Alternative or Streamlined Mechanisms for Complying With the Current Good Manufacturing Practice Requirements for Combination Products; List Under the 21st Century Cures Act, 56066-56070 [2022-19713]
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[FR Doc. 2022–19709 Filed 9–12–22; 8:45 am]
BILLING CODE 4164–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Food and Drug Administration
[Docket No. FDA–2018–N–2065]
Alternative or Streamlined
Mechanisms for Complying With the
Current Good Manufacturing Practice
Requirements for Combination
Products; List Under the 21st Century
Cures Act
AGENCY:
Food and Drug Administration,
HHS.
ACTION:
Notice.
As required by the 21st
Century Cures Act (Cures Act), the Food
and Drug Administration (FDA, Agency,
or we) is finalizing a list of alternative
or streamlined mechanisms for
complying with the current good
manufacturing practice (CGMP)
requirements for combination products.
A combination product is a product
composed of any combination of a drug,
a device, and/or a biological product.
DATES: This notice is published in the
Federal Register on September 13, 2022.
ADDRESSES: For access to the docket, 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
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SUMMARY:
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Lane, Rm. 1061, Rockville, MD 20852,
between 9 a.m. and 4 p.m., Monday
through Friday, 240–402–7500. Publicly
available submissions may be seen in
the docket.
FOR FURTHER INFORMATION CONTACT: John
Barlow Weiner, Office of Combination
Products, Food and Drug
Administration, 10903 New Hampshire
Ave., Bldg. 32, Rm. 5130, Silver Spring,
MD 20993, 301–796–8930, john.weiner@
fda.hhs.gov or combination@
fda.hhs.gov.
SUPPLEMENTARY INFORMATION:
I. Background
On January 22, 2013, FDA issued a
final rule on CGMP requirements for
combination products (see 78 FR 4307
and part 4, subpart A (21 CFR part 4,
subpart A)) (CGMP Rule). The drugs,
devices, and biological products
included in combination products are
referred to as ‘‘constituent parts’’ of the
combination product. Combination
products include ‘‘single-entity’’
combination products, the constituent
parts of which are physically,
chemically, or otherwise combined or
mixed and produced as a single entity
(see § 3.2(e)(1) (21 CFR 3.2(e)(1))) (e.g.,
prefilled syringes and drug-eluting
stents), and ‘‘co-packaged’’ combination
products where the constituent parts are
packaged together in a single package or
as a unit (see § 3.2(e)(2)) (e.g., a surgical
or first-aid kit).1 Section 4.4 (21 CFR
1 There are also ‘‘cross-labeled’’ combination
products (§ 3.2(e)(3) and (4)). See Ref. 1 for
additional information regarding CGMP
requirements for them, as well as use of the
‘‘streamlined approach’’ if a device and drug or
biological product constituent part of a cross-
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4.4) outlines how manufacturers of
single-entity and co-packaged
combination products (hereafter ‘‘CP
manufacturers’’) can demonstrate
compliance with applicable CGMP
requirements, including through
implementation of a streamlined
approach to meet the requirements of
both the drug CGMP and the device
quality system (QS) regulations.
In December 2016, the Cures Act
(Pub. L. 114–255) was signed into law.
Section 3038(c) of the Cures Act
mandated that FDA publish in the
Federal Register a list identifying types
of combination products and
manufacturing processes for which
‘‘good manufacturing processes’’ may be
adopted that vary from the requirements
set forth in § 4.4, or that FDA proposes
can satisfy the requirements in § 4.4
through ‘‘alternative or streamlined
mechanisms,’’ and to review this list
periodically. In accordance with this
statutory mandate, FDA published a
proposed list on June 13, 2018 (83 FR
27609).
FDA received six comments on this
proposed list, has considered them, and
is now publishing a list after such
consideration (see section II of this
document). In response to the
comments, FDA added and refined
examples and provided additional
clarity regarding FDA’s expectations for
CP manufacturers when applying
mechanisms presented in this list. FDA
also added reference to a guidance on
how to request FDA feedback on
combination products, which provides
additional detail on interacting with
labeled combination product are manufactured at
the same facility.
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FDA, including with respect to CGMP
issues addressed in this list.
While FDA has provided examples in
this notice of the types of mechanisms
that may be appropriate, CP
manufacturers should consider the
suitability of an approach in the context
of their product and manufacturing
process. For these examples, we have
recommended engaging the Agency
before adoption of some, whereas others
may be evaluated on inspection as
appropriate. Additional approaches may
be permissible as well for evaluation on
a case-by-case basis for a particular
product and CP manufacturer. FDA
continues to apply a risk-based
approach to evaluating alternative or
streamlined mechanisms for ensuring
the quality of combination products,
and as FDA and CP manufacturers
develop additional data and rationales,
this list may be expanded, including to
provide additional examples or to
identify types of combination products
for which alternative or streamlined
mechanisms may be applicable.
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II. List of Mechanisms for Complying
With § 4.4 CGMP Requirements for
Combination Products
A. Introduction
Sections II.B and II.C present
mechanisms for demonstrating
compliance with relevant combination
product CGMP requirements. Where
applicable, reference is made to sections
of the ‘‘Guidance for Industry and FDA
Staff: Current Good Manufacturing
Practice Requirements for Combination
Products’’ for additional information
(Ref. 1). FDA will continue to evaluate
this list in light of Agency experience
and stakeholder input. CP
manufacturers are welcome to propose
other approaches not described,
including approaches to other
requirements set forth in § 4.4 for which
FDA is not currently describing
mechanisms for demonstrating
compliance in the sections below.
For each mechanism described below,
CP manufacturers should consider what
documentation would be sufficient to
support that the mechanism, including
the specific approach for implementing
it, assures appropriate control of the
manufacture of the combination product
to ensure safety and effectiveness of the
product. Appropriate evidence and an
explanation of the rationale to support
the approach should be accessible at the
manufacturing facility for review during
facility inspections regardless of
whether the approach has been
discussed with FDA.
In some cases, CP manufacturers may
need to interact with FDA to gain
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approval or otherwise notify FDA of a
manufacturing change (see section
III.A). For example, if a CP manufacturer
utilizes a bracketing/matrixing design
for stability studies, this approach
should be submitted to FDA either as a
proposal at the time of premarket review
or as a postmarket change.
For additional discussion on how to
interact with FDA regarding the
mechanisms described below, see
section III.
