Mallinckrodt Pharmaceuticals; Proposal To Withdraw Approval of an Abbreviated New Drug Application for Extended-Release Methylphenidate Tablets; Opportunity for a Hearing, 71737-71741 [2016-25093]
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Federal Register / Vol. 81, No. 201 / Tuesday, October 18, 2016 / Notices
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[FR Doc. 2016–25120 Filed 10–17–16; 8:45 am]
BILLING CODE 4184–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Food and Drug Administration
[Docket No. FDA–2016–N–3118]
Mallinckrodt Pharmaceuticals;
Proposal To Withdraw Approval of an
Abbreviated New Drug Application for
Extended-Release Methylphenidate
Tablets; Opportunity for a Hearing
AGENCY:
Food and Drug Administration,
HHS.
ACTION:
Notice.
The Food and Drug
Administration’s (FDA or Agency)
Center for Drug Evaluation and Research
(CDER) is proposing to withdraw
approval of an abbreviated new drug
application (ANDA) for
methylphenidate hydrochloride (HCl)
extended-release (ER) tablets and is
announcing an opportunity for the
holder of the ANDA to request a hearing
on this proposal.
DATES: Mallinckrodt Pharmaceuticals
may submit a request for a hearing by
November 17, 2016. Submit all data,
information, and analyses upon which
the request for a hearing relies by
December 19, 2016. Submit written or
electronic comments by December 19,
2016.
ADDRESSES: The request for a hearing
may be submitted by Mallinckrodt
Pharmaceuticals by either of the
following methods:
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SUMMARY:
Electronic Submissions
Submit electronic comments in the
following way:
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• Federal eRulemaking Portal: https://
www.regulations.gov. Follow the
instructions for submitting comments to
submit your request for a hearing.
Comments submitted electronically to
https://www.regulations.gov, including
any attachments to the request for
hearing, will be posted to the docket
unchanged.
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.
• Because your request for a hearing
will be made public, you are solely
responsible for ensuring that your
request does not include any
confidential information that you may
not wish to be publicly posted, such as
confidential business information, e.g., a
manufacturing process. The request for
a hearing must include the Docket No.
FDA–2016–N–3118 for ‘‘Mallinckrodt
Pharmaceuticals; Proposal to Withdraw
Approval of an Abbreviated New Drug
Application for Extended-Release
Methylphenidate Tablets; Opportunity
for a Hearing.’’ The request for a hearing
will be placed in the docket and
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.
Mallinckrodt Pharmaceuticals may
submit all data and analysis upon which
the request for a hearing relies in the
same manner as the request for a
hearing except as follows:
• Confidential Submissions—To
submit any data analyses with
confidential information that you do not
wish to be made publicly available,
submit your data and analyses only as
a written/paper submission. You should
submit two copies total of all data and
analyses. 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 any decisions on
this matter. 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 or
available at the Division of Dockets
Management between 9 a.m. and 4 p.m.,
Monday through Friday. Submit both
copies to the Division of Dockets
Management. Any information marked
as ‘‘confidential’’ will not be disclosed
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except in accordance with 21 CFR 10.20
and other applicable disclosure law.
Comments Submitted by Other
Interested Parties: For all comments
submitted by other interested parties,
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–3118 for ‘‘Mallinckrodt
Pharmaceuticals; Proposal to Withdraw
Approval of an Abbreviated New Drug
Application for Extended-Release
Methylphenidate Tablets; Opportunity
for a Hearing.’’ 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
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Federal Register / Vol. 81, No. 201 / Tuesday, October 18, 2016 / Notices
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.
FOR FURTHER INFORMATION CONTACT:
Maryll W. Toufanian, Center for Drug
Evaluation and Research, Food and
Drug Administration, 10903 New
Hampshire Ave., Bldg. 75, Rm. 1716,
Silver Spring, MD 20993–0002, 240–
402–7944.
SUPPLEMENTARY INFORMATION:
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I. Background
A. Approval of ANDAs Referencing
CONCERTA
CONCERTA (methylphenidate HCl)
ER tablet is the subject of new drug
application (NDA) 021121, held by
Janssen Pharmaceuticals, Inc., and was
approved on August 1, 2000.
CONCERTA is a central nervous system
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stimulant intended for the treatment of
attention deficit hyperactivity disorder
in children 6 years of age and older,
adolescents, and adults up to the age of
65. CONCERTA is a multiphasic
modified-release product that is
formulated to release a bolus of
methylphenidate, resulting in an initial
rapid rise in plasma concentration
comparable to the effect of an
immediate-release (IR) methylphenidate
formulation, followed by sustained
delivery later in the day, thereby
allowing for once daily dosing. The
relative bioavailability of CONCERTA in
adults is comparable to IR
methylphenidate administered three
times daily, but the CONCERTA
formulation minimizes the fluctuations
between peak and trough concentrations
associated with IR methylphenidate
administered three times daily.
CONCERTA is approved for the
following strengths: 18 milligrams (mg),
27 mg, 36 mg, and 54 mg. CONCERTA
was approved based on, among other
things, safety studies and adequate and
well-controlled clinical efficacy studies
showing that the product is safe for its
intended uses and has the effects
claimed for it.
FDA’s Office of Generic Drugs (OGD)
approved ANDA 202608, held by
Mallinckrodt Pharmaceuticals
(Mallinckrodt), for a generic version of
CONCERTA under the requirements of
section 505(j) of the Federal Food, Drug,
and Cosmetic Act (the FD&C Act) (21
U.S.C. 355(j)) and FDA’s implementing
regulations. OGD approved ANDA
202608 on December 28, 2012, for the
27-mg, 36-mg, and 54-mg strengths.
At the time of approval, FDA
determined that the ANDA included
data sufficient to demonstrate the
bioequivalence of the Mallinckrodt
product to CONCERTA. The
bioequivalence (BE) testing and data
submitted in the ANDA conformed to
recommendations provided in a draft
guidance for industry on
‘‘Methylphenidate hydrochloride.’’ The
draft guidance was issued on September
14, 2012 (77 FR 56851), and provided
information and recommendations for
establishing bioequivalence to
CONCERTA that reflected FDA’s
understanding, at that time, of how to
evaluate the pharmacokinetic (PK)
properties of CONCERTA to support a
demonstration of bioequivalence. The
demonstration of bioequivalence was
necessary to the approval of
Mallinckrodt’s product. Unlike
CONCERTA, Mallinckrodt was not
required to submit clinical studies to
demonstrate the safety and effectiveness
of its product. Instead, Mallinckrodt’s
ANDA was approved based on a finding
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that the product was bioequivalent to
CONCERTA and met the other
requirements for ANDA approval in
section 505(j) of the FD&C Act.
