Testing for Biotin Interference in In Vitro Diagnostic Devices; Guidance for Industry; Availability, 65817-65819 [2020-22926]
Download as PDF
jbell on DSKJLSW7X2PROD with NOTICES
Federal Register / Vol. 85, No. 201 / Friday, October 16, 2020 / Notices
sources from within the United States or
elsewhere may be sufficient to establish
that a new medical service or
technology represents an advance that
substantially improves, relative to
services or technologies previously
available, the diagnosis or treatment of
Medicare beneficiaries: Clinical trials,
peer reviewed journal articles; study
results; meta-analyses; consensus
statements; white papers; patient
surveys; case studies; reports;
systematic literature reviews; letters
from major healthcare associations;
editorials and letters to the editor; and
public comments. Other appropriate
information sources may be considered.
• The medical condition diagnosed or
treated by the new medical service or
technology may have a low prevalence
among Medicare beneficiaries.
• The new medical service or
technology may represent an advance
that substantially improves, relative to
services or technologies previously
available, the diagnosis or treatment of
a subpopulation of patients with the
medical condition diagnosed or treated
by the new medical service or
technology.
Section 1886(d)(5)(K)(viii) of the Act
requires that as part of the process for
evaluating new medical services and
technology applications, the Secretary
shall do the following:
• Provide for public input regarding
whether a new service or technology
represents an advance in medical
technology that substantially improves
the diagnosis or treatment of Medicare
beneficiaries before publication of a
proposed rule.
• Make public and periodically
update a list of all the services and
technologies for which an application is
pending.
• Accept comments,
recommendations, and data from the
public regarding whether the service or
technology represents a substantial
improvement.
• Provide for a meeting at which
organizations representing hospitals,
physicians, manufacturers and any
other interested party may present
comments, recommendations, and data
to the clinical staff of CMS as to whether
the service or technology represents a
substantial improvement before
publication of a proposed rule.
The opinions and presentations
provided during this meeting will assist
us as we evaluate the new medical
services and technology applications for
FY 2022. In addition, they will help us
to evaluate our policy on the IPPS new
technology add-on payment process
before the publication of the FY 2022
IPPS/LTCH PPS proposed rule.
VerDate Sep<11>2014
18:59 Oct 15, 2020
Jkt 253001
II. Town Hall Meeting Format and
Conference Call/Live Streaming
Information
A. Format of the Town Hall Meeting
As noted in section I. of this notice,
we are required to provide for a meeting
at which organizations representing
hospitals, physicians, manufacturers
and any other interested party may
present comments, recommendations,
and data to the clinical staff of CMS
concerning whether the service or
technology represents a substantial
clinical improvement. This meeting will
allow for a discussion of the substantial
clinical improvement criterion for the
FY 2022 new medical services and
technology add-on payment
applications. Information regarding the
applications can be found on our
website at https://www.cms.gov/
Medicare/Medicare-Fee-for-ServicePayment/AcuteInpatientPPS/
newtech.html.
The majority of the meeting will be
reserved for presentations of comments,
recommendations, and data from
registered presenters. The time for each
presenter’s comments will be
approximately 10 to 15 minutes and
will be based on the number of
registered presenters. Individuals who
would like to present must register and
submit their agenda item(s) via email to
newtech@cms.hhs.gov by the date
specified in the DATES section of this
notice.
Depending on the number of
applications received, we will
determine if a second meeting day is
necessary. A preliminary agenda will be
posted on the CMS website at https://
www.cms.gov/Medicare/Medicare-Feefor-Service-Payment/AcuteInpatient
PPS/newtech.html by November 23,
2020 to inform the public of the number
of days of the meeting.
In addition, written comments will
also be accepted and presented at the
meeting if they are received via email to
newtech@cms.hhs.gov by the date
specified in the DATES section of this
notice. Written comments may also be
submitted after the meeting for our
consideration. If the comments are to be
considered before the publication of the
FY 2022 IPPS/LTCH PPS proposed rule,
the comments must be received via
email to newtech@cms.hhs.gov by the
date specified in the DATES section of
this notice.
B. Conference Call, Live Streaming, and
Webinar Information
As noted previously, the Town Hall
meeting will be held virtually due to the
COVID–19 pandemic. There will be an
option to participate in the Town Hall
PO 00000
Frm 00030
Fmt 4703
Sfmt 4703
65817
Meeting via live streaming technology
or webinar and a toll-free teleconference
phone line. Information on the option to
participate via live streaming
technology or webinar and a
teleconference dial-in will be provided
through an upcoming listserv notice and
will appear on the final meeting agenda,
which will be posted on the New
Technology website at: https://
www.cms.gov/Medicare/Medicare-Feefor-Service-Payment/AcuteInpatient
PPS/newtech.html. Continue to check
the website for updates.