B. Mechanisms for Complying With
Drug CGMP Requirements (Part 211)
Specified in § 4.4 2
FDA interprets the mechanisms
identified in the sections below as
means to demonstrate compliance with
the following part 211 (21 CFR part 211)
requirements specified in § 4.4:
1. Section 211.165 Testing and Release
for Distribution
Use of samples that are not finished
combination products, but that are
representative of the finished
combination product with respect to the
characteristics and attributes being
tested, when performing testing required
by § 211.165 (21 CFR 211.165) to
determine whether the drug constituent
part, and thus the combination product,
meets relevant final specifications. To
meet the requirements of § 211.165, the
CP manufacturer using this mechanism
would need to establish, including
where appropriate through bridging
studies and other quantitative means,
that any differences in the
manufacturing process for the
representative samples as compared to
the finished combination product do not
affect the drug constituent part (i.e., to
establish that there is no difference in
the quality attributes related to the drug
constituent part in the representative
sample as compared to the attributes
related to the drug constituent part in
the finished combination product). For
example, as part of product release
testing, drug-eluting lead CP
manufacturers could perform release
testing for identity, potency, or other
quality attributes on a representative
lead tip assembly that contains the drug
constituent part, rather than on the
finished combination product
containing the full electronic and
mechanical assembly, so long as they
can establish that the representative
lead tip assemblies meet the relevant
acceptance criteria and there are no
2 Several drug CGMP mechanisms included in
this list depend upon use of a more broadly defined
batch. FDA notes that approaches that depend upon
broadly defined batches may increase the number
of distributed products implicated when corrective
actions are necessary to address postmarket issues.
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statistically significant differences in the
test results for the representative lead
tip assemblies compared to the finished
combination product.
(See also section IV.B.5 of Ref. 1 for
additional information on testing and
release for combination products.)
2. Section 211.166 Stability Testing
Use of bracketing and matrixing
approaches to stability studies for
combination products. Principles for
bracketing and matrixing approaches to
meet the requirements of § 211.166 (21
CFR 211.166) have already been
addressed by the Agency, including in
The International Council for
Harmonisation of Technical
Requirements for Pharmaceuticals for
Human Use (ICH) guidelines with
regard to drug products (Refs. 2 and 3),
and such principles can also be applied
to combination products. CP
manufacturers could utilize a
bracketing/matrixing design, if
appropriate, for stability studies. For
example, when assessing stability for a
prefilled syringe that is marketed in
various fill volumes, one of the
approaches that a CP manufacturer
could utilize, if appropriate, is
bracketing based on the smallest and the
largest fill volume of product
configurations. In determining the
extremes for a bracketing approach and/
or when justifying the use of a matrix
design for single-entity combination
products, it is important that the drugdevice interactions and variations in the
manufacturing processes are considered.
For co-packaged combination products,
such approaches can only be applied to
the drug constituent part of the product.
Leveraging stability data for an
already marketed combination product.
Mechanisms that use prior stability
knowledge, data, or information for an
existing product to support stability
assessment for a modification to that
product may be appropriate when a new
combination product is a modification
of an already marketed product and the
modification does not have the potential
to impact the stability of the drug
constituent part. For example, when
developing new lengths of a drug-coated
catheter product for which the catheter
materials, drug coating, manufacturing
process, and packaging configurations
are largely unchanged from existing
marketed sizes, the CP manufacturer
would generally be able to leverage
existing stability data to establish initial
product shelf life or to support reduced
stability data requirements, so long as
characteristics of the product that could
impact stability (e.g., materials,
packaging configuration) remain the
same. However, if the device constituent
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part of a drug-coated catheter includes
a new material that is in contact with
the drug coating or is a new design with
a different drug-coated area or geometry,
for example, new stability studies
would generally be needed under
§ 211.166.
(See also section IV.B.6 of Ref. 1 for
additional information on stability
requirements for combination products.)
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3. Section 211.167 Special Testing
Requirements
Defining ‘‘batch’’ based on the drug
constituent part rather than the finished
combination product for purposes of
special testing requirements for
pyrogens and endotoxins. For example,
a CP manufacturer of a combination
product consisting of a device that is
coated with a drug, where a larger batch
of coating is used to manufacture
several ‘‘batches’’ or ‘‘lots’’ of the overall
combination product, may be able to
define a batch for purposes of pyrogen
and endotoxin testing as a set of
combination products that were all
manufactured using the same coating
batch for purposes of meeting the
requirements of § 211.167 (21 CFR
211.167). As with the other mechanisms
described in this list, this mechanism
would only potentially be available if
there would be no impact on the
endotoxin or pyrogen levels for the
finished combination product from
subsequent manufacturing processes,
including when the constituent parts are
combined to produce the final
combination product (e.g., there are no
statistically significant differences in
pyrogen or endotoxin test results for the
combination product immediately
following the coating process step as
compared to the finished combination
product). When defining the batch, CP
manufacturers should consider whether
such risks may be introduced later in
the production process.
(See also section IV.B.7 of Ref. 1 for
additional information on special
testing requirements for combination
products.)
4. Section 211.170 Reserve Samples
Keeping reserve samples that are
representative of the finished
combination product. CP manufacturers
may use validated surrogates as
representative samples to meet the
requirements of § 211.170 (21 CFR
211.170), provided the surrogate is
appropriate, both in terms of the
manufacturing process and the
characteristics of the container closure.
For example, it may be permissible to
maintain as a reserve sample only the
drug-containing subassembly of a
single-entity combination product, such
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as only the distal tip subassembly (with
drug-containing collar) of a pacemaker
lead without the associated internal
electronic components, or the drug
constituent part of a co-packaged
combination product, such as the
prefilled cartridge of a combination
product that is distributed as a prefilled
cartridge with an injector system. Such
approaches would generally be
permissible under the regulation when:
(1) all subsequent manufacturing
process steps to produce the final
combination product are shown not to
affect the drug constituent part, (2) the
immediate container closure has
essentially the same characteristics as
that for the drug constituent part as
packaged in the combination product
for distribution, and (3) the
representative samples are suitable for
all required testing of the drug
constituent part for which the reserve
samples are being kept.
Using samples from representative
lots of a larger batch for retention of
reserve samples. To meet the
requirements of § 211.170, CP
manufacturers may be able to use
bracketing and matrixing approaches to
retain reserve samples from certain lots
to adequately represent the broadly
defined batch of the combination
product. For example, where relevant
lot-release tests, analytical procedures,
and acceptance criteria are the same for
the product matrix and the relevant
aspects of the manufacturing process are
the same, CP manufacturers might be
able to retain reserve samples of
appropriately varied sizes of a drugcoated combination product from across
that matrix.
(See also section IV.B.8 of Ref. 1 for
additional information on reserve
sample requirements for combination
products.)
C. Mechanisms for Complying With
Device Quality System Requirements
(Part 820) Specified in § 4.4
FDA interprets the mechanisms
identified in the sections below as
means to demonstrate compliance with
the following part 820 (21 CFR part 820)
requirements specified in § 4.4:
1. Section 820.30 Design Controls
Using existing pharmaceutical
development practices and
documentation that align with the
design control principles and
requirements of § 820.30 (21 CFR
820.30). Robust pharmaceutical
development practices would address
many design control requirements to
assure compliance with § 820.30 where
applicable (Ref. 4). CP manufacturers
need to demonstrate how development
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processes, procedures, and terminology
align with design control principles and
requirements in § 820.30, when
applicable, including developing
additional design control elements, if
necessary. When evaluating the
adequacy of existing pharmaceutical
development processes and related
documentation, particular attention
should be given to postmarket
management of design changes to the
combination product and the alignment
of change control practices with the
principles and requirements of § 820.30,
as applicable.
(See also section IV.A.2 of Ref. 1 for
additional information on the
requirements of § 820.30 as they apply
to combination products.)