B. Concerns About Insufficient
Therapeutic Effect
1. ANDA 202608
Mallinckrodt began marketing its
generic version of CONCERTA in March
2013. OGD routinely monitors all newly
approved ANDA products for safety and
efficacy concerns as they penetrate the
marketplace, including the monitoring
of adverse events reported to the
Agency. In May 2013, the FDA Adverse
Event Reporting System (FAERS) began
receiving reports that described
insufficient therapeutic effect of the
Mallinckrodt product, particularly
reports describing insufficient effect
later in the day.1 These reports
indicated potential therapeutic
inequivalence of the Mallinckrodt
product as compared to CONCERTA. In
light of the reports received, CDER
began an investigation of the
Mallinckrodt product.2
2. CDER’s Investigations
a. Tracked safety issue (TSI). CDER
began its investigation of the
Mallinckrodt product with a
reevaluation of the data and information
submitted in the application to
demonstrate bioequivalence; an
assessment of FAERS data; and a
comparative analysis of the design,
composition, dissolution, and active
pharmaceutical ingredient (API)
degradation of the generic product as
compared to CONCERTA. The findings
of these investigations led to the
initiation of a TSI. In general, when
CDER staff suspect that a potential
safety issue could be significant, a TSI
is opened and an interdisciplinary team
assesses the safety issue, reevaluates the
risk-benefit profile of the drug, and
determines the need for further action.
CDER considers postmarketing safety
issues to be significant for tracking
purposes if these issues have the
potential to lead to, among other things,
withdrawal of FDA approval of a drug
application.
The initial meeting of the TSI
Committee occurred in December 2013.
1 In addition to reports submitted to FAERS, FDA
received complaints related to therapeutic failure
from multiple other sources, including FDA’s
Detroit District Office and a director of anesthesia
support at a children’s hospital.
2 FDA investigated ANDA 202608 concurrently
with ANDA 091695, which is another generic
product referencing CONCERTA, held by Kremers
Urban Pharmaceuticals Inc. Elsewhere in this issue
of the Federal Register, FDA is proposing to
withdraw approval of ANDA 091695.
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The TSI Committee was composed of
CDER physicians, pharmacists, and
chemists, as well as other CDER
scientists and experts, who carefully
reviewed all of the data and information
related to the Mallinckrodt product. Key
information reviewed and discussed by
the TSI Committee is summarized as
follows:
• Adverse event reports. An analysis
was conducted of FAERS reports, along
with additional data regarding
therapeutic failure provided by
Mallinckrodt and Janssen (CONCERTA’s
NDA holder), to assess, among other
things, the reporting rate for therapeutic
failure for the Mallinckrodt product as
compared to the reporting rate for
therapeutic failure for the authorized
generic version of CONCERTA marketed
by Actavis plc.3 The reporting rate for
therapeutic failure was found to be 88
per 100,000 person-years of exposure for
the Mallinckrodt product and 7.0 per
100,000 person-years of exposure for the
authorized generic drug product.
• Product composition. The
Mallinckrodt product and CONCERTA
were tested in FDA laboratories to
evaluate differences in drug design,
composition, stability, and dissolution.
The testing identified concerns with API
degradation and in vivo dissolution,
which could result in differences in
drug release. These differences could, in
turn, result in differences in therapeutic
effect of the generic product compared
to CONCERTA.
• BE data. A review and reanalysis
were conducted of the data that were
submitted in the ANDA to establish
bioequivalence to CONCERTA. In
particular, an outlier analysis was
3 Authorized generic drug is defined in section
505(t) of the FD&C Act and in § 314.3(b) (21 CFR
314.3(b)) (Authorized generic drug means a listed
drug, as defined in § 314.3(b), that has been
approved under section 505(c) of the FD&C Act and
is marketed, sold, or distributed directly or
indirectly to retail class of trade with labeling,
packaging (other than repackaging as the listed drug
in blister packs, unit doses, or similar packaging for
use in institutions), product code, labeler code,
trade name, or trademark that differs from that of
the listed drug.). A listed drug is a new drug
product that has an effective approval under section
505(c) of the FD&C Act for safety and effectiveness,
or under section 505(j), that has not been
withdrawn or suspended under section 505(e)(1)
through (e)(5) or (j)(5) of the FD&C Act, and that has
not been withdrawn from sale for what FDA
determines are reasons of safety or effectiveness
(§ 314.3(b)). Listed drugs are identified as drugs
with an effective approval in FDA’s current edition
of ‘‘Approved Drug Products With Therapeutic
Equivalence Evaluations’’ (commonly referred to as
the ‘‘Orange Book’’) (Id.). A list of currently
available authorized generics is available at https://
www.fda.gov/AboutFDA/CentersOffices/Officeof
MedicalProductsandTobacco/CDER/
ucm126391.htm. (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.)
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performed on the BE data to evaluate
the difference in product absorption
between the Mallinckrodt product and
CONCERTA across various PK sampling
time points. The analysis showed that
the greatest difference in product
absorption between the Mallinckrodt
product and CONCERTA occurred at 10
hours post-dosing under fasting
conditions.
• Modeling of potential clinical
impact. In light of the close relationship
between the PK profile and clinical
effect of methylphenidate products (Ref.
1), modeling was done based on the BE
data submitted in the ANDA to predict
the potential clinical significance of the
difference in PK profile, i.e., product
absorption, of the Mallinckrodt product
compared to CONCERTA. The modeling
suggested some potential clinical
inequivalence between the generic
product and CONCERTA after 6 hours
post-dosing. The greatest mean percent
reduction in clinical efficacy for the
Mallinckrodt product is predicted to be
approximately 21 percent at 10 hours
post-dosing under fasting condition.
The TSI was concluded in June 2014.
Based on the information considered,
the TSI Committee determined that the
Mallinckrodt product may deliver
methylphenidate into the body at a
slower rate than CONCERTA during the
time period of 7 to 12 hours post-dosing,
and therefore, the product may not be
bioequivalent or therapeutically
equivalent to CONCERTA. Following
the TSI Committee’s investigation,
CDER concluded that the therapeutic
equivalence (TE) rating for the
Mallinckrodt product in FDA’s
‘‘Approved Drug Products with
Therapeutic Equivalence Evaluations’’
(commonly referred to as the ‘‘Orange
Book’’) should be changed from AB to
BX to indicate that the data are
insufficient to determine that the
Mallinckrodt product is therapeutically
equivalent to CONCERTA.4
4 In the Orange Book, FDA ‘‘classifies as
therapeutically equivalent those products that meet
the following general criteria: (1) [T]hey are
approved as safe and effective; (2) they are
pharmaceutical equivalents in that they (a) contain
identical amounts of the same active drug
ingredient in the same dosage form and route of
administration, and (b) meet compendial or other
applicable standards of strength, quality, purity,
and identity; (3) they are bioequivalent in that (a)
they do not present a known or potential
bioequivalence problem, and they meet an
acceptable in vitro standard, or (b) if they do
present such a known or potential problem, they are
shown to meet an appropriate bioequivalence
standard; (4) they are adequately labeled; (5) they
are manufactured in compliance with Current Good
Manufacturing Practice regulations’’ (Orange Book
Preface at vii, available at https://www.fda.gov/
downloads/Drugs/DevelopmentApprovalProcess/
UCM071436.pdf. (FDA has verified the Web site
addresses, as of the date this document publishes
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On November 6, 2014 (79 FR 65978),
CDER issued a revised draft guidance
for industry on ‘‘Bioequivalence
Recommendations for CONCERTA
(Methylphenidate Hydrochloride)
Extended-Release Tablets’’ (revised draft
BE guidance) (Ref. 2), with
recommendations for establishing
bioequivalence to CONCERTA that
reflect CDER’s refined understanding of
the relationship between the PK profile
of CONCERTA and its therapeutic
effect. The revised draft BE guidance is
available on FDA’s Web site and will be
placed in Docket No. FDA–2016–N–
3118.