C. Disclaimer
We cannot guarantee reliability for
live streaming technology or a webinar.
III. Registration Instructions
The Division of New Technology in
CMS is coordinating the meeting
registration for the Town Hall Meeting
on substantial clinical improvement.
While there is no registration fee,
individuals planning to present at the
Town Hall Meeting must register to
present.
Registration for presenters may be
completed by sending an email to
newtech@cms.hhs.gov. Please include
your name, address, telephone number,
email address and fax number.
Registration for attendees not
presenting at the meeting is not
required.
The Administrator of the Centers for
Medicare & Medicaid Services (CMS),
Seema Verma, having reviewed and
approved this document, authorizes
Lynette Wilson, who is the Federal
Register Liaison, to electronically sign
this document for purposes of
publication in the Federal Register.
Dated: October 8, 2020.
Lynette Wilson,
Federal Register Liaison, Centers for Medicare
& Medicaid Services.
[FR Doc. 2020–22894 Filed 10–14–20; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Food and Drug Administration
[Docket No. FDA–2019–D–1876]
Testing for Biotin Interference in In
Vitro Diagnostic Devices; 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 final
SUMMARY:
E:\FR\FM\16OCN1.SGM
16OCN1
65818
Federal Register / Vol. 85, No. 201 / Friday, October 16, 2020 / Notices
guidance entitled ‘‘Testing for Biotin
Interference in In Vitro Diagnostic
Devices; Guidance for Industry.’’ The
guidance provides FDA’s
recommendations on the testing for
interference by biotin on the
performance of in vitro diagnostic
devices (IVDs). The guidance is
intended to help device developers and
clinicians understand how FDA
recommends biotin interference testing
be performed, and how the results of the
testing should be communicated to end
users, including clinical laboratories
and clinicians. The guidance announced
in this notice finalizes the draft
guidance of the same title dated June
2019.
The announcement of the
guidance is published in the Federal
Register on October 16, 2020.
ADDRESSES: You may submit either
electronic or written comments on
Agency guidances at any time as
follows:
DATES:
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’’).
jbell on DSKJLSW7X2PROD with NOTICES
Written/Paper Submissions
Submit written/paper submissions as
follows:
• Mail/Hand Delivery/Courier (for
written/paper submissions): Dockets
Management Staff (HFA–305), Food and
Drug Administration, 5630 Fishers
Lane, Rm. 1061, Rockville, MD 20852.
• For written/paper comments
submitted to the Dockets Management
VerDate Sep<11>2014
18:59 Oct 15, 2020
Jkt 253001
Staff, 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–
2019–D–1876 for ‘‘Testing for Biotin
Interference in In Vitro Diagnostic
Devices; Guidance for Industry.’’
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
Dockets Management Staff between 9
a.m. and 4 p.m., Monday through
Friday, 240–402–7500.
• 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 Dockets Management
Staff. 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.govinfo.gov/content/pkg/FR-201509-18/pdf/2015-23389.pdf.
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 Dockets Management
Staff, 5630 Fishers Lane, Rm. 1061,
Rockville, MD 20852, 240–402–7500.
You may submit comments on any
guidance at any time (see 21 CFR
10.115(g)(5)).
PO 00000
Frm 00031
Fmt 4703
Sfmt 4703
Submit written requests for single
copies of the guidance to the Office of
Communication, Outreach and
Development, Center for Biologics
Evaluation and Research (CBER), Food
and Drug Administration, 10903 New
Hampshire Ave., Bldg. 71, Rm. 3128,
Silver Spring, MD 20993–0002 or the
Office of Policy, Guidance and Policy
Development, Center for Devices and
Radiological Health, Food and Drug
Administration, 10903 New Hampshire
Ave., Bldg. 66, Rm. 5431, Silver Spring,
MD 20993–0002. Send one selfaddressed adhesive label to assist the
office in processing your requests. The
guidance may also be obtained by mail
by calling CBER at 1–800–835–4709 or
240–402–8010. See the SUPPLEMENTARY
INFORMATION section for electronic
access to the guidance document.
FOR FURTHER INFORMATION CONTACT:
Shruti Modi, Center for Biologics
Evaluation and Research, Food and
Drug Administration, 10903 New
Hampshire Ave., Bldg. 71, Rm. 7301,
Silver Spring, MD 20993–0002, 240–
402–7911.
