Drug Administration,
HHS.
ACTION:
Notice of availability.
The Food and Drug
Administration (FDA or Agency) is
announcing the availability of a
guidance for industry entitled ‘‘Head
Lice Infestation: Developing Drugs for
Topical Treatment.’’ The purpose of this
guidance is to assist sponsors in the
clinical development of drugs for the
treatment of head lice infestation. This
guidance addresses the Agency’s current
thinking regarding the overall
development program and clinical trial
designs of drugs to support approval of
an indication for topical treatment of
head lice infestation. The information
SUMMARY:
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Agencies
[Federal Register Volume 81, Number 194 (Thursday, October 6, 2016)]
[Notices]
[Pages 69532-69535]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-24234]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Food and Drug Administration
[Docket No. FDA-2016-N-2896]
Public Meeting on Pre-Market Evaluation of Abuse-Deterrent
Properties of Opioid Drug Products
AGENCY: Food and Drug Administration, HHS.
ACTION: Notice of public meeting; request for comments.
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SUMMARY: The Food and Drug Administration (FDA) is announcing a public
meeting to discuss scientific and technical issues relating to
formulation development and pre-market evaluation of opioid drug
products with abuse-deterrent properties. The meeting is intended to
give FDA the opportunity to discuss, and seek public input from
stakeholders on, the approach to testing FDA recommended in its draft
guidance ``General Principles for Evaluating the Abuse Deterrence of
Generic Solid Oral Opioid Drug Products.'' The meeting will also
provide an opportunity to discuss FDA's efforts to develop standardized
in vitro testing methodologies for evaluating the abuse deterrence of
opioid drug products. FDA is seeking input from all stakeholders,
including patients, health care providers, health care payers, the
pharmaceutical industry, patient advocates, academics, researchers, and
other government entities.
FDA may hold one or more additional meetings in the future to
discuss the risk-benefit paradigm for opioid drug products to ensure
that FDA is appropriately considering the full public health impact of
prescription opioid drug products and the post-market impact (``real
world effects'') of abuse-deterrent opioid drug products.
DATES: The public meeting will be held on October 31, 2016, from 8:30
a.m. to 4:30 p.m. and November 1, 2016, from 8:30 a.m. to 4 p.m. The
meeting may be extended or end early depending on the level of public
participation. Individuals seeking to attend or to present at the
meeting must register by October 17, 2016. Please register here for the
meeting: https://www.cvent.com/d/wvq0sm/4W. Electronic or written
comments regarding scientific and technical issues relating to
formulation development and pre-market evaluation of abuse-deterrent
properties of opioid drug products will be accepted until December 1,
2016.
ADDRESSES: The public meeting will be held at College Park Marriott
Hotel and Conference Center, 3501 University Blvd. East, Hyattsville,
MD 20783.
You may submit comments as follows:
Electronic Submissions
Submit electronic comments in the following way:
Federal eRulemaking Portal: https://www.regulations.gov.
Follow the instructions for submitting comments. Comments submitted
electronically, including attachments, to https://www.regulations.gov
will be posted to the docket unchanged. Because your comment will be
made public, you are solely responsible for ensuring that your comment
does not include any confidential information that you or a third party
may not wish to be posted, such as medical information, your or anyone
else's Social Security number, or confidential business information,
such as a manufacturing process. Please note that if you include your
name, contact information, or other information that identifies you in
the body of your comments, that information will be posted on https://www.regulations.gov.
If you want to submit a comment with confidential
information that you do not wish to be made available to the public,
submit the comment as a written/paper submission and in the manner
detailed (see ``Written/Paper Submissions'' and ``Instructions'').
Written/Paper Submissions
Submit written/paper submissions as follows:
Mail/Hand delivery/Courier (for written/paper
submissions): Division of Dockets Management (HFA-305), Food and Drug
Administration, 5630 Fishers Lane, Rm. 1061, Rockville, MD 20852.