On November 12, 2014,
representatives from OGD and other
CDER offices notified Mallinckrodt by
telephone of CDER’s concerns regarding
its generic product. OGD explained that
the TE rating for the product would be
changed from AB to BX immediately.
OGD requested that Mallinckrodt: (1)
Voluntarily withdraw its product from
the market under 21 CFR 314.150(d) and
request that FDA withdraw approval of
the ANDA or (2) confirm bioequivalence
of its product within 6 months,
consistent with the recommendations in
the revised draft BE guidance issued on
November 6, 2014. Mallinckrodt
declined to voluntarily withdraw its
product from the market, and it has not
submitted data or information that
confirms bioequivalence of its product
to CONCERTA.
b. Post-TSI investigation. After
communicating CDER’s concerns to
Mallinckrodt about its methylphenidate
product and changing the TE rating for
the product to BX, CDER continued to
evaluate data and information related to
the bioequivalence of Mallinckrodt’s
product to CONCERTA. CDER
reanalyzed the BE data originally
submitted in Mallinckrodt’s ANDA in
accordance with the recommendations
provided in the November 6, 2014,
revised draft BE guidance. The
reanalysis showed that the 54-mg
Mallinckrodt product on which the in
vivo BE testing was conducted does not
provide the same extent of
methylphenidate exposure as
CONCERTA during the 7- to 12-hour
time period after administration.
Specifically, the 90 percent confidence
interval (CI) of the geometric mean ratio
of the test product (Mallinckrodt’s) to
reference product (CONCERTA) for
AUC7–12 5 (at 64.41 percent to 72.49
in the Federal Register, but Web sites are subject
to change over time.)).
5 The area under the plasma concentration-time
curve (AUC) is used to evaluate the ‘‘extent’’ of
absorption of a drug. See section 505(j)(7)(B) of the
FD&C Act. AUC7–12 captures the extent of
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percent) falls outside of the 80 percent
to 125 percent BE acceptance criteria
(Ref. 4). The lower level of
methylphenidate exposure compared to
CONCERTA 7 to 12 hours after
administration is consistent with the
reports received describing lack of
therapeutic effect later in the day.
In addition to the reanalysis described
above, FDA performed further clinical
trial simulations based on the BE data
originally submitted in the ANDA to
assess the potential clinical significance
of the difference in PK profile, i.e.,
methylphenidate absorption, of the
Mallinckrodt product compared to
CONCERTA (Ref. 5). The simulation
suggested some potential difference in
effect between Mallinckrodt’s product
and CONCERTA after 6 hours postdosing. Consistent with the evaluation
presented during the TSI, the greatest
mean percent reduction in efficacy was
predicted to be 21.17 percent at 10
hours post-dosing, with individual
changes ranging from a 44.09 percent
decrease and a 9.04 percent increase in
efficacy compared to CONCERTA.
Along with a reanalysis of data
submitted in the original ANDA, in
March 2015, CDER sponsored its own
study to evaluate bioequivalence of the
27-mg Mallinckrodt product as
compared to CONCERTA. The CDERsponsored study was a single-dose, 4treatment, fully replicated, crossover,
randomized BE study (consistent with
the study design recommended in the
revised draft BE guidance) in healthy
subjects under fasting conditions. The
study compared: (1) The test product—
Mallinckrodt’s methylphenidate HCl ER
tablets, 27 mg; and (2) the reference
product—CONCERTA ER tablets, 27 mg.
A total of 28 subjects were enrolled in
the study, and 24 subjects completed all
4 periods. Plasma samples were
collected for up to 24 hours following
each treatment. The mean
methylphenidate plasma concentration
profiles for both the test and reference
products exhibited PK properties
consistent with those observed in the
54-mg fasting BE study submitted by
Mallinckrodt in its ANDA. In particular,
decreased plasma concentrations were
observed with administration of the
Mallinckrodt product as compared to
CONCERTA after 6 to 7 hours. The 90
percent CI of the geometric mean testto-reference ratio for AUC7–12 was below
the 80 percent to 125 percent BE
acceptance range (at 60.99 percent to
70.50 percent). All other metrics were
absorption from 7 to 12 hours post-dosing. See, e.g.,
the draft guidance for industry entitled
‘‘Bioequivalence Studies with Pharmacokinetic
Endpoints for Drugs Submitted under an ANDA’’
(Ref. 3).
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found to be within the BE acceptance
range of 80 percent to 125 percent. The
observed lower level of
methylphenidate exposure compared to
CONCERTA 7 to 12 hours after
administration is consistent with that
observed in the reanalysis of the 54-mg
BE study submitted in Mallinckrodt’s
ANDA.
Finally, FDA analyzed FAERS reports
from February 2014 to May 2015. The
types and quality of reports received by
FDA during that time period were very
similar to the reports received before
FDA changed the TE rating. The reports
continued to contain specific
complaints describing the failure of
therapeutic effect during the latter part
of the day.
The applicant has not submitted data
that confirms bioequivalence of its
product to CONCERTA. A
memorandum describing in detail the
information considered following the
TSI and explaining CDER’s
determination will be placed in Docket
No. FDA–2016–N–3118 (Ref. 6).
II. Conclusions and Proposed Action
An NDA (or reference listed drug)
applicant must submit ‘‘full reports of
investigations’’ to show that the drug for
which the applicant is seeking approval
is safe and effective. In other words,
reference listed drugs must meet the
safety and substantial evidence of
effectiveness standard (see section
505(b)(1) and (2), (c), and (d) of the
FD&C Act). A reference listed drug
applicant can meet the standard by
conducting its own clinical studies
(stand-alone application) or relying, in
part, on the Agency’s previous finding
of safety and/or effectiveness or
literature (a 505(b)(2) application). An
ANDA applicant does not submit
independent clinical studies to
demonstrate safety and effectiveness.