SUPPLEMENTARY INFORMATION:
I. Background
FDA is announcing the availability of
a document entitled ‘‘Testing for Biotin
Interference in In Vitro Diagnostic
Devices; Guidance for Industry.’’ The
guidance provides FDA’s
recommendations on the testing for
interference by biotin on the
performance of IVDs. The guidance is
intended to help device developers and
clinicians understand how FDA
recommends biotin interference testing
be performed, and how the results of the
testing should be communicated to end
users, including clinical laboratories
and clinicians. The recommendations
apply to IVDs, including devices that
are licensed under section 351 of the
Public Health Service Act (42 U.S.C.
262) and used in donor screening, that
use biotin technology.
Biotin, also known as vitamin B7, is
a water-soluble vitamin often found in
multivitamins, prenatal vitamins, and
dietary supplements marketed for hair,
skin, and nail growth. FDA has become
aware of potential biotin interference
with IVDs that use biotin/avidin
interactions as part of the device
technology. Biotin levels in samples
from patients who consume more than
the recommended daily intake of biotin
can cause falsely high or falsely low
results, depending on the test principle.
In the Federal Register of June 10,
2019 (84 FR 27781), FDA announced the
availability of the draft guidance of the
same title. FDA received a few
E:\FR\FM\16OCN1.SGM
16OCN1
Federal Register / Vol. 85, No. 201 / Friday, October 16, 2020 / Notices
comments on the draft guidance and
those comments were considered as the
guidance was finalized. We considered
comments on the recommended level of
biotin concentration for evaluation. We
decline to recommend evaluating a
concentration level below 3,500
nanograms per milliliter. We believe
this level is appropriate for minimizing
the risk to patients from incorrect test
results. Further, this level is consistent
with best practices among the industry
to test at three times the highest
concentration levels observed, as
recommended in the FDA-recognized
standard published by the Clinical
Laboratory Standards Institute. Other
comments recommended FDA clarify or
expand upon the necessity of mitigation
strategies to address biotin interference
other than labeling. We decline to
recommend other specific mitigation
strategies, but note that other mitigation
strategies such as customer information
letters and technical mitigations may be
considered when the risk of potentially
incorrect results from biotin interference
could significantly affect patient or
public health. Finally, we considered
comments regarding additional types of
information to be communicated to endusers, but we declined to provide more
specific recommendations because
manufacturers may not have sufficient
data to provide more specific
information in the labeling. In addition,
editorial edits were made to improve
clarity. The guidance announced in this
notice finalizes the draft guidance of the
same title dated June 2019.
This guidance is being issued
consistent with FDA’s good guidance
practices regulation (21 CFR 10.115).
The guidance represents the current
thinking of FDA on testing for biotin
interference in in vitro diagnostic
devices. It does not establish any rights
for any person and is not binding on
FDA or the public. You can use an
alternative approach if it satisfies the
requirements of the applicable statutes
and regulations.
jbell on DSKJLSW7X2PROD with NOTICES
II. Paperwork Reduction Act of 1995
While this guidance contains no
collection of information, it does refer to
previously approved FDA collections of
information. Therefore, clearance by the
Office of Management and Budget
(OMB) under the Paperwork Reduction
Act of 1995 (PRA) (44 U.S.C. 3501–
3521) is not required for this guidance.
The previously approved collections of
information are subject to review by
OMB under the PRA. The collections of
information in 21 CFR part 809 have
been approved under OMB control
number 0910–0485.
VerDate Sep<11>2014
18:59 Oct 15, 2020
Jkt 253001
III. Electronic Access
Persons with access to the internet
may obtain the guidance at either
https://www.fda.gov/vaccines-bloodbiologics/guidance-complianceregulatory-information-biologics/
biologics-guidances, https://
www.fda.gov/medical-devices/deviceadvice-comprehensive-regulatoryassistance/guidance-documentsmedical-devices-and-radiation-emittingproducts, or https://
www.regulations.gov.
Dated: October 9, 2020.
Lauren K. Roth,
Acting Principal Associate Commissioner for
Policy.
[FR Doc. 2020–22926 Filed 10–15–20; 8:45 am]
BILLING CODE 4164–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Food and Drug Administration
[Docket No. FDA–2020–N–1127]
Listing of Patent Information in the
Orange Book; Establishment of a
Public Docket; Request for Comments;
Reopening of the Comment Period
AGENCY:
Food and Drug Administration,
HHS.