For written/paper comments submitted to the Division of
Dockets Management, FDA will post your comment, as well as any
attachments, except for information submitted, marked and identified,
as confidential, if submitted as detailed in ``Instructions.''
Instructions: All submissions received must include the Docket No.
FDA-2016-N-2896 for ``Public Meeting on Pre-Market Evaluation of Abuse-
Deterrent Properties of Opioid Drug Products.'' Received comments will
be placed in the docket and, except for those submitted as
``Confidential Submissions,'' publicly viewable at https://www.regulations.gov or at the Division of Dockets Management between 9
a.m. and 4 p.m., Monday through Friday.
Confidential Submissions--To submit a comment with
confidential information that you do not wish to be made publicly
available, submit your comments only as a written/paper submission. You
should submit two copies total. One copy will include the information
you claim to be confidential with a heading or cover note that states
``THIS DOCUMENT CONTAINS CONFIDENTIAL INFORMATION.'' The Agency will
review this copy, including the claimed confidential information, in
its consideration of comments. The second copy, which will have the
claimed confidential information redacted/blacked out, will be
available for public viewing and posted on https://www.regulations.gov.
Submit both copies to the Division of Dockets Management. If you do not
wish your name and contact information to be made publicly available,
you can provide this information on the cover sheet and not in the body
of your comments and you must identify this information as
``confidential.'' Any information marked as ``confidential'' will not
be disclosed except in accordance with 21 CFR 10.20 and other
applicable disclosure law. For more information about FDA's posting of
comments to public dockets, see 80 FR 56469, September 18, 2015, or
access the information at: https://www.fda.gov/regulatoryinformation/dockets/default.htm.
Docket: For access to the docket to read background documents or
the electronic and written/paper 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.
FDA will post the agenda approximately 3 days before the public
meeting at: https://www.fda.gov/Drugs/NewsEvents/ucm509853.htm. FDA will
also post a link to the live Webcast of this public meeting on the day
of the public meeting.
FOR FURTHER INFORMATION CONTACT: Michelle Eby, Center for Drug
Evaluation and Research, Food and Drug Administration, 10903 New
Hampshire Ave., Bldg. 51, Rm. 6184, Silver Spring, MD 20993, 301-796-
4714, Michelle.Eby@fda.hhs.gov.
[[Page 69533]]
SUPPLEMENTARY INFORMATION:
I. Background
Prescription opioid analgesics are an important component of modern
pain management. Prescription opioid analgesic products such as
oxycodone, hydrocodone, and morphine, are widely prescribed for the
treatment of pain, and certain opioid drug products are also used in
opioid dependence treatment programs. When used properly, opioid drug
products can provide significant benefits for patients. Unfortunately,
misuse and abuse of opioid drug products is a serious public health
problem.
When misused or abused, opioid drug products can cause serious
harm, including addiction, overdose, and death. According to the
Centers for Disease Control and Prevention (CDC), prescription opioid
drug products were involved in over 14,000 deaths in 2014.\1\ FDA is
determined to help defeat this epidemic through an adaptive, science-
based approach.
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\1\ Wide-Ranging Online Data for Epidemiologic Research
(WONDER), National Center for Health Statistics; available at https://wonder.cdc.gov.
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In February 2016, FDA announced a comprehensive action plan to take
concrete steps toward reducing the impact of opioid abuse on families
and communities.\2\ As part of this plan, FDA strongly supports the
development of, and transition to use of, opioid drug products with
meaningful abuse-deterrent formulations. FDA has taken and is
continuing to take steps to incentivize and support the development of
opioid drug products with progressively better abuse-deterrent
properties. These steps include working with individual sponsors on
promising abuse-deterrent technologies, publishing guidance on the
evaluation and labeling of abuse-deterrent drug products, and
conducting and supporting research in developing appropriate pre-market
testing methodologies for evaluating the abuse deterrence of both
innovator and generic drugs.
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\2\ https://www.fda.gov/NewsEvents/Newsroom/FactSheets/ucm484714.htm.