2. Exemption of Combination Products
From Device QS Regulation
Exemption of the combination
product from provisions of the device
QS regulation (part 820) if the device
constituent part of the combination
product is itself exempt from the device
QS requirements specified in § 4.4(b)(1)
(i.e., the intended use of the device as
a constituent part falls within the scope
of the relevant exemption). Some
devices are exempt from certain
provisions of the device QS regulation
(see, for example, liquid medication
dispensers such as cups and droppers
that fall within the scope of § 880.6430
(21 CFR 880.6430); see also, for
example, limitations to device
exemptions under 21 CFR 880.9).
Accordingly, a combination product is
exempt from the associated provisions
of the device QS regulation specified in
§ 4.4(b)(1) if the device constituent part
falls within the scope of the relevant
exemption; i.e., if the intended use of
the device in the combination product
is not a new intended use and does not
otherwise raise different safety and
effectiveness questions for the device.
This circumstance will most frequently
apply to co-packaged combination
products. For example, an oral dosing
syringe (a liquid medication dispenser
under § 880.6430) that is co-packaged
with a drug may be exempt from all
provisions of the device QS regulation
except for 21 CFR 820.180 (general
requirements concerning records) and
21 CFR 820.198 (requirements
concerning complaint files) when
marketed as a stand-alone device (and
hence the combination product may
also be exempt from such provisions).
Accordingly, if the CP manufacturer for
the co-packaged combination product is
using a streamlined approach based on
drug CGMP requirements (see
§ 4.4(b)(1)), the CP manufacturer does
not need to demonstrate compliance
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with the device QS requirements
because the product is exempt from all
device QS requirements specified in
§ 4.4(b)(1) and, therefore, must only be
compliant with the drug CGMP
requirements. However, incorporating
such a dispenser into a primary
container closure system or copackaging of such a dispenser with a
drug with a narrow therapeutic index,
for example, each may constitute a new
intended use for the dispenser or raise
different safety and effectiveness
questions related to performance of the
dispenser, such that the relevant
exemption would not apply.
(See also section III.C.3 of Ref. 1 for
additional information on the
exemption from provisions of the device
QS regulation for combination
products.)
III. Interacting With FDA on
Mechanisms for Complying With CGMP
for Combination Products
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A. Process for Interacting With FDA
In some cases, CP manufacturers may
need to interact with FDA to gain
approval or otherwise notify FDA of a
manufacturing change. In other cases,
although a submission or notification is
not required, CP manufacturers may
want to discuss potential use of CGMP
mechanisms with FDA. CP
manufacturers are encouraged to
interact early with FDA on any such
contemplated use of alternative or
streamlined CGMP mechanisms for
combination products (see also Ref. 5
regarding interactions with FDA on
combination products).
• Pre-Submissions and Meeting
Requests. CP manufacturers who want
to obtain FDA feedback prior to making
a premarket submission or submitting a
postmarket supplement or who
otherwise want to obtain feedback on
their CGMP approach, may interact with
FDA via the processes available for such
questions at the lead Center 3 for the
combination product (see Ref. 5). For
combination products reviewed under a
new drug application (NDA) or a
biologics license application (BLA),
such interactions will generally be
through Type C meetings (Ref. 6). For
3 A combination product is assigned to an Agency
center (Center for Biologics Evaluation and
Research, Center for Drug Evaluation and Research,
or Center for Devices and Radiological Health) that
will have primary jurisdiction (i.e., be the ‘‘lead
Center’’) for that combination product’s review and
regulation. Assignment of a combination product to
a lead Center is based on a determination of which
constituent part provides the primary mode of
action of the combination product (21 U.S.C.
353(g)). Manufacturers who are unsure of the lead
Center for their combination product or of whether
their product is a combination product, should
contact the Office of Combination Products.
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combination products reviewed under
an abbreviated new drug application
(ANDA), such interactions will
generally be through the pre-ANDA
program or controlled correspondence
for a premarket application (Refs. 7 and
8). For combination products reviewed
under a device premarket submission
(e.g., a premarket approval application
(PMA), de novo classification, or
premarket notification (510(k)), these
interactions will generally be via the
pre-submission process (Ref. 9).
Regardless of the type of submission or
meeting, such interactions should be
focused on a general discussion of the
CGMP approach the CP manufacturer
wishes to pursue and associated
justification to support the approach.4
Only representative data is typically
appropriate in these interactions;
complete data should be included in the
subsequent premarket submission or
postmarket supplement and/or be
maintained at the manufacturing
facility, as appropriate.
• Premarket Review. CP
manufacturers should include in their
original submission for NDAs, BLAs,
ANDAs, and PMAs information on any
alternative or streamlined mechanisms
for complying with combination
product CGMP requirements. For PMAs,
this information should be included in
the manufacturing section of the PMA.
For information regarding where to
place information in NDAs, BLAs, or
ANDAs, refer to ‘‘eCTD Technical
Conformance Guide’’ (Ref. 10).
• Postmarket Supplements or
Notifications to FDA. Postmarket
changes to implement a combination
product CGMP mechanism for NDAs,
ANDAs, BLAs, and PMAs may require
submission of a supplement or
notification to FDA.5 CP manufacturers
4 Note that to discuss a mechanism for complying
with CGMP requirements for which the CP
manufacturer is referencing information in a master
file, the CP manufacturer must have the appropriate
authorization from the master file holder (see, e.g.,
21 CFR 314.420 and 814.20(c)). The authorization
should clearly identify the specific information
within the master file that is being made available
to reference. For more information on biologics,
device, and drug master files, see CBER’s master
files for CBER-Regulated Products web page
(available at https://www.fda.gov/vaccines-bloodbiologics/development-approval-process-cber/
master-files-cber-regulated-products), CDRH’s
master files web page (available at https://
www.fda.gov/medical-devices/premarket-approvalpma/master-files), and CDER’s drug master files
web page (available at https://www.fda.gov/drugs/
forms-submission-requirements/drug-master-filesdmfs), respectively.
5 Requirements for postmarket supplements are
contained, for example, in 21 CFR 314.70 and
314.97 (NDAs and ANDAs), 21 CFR 601.12 (BLAs),
and 21 CFR 814.39 (PMAs). Any questions on
whether FDA review is required for a postmarket
CGMP mechanism should generally be directed to
the lead Center.
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should consult related guidances
relevant to the type of constituent
part(s) included in the combination
product (e.g., Refs. 11 to 13, as
appropriate). If a CP manufacturer has
questions on the appropriate submission
type or the need for a submission, they
can contact the lead Center for
assistance.
B. Submission Content
When submitting information on a
CGMP mechanism, CP manufacturers
should refer to applicable guidance (see
section V below) as the primary
reference regarding what information to
provide. Along with other information
indicated in relevant guidance (see
section V), the following content should
be included:
• Applicable CGMP Regulation.
Identify the applicable CGMP regulation
to which the described mechanism
relates. For example, if a submission
includes a mechanism related to
stability testing, indicate that § 211.166
is the applicable CGMP requirement.
• Applicable Products. If the
mechanism is to be applied to multiple
products and/or product configurations,
list all related sizes, strengths, etc., as
well as all related application numbers.