Rather, an ANDA applicant relies on the
Agency’s previous finding of safety and
effectiveness for the reference listed
drug and is required to meet other
requirements such as demonstrating
bioequivalence to the reference listed
drug to support approval. In the absence
of information showing bioequivalence
between the generic drug at issue and
the reference listed drug, there is no
basis for concluding that the Agency’s
finding of safety and efficacy (or
substantial evidence of effectiveness)
supporting approval of the reference
listed drug likewise supports approval
of the generic drug.
Therefore, based on all available data
and information, notice is given to
Mallinckrodt and to all other interested
persons that the Director of CDER
proposes to issue an order, under
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section 505(e)(3) of the FD&C Act and
§ 314.150(a)(2)(iii), withdrawing
approval of ANDA 202608 and all
amendments and supplements to it on
the grounds that, on the basis of new
information, evaluated together with the
evidence available when the application
was approved, there is a lack of
substantial evidence that the drug will
have the effect it is represented to have
under the conditions of use prescribed,
recommended, or suggested in its
labeling.
III. Hearing Procedures
In accordance with section 505(e) of
the FD&C Act, the applicant is hereby
provided an opportunity to request a
hearing to show why approval of ANDA
202608 should not be withdrawn and an
opportunity to raise, for administrative
determination, all issues relating to the
legal status of the drug product covered
by this application.
An applicant who decides to seek a
hearing must file the following: (1) A
written notice of participation and
request for hearing (see DATES), and (2)
the data, information, and analyses
relied on to demonstrate that there is a
genuine and substantial issue of fact
that requires a hearing to resolve (see
DATES). Any other interested person may
also submit comments on this notice.
The procedures and requirements
governing this notice of opportunity for
a hearing, notice of participation and
request for a hearing, the information
and analyses to justify a hearing, other
comments, and a grant or denial of a
hearing are contained in § 314.200 (21
CFR 314.200) and in 21 CFR part 12.
The failure of an applicant to file a
timely written notice of participation
and request for a hearing, as required by
§ 314.200, constitutes an election by that
applicant not to avail itself of the
opportunity for a hearing concerning
CDER’s proposal to withdraw approval
of the application and constitutes a
waiver of any contentions concerning
the legal status of the drug product. FDA
will then withdraw approval of the
application, and the drug product may
not thereafter be lawfully introduced or
delivered for introduction into interstate
commerce. Any new drug product
introduced or delivered for introduction
into interstate commerce without an
approved application is subject to
regulatory action at any time.
A request for a hearing may not rest
upon mere allegations or denials, but
must present specific facts showing that
there is a genuine and substantial issue
of fact that requires a hearing. If a
request for a hearing is not complete or
is not supported, the Commissioner of
Food and Drugs will enter summary
E:\FR\FM\18OCN1.SGM
18OCN1
Federal Register / Vol. 81, No. 201 / Tuesday, October 18, 2016 / Notices
judgment against the person who
requests the hearing, making findings
and conclusions, and denying a hearing.
All submissions under this notice of
opportunity for a hearing must be filed
in two copies. Except for data and
information prohibited from public
disclosure under 21 U.S.C. 331(j) or 18
U.S.C. 1905, the submissions may be
seen in the Division of Dockets
Management (see ADDRESSES) between 9
a.m. and 4 p.m., Monday through
Friday, and will be posted to the docket
at https://www.regulations.gov.
This notice is issued under section
505(e) of the FD&C Act and under the
authority delegated to the Director of
CDER by the Commissioner of Food and
Drugs.
Lhorne on DSK30JT082PROD with NOTICES
IV. References
The following references are on
display in the Division of Dockets
Management (see ADDRESSES) and are
available for viewing by interested
persons between 9 a.m. and 4 p.m.,
Monday through Friday; they are also
available electronically at https://
www.regulations.gov. 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.
1. Swanson, J.M., et al., ‘‘A Comparison of
Once-Daily Extended-Release
Methylphenidate Formulations in
Children With Attention-Deficit/
Hyperactivity Disorder in the Laboratory
School (The Comacs Study),’’ Pediatrics,
vol. 113, pp. 206–216, 2004.
2. FDA, draft guidance for industry,
‘‘Bioequivalence Recommendations for
CONCERTA (Methylphenidate
Hydrochloride) Extended-Release
Tablets,’’ November 2014 (available at
https://www.fda.gov/downloads/Drugs/
GuidanceComplianceRegulatory
Information/Guidances/
UCM320007.pdf).
3. FDA, draft guidance for industry,
‘‘Bioequivalence Studies With
Pharmacokinetic Endpoints for Drugs
Submitted Under an ANDA,’’ December
2013 (available at https://www.fda.gov/
Drugs/GuidanceComplianceRegulatory
Information/Guidances/UCM377465).
4. Dighe, S.V. and W.P. Adams.
‘‘Bioequivalence: A United States
Regulatory Perspective.’’ In Welling,
P.G., L.S. Tse, and S.V. Dighe, eds.,
Pharmaceutical Bioequivalence. New
York: Marcel Dekker, Inc., pp. 347–380,
1991.
5. Kimko, H., et al., ‘‘Population
Pharmacodynamic Modeling of Various
Extended-Release Formulations of
Methylphenidate in Children With
Attention Deficit Hyperactivity Disorder
Via Meta-Analysis,’’ Journal of
Pharmacokinetics and
Pharmacodynamics, vol. 39(2), pp. 161–
176, 2012.
VerDate Sep<11>2014
13:19 Oct 17, 2016
Jkt 241001
6. Memorandum to Janet Woodcock, Director,
Center for Drug Evaluation and Research,
in Support of Beginning Approval
Withdrawal Proceedings for ANDA
202608 (October 1, 2016, Peters).
Dated: October 12, 2016.
Janet Woodcock,
Director, Center for Drug Evaluation and
Research.
[FR Doc. 2016–25093 Filed 10–17–16; 8:45 am]
BILLING CODE 4164–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Food and Drug Administration
[Docket No. FDA–2016–N–3120]
Kremers Urban Pharmaceuticals Inc.;
Proposal To Withdraw Approval of an
Abbreviated New Drug Application for
Extended-Release Methylphenidate
Tablets; Opportunity for a Hearing
AGENCY:
Food and Drug Administration,
HHS.
ACTION:
Notice.
The Food and Drug
Administration’s (FDA or Agency)
Center for Drug Evaluation and Research
(CDER) is proposing to withdraw
approval of an abbreviated new drug
application (ANDA) for
methylphenidate hydrochloride (HCl)
extended-release (ER) tablets and is
announcing an opportunity for the
holder of the ANDA to request a hearing
on this proposal.
DATES: Kremers Urban Pharmaceuticals
Inc., may submit a request for a hearing
by November 17, 2016. Submit all data,
information, and analyses upon which
the request for a hearing relies by
December 19, 2016. Submit written or
electronic comments by December 19,
2016.