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FDA believes abuse-deterrent technologies can and will improve
substantially and can make a real impact in the fight against
prescription opioid abuse. FDA hopes that as the market transitions to
abuse-deterrent formulations, abuse rates will decrease and the most
significant consequences of that abuse (addiction, overdose, and death)
will diminish. To that end, fostering the development, marketing, and
iterative improvement of abuse-deterrent formulations of opioid drug
products, including generic opioid drug products, is a top priority. It
is important that generic versions of opioids that reference approved
opioids whose labeling describes abuse-deterrent properties are
available to help ensure widespread access to safe and effective
analgesics for patients who need them and to accelerate the prescribing
of abuse-deterrent opioids. Such generic opioids should be no less
abuse-deterrent than the opioids they reference; otherwise opioid
abusers could preferentially seek out and abuse easier-to-abuse
generics.
FDA's work to date to support the development, marketing, and
iterative improvement of abuse-deterrent formulations includes:
Holding a public meeting in October 2014 to discuss the
``Development and Regulation of Abuse-Deterrent Formulations of Opioid
Medications;''
Issuing a final guidance in April 2015 on the ``Abuse-
Deterrent Opioids--Evaluation and Labeling.'' This guidance explains
FDA's current thinking about the studies, both pre- and post-marketing,
that should be conducted to demonstrate that a given formulation for
which a new drug application (NDA) is submitted has abuse-deterrent
properties. It also makes recommendations about how those studies
should be performed and evaluated and what information about a
product's abuse-deterrent properties should be included in labeling;
To date, approving seven opioid analgesic drug products
with labeling describing abuse-deterrent properties \3\ consistent with
the final guidance on evaluation and labeling of abuse-deterrent
opioids;
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\3\ A list of opioid medications with FDA-approved labeling
describing abuse-deterrent properties can be found at https://www.fda.gov/NewsEvents/Newsroom/FactSheets/ucm514939.htm.
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Seeking guidance from outside experts in the fields of
pain management and drug abuse. For example, FDA has asked the National
Academies of Sciences, Engineering, and Medicine to help develop a
framework for opioid drug product review, approval, and monitoring that
balances individual needs for pain control with the risk of addiction,
as well as the broader public health consequences of opioid drug
product misuse and abuse;
Conducting or supporting research on opioid drug product
formulations designed to deter abuse. This includes development of in
vitro testing methodologies to assess purportedly abuse-deterrent
formulations; and
Issuing a draft guidance on the ``General Principles for
Evaluating Abuse Deterrence of Generic Solid Oral Opioid Drug
Products.''
In the notice of availability for the draft guidance on evaluating
abuse deterrence of generic opioid drug products, FDA announced its
intent to hold a public meeting following the close of the comment
period to discuss further the pre-market evaluation of the abuse
deterrence of generic opioid drug products and related issues, as
appropriate. FDA is opening a docket and holding this public meeting to
further discuss pre-market evaluation of the abuse deterrence of
generic opioid drug products and the development of standardized in
vitro testing methodologies for evaluating the abuse deterrence of
opioid drug products.
Day 1 of this meeting will focus on scientific and technical issues
related to the pre-market evaluation of the abuse deterrence of generic
opioid drug products. It is important to have a viable pathway for
approval of generic abuse-deterrent opioid drug products to further
FDA's goal to transition to abuse-deterrent formulations as FDA looks
forward to a future in which all or substantially all opioid
medications are less susceptible to abuse than the formulations on the
market today. The availability of generic versions of opioid drug
products that reference listed drugs whose labeling describes abuse-
deterrent properties can help to ensure access to safe and effective,
and affordable, opioid analgesics for patients who need them.