• Prior, Related Interactions with
FDA. If the CP manufacturer has had
previous interactions with FDA relevant
to the proposed mechanism, either for
the product addressed in the submission
or for related products, the CP
manufacturer should provide reference
to those interactions. Where applicable,
the CP manufacturer may crossreference previously submitted
information.
• Justification and Scientific Data.
Include a justification to support that
the proposed mechanism assures
adequate manufacturing control to
ensure product safety and effectiveness.
When describing a CGMP alternative or
streamlined mechanism in a premarket
or postmarket submission, the
description should be accompanied by
such data as may be necessary to
support the approach. When proposing
a change from a CGMP approach that
was reviewed previously by FDA, such
justification should include analysis of
how the proposed approach compares to
the previously reviewed approach as an
effective manufacturing control,
including representative data, as
appropriate, to substantiate the analysis.
• Exemption from Part 820. For
interactions with FDA regarding
whether a combination product is
exempt from the provisions of part 820
specified in § 4.4(b)(1), the submission
should include a description of the
device constituent part and justification
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that: (1) the intended use of the device
in the combination product is consistent
with the intended use of a separately
marketed device that has been exempted
from the requirements of part 820
specified in § 4.4(b)(1), and (2) the use
of the device constituent part in the
combination product does not raise any
different device performance-related
safety and effectiveness questions as
compared to a separately marketed
device.
C. FDA Engagement
CP manufacturers are encouraged to
discuss combination product CGMP
mechanisms with FDA. In some cases,
CP manufacturers may need to interact
with FDA to gain approval or otherwise
notify FDA of a manufacturing change
(see III.A above). Any questions on how
to engage FDA in such discussions
should generally be directed to the lead
Center for the product (see Ref. 5). The
lead Center will engage appropriate
expertise from within the lead Center
and from other FDA Centers and the
Office of Combination Products, as
needed, to support review (see Ref. 14),
and FDA will provide appropriate
feedback (see section III.D below).
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D. FDA Review
FDA may review information from a
CP manufacturer related to alternative
or streamlined mechanisms in presubmissions and meetings, premarket
applications, postmarket supplements
or notifications, and during facility
inspections. FDA may determine
whether the data and rationale
presented by a CP manufacturer for a
particular mechanism are sufficient to
demonstrate that the mechanism, as
proposed or implemented, is acceptable.
In such cases, FDA generally will notify
the CP manufacturer and/or applicant
regarding acceptability of the
mechanism, consistent with existing
policies and practices for the
submission type and, if the Agency
finds the approach insufficient, FDA
intends to provide the scientific and/or
regulatory basis for this determination.
IV. Paperwork Reduction Act
This notice refers to previously
approved collections of information
found in FDA regulations. These
collections of information are subject to
review by the Office of Management and
Budget (OMB) under the Paperwork
Reduction Act of 1995 (44 U.S.C. 3501–
3521). We note that the information
collected under the underlying CGMP
regulations for drugs, devices, and
biological products, including current
good tissue practices for human cells,
tissues, and cellular and tissue-based
VerDate Sep<11>2014
17:30 Sep 12, 2022
Jkt 256001
products, found in parts 211, 820, 600
through 680, and 1271 (21 CFR parts
211, 820, 600 through 680, and 1271),
have already been approved and are in
effect. The provisions of part 211 are
approved under the OMB control
number 0910–0139. The provisions of
part 820 are approved under OMB
control number 0910–0073. The
provisions of parts 606 and 640 are
approved under OMB control number
0910–0116. The provisions of part 610
are approved under OMB control
number 0910–0116 and OMB control
number 0910–0338 (also for part 680).
The provisions of part 1271, subparts C
and D, are approved under OMB control
number 0910–0543.
We note that the information
collected under the related submission
types have already been approved and
are in effect. The collections of
information regarding formal meetings
with sponsors and applicants are
approved under OMB control number
0910–0429. The collections of
information regarding NDA and ANDA
are approved under OMB control
number 0910–0001. The collections of
information regarding the pre-ANDA
program and controlled correspondence
are approved under OMB control
number 0910–0797. The collections of
information regarding pre-submissions
are approved under OMB control
number 0910–0756. The collections of
information regarding PMAs are
approved under OMB control number
0910–0231. The collections of
information for premarket notification
(510(k)) are approved under OMB
control number 0910–0120. The
collections of information for the de
novo classification process are approved
under OMB control number 0910–0844.
The collections of information regarding
BLAs are approved under OMB control
number 0910–0338. The collections of
information regarding combination
product agreement meetings are
approved under OMB control number
0910–0523.
V. References
The following references are on
display in the Dockets Management
Staff (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 website addresses, as of the date this
document publishes in the Federal
Register, but websites are subject to
change over time.
1. ‘‘Guidance for Industry and FDA Staff:
Current Good Manufacturing Practice
Requirements for Combination
PO 00000
Frm 00083
Fmt 4703
Sfmt 9990
Products,’’ January 2017. https://
www.fda.gov/media/90425/download.
2. ‘‘Guidance for Industry Q1D Bracketing
and Matrixing Designs for Stability
Testing of New Drug Substances and
Products,’’ January 2003. https://
www.fda.gov/media/71720/download.
3. ‘‘Guidance for Industry Quality of
Biotechnological Products: Stability
Testing of Biotechnological/Biological
Products’’ Q5C, July 1996. https://
www.fda.gov/media/71441/download.
4. ‘‘Guidance for Industry Q8(R2)
Pharmaceutical Development,’’
November 2009. https://www.fda.gov/
media/71535/download.
5. ‘‘Guidance for Industry and FDA Staff:
Requesting FDA Feedback on
Combination Products,’’ December 2020.
https://www.fda.gov/media/133768/
download.
6. ‘‘Draft Guidance for Industry Formal
Meetings Between the FDA and Sponsors
or Applicants of PDUFA Products,’’
December 2017. https://www.fda.gov/
media/109951/download.
7. ‘‘Guidance for Industry Formal Meetings
Between FDA and ANDA Applicants of
Complex Products Under GDUFA,’’
November 2020. https://www.fda.gov/
media/107626/download.
8. ‘‘Guidance for Industry Controlled
Correspondence Related to Generic Drug
Development,’’ December 2020. https://
www.fda.gov/media/109232/download.
9. ‘‘Guidance for Industry and FDA Staff
Requests for Feedback and Meetings for
Medical Device Submissions: The QSubmission Program,’’ January 2021.
https://www.fda.gov/media/114034/
download.
10. ‘‘eCTD Technical Conformance Guide,’’
March 2022. https://www.fda.gov/media/
93818/download.
11. ‘‘Guidance for Industry Changes to an
Approved NDA or ANDA,’’ April 2004.
https://www.fda.gov/media/71846/
download.
12. ‘‘Guidance for Industry Chemistry,
Manufacturing, and Controls Changes to
an Approved Application: Certain
Biological Products,’’ June 2021. https://
www.fda.gov/media/109615/download.