Notice; reopening of the
comment period.
ACTION:
The Food and Drug
Administration (FDA or the Agency) is
reopening the comment period for the
notice entitled ‘‘Listing of Patent
Information in the Orange Book;
Establishment of a Public Docket;
Request for Comments’’ that appeared in
the Federal Register of June 1, 2020.
The notice announced the establishment
of a docket to solicit comments on the
listing of patent information in the FDA
publication, ‘‘Approved Drug Products
With Therapeutic Equivalence
Evaluations’’ (commonly known as the
‘‘Orange Book’’). The Agency is taking
this action in response to a request for
an extension to allow interested persons
additional time to submit comments.
DATES: FDA is reopening the comment
period for the notice published on June
1, 2020 (85 FR 33169). Submit either
electronic or written comments by
November 16, 2020.
ADDRESSES: You may submit comments
as follows. Please note that late,
untimely filed comments will not be
considered. Electronic comments must
be submitted on or before November 16,
2020. The https://www.regulations.gov
electronic filing system will accept
comments until 11:59 p.m. Eastern Time
SUMMARY:
PO 00000
Frm 00032
Fmt 4703
Sfmt 4703
65819
at the end of November 16, 2020.
Comments received by mail/hand
delivery/courier (for written/paper
submissions) will be considered timely
if they are postmarked or the delivery
service acceptance receipt is on or
before that date.
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): Dockets
Management Staff (HFA–305), Food and
Drug Administration, 5630 Fishers
Lane, Rm. 1061, Rockville, MD 20852.
• For written/paper comments
submitted to the Dockets Management
Staff, 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–
2020–N–1127 for ‘‘Listing of Patent
Information in the Orange Book;
Establishment of a Public Docket;
Request for Comments; Reopening of
Comment Period.’’ Received comments,
those filed in a timely manner (see
ADDRESSES), will be placed in the docket
and, except for those submitted as
‘‘Confidential Submissions,’’ publicly
viewable at https://www.regulations.gov
or at the Dockets Management Staff
E:\FR\FM\16OCN1.SGM
16OCN1
Agencies
[Federal Register Volume 85, Number 201 (Friday, October 16, 2020)]
[Notices]
[Pages 65817-65819]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2020-22926]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Food and Drug Administration
[Docket No. FDA-2019-D-1876]
Testing for Biotin Interference in In Vitro Diagnostic Devices;
Guidance for Industry; Availability
AGENCY: Food and Drug Administration, HHS.
ACTION: Notice of availability.
-----------------------------------------------------------------------
SUMMARY: The Food and Drug Administration (FDA or Agency) is announcing
the availability of a final
[[Page 65818]]
guidance entitled ``Testing for Biotin Interference in In Vitro
Diagnostic Devices; Guidance for Industry.'' The guidance provides
FDA's recommendations on the testing for interference by biotin on the
performance of in vitro diagnostic devices (IVDs). The guidance is
intended to help device developers and clinicians understand how FDA
recommends biotin interference testing be performed, and how the
results of the testing should be communicated to end users, including
clinical laboratories and clinicians. The guidance announced in this
notice finalizes the draft guidance of the same title dated June 2019.
DATES: The announcement of the guidance is published in the Federal
Register on October 16, 2020.
ADDRESSES: You may submit either electronic or written comments on
Agency guidances at any time 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): Dockets Management Staff (HFA-305), Food and Drug
Administration, 5630 Fishers Lane, Rm. 1061, Rockville, MD 20852.
For written/paper comments submitted to the Dockets
Management Staff, 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-2019-D-1876 for ``Testing for Biotin Interference in In Vitro
Diagnostic Devices; Guidance for Industry.'' 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 Dockets Management Staff between 9 a.m. and 4 p.m., Monday through
Friday, 240-402-7500.
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 Dockets Management Staff. 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.govinfo.gov/content/pkg/FR-2015-09-18/pdf/2015-23389.pdf.
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 Dockets Management Staff, 5630 Fishers Lane,
Rm. 1061, Rockville, MD 20852, 240-402-7500.
You may submit comments on any guidance at any time (see 21 CFR
10.115(g)(5)).