ADDRESSES: The request for a hearing
may be submitted by Kremers Urban
Pharmaceuticals Inc., by either of the
following methods:
SUMMARY:
Electronic Submissions
Submit electronic comments in the
following way:
• Federal eRulemaking Portal: https://
www.regulations.gov. Follow the
instructions for submitting comments to
submit your request for a hearing. Your
request for a hearing submitted
electronically to https://
www.regulations.gov, including any
attachments to the request for hearing,
will be posted to the docket unchanged.
Written/Paper Submissions
Submit written/paper submissions as
follows:
PO 00000
Frm 00053
Fmt 4703
Sfmt 4703
71741
• Mail/Hand delivery/Courier (for
written/paper request for a hearing):
Division of Dockets Management (HFA–
305), Food and Drug Administration,
5630 Fishers Lane, Rm. 1061, Rockville,
MD 20852.
Because your request for a hearing
will be made public, you are solely
responsible for ensuring that your
request does not include any
confidential information that you may
not wish to be publicly posted, such as
confidential business information, e.g., a
manufacturing process. The request for
a hearing must include the Docket No.
FDA–2016–N–3120 for ‘‘Kremers Urban
Pharmaceuticals Inc.; Proposal to
Withdraw Approval of an Abbreviated
New Drug Application for ExtendedRelease Methylphenidate Tablets;
Opportunity for a Hearing.’’ The request
for a hearing will be placed in the
docket and 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.
Kremers Urban Pharmaceutical Inc.,
may submit all data and analysis upon
which the request for a hearing relies in
the same manner as the request for a
hearing except as follows:
• Confidential Submissions—To
submit any data and analyses with
confidential information that you do not
wish to be made publicly available,
submit your data and analyses only as
a written/paper submission. You should
submit two copies total of all data and
analysis. 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 any decisions on
this matter. The second copy, which
will have the claimed information
redacted/blacked out, will be available
for public viewing and posted on https://
www.regulations.gov or available at the
Division of Dockets Management
between 9 a.m. and 4 p.m., Monday
through Friday. Submit both copies to
the Division of Dockets Management.
Any information marked as
‘‘confidential’’ will not be disclosed
except in accordance with 21 CFR 10.20
and other applicable disclosure law.
Comments Submitted by Other
Interested Parties: For all comments
submitted by other interested parties
you may submit comments as follows:
Electronic Submissions
Submit electronic comments in the
following way:
• Federal eRulemaking Portal: https://
www.regulations.gov. Follow the
E:\FR\FM\18OCN1.SGM
18OCN1
Agencies
[Federal Register Volume 81, Number 201 (Tuesday, October 18, 2016)]
[Notices]
[Pages 71737-71741]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-25093]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Food and Drug Administration
[Docket No. FDA-2016-N-3118]
Mallinckrodt Pharmaceuticals; Proposal To Withdraw Approval of an
Abbreviated New Drug Application for Extended-Release Methylphenidate
Tablets; Opportunity for a Hearing
AGENCY: Food and Drug Administration, HHS.
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: The Food and Drug Administration's (FDA or Agency) Center for
Drug Evaluation and Research (CDER) is proposing to withdraw approval
of an abbreviated new drug application (ANDA) for methylphenidate
hydrochloride (HCl) extended-release (ER) tablets and is announcing an
opportunity for the holder of the ANDA to request a hearing on this
proposal.
DATES: Mallinckrodt Pharmaceuticals may submit a request for a hearing
by November 17, 2016. Submit all data, information, and analyses upon
which the request for a hearing relies by December 19, 2016. Submit
written or electronic comments by December 19, 2016.
ADDRESSES: The request for a hearing may be submitted by Mallinckrodt
Pharmaceuticals by either of the following methods:
Electronic Submissions
Submit electronic comments in the following way:
Federal eRulemaking Portal: https://www.regulations.gov.
Follow the instructions for submitting comments to submit your request
for a hearing. Comments submitted electronically to https://www.regulations.gov, including any attachments to the request for
hearing, will be posted to the docket unchanged.
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.
Because your request for a hearing will be made public,
you are solely responsible for ensuring that your request does not
include any confidential information that you may not wish to be
publicly posted, such as confidential business information, e.g., a
manufacturing process. The request for a hearing must include the
Docket No. FDA-2016-N-3118 for ``Mallinckrodt Pharmaceuticals; Proposal
to Withdraw Approval of an Abbreviated New Drug Application for
Extended-Release Methylphenidate Tablets; Opportunity for a Hearing.''
The request for a hearing will be placed in the docket and 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.
Mallinckrodt Pharmaceuticals may submit all data and analysis upon
which the request for a hearing relies in the same manner as the
request for a hearing except as follows:
Confidential Submissions--To submit any data analyses with
confidential information that you do not wish to be made publicly
available, submit your data and analyses only as a written/paper
submission. You should submit two copies total of all data and
analyses. 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
any decisions on this matter. 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
or available at the Division of Dockets Management between 9 a.m. and 4
p.m., Monday through Friday. Submit both copies to the Division of
Dockets Management. Any information marked as ``confidential'' will not
be disclosed except in accordance with 21 CFR 10.20 and other
applicable disclosure law.
Comments Submitted by Other Interested Parties: For all comments
submitted by other interested parties, 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-3118 for ``Mallinckrodt Pharmaceuticals; Proposal to
Withdraw Approval of an Abbreviated New Drug Application for Extended-
Release Methylphenidate Tablets; Opportunity for a Hearing.'' 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
[[Page 71738]]
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.
FOR FURTHER INFORMATION CONTACT: Maryll W. Toufanian, Center for Drug
Evaluation and Research, Food and Drug Administration, 10903 New
Hampshire Ave., Bldg. 75, Rm. 1716, Silver Spring, MD 20993-0002, 240-
402-7944.
SUPPLEMENTARY INFORMATION:
I. Background
A. Approval of ANDAs Referencing CONCERTA
CONCERTA (methylphenidate HCl) ER tablet is the subject of new drug
application (NDA) 021121, held by Janssen Pharmaceuticals, Inc., and
was approved on August 1, 2000. CONCERTA is a central nervous system
stimulant intended for the treatment of attention deficit hyperactivity
disorder in children 6 years of age and older, adolescents, and adults
up to the age of 65. CONCERTA is a multiphasic modified-release product
that is formulated to release a bolus of methylphenidate, resulting in
an initial rapid rise in plasma concentration comparable to the effect
of an immediate-release (IR) methylphenidate formulation, followed by
sustained delivery later in the day, thereby allowing for once daily
dosing. The relative bioavailability of CONCERTA in adults is
comparable to IR methylphenidate administered three times daily, but
the CONCERTA formulation minimizes the fluctuations between peak and
trough concentrations associated with IR methylphenidate administered
three times daily. CONCERTA is approved for the following strengths: 18
milligrams (mg), 27 mg, 36 mg, and 54 mg. CONCERTA was approved based
on, among other things, safety studies and adequate and well-controlled
clinical efficacy studies showing that the product is safe for its
intended uses and has the effects claimed for it.