13. ‘‘Guidance for Industry and FDA Staff:
30-Day Notices, 135-Day Premarket
Approval (PMA) Supplements and 75Day Humanitarian Device Exemption
(HDE) Supplements for Manufacturing
Method or Process Changes,’’ December
2019. https://www.fda.gov/media/72663/
download.
14. FDA Staff Manual Guide SMG 4101
‘‘Inter-Center Consult Request Process,’’
June 2018. https://www.fda.gov/media/
81927/download.
Dated: September 7, 2022.
Lauren K. Roth,
Associate Commissioner for Policy.
[FR Doc. 2022–19713 Filed 9–12–22; 8:45 am]
BILLING CODE 4164–01–P
E:\FR\FM\13SEN1.SGM
13SEN1
Agencies
[Federal Register Volume 87, Number 176 (Tuesday, September 13, 2022)]
[Notices]
[Pages 56066-56070]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2022-19713]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Food and Drug Administration
[Docket No. FDA-2018-N-2065]
Alternative or Streamlined Mechanisms for Complying With the
Current Good Manufacturing Practice Requirements for Combination
Products; List Under the 21st Century Cures Act
AGENCY: Food and Drug Administration, HHS.
ACTION: Notice.
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SUMMARY: As required by the 21st Century Cures Act (Cures Act), the
Food and Drug Administration (FDA, Agency, or we) is finalizing a list
of alternative or streamlined mechanisms for complying with the current
good manufacturing practice (CGMP) requirements for combination
products. A combination product is a product composed of any
combination of a drug, a device, and/or a biological product.
DATES: This notice is published in the Federal Register on September
13, 2022.
ADDRESSES: For access to the docket, 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, between 9 a.m. and 4 p.m., Monday through Friday, 240-402-
7500. Publicly available submissions may be seen in the docket.
FOR FURTHER INFORMATION CONTACT: John Barlow Weiner, Office of
Combination Products, Food and Drug Administration, 10903 New Hampshire
Ave., Bldg. 32, Rm. 5130, Silver Spring, MD 20993, 301-796-8930,
[email protected] or [email protected].
SUPPLEMENTARY INFORMATION:
I. Background
On January 22, 2013, FDA issued a final rule on CGMP requirements
for combination products (see 78 FR 4307 and part 4, subpart A (21 CFR
part 4, subpart A)) (CGMP Rule). The drugs, devices, and biological
products included in combination products are referred to as
``constituent parts'' of the combination product. Combination products
include ``single-entity'' combination products, the constituent parts
of which are physically, chemically, or otherwise combined or mixed and
produced as a single entity (see Sec. 3.2(e)(1) (21 CFR 3.2(e)(1)))
(e.g., prefilled syringes and drug-eluting stents), and ``co-packaged''
combination products where the constituent parts are packaged together
in a single package or as a unit (see Sec. 3.2(e)(2)) (e.g., a
surgical or first-aid kit).\1\ Section 4.4 (21 CFR 4.4) outlines how
manufacturers of single-entity and co-packaged combination products
(hereafter ``CP manufacturers'') can demonstrate compliance with
applicable CGMP requirements, including through implementation of a
streamlined approach to meet the requirements of both the drug CGMP and
the device quality system (QS) regulations.
---------------------------------------------------------------------------
\1\ There are also ``cross-labeled'' combination products (Sec.
3.2(e)(3) and (4)). See Ref. 1 for additional information regarding
CGMP requirements for them, as well as use of the ``streamlined
approach'' if a device and drug or biological product constituent
part of a cross-labeled combination product are manufactured at the
same facility.
---------------------------------------------------------------------------
In December 2016, the Cures Act (Pub. L. 114-255) was signed into
law. Section 3038(c) of the Cures Act mandated that FDA publish in the
Federal Register a list identifying types of combination products and
manufacturing processes for which ``good manufacturing processes'' may
be adopted that vary from the requirements set forth in Sec. 4.4, or
that FDA proposes can satisfy the requirements in Sec. 4.4 through
``alternative or streamlined mechanisms,'' and to review this list
periodically. In accordance with this statutory mandate, FDA published
a proposed list on June 13, 2018 (83 FR 27609).
FDA received six comments on this proposed list, has considered
them, and is now publishing a list after such consideration (see
section II of this document). In response to the comments, FDA added
and refined examples and provided additional clarity regarding FDA's
expectations for CP manufacturers when applying mechanisms presented in
this list. FDA also added reference to a guidance on how to request FDA
feedback on combination products, which provides additional detail on
interacting with
[[Page 56067]]
FDA, including with respect to CGMP issues addressed in this list.
While FDA has provided examples in this notice of the types of
mechanisms that may be appropriate, CP manufacturers should consider
the suitability of an approach in the context of their product and
manufacturing process. For these examples, we have recommended engaging
the Agency before adoption of some, whereas others may be evaluated on
inspection as appropriate. Additional approaches may be permissible as
well for evaluation on a case-by-case basis for a particular product
and CP manufacturer. FDA continues to apply a risk-based approach to
evaluating alternative or streamlined mechanisms for ensuring the
quality of combination products, and as FDA and CP manufacturers
develop additional data and rationales, this list may be expanded,
including to provide additional examples or to identify types of
combination products for which alternative or streamlined mechanisms
may be applicable.
II. List of Mechanisms for Complying With Sec. 4.4 CGMP Requirements
for Combination Products
A. Introduction
Sections II.B and II.C present mechanisms for demonstrating
compliance with relevant combination product CGMP requirements. Where
applicable, reference is made to sections of the ``Guidance for
Industry and FDA Staff: Current Good Manufacturing Practice
Requirements for Combination Products'' for additional information
(Ref. 1). FDA will continue to evaluate this list in light of Agency
experience and stakeholder input. CP manufacturers are welcome to
propose other approaches not described, including approaches to other
requirements set forth in Sec. 4.4 for which FDA is not currently
describing mechanisms for demonstrating compliance in the sections
below.
For each mechanism described below, CP manufacturers should
consider what documentation would be sufficient to support that the
mechanism, including the specific approach for implementing it, assures
appropriate control of the manufacture of the combination product to
ensure safety and effectiveness of the product. Appropriate evidence
and an explanation of the rationale to support the approach should be
accessible at the manufacturing facility for review during facility
inspections regardless of whether the approach has been discussed with
FDA.
In some cases, CP manufacturers may need to interact with FDA to
gain approval or otherwise notify FDA of a manufacturing change (see
section III.A). For example, if a CP manufacturer utilizes a
bracketing/matrixing design for stability studies, this approach should
be submitted to FDA either as a proposal at the time of premarket
review or as a postmarket change.
For additional discussion on how to interact with FDA regarding the
mechanisms described below, see section III.
B. Mechanisms for Complying With Drug CGMP Requirements (Part 211)
Specified in Sec. 4.4 2
---------------------------------------------------------------------------
\2\ Several drug CGMP mechanisms included in this list depend
upon use of a more broadly defined batch. FDA notes that approaches
that depend upon broadly defined batches may increase the number of
distributed products implicated when corrective actions are
necessary to address postmarket issues.