Submit written requests for single copies of the guidance to the
Office of Communication, Outreach and Development, Center for Biologics
Evaluation and Research (CBER), Food and Drug Administration, 10903 New
Hampshire Ave., Bldg. 71, Rm. 3128, Silver Spring, MD 20993-0002 or the
Office of Policy, Guidance and Policy Development, Center for Devices
and Radiological Health, Food and Drug Administration, 10903 New
Hampshire Ave., Bldg. 66, Rm. 5431, Silver Spring, MD 20993-0002. Send
one self-addressed adhesive label to assist the office in processing
your requests. The guidance may also be obtained by mail by calling
CBER at 1-800-835-4709 or 240-402-8010. See the SUPPLEMENTARY
INFORMATION section for electronic access to the guidance document.
FOR FURTHER INFORMATION CONTACT: Shruti Modi, Center for Biologics
Evaluation and Research, Food and Drug Administration, 10903 New
Hampshire Ave., Bldg. 71, Rm. 7301, Silver Spring, MD 20993-0002, 240-
402-7911.
SUPPLEMENTARY INFORMATION:
I. Background
FDA is announcing the availability of a document entitled ``Testing
for Biotin Interference in In Vitro Diagnostic Devices; Guidance for
Industry.'' The guidance provides FDA's recommendations on the testing
for interference by biotin on the performance of IVDs. The guidance is
intended to help device developers and clinicians understand how FDA
recommends biotin interference testing be performed, and how the
results of the testing should be communicated to end users, including
clinical laboratories and clinicians. The recommendations apply to
IVDs, including devices that are licensed under section 351 of the
Public Health Service Act (42 U.S.C. 262) and used in donor screening,
that use biotin technology.
Biotin, also known as vitamin B7, is a water-soluble vitamin often
found in multivitamins, prenatal vitamins, and dietary supplements
marketed for hair, skin, and nail growth. FDA has become aware of
potential biotin interference with IVDs that use biotin/avidin
interactions as part of the device technology. Biotin levels in samples
from patients who consume more than the recommended daily intake of
biotin can cause falsely high or falsely low results, depending on the
test principle.
In the Federal Register of June 10, 2019 (84 FR 27781), FDA
announced the availability of the draft guidance of the same title. FDA
received a few
[[Page 65819]]
comments on the draft guidance and those comments were considered as
the guidance was finalized. We considered comments on the recommended
level of biotin concentration for evaluation. We decline to recommend
evaluating a concentration level below 3,500 nanograms per milliliter.
We believe this level is appropriate for minimizing the risk to
patients from incorrect test results. Further, this level is consistent
with best practices among the industry to test at three times the
highest concentration levels observed, as recommended in the FDA-
recognized standard published by the Clinical Laboratory Standards
Institute. Other comments recommended FDA clarify or expand upon the
necessity of mitigation strategies to address biotin interference other
than labeling. We decline to recommend other specific mitigation
strategies, but note that other mitigation strategies such as customer
information letters and technical mitigations may be considered when
the risk of potentially incorrect results from biotin interference
could significantly affect patient or public health. Finally, we
considered comments regarding additional types of information to be
communicated to end-users, but we declined to provide more specific
recommendations because manufacturers may not have sufficient data to
provide more specific information in the labeling. In addition,
editorial edits were made to improve clarity. The guidance announced in
this notice finalizes the draft guidance of the same title dated June
2019.
This guidance is being issued consistent with FDA's good guidance
practices regulation (21 CFR 10.115). The guidance represents the
current thinking of FDA on testing for biotin interference in in vitro
diagnostic devices. It does not establish any rights for any person and
is not binding on FDA or the public. You can use an alternative
approach if it satisfies the requirements of the applicable statutes
and regulations.
II. Paperwork Reduction Act of 1995
While this guidance contains no collection of information, it does
refer to previously approved FDA collections of information. Therefore,
clearance by the Office of Management and Budget (OMB) under the
Paperwork Reduction Act of 1995 (PRA) (44 U.S.C. 3501-3521) is not
required for this guidance. The previously approved collections of
information are subject to review by OMB under the PRA. The collections
of information in 21 CFR part 809 have been approved under OMB control
number 0910-0485.
III. Electronic Access
Persons with access to the internet may obtain the guidance at
either https://www.fda.gov/vaccines-blood-biologics/guidance-compliance-regulatory-information-biologics/biologics-guidances,
https://www.fda.gov/medical-devices/device-advice-comprehensive-regulatory-assistance/guidance-documents-medical-devices-and-radiation-emitting-products, or https://www.regulations.gov.
Dated: October 9, 2020.
Lauren K. Roth,
Acting Principal Associate Commissioner for Policy.
[FR Doc. 2020-22926 Filed 10-15-20; 8:45 am]
BILLING CODE 4164-01-P