FDA's Office of Generic Drugs (OGD) approved ANDA 202608, held by
Mallinckrodt Pharmaceuticals (Mallinckrodt), for a generic version of
CONCERTA under the requirements of section 505(j) of the Federal Food,
Drug, and Cosmetic Act (the FD&C Act) (21 U.S.C. 355(j)) and FDA's
implementing regulations. OGD approved ANDA 202608 on December 28,
2012, for the 27-mg, 36-mg, and 54-mg strengths.
At the time of approval, FDA determined that the ANDA included data
sufficient to demonstrate the bioequivalence of the Mallinckrodt
product to CONCERTA. The bioequivalence (BE) testing and data submitted
in the ANDA conformed to recommendations provided in a draft guidance
for industry on ``Methylphenidate hydrochloride.'' The draft guidance
was issued on September 14, 2012 (77 FR 56851), and provided
information and recommendations for establishing bioequivalence to
CONCERTA that reflected FDA's understanding, at that time, of how to
evaluate the pharmacokinetic (PK) properties of CONCERTA to support a
demonstration of bioequivalence. The demonstration of bioequivalence
was necessary to the approval of Mallinckrodt's product. Unlike
CONCERTA, Mallinckrodt was not required to submit clinical studies to
demonstrate the safety and effectiveness of its product. Instead,
Mallinckrodt's ANDA was approved based on a finding that the product
was bioequivalent to CONCERTA and met the other requirements for ANDA
approval in section 505(j) of the FD&C Act.
B. Concerns About Insufficient Therapeutic Effect
1. ANDA 202608
Mallinckrodt began marketing its generic version of CONCERTA in
March 2013. OGD routinely monitors all newly approved ANDA products for
safety and efficacy concerns as they penetrate the marketplace,
including the monitoring of adverse events reported to the Agency. In
May 2013, the FDA Adverse Event Reporting System (FAERS) began
receiving reports that described insufficient therapeutic effect of the
Mallinckrodt product, particularly reports describing insufficient
effect later in the day.\1\ These reports indicated potential
therapeutic inequivalence of the Mallinckrodt product as compared to
CONCERTA. In light of the reports received, CDER began an investigation
of the Mallinckrodt product.\2\
---------------------------------------------------------------------------
\1\ In addition to reports submitted to FAERS, FDA received
complaints related to therapeutic failure from multiple other
sources, including FDA's Detroit District Office and a director of
anesthesia support at a children's hospital.
\2\ FDA investigated ANDA 202608 concurrently with ANDA 091695,
which is another generic product referencing CONCERTA, held by
Kremers Urban Pharmaceuticals Inc. Elsewhere in this issue of the
Federal Register, FDA is proposing to withdraw approval of ANDA
091695.
---------------------------------------------------------------------------
2. CDER's Investigations
a. Tracked safety issue (TSI). CDER began its investigation of the
Mallinckrodt product with a reevaluation of the data and information
submitted in the application to demonstrate bioequivalence; an
assessment of FAERS data; and a comparative analysis of the design,
composition, dissolution, and active pharmaceutical ingredient (API)
degradation of the generic product as compared to CONCERTA. The
findings of these investigations led to the initiation of a TSI. In
general, when CDER staff suspect that a potential safety issue could be
significant, a TSI is opened and an interdisciplinary team assesses the
safety issue, reevaluates the risk-benefit profile of the drug, and
determines the need for further action. CDER considers postmarketing
safety issues to be significant for tracking purposes if these issues
have the potential to lead to, among other things, withdrawal of FDA
approval of a drug application.
The initial meeting of the TSI Committee occurred in December 2013.
[[Page 71739]]
The TSI Committee was composed of CDER physicians, pharmacists, and
chemists, as well as other CDER scientists and experts, who carefully
reviewed all of the data and information related to the Mallinckrodt
product. Key information reviewed and discussed by the TSI Committee is
summarized as follows:
Adverse event reports. An analysis was conducted of FAERS
reports, along with additional data regarding therapeutic failure
provided by Mallinckrodt and Janssen (CONCERTA's NDA holder), to
assess, among other things, the reporting rate for therapeutic failure
for the Mallinckrodt product as compared to the reporting rate for
therapeutic failure for the authorized generic version of CONCERTA
marketed by Actavis plc.\3\ The reporting rate for therapeutic failure
was found to be 88 per 100,000 person-years of exposure for the
Mallinckrodt product and 7.0 per 100,000 person-years of exposure for
the authorized generic drug product.
---------------------------------------------------------------------------
\3\ Authorized generic drug is defined in section 505(t) of the
FD&C Act and in Sec. 314.3(b) (21 CFR 314.3(b)) (Authorized
generic drug means a listed drug, as defined in Sec. 314.3(b), that
has been approved under section 505(c) of the FD&C Act and is
marketed, sold, or distributed directly or indirectly to retail
class of trade with labeling, packaging (other than repackaging as
the listed drug in blister packs, unit doses, or similar packaging
for use in institutions), product code, labeler code, trade name, or
trademark that differs from that of the listed drug.). A listed drug
is a new drug product that has an effective approval under section
505(c) of the FD&C Act for safety and effectiveness, or under
section 505(j), that has not been withdrawn or suspended under
section 505(e)(1) through (e)(5) or (j)(5) of the FD&C Act, and that
has not been withdrawn from sale for what FDA determines are reasons
of safety or effectiveness (Sec. 314.3(b)). Listed drugs are
identified as drugs with an effective approval in FDA's current
edition of ``Approved Drug Products With Therapeutic Equivalence
Evaluations'' (commonly referred to as the ``Orange Book'') (Id.). A
list of currently available authorized generics is available at
https://www.fda.gov/AboutFDA/CentersOffices/OfficeofMedicalProductsandTobacco/CDER/ucm126391.htm. (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.)
---------------------------------------------------------------------------
Product composition. The Mallinckrodt product and CONCERTA
were tested in FDA laboratories to evaluate differences in drug design,
composition, stability, and dissolution. The testing identified
concerns with API degradation and in vivo dissolution, which could
result in differences in drug release. These differences could, in
turn, result in differences in therapeutic effect of the generic
product compared to CONCERTA.
BE data. A review and reanalysis were conducted of the
data that were submitted in the ANDA to establish bioequivalence to
CONCERTA. In particular, an outlier analysis was performed on the BE
data to evaluate the difference in product absorption between the
Mallinckrodt product and CONCERTA across various PK sampling time
points. The analysis showed that the greatest difference in product
absorption between the Mallinckrodt product and CONCERTA occurred at 10
hours post-dosing under fasting conditions.