---------------------------------------------------------------------------
FDA interprets the mechanisms identified in the sections below as
means to demonstrate compliance with the following part 211 (21 CFR
part 211) requirements specified in Sec. 4.4:
1. Section 211.165 Testing and Release for Distribution
Use of samples that are not finished combination products, but that
are representative of the finished combination product with respect to
the characteristics and attributes being tested, when performing
testing required by Sec. 211.165 (21 CFR 211.165) to determine whether
the drug constituent part, and thus the combination product, meets
relevant final specifications. To meet the requirements of Sec.
211.165, the CP manufacturer using this mechanism would need to
establish, including where appropriate through bridging studies and
other quantitative means, that any differences in the manufacturing
process for the representative samples as compared to the finished
combination product do not affect the drug constituent part (i.e., to
establish that there is no difference in the quality attributes related
to the drug constituent part in the representative sample as compared
to the attributes related to the drug constituent part in the finished
combination product). For example, as part of product release testing,
drug-eluting lead CP manufacturers could perform release testing for
identity, potency, or other quality attributes on a representative lead
tip assembly that contains the drug constituent part, rather than on
the finished combination product containing the full electronic and
mechanical assembly, so long as they can establish that the
representative lead tip assemblies meet the relevant acceptance
criteria and there are no statistically significant differences in the
test results for the representative lead tip assemblies compared to the
finished combination product.
(See also section IV.B.5 of Ref. 1 for additional information on
testing and release for combination products.)
2. Section 211.166 Stability Testing
Use of bracketing and matrixing approaches to stability studies for
combination products. Principles for bracketing and matrixing
approaches to meet the requirements of Sec. 211.166 (21 CFR 211.166)
have already been addressed by the Agency, including in The
International Council for Harmonisation of Technical Requirements for
Pharmaceuticals for Human Use (ICH) guidelines with regard to drug
products (Refs. 2 and 3), and such principles can also be applied to
combination products. CP manufacturers could utilize a bracketing/
matrixing design, if appropriate, for stability studies. For example,
when assessing stability for a prefilled syringe that is marketed in
various fill volumes, one of the approaches that a CP manufacturer
could utilize, if appropriate, is bracketing based on the smallest and
the largest fill volume of product configurations. In determining the
extremes for a bracketing approach and/or when justifying the use of a
matrix design for single-entity combination products, it is important
that the drug-device interactions and variations in the manufacturing
processes are considered. For co-packaged combination products, such
approaches can only be applied to the drug constituent part of the
product.
Leveraging stability data for an already marketed combination
product. Mechanisms that use prior stability knowledge, data, or
information for an existing product to support stability assessment for
a modification to that product may be appropriate when a new
combination product is a modification of an already marketed product
and the modification does not have the potential to impact the
stability of the drug constituent part. For example, when developing
new lengths of a drug-coated catheter product for which the catheter
materials, drug coating, manufacturing process, and packaging
configurations are largely unchanged from existing marketed sizes, the
CP manufacturer would generally be able to leverage existing stability
data to establish initial product shelf life or to support reduced
stability data requirements, so long as characteristics of the product
that could impact stability (e.g., materials, packaging configuration)
remain the same. However, if the device constituent
[[Page 56068]]
part of a drug-coated catheter includes a new material that is in
contact with the drug coating or is a new design with a different drug-
coated area or geometry, for example, new stability studies would
generally be needed under Sec. 211.166.
(See also section IV.B.6 of Ref. 1 for additional information on
stability requirements for combination products.)
3. Section 211.167 Special Testing Requirements
Defining ``batch'' based on the drug constituent part rather than
the finished combination product for purposes of special testing
requirements for pyrogens and endotoxins. For example, a CP
manufacturer of a combination product consisting of a device that is
coated with a drug, where a larger batch of coating is used to
manufacture several ``batches'' or ``lots'' of the overall combination
product, may be able to define a batch for purposes of pyrogen and
endotoxin testing as a set of combination products that were all
manufactured using the same coating batch for purposes of meeting the
requirements of Sec. 211.167 (21 CFR 211.167). As with the other
mechanisms described in this list, this mechanism would only
potentially be available if there would be no impact on the endotoxin
or pyrogen levels for the finished combination product from subsequent
manufacturing processes, including when the constituent parts are
combined to produce the final combination product (e.g., there are no
statistically significant differences in pyrogen or endotoxin test
results for the combination product immediately following the coating
process step as compared to the finished combination product). When
defining the batch, CP manufacturers should consider whether such risks
may be introduced later in the production process.
(See also section IV.B.7 of Ref. 1 for additional information on
special testing requirements for combination products.)
4. Section 211.170 Reserve Samples
Keeping reserve samples that are representative of the finished
combination product. CP manufacturers may use validated surrogates as
representative samples to meet the requirements of Sec. 211.170 (21
CFR 211.170), provided the surrogate is appropriate, both in terms of
the manufacturing process and the characteristics of the container
closure. For example, it may be permissible to maintain as a reserve
sample only the drug-containing subassembly of a single-entity
combination product, such as only the distal tip subassembly (with
drug-containing collar) of a pacemaker lead without the associated
internal electronic components, or the drug constituent part of a co-
packaged combination product, such as the prefilled cartridge of a
combination product that is distributed as a prefilled cartridge with
an injector system. Such approaches would generally be permissible
under the regulation when: (1) all subsequent manufacturing process
steps to produce the final combination product are shown not to affect
the drug constituent part, (2) the immediate container closure has
essentially the same characteristics as that for the drug constituent
part as packaged in the combination product for distribution, and (3)
the representative samples are suitable for all required testing of the
drug constituent part for which the reserve samples are being kept.
Using samples from representative lots of a larger batch for
retention of reserve samples. To meet the requirements of Sec.
211.170, CP manufacturers may be able to use bracketing and matrixing
approaches to retain reserve samples from certain lots to adequately
represent the broadly defined batch of the combination product. For
example, where relevant lot-release tests, analytical procedures, and
acceptance criteria are the same for the product matrix and the
relevant aspects of the manufacturing process are the same, CP
manufacturers might be able to retain reserve samples of appropriately
varied sizes of a drug-coated combination product from across that
matrix.
(See also section IV.B.8 of Ref. 1 for additional information on
reserve sample requirements for combination products.)
C. Mechanisms for Complying With Device Quality System Requirements
(Part 820) Specified in Sec. 4.4
FDA interprets the mechanisms identified in the sections below as
means to demonstrate compliance with the following part 820 (21 CFR
part 820) requirements specified in Sec. 4.4:
1. Section 820.30 Design Controls
Using existing pharmaceutical development practices and
documentation that align with the design control principles and
requirements of Sec. 820.30 (21 CFR 820.30). Robust pharmaceutical
development practices would address many design control requirements to
assure compliance with Sec. 820.30 where applicable (Ref. 4). CP
manufacturers need to demonstrate how development processes,
procedures, and terminology align with design control principles and
requirements in Sec. 820.30, when applicable, including developing
additional design control elements, if necessary. When evaluating the
adequacy of existing pharmaceutical development processes and related
documentation, particular attention should be given to postmarket
management of design changes to the combination product and the
alignment of change control practices with the principles and
requirements of Sec. 820.30, as applicable.