Day 2 will focus on FDA's efforts to develop standardized in vitro
testing methodologies for evaluating the abuse deterrence of opioid
drug products. In vitro testing should, to the greatest extent
possible, provide information sufficient to fully characterize a drug
product's abuse-deterrent properties, including the degree of effort
required to bypass or defeat those properties. In vitro studies should
assess each potential route of abuse (including ingestion, injection,
insufflation, and smoking) starting with simple and gentle mechanical
and chemical manipulations progressing to complex and more destructive
manipulations until a drug product's abuse-deterrent properties are
defeated or compromised. To be sufficiently comprehensive, in vitro
testing should address both the mechanisms by which abusers can be
expected to attempt to deliberately overcome the abuse-deterrent
properties of the product as well as the ways that patients may alter
the formulation (intentionally or unintentionally) that
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change the rate or amount of drug released.
A. Day 1: FDA's Evaluation of Generic Abuse-Deterrent Opioids
Section 505(j) of the Federal Food, Drug, and Cosmetic Act (21
U.S.C. 355(j)) (FD&C Act) permits any person to submit to the FDA an
abbreviated new drug application (ANDA) to seek approval to market a
generic version of a previously approved drug product. To obtain
approval, an ANDA applicant is not required to provide independent
evidence of the safety and effectiveness of the proposed generic drug.
Instead, the applicant relies on FDA's finding that a previously
approved drug product, i.e, the reference listed drug (RLD), is safe
and effective, and must demonstrate, among other things, that the
proposed generic drug is the ``same'' as the RLD in certain ways and is
bioequivalent.
For FDA to approve an ANDA, the Agency must find, among other
things, that the generic drug product has the same active
ingredient(s), dosage form, route of administration, strength,
conditions of use, and, with limited exceptions, labeling as the RLD,
is bioequivalent to its RLD, that the methods used in, or the
facilities and controls used for, the manufacture, processing, and
packing of the drug are adequate to assure and preserve its identity,
strength, quality, and purity, and that the inactive ingredients and
composition of the generic drug are not unsafe under the conditions of
use prescribed, recommended, or suggested in the labeling. See section
505(j)(2)(A) and (j)(4) of the FD&C Act.
FDA classifies as ``therapeutically equivalent'' those products
that meet the following general criteria: (1) They are approved as safe
and effective; (2) they are pharmaceutical equivalents in that they
contain identical amounts of the same active ingredient(s) with the
same route of administration and dosage form and meet compendial or
other applicable standards of strength, quality, purity, and identity;
(3) they are bioequivalent; (4) they are adequately labeled; and (5)
they are manufactured in compliance with current good manufacturing
practices regulations. See FDA's ``Approved Drug Products with
Therapeutic Equivalence Evaluations'' (the Orange Book), Preface. FDA
believes that a product classified as therapeutically equivalent can be
substituted with the full expectation that the substituted product will
produce the same clinical effect and safety profile as the reference
product.
If the RLD's labeling describes properties that are expected to
deter misuse or abuse then the potential ANDA applicant should evaluate
its proposed generic drug product in comparative in vitro studies and,
in some cases, in relevant pharmacokinetic or other studies to show
that it is no less abuse-deterrent than the RLD with respect to all
potential routes of abuse.\4\
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\4\ FDA's current thinking regarding the labeling of opioids is
described in FDA's guidance for industry on ``Abuse-Deterrent
Opioids--Evaluation and Labeling'' (April 2015). Any data relating
to abuse-deterrent properties would be included in the DRUG ABUSE
AND DEPENDENCE section of product labeling, 9.2 Abuse.
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It is important that generic versions of opioid drug products
referencing opioid drug products with FDA-approved labeling describing
abuse-deterrent properties are available to help ensure availability of
analgesics for patients who need them. FDA is interested in supporting
the submission of ANDAs for which the RLD is an opioid drug product
whose labeling describes abuse-deterrent properties and ensuring that
generic opioid drug products are no less abuse-deterrent than the RLD
in its efforts to combat the opioid epidemic.
Topics for discussion during the open public comment period on Day
1 and by the panel:
Based on any testing you have attempted to perform or
performed in accordance with the March 2016 draft guidance, are there
any aspects of the guidance that need clarification or improvement?