Modeling of potential clinical impact. In light of the
close relationship between the PK profile and clinical effect of
methylphenidate products (Ref. 1), modeling was done based on the BE
data submitted in the ANDA to predict the potential clinical
significance of the difference in PK profile, i.e., product absorption,
of the Mallinckrodt product compared to CONCERTA. The modeling
suggested some potential clinical inequivalence between the generic
product and CONCERTA after 6 hours post-dosing. The greatest mean
percent reduction in clinical efficacy for the Mallinckrodt product is
predicted to be approximately 21 percent at 10 hours post-dosing under
fasting condition.
The TSI was concluded in June 2014. Based on the information
considered, the TSI Committee determined that the Mallinckrodt product
may deliver methylphenidate into the body at a slower rate than
CONCERTA during the time period of 7 to 12 hours post-dosing, and
therefore, the product may not be bioequivalent or therapeutically
equivalent to CONCERTA. Following the TSI Committee's investigation,
CDER concluded that the therapeutic equivalence (TE) rating for the
Mallinckrodt product in FDA's ``Approved Drug Products with Therapeutic
Equivalence Evaluations'' (commonly referred to as the ``Orange Book'')
should be changed from AB to BX to indicate that the data are
insufficient to determine that the Mallinckrodt product is
therapeutically equivalent to CONCERTA.\4\
---------------------------------------------------------------------------
\4\ In the Orange Book, FDA ``classifies as therapeutically
equivalent those products that meet the following general criteria:
(1) [T]hey are approved as safe and effective; (2) they are
pharmaceutical equivalents in that they (a) contain identical
amounts of the same active drug ingredient in the same dosage form
and route of administration, and (b) meet compendial or other
applicable standards of strength, quality, purity, and identity; (3)
they are bioequivalent in that (a) they do not present a known or
potential bioequivalence problem, and they meet an acceptable in
vitro standard, or (b) if they do present such a known or potential
problem, they are shown to meet an appropriate bioequivalence
standard; (4) they are adequately labeled; (5) they are manufactured
in compliance with Current Good Manufacturing Practice regulations''
(Orange Book Preface at vii, available at https://www.fda.gov/downloads/Drugs/DevelopmentApprovalProcess/UCM071436.pdf. (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.)).
---------------------------------------------------------------------------
On November 6, 2014 (79 FR 65978), CDER issued a revised draft
guidance for industry on ``Bioequivalence Recommendations for CONCERTA
(Methylphenidate Hydrochloride) Extended-Release Tablets'' (revised
draft BE guidance) (Ref. 2), with recommendations for establishing
bioequivalence to CONCERTA that reflect CDER's refined understanding of
the relationship between the PK profile of CONCERTA and its therapeutic
effect. The revised draft BE guidance is available on FDA's Web site
and will be placed in Docket No. FDA-2016-N-3118.
On November 12, 2014, representatives from OGD and other CDER
offices notified Mallinckrodt by telephone of CDER's concerns regarding
its generic product. OGD explained that the TE rating for the product
would be changed from AB to BX immediately. OGD requested that
Mallinckrodt: (1) Voluntarily withdraw its product from the market
under 21 CFR 314.150(d) and request that FDA withdraw approval of the
ANDA or (2) confirm bioequivalence of its product within 6 months,
consistent with the recommendations in the revised draft BE guidance
issued on November 6, 2014. Mallinckrodt declined to voluntarily
withdraw its product from the market, and it has not submitted data or
information that confirms bioequivalence of its product to CONCERTA.
b. Post-TSI investigation. After communicating CDER's concerns to
Mallinckrodt about its methylphenidate product and changing the TE
rating for the product to BX, CDER continued to evaluate data and
information related to the bioequivalence of Mallinckrodt's product to
CONCERTA. CDER reanalyzed the BE data originally submitted in
Mallinckrodt's ANDA in accordance with the recommendations provided in
the November 6, 2014, revised draft BE guidance. The reanalysis showed
that the 54-mg Mallinckrodt product on which the in vivo BE testing was
conducted does not provide the same extent of methylphenidate exposure
as CONCERTA during the 7- to 12-hour time period after administration.
Specifically, the 90 percent confidence interval (CI) of the geometric
mean ratio of the test product (Mallinckrodt's) to reference product
(CONCERTA) for AUC7-12 \5\ (at 64.41 percent to 72.49
[[Page 71740]]
percent) falls outside of the 80 percent to 125 percent BE acceptance
criteria (Ref. 4). The lower level of methylphenidate exposure compared
to CONCERTA 7 to 12 hours after administration is consistent with the
reports received describing lack of therapeutic effect later in the
day.
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\5\ The area under the plasma concentration-time curve (AUC) is
used to evaluate the ``extent'' of absorption of a drug. See section
505(j)(7)(B) of the FD&C Act. AUC7-12 captures the extent
of absorption from 7 to 12 hours post-dosing. See, e.g., the draft
guidance for industry entitled ``Bioequivalence Studies with
Pharmacokinetic Endpoints for Drugs Submitted under an ANDA'' (Ref.
3).
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In addition to the reanalysis described above, FDA performed
further clinical trial simulations based on the BE data originally
submitted in the ANDA to assess the potential clinical significance of
the difference in PK profile, i.e., methylphenidate absorption, of the
Mallinckrodt product compared to CONCERTA (Ref. 5). The simulation
suggested some potential difference in effect between Mallinckrodt's
product and CONCERTA after 6 hours post-dosing. Consistent with the
evaluation presented during the TSI, the greatest mean percent
reduction in efficacy was predicted to be 21.17 percent at 10 hours
post-dosing, with individual changes ranging from a 44.09 percent
decrease and a 9.04 percent increase in efficacy compared to CONCERTA.
Along with a reanalysis of data submitted in the original ANDA, in
March 2015, CDER sponsored its own study to evaluate bioequivalence of
the 27-mg Mallinckrodt product as compared to CONCERTA. The CDER-
sponsored study was a single-dose, 4-treatment, fully replicated,
crossover, randomized BE study (consistent with the study design
recommended in the revised draft BE guidance) in healthy subjects under
fasting conditions. The study compared: (1) The test product--
Mallinckrodt's methylphenidate HCl ER tablets, 27 mg; and (2) the
reference product--CONCERTA ER tablets, 27 mg. A total of 28 subjects
were enrolled in the study, and 24 subjects completed all 4 periods.
Plasma samples were collected for up to 24 hours following each
treatment. The mean methylphenidate plasma concentration profiles for
both the test and reference products exhibited PK properties consistent
with those observed in the 54-mg fasting BE study submitted by
Mallinckrodt in its ANDA. In particular, decreased plasma
concentrations were observed with administration of the Mallinckrodt
product as compared to CONCERTA after 6 to 7 hours. The 90 percent CI
of the geometric mean test-to-reference ratio for AUC7-12
was below the 80 percent to 125 percent BE acceptance range (at 60.99
percent to 70.50 percent). All other metrics were found to be within
the BE acceptance range of 80 percent to 125 percent. The observed
lower level of methylphenidate exposure compared to CONCERTA 7 to 12
hours after administration is consistent with that observed in the
reanalysis of the 54-mg BE study submitted in Mallinckrodt's ANDA.