(See also section IV.A.2 of Ref. 1 for additional information on
the requirements of Sec. 820.30 as they apply to combination
products.)
2. Exemption of Combination Products From Device QS Regulation
Exemption of the combination product from provisions of the device
QS regulation (part 820) if the device constituent part of the
combination product is itself exempt from the device QS requirements
specified in Sec. 4.4(b)(1) (i.e., the intended use of the device as a
constituent part falls within the scope of the relevant exemption).
Some devices are exempt from certain provisions of the device QS
regulation (see, for example, liquid medication dispensers such as cups
and droppers that fall within the scope of Sec. 880.6430 (21 CFR
880.6430); see also, for example, limitations to device exemptions
under 21 CFR 880.9). Accordingly, a combination product is exempt from
the associated provisions of the device QS regulation specified in
Sec. 4.4(b)(1) if the device constituent part falls within the scope
of the relevant exemption; i.e., if the intended use of the device in
the combination product is not a new intended use and does not
otherwise raise different safety and effectiveness questions for the
device. This circumstance will most frequently apply to co-packaged
combination products. For example, an oral dosing syringe (a liquid
medication dispenser under Sec. 880.6430) that is co-packaged with a
drug may be exempt from all provisions of the device QS regulation
except for 21 CFR 820.180 (general requirements concerning records) and
21 CFR 820.198 (requirements concerning complaint files) when marketed
as a stand-alone device (and hence the combination product may also be
exempt from such provisions). Accordingly, if the CP manufacturer for
the co-packaged combination product is using a streamlined approach
based on drug CGMP requirements (see Sec. 4.4(b)(1)), the CP
manufacturer does not need to demonstrate compliance
[[Page 56069]]
with the device QS requirements because the product is exempt from all
device QS requirements specified in Sec. 4.4(b)(1) and, therefore,
must only be compliant with the drug CGMP requirements. However,
incorporating such a dispenser into a primary container closure system
or co-packaging of such a dispenser with a drug with a narrow
therapeutic index, for example, each may constitute a new intended use
for the dispenser or raise different safety and effectiveness questions
related to performance of the dispenser, such that the relevant
exemption would not apply.
(See also section III.C.3 of Ref. 1 for additional information on
the exemption from provisions of the device QS regulation for
combination products.)
III. Interacting With FDA on Mechanisms for Complying With CGMP for
Combination Products
A. Process for Interacting With FDA
In some cases, CP manufacturers may need to interact with FDA to
gain approval or otherwise notify FDA of a manufacturing change. In
other cases, although a submission or notification is not required, CP
manufacturers may want to discuss potential use of CGMP mechanisms with
FDA. CP manufacturers are encouraged to interact early with FDA on any
such contemplated use of alternative or streamlined CGMP mechanisms for
combination products (see also Ref. 5 regarding interactions with FDA
on combination products).
Pre-Submissions and Meeting Requests. CP manufacturers who
want to obtain FDA feedback prior to making a premarket submission or
submitting a postmarket supplement or who otherwise want to obtain
feedback on their CGMP approach, may interact with FDA via the
processes available for such questions at the lead Center \3\ for the
combination product (see Ref. 5). For combination products reviewed
under a new drug application (NDA) or a biologics license application
(BLA), such interactions will generally be through Type C meetings
(Ref. 6). For combination products reviewed under an abbreviated new
drug application (ANDA), such interactions will generally be through
the pre-ANDA program or controlled correspondence for a premarket
application (Refs. 7 and 8). For combination products reviewed under a
device premarket submission (e.g., a premarket approval application
(PMA), de novo classification, or premarket notification (510(k)),
these interactions will generally be via the pre-submission process
(Ref. 9). Regardless of the type of submission or meeting, such
interactions should be focused on a general discussion of the CGMP
approach the CP manufacturer wishes to pursue and associated
justification to support the approach.\4\ Only representative data is
typically appropriate in these interactions; complete data should be
included in the subsequent premarket submission or postmarket
supplement and/or be maintained at the manufacturing facility, as
appropriate.
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\3\ A combination product is assigned to an Agency center
(Center for Biologics Evaluation and Research, Center for Drug
Evaluation and Research, or Center for Devices and Radiological
Health) that will have primary jurisdiction (i.e., be the ``lead
Center'') for that combination product's review and regulation.
Assignment of a combination product to a lead Center is based on a
determination of which constituent part provides the primary mode of
action of the combination product (21 U.S.C. 353(g)). Manufacturers
who are unsure of the lead Center for their combination product or
of whether their product is a combination product, should contact
the Office of Combination Products.
\4\ Note that to discuss a mechanism for complying with CGMP
requirements for which the CP manufacturer is referencing
information in a master file, the CP manufacturer must have the
appropriate authorization from the master file holder (see, e.g., 21
CFR 314.420 and 814.20(c)). The authorization should clearly
identify the specific information within the master file that is
being made available to reference. For more information on
biologics, device, and drug master files, see CBER's master files
for CBER-Regulated Products web page (available at https://www.fda.gov/vaccines-blood-biologics/development-approval-process-cber/master-files-cber-regulated-products), CDRH's master files web
page (available at https://www.fda.gov/medical-devices/premarket-approval-pma/master-files), and CDER's drug master files web page
(available at https://www.fda.gov/drugs/forms-submission-requirements/drug-master-files-dmfs), respectively.
---------------------------------------------------------------------------
Premarket Review. CP manufacturers should include in their
original submission for NDAs, BLAs, ANDAs, and PMAs information on any
alternative or streamlined mechanisms for complying with combination
product CGMP requirements. For PMAs, this information should be
included in the manufacturing section of the PMA. For information
regarding where to place information in NDAs, BLAs, or ANDAs, refer to
``eCTD Technical Conformance Guide'' (Ref. 10).
Postmarket Supplements or Notifications to FDA. Postmarket
changes to implement a combination product CGMP mechanism for NDAs,
ANDAs, BLAs, and PMAs may require submission of a supplement or
notification to FDA.\5\ CP manufacturers should consult related
guidances relevant to the type of constituent part(s) included in the
combination product (e.g., Refs. 11 to 13, as appropriate). If a CP
manufacturer has questions on the appropriate submission type or the
need for a submission, they can contact the lead Center for assistance.
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\5\ Requirements for postmarket supplements are contained, for
example, in 21 CFR 314.70 and 314.97 (NDAs and ANDAs), 21 CFR 601.12
(BLAs), and 21 CFR 814.39 (PMAs). Any questions on whether FDA
review is required for a postmarket CGMP mechanism should generally
be directed to the lead Center.
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B. Submission Content
When submitting information on a CGMP mechanism, CP manufacturers
should refer to applicable guidance (see section V below) as the
primary reference regarding what information to provide. Along with
other information indicated in relevant guidance (see section V), the
following content should be included:
Applicable CGMP Regulation. Identify the applicable CGMP
regulation to which the described mechanism relates. For example, if a
submission includes a mechanism related to stability testing, indicate
that Sec. 211.166 is the applicable CGMP requirement.
Applicable Products. If the mechanism is to be applied to
multiple products and/or product configurations, list all related
sizes, strengths, etc., as well as all related application numbers.