Are there any characteristics of the currently approved
abuse-deterrent RLDs for which issuance of product specific guidance,
beyond what is described in FDA's March 2016 draft guidance, would
facilitate development of abuse-deterrent generic opioid drug products?
Are there approaches or technologies for evaluating the
abuse deterrence of generic opioid drug products that were not included
in the March 2016 draft guidance that should be?
What additional actions could FDA take to encourage the
submission of ANDAs that reference an opioid drug product whose
labeling describes abuse-deterrent properties?
Are there potential consequences of the development and
introduction of abuse-deterrent opioid drug products that warrant
further consideration?
B. Day 2: Development of Standardized In Vitro Testing To Evaluate
Abuse Deterrence
The Office of Pharmaceutical Quality (OPQ) will discuss its vision
for standardizing in vitro testing methodologies for evaluating
purportedly abuse-deterrent formulations of opioid drug products. OPQ
will also discuss the efforts being made to standardize in vitro
testing conditions to apply to future products and some of the
challenges being encountered. OPQ's Office of Testing and Research will
then provide an update on its testing of abuse-deterrent formulations,
including approaches being taken to simulate the ways individuals who
abuse opioids manipulate opioid drug products for purposes of abuse
(e.g., crushing, heating, dissolving). FDA recognizes that new
technologies for deterring abuse of oral opioid drug products are
rapidly evolving and is seeking public input on novel mechanisms and
approaches being considered so that it may further consider how testing
could be standardized.
FDA intends to issue a general guidance describing FDA's
recommendations for standardized in vitro testing to evaluate purported
abuse-deterrent properties and considerations for a potential applicant
as it develops an abuse-deterrent formulation of an opioid drug
product. Building on the testing FDA has conducted and other available
information including public input, FDA may recommend common protocols
that incorporate standard test conditions, specified performance
standards, control formulations and provide a tiered approach for
determining when abuse-deterrent properties have been defeated and how
that information may be used during drug development and for other
relevant comparative situations. The guidance also may describe
lifecycle considerations (e.g., the need for testing abuse deterrence
throughout shelf life to determine if any product changes over time
affect abuse-deterrence performance) and provide additional guidance on
evaluating novel technological approaches used to deter abuse of oral
opioid drug products.
Topics for discussion during the open public comment period on Day
2 and by the panel:
What technical and quantitative issues should FDA consider
as it develops guidance to recommend standardization of in vitro
testing to evaluate the abuse deterrence of opioid drug product
formulations for various routes of abuse, including ingestion,
insufflation, injection, and smoking? For example, what should FDA
consider with respect to mechanical manipulations (e.g., equipment,
amount of effort, and time), chemical manipulations (e.g., solvent
choice and availability), particle size distribution,
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and volume of solvent used for extraction?
How can FDA standardize in vitro testing to help
substantiate appropriate and consistent product manufacture that
assures abuse deterrence at release and through a drug product's shelf
life?
How can performance attributes measured by in vitro
testing be quantified and linked to their impact on abuse deterrence?
For example, discuss what amount of time delay in defeating an abuse-
deterrent property should be considered significant and the basis for
the recommendation.
How can FDA build flexibility into standardized testing so
that it may be suitable for application to emerging technologies? Are
there any specific emerging technologies that might require new types
of testing?
II. Registration and Accommodations
Registration: Registration is free and available on a first-come,
first-served basis. Persons interested in attending this public meeting
must register by close of business on October 17, 2016.
If you need special accommodations because of a disability, please
contact La'Shaune Morant, 240-316-3206, email: lashaune@tepgevents.com
no later than October 12, 2016.
To register for the public meeting, please visit https://www.cvent.com/d/wvq0sm/4W (FDA has verified the Web address, but FDA is
not responsible for subsequent changes to the Web site after this
document publishes in the Federal Register) by October 17, 2016. Those
without Internet access may register by contacting La'Shaune Morant,
240-316-3206. Early registration is recommended because facilities are
limited and, therefore, FDA may limit the number of participants from
each organization. You will receive confirmation after you have
registered and been accepted or you will be notified if you are on a
waiting list. FDA may allow onsite registration if space is available.