Finally, FDA analyzed FAERS reports from February 2014 to May 2015.
The types and quality of reports received by FDA during that time
period were very similar to the reports received before FDA changed the
TE rating. The reports continued to contain specific complaints
describing the failure of therapeutic effect during the latter part of
the day.
The applicant has not submitted data that confirms bioequivalence
of its product to CONCERTA. A memorandum describing in detail the
information considered following the TSI and explaining CDER's
determination will be placed in Docket No. FDA-2016-N-3118 (Ref. 6).
II. Conclusions and Proposed Action
An NDA (or reference listed drug) applicant must submit ``full
reports of investigations'' to show that the drug for which the
applicant is seeking approval is safe and effective. In other words,
reference listed drugs must meet the safety and substantial evidence of
effectiveness standard (see section 505(b)(1) and (2), (c), and (d) of
the FD&C Act). A reference listed drug applicant can meet the standard
by conducting its own clinical studies (stand-alone application) or
relying, in part, on the Agency's previous finding of safety and/or
effectiveness or literature (a 505(b)(2) application). An ANDA
applicant does not submit independent clinical studies to demonstrate
safety and effectiveness. Rather, an ANDA applicant relies on the
Agency's previous finding of safety and effectiveness for the reference
listed drug and is required to meet other requirements such as
demonstrating bioequivalence to the reference listed drug to support
approval. In the absence of information showing bioequivalence between
the generic drug at issue and the reference listed drug, there is no
basis for concluding that the Agency's finding of safety and efficacy
(or substantial evidence of effectiveness) supporting approval of the
reference listed drug likewise supports approval of the generic drug.
Therefore, based on all available data and information, notice is
given to Mallinckrodt and to all other interested persons that the
Director of CDER proposes to issue an order, under section 505(e)(3) of
the FD&C Act and Sec. 314.150(a)(2)(iii), withdrawing approval of ANDA
202608 and all amendments and supplements to it on the grounds that, on
the basis of new information, evaluated together with the evidence
available when the application was approved, there is a lack of
substantial evidence that the drug will have the effect it is
represented to have under the conditions of use prescribed,
recommended, or suggested in its labeling.
III. Hearing Procedures
In accordance with section 505(e) of the FD&C Act, the applicant is
hereby provided an opportunity to request a hearing to show why
approval of ANDA 202608 should not be withdrawn and an opportunity to
raise, for administrative determination, all issues relating to the
legal status of the drug product covered by this application.
An applicant who decides to seek a hearing must file the following:
(1) A written notice of participation and request for hearing (see
DATES), and (2) the data, information, and analyses relied on to
demonstrate that there is a genuine and substantial issue of fact that
requires a hearing to resolve (see DATES). Any other interested person
may also submit comments on this notice. The procedures and
requirements governing this notice of opportunity for a hearing, notice
of participation and request for a hearing, the information and
analyses to justify a hearing, other comments, and a grant or denial of
a hearing are contained in Sec. 314.200 (21 CFR 314.200) and in 21 CFR
part 12.
The failure of an applicant to file a timely written notice of
participation and request for a hearing, as required by Sec. 314.200,
constitutes an election by that applicant not to avail itself of the
opportunity for a hearing concerning CDER's proposal to withdraw
approval of the application and constitutes a waiver of any contentions
concerning the legal status of the drug product. FDA will then withdraw
approval of the application, and the drug product may not thereafter be
lawfully introduced or delivered for introduction into interstate
commerce. Any new drug product introduced or delivered for introduction
into interstate commerce without an approved application is subject to
regulatory action at any time.
A request for a hearing may not rest upon mere allegations or
denials, but must present specific facts showing that there is a
genuine and substantial issue of fact that requires a hearing. If a
request for a hearing is not complete or is not supported, the
Commissioner of Food and Drugs will enter summary
[[Page 71741]]
judgment against the person who requests the hearing, making findings
and conclusions, and denying a hearing.
All submissions under this notice of opportunity for a hearing must
be filed in two copies. Except for data and information prohibited from
public disclosure under 21 U.S.C. 331(j) or 18 U.S.C. 1905, the
submissions may be seen in the Division of Dockets Management (see
ADDRESSES) between 9 a.m. and 4 p.m., Monday through Friday, and will
be posted to the docket at https://www.regulations.gov.
This notice is issued under section 505(e) of the FD&C Act and
under the authority delegated to the Director of CDER by the
Commissioner of Food and Drugs.
IV. References
The following references are on display in the Division of Dockets
Management (see ADDRESSES) and are available for viewing by interested
persons between 9 a.m. and 4 p.m., Monday through Friday; they are also
available electronically at https://www.regulations.gov. 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.
1. Swanson, J.M., et al., ``A Comparison of Once-Daily Extended-
Release Methylphenidate Formulations in Children With Attention-
Deficit/Hyperactivity Disorder in the Laboratory School (The Comacs
Study),'' Pediatrics, vol. 113, pp. 206-216, 2004.
2. FDA, draft guidance for industry, ``Bioequivalence
Recommendations for CONCERTA (Methylphenidate Hydrochloride)
Extended-Release Tablets,'' November 2014 (available at https://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/UCM320007.pdf).
3. FDA, draft guidance for industry, ``Bioequivalence Studies With
Pharmacokinetic Endpoints for Drugs Submitted Under an ANDA,''
December 2013 (available at https://www.fda.gov/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/UCM377465).
4. Dighe, S.V. and W.P. Adams. ``Bioequivalence: A United States
Regulatory Perspective.'' In Welling, P.G., L.S. Tse, and S.V.
Dighe, eds., Pharmaceutical Bioequivalence. New York: Marcel Dekker,
Inc., pp. 347-380, 1991.
5. Kimko, H., et al., ``Population Pharmacodynamic Modeling of
Various Extended-Release Formulations of Methylphenidate in Children
With Attention Deficit Hyperactivity Disorder Via Meta-Analysis,''
Journal of Pharmacokinetics and Pharmacodynamics, vol. 39(2), pp.
161-176, 2012.
6. Memorandum to Janet Woodcock, Director, Center for Drug
Evaluation and Research, in Support of Beginning Approval Withdrawal
Proceedings for ANDA 202608 (October 1, 2016, Peters).
Dated: October 12, 2016.
Janet Woodcock,
Director, Center for Drug Evaluation and Research.
[FR Doc. 2016-25093 Filed 10-17-16; 8:45 am]
BILLING CODE 4164-01-P