Prior, Related Interactions with FDA. If the CP
manufacturer has had previous interactions with FDA relevant to the
proposed mechanism, either for the product addressed in the submission
or for related products, the CP manufacturer should provide reference
to those interactions. Where applicable, the CP manufacturer may cross-
reference previously submitted information.
Justification and Scientific Data. Include a justification
to support that the proposed mechanism assures adequate manufacturing
control to ensure product safety and effectiveness. When describing a
CGMP alternative or streamlined mechanism in a premarket or postmarket
submission, the description should be accompanied by such data as may
be necessary to support the approach. When proposing a change from a
CGMP approach that was reviewed previously by FDA, such justification
should include analysis of how the proposed approach compares to the
previously reviewed approach as an effective manufacturing control,
including representative data, as appropriate, to substantiate the
analysis.
Exemption from Part 820. For interactions with FDA
regarding whether a combination product is exempt from the provisions
of part 820 specified in Sec. 4.4(b)(1), the submission should include
a description of the device constituent part and justification
[[Page 56070]]
that: (1) the intended use of the device in the combination product is
consistent with the intended use of a separately marketed device that
has been exempted from the requirements of part 820 specified in Sec.
4.4(b)(1), and (2) the use of the device constituent part in the
combination product does not raise any different device performance-
related safety and effectiveness questions as compared to a separately
marketed device.
C. FDA Engagement
CP manufacturers are encouraged to discuss combination product CGMP
mechanisms with FDA. In some cases, CP manufacturers may need to
interact with FDA to gain approval or otherwise notify FDA of a
manufacturing change (see III.A above). Any questions on how to engage
FDA in such discussions should generally be directed to the lead Center
for the product (see Ref. 5). The lead Center will engage appropriate
expertise from within the lead Center and from other FDA Centers and
the Office of Combination Products, as needed, to support review (see
Ref. 14), and FDA will provide appropriate feedback (see section III.D
below).
D. FDA Review
FDA may review information from a CP manufacturer related to
alternative or streamlined mechanisms in pre-submissions and meetings,
premarket applications, postmarket supplements or notifications, and
during facility inspections. FDA may determine whether the data and
rationale presented by a CP manufacturer for a particular mechanism are
sufficient to demonstrate that the mechanism, as proposed or
implemented, is acceptable. In such cases, FDA generally will notify
the CP manufacturer and/or applicant regarding acceptability of the
mechanism, consistent with existing policies and practices for the
submission type and, if the Agency finds the approach insufficient, FDA
intends to provide the scientific and/or regulatory basis for this
determination.
IV. Paperwork Reduction Act
This notice refers to previously approved collections of
information found in FDA regulations. These collections of information
are subject to review by the Office of Management and Budget (OMB)
under the Paperwork Reduction Act of 1995 (44 U.S.C. 3501-3521). We
note that the information collected under the underlying CGMP
regulations for drugs, devices, and biological products, including
current good tissue practices for human cells, tissues, and cellular
and tissue-based products, found in parts 211, 820, 600 through 680,
and 1271 (21 CFR parts 211, 820, 600 through 680, and 1271), have
already been approved and are in effect. The provisions of part 211 are
approved under the OMB control number 0910-0139. The provisions of part
820 are approved under OMB control number 0910-0073. The provisions of
parts 606 and 640 are approved under OMB control number 0910-0116. The
provisions of part 610 are approved under OMB control number 0910-0116
and OMB control number 0910-0338 (also for part 680). The provisions of
part 1271, subparts C and D, are approved under OMB control number
0910-0543.
We note that the information collected under the related submission
types have already been approved and are in effect. The collections of
information regarding formal meetings with sponsors and applicants are
approved under OMB control number 0910-0429. The collections of
information regarding NDA and ANDA are approved under OMB control
number 0910-0001. The collections of information regarding the pre-ANDA
program and controlled correspondence are approved under OMB control
number 0910-0797. The collections of information regarding pre-
submissions are approved under OMB control number 0910-0756. The
collections of information regarding PMAs are approved under OMB
control number 0910-0231. The collections of information for premarket
notification (510(k)) are approved under OMB control number 0910-0120.
The collections of information for the de novo classification process
are approved under OMB control number 0910-0844. The collections of
information regarding BLAs are approved under OMB control number 0910-
0338. The collections of information regarding combination product
agreement meetings are approved under OMB control number 0910-0523.
V. References
The following references are on display in the Dockets Management
Staff (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 website addresses, as of the date this document publishes
in the Federal Register, but websites are subject to change over time.
1. ``Guidance for Industry and FDA Staff: Current Good Manufacturing
Practice Requirements for Combination Products,'' January 2017.
https://www.fda.gov/media/90425/download.
2. ``Guidance for Industry Q1D Bracketing and Matrixing Designs for
Stability Testing of New Drug Substances and Products,'' January
2003. https://www.fda.gov/media/71720/download.
3. ``Guidance for Industry Quality of Biotechnological Products:
Stability Testing of Biotechnological/Biological Products'' Q5C,
July 1996. https://www.fda.gov/media/71441/download.
4. ``Guidance for Industry Q8(R2) Pharmaceutical Development,''
November 2009. https://www.fda.gov/media/71535/download.
5. ``Guidance for Industry and FDA Staff: Requesting FDA Feedback on
Combination Products,'' December 2020. https://www.fda.gov/media/133768/download.
6. ``Draft Guidance for Industry Formal Meetings Between the FDA and
Sponsors or Applicants of PDUFA Products,'' December 2017. https://www.fda.gov/media/109951/download.
7. ``Guidance for Industry Formal Meetings Between FDA and ANDA
Applicants of Complex Products Under GDUFA,'' November 2020. https://www.fda.gov/media/107626/download.
8. ``Guidance for Industry Controlled Correspondence Related to
Generic Drug Development,'' December 2020. https://www.fda.gov/media/109232/download.
9. ``Guidance for Industry and FDA Staff Requests for Feedback and
Meetings for Medical Device Submissions: The Q-Submission Program,''
January 2021. https://www.fda.gov/media/114034/download.
10. ``eCTD Technical Conformance Guide,'' March 2022. https://www.fda.gov/media/93818/download.
11. ``Guidance for Industry Changes to an Approved NDA or ANDA,''
April 2004. https://www.fda.gov/media/71846/download.
12. ``Guidance for Industry Chemistry, Manufacturing, and Controls
Changes to an Approved Application: Certain Biological Products,''
June 2021. https://www.fda.gov/media/109615/download.
13. ``Guidance for Industry and FDA Staff: 30-Day Notices, 135-Day
Premarket Approval (PMA) Supplements and 75-Day Humanitarian Device
Exemption (HDE) Supplements for Manufacturing Method or Process
Changes,'' December 2019. https://www.fda.gov/media/72663/download.
14. FDA Staff Manual Guide SMG 4101 ``Inter-Center Consult Request
Process,'' June 2018. https://www.fda.gov/media/81927/download.
Dated: September 7, 2022.
Lauren K. Roth,
Associate Commissioner for Policy.
[FR Doc. 2022-19713 Filed 9-12-22; 8:45 am]
BILLING CODE 4164-01-P