If registration reaches maximum capacity, FDA will post a notice
closing registration at https://www.fda.gov/Drugs/NewsEvents/ucm509853.htm.
Streaming Webcast of the Public Meeting: The meeting will also be
Webcast. Persons interested in viewing the Webcast must register online
by October 17, 2016. Early registration is recommended because Webcast
connections may be limited. Organizations are requested to register all
participants, but to view using one connection per location. A link to
the live Webcast will be available at https://www.fda.gov/Drugs/NewsEvents/ucm509853.htm on the day of the public meeting. A video
record of the public meeting will be available at https://www.fda.gov/Drugs/NewsEvents/ucm509853.htm following the meeting. FDA has verified
the Web site addresses, as of the date this document publishes in the
Federal Register, but Web sites are subject to change over time.
Requests for Oral Presentations: If you wish to present at the
public meeting, you must register and indicate which topic(s) you wish
to address: approach to testing FDA recommended in its draft guidance
``General Principles for Evaluating the Abuse Deterrence of Generic
Solid Oral Opioid Drug Products,'' new technologies for deterring abuse
of oral opioid drug products, or standardization of in vitro testing
methodologies for evaluating purportedly abuse-deterrent formulations
of opioid drug products. This will help FDA organize the presentations.
FDA will do its best to accommodate requests to make public comments.
Individuals and organizations with common interests are urged to
consolidate or coordinate their presentations, and request time for a
joint presentation. Following the close of the registration, FDA will
determine the amount of time allotted to each presenter and the
approximate time each oral presentation is to begin, and will select
and notify participants by October 24, 2016. All requests to make oral
presentations must be received by the close of registration, October
17, 2016. If you are selected, any presentation materials must be
emailed to Michelle Eby (see FOR FURTHER INFORMATION CONTACT) no later
than October 27, 2016. No commercial or promotional material will be
permitted to be presented or distributed at the public meeting.
FDA is holding this public meeting to obtain information on
scientific and technical issues relating to formulation development and
pre-market evaluation of opioid drug products with abuse-deterrent
properties. In order to permit the widest possible opportunity for
public comment, FDA is soliciting either electronic or written comments
on all aspects of the public meeting topics. The deadline for
submitting comments related to this public meeting is December 1, 2016.
Accommodations: Attendees are responsible for their own hotel
accommodations. Attendees making reservations at the College Park
Marriott Hotel and Conference Center, 3501 University Blvd. East,
Hyattsville, MD 20783, are eligible for a reduced rate of $231/night,
not including applicable taxes. To receive the reduced rate, please
reference ``FDA Opioid Drug Meeting'' if you make your reservation by
calling 1-800-676-6137, or book your reservation at https://www.marriott.com/meeting-event-hotels/group-corporate-travel/groupCorp.mi?resLinkData=FDA%20Opioid%20Drug%20Meeting%5Ewasum%60FDGFDGA%60231.00%60USD%60false%602%6010/30/16%6011/1/16%6010/12/16&app=resvlink&stop_mobi=yes.
If you need special accommodations because of a disability, please
contact La'Shaune Morant, 240-316-3206, lashaune@tepgevents.com no
later than October 12, 2016.
III. Transcript Request
Transcripts of the meeting will be available for review at the
Division of Dockets Management (HFA-305), Food and Drug Administration,
5630 Fishers Lane, Rm. 1061, Rockville, MD 20850, and on the Internet
at https://www.regulations.gov approximately 30 days after the meeting.
A transcript will also be available in either hard copy or on CD-ROM,
after submission of a Freedom of Information request. The Freedom of
Information office address is available on the Agency's Web site at
https://www.fda.gov.
Dated: September 30, 2016.
Leslie Kux,
Associate Commissioner for Policy.
[FR Doc. 2016-24234 Filed 10-5-16; 8:45 am]
BILLING CODE 4164-01-P