Importation of Certain Food and Drug Administration-Approved Human Prescription Drugs, Including Biological Products, Under Section 801(d)(1)(B) of the Federal Food, Drug, and Cosmetic Act; Draft Guidance for Industry; Availability

Citation84 FR 70557
Record Number2019-27475
Published date23 December 2019
SectionNotices
CourtFood And Drug Administration
Federal Register, Volume 84 Issue 246 (Monday, December 23, 2019)
[Federal Register Volume 84, Number 246 (Monday, December 23, 2019)]
                [Notices]
                [Pages 70557-70559]
                From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
                [FR Doc No: 2019-27475]
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                DEPARTMENT OF HEALTH AND HUMAN SERVICES
                Food and Drug Administration
                [Docket No. FDA-2019-D-5743]
                Importation of Certain Food and Drug Administration-Approved
                Human Prescription Drugs, Including Biological Products, Under Section
                801(d)(1)(B) of the Federal Food, Drug, and Cosmetic Act; Draft
                Guidance for Industry; Availability
                AGENCY: Food and Drug Administration, HHS.
                ACTION: Notice of availability.
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                SUMMARY: The Food and Drug Administration (FDA, Agency, or we) is
                announcing the availability of a draft guidance for industry entitled
                ``Importation of Certain FDA-Approved Human Prescription Drugs,
                Including Biological Products, under Section 801(d)(1)(B) of the
                Federal Food, Drug, and Cosmetic Act.'' This draft guidance describes
                procedures to obtain a National Drug Code (NDC) for an FDA-approved
                prescription drug that is imported into the United States in compliance
                with the Federal Food, Drug, and Cosmetic Act (FD&C Act), which would
                provide an additional avenue through which drugs could be sold at a
                lower cost in the U.S. market. This draft guidance is intended to
                address certain challenges in the private market faced by manufacturers
                seeking to sell their drugs at lower costs.
                DATES: Submit either electronic or written comments on the draft
                guidance by February 21, 2020 to ensure that the Agency considers your
                comment on this draft guidance before it begins work on the final
                version of the guidance.
                ADDRESSES: You may submit comments on any guidance 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-5743 for ``Importation of Certain FDA-Approved Human
                Prescription Drugs, Including Biological Products, under Section
                801(d)(1)(B) of the Federal Food, Drug, and Cosmetic Act.'' 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.
                 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.
                 You may submit comments on any guidance at any time (see 21 CFR
                10.115(g)(5)).
                [[Page 70558]]
                 Submit written requests for single copies of the draft guidance to
                the Division of Drug Information, Center for Drug Evaluation and
                Research, Food and Drug Administration, 10001 New Hampshire Ave.,
                Hillandale Building, 4th Floor, Silver Spring, MD 20993-0002 or the
                Office of Communication, Outreach, and Development, Center for
                Biologics Evaluation and Research, Food and Drug Administration, 10903
                New Hampshire Ave., Bldg. 71, Rm. 3128, Silver Spring, MD 20993-0002.
                Send one self-addressed adhesive label to assist that office in
                processing your requests. See the SUPPLEMENTARY INFORMATION section for
                electronic access to the draft guidance document.
                FOR FURTHER INFORMATION CONTACT: Lyndsay Hennessey, Center for Drug
                Evaluation and Research, Food and Drug Administration, 10903 New
                Hampshire Ave., Silver Spring, MD 20993-0002, 301-796-7605, or Stephen
                Ripley, 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 draft guidance for industry
                entitled ``Importation of Certain FDA-Approved Human Prescription
                Drugs, Including Biological Products, under Section 801(d)(1)(B) of the
                Federal Food, Drug, and Cosmetic Act,'' which, when finalized, will
                represent the Agency's current thinking on the importation of multi-
                market approved (MMA) products. This draft guidance describes
                procedures to obtain an NDC for an FDA-approved prescription drug that
                is imported into the United States in compliance with section 801 of
                the FD&C Act (21 U.S.C. 381), which would provide an additional avenue
                through which drugs could be sold at a lower cost in the U.S. market.
                In recent years, FDA has become aware that some drug manufacturers may
                be interested in offering certain of their drugs at lower costs and
                that obtaining additional NDCs for these drugs may help them to address
                certain challenges in the private market. This guidance is not intended
                to address the applicability of the Medicaid drug rebate program for
                manufacturers. This guidance is intended to outline a potential pathway
                by which manufacturers could obtain an additional NDC for an FDA-
                approved drug that was originally intended to be marketed in a foreign
                country. This guidance specifically addresses the importation of FDA-
                approved drugs that were also authorized for sale in a foreign country
                in which the drugs were originally intended to be marketed (``MMA
                product''). This guidance describes: (1) The process for submitting a
                supplement to an approved FDA application for an MMA product; (2) the
                recommended labeling for an MMA product; (3) the process for
                registration and listing and for obtaining an NDC for the MMA product;
                (4) the requirements of section 582 of the FD&C Act (21 U.S.C. 360eee-
                1) as added by the Drug Supply Chain Security Act (DSCSA) (Title II of
                Pub. L. 113-54); (5) recommendations related to procedures for
                importation of the MMA product; and (6) other FDA requirements
                applicable to MMA products.
                 This guidance, when finalized, will help ensure manufacturers are
                aware of procedures to provide access to lower-cost drugs in the United
                States.\1\ The guidance details procedures that will enable
                manufacturers to obtain an additional NDC for the MMA product, which
                could allow greater pricing flexibility for a drug or biological
                product. The additional NDC also will support pharmacovigilance,
                accurate billing and reimbursement, and facilitate clearance of the MMA
                products through customs. This draft guidance is not final nor is it in
                effect at this time.
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                 \1\ Elsewhere in this issue of the Federal Register, FDA is
                issuing a Notice of Proposed Rulemaking under 21 U.S.C. 384 to offer
                a pathway for importation of drugs from Canada without the
                authorization of the manufacturer.
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                 This draft guidance is being issued consistent with FDA's good
                guidance practices regulation (21 CFR 10.115). The draft guidance, when
                finalized, will represent the current thinking of FDA on the
                importation of MMA products. 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. Issues for Consideration
                 As previously noted, FDA is interested in receiving comments on the
                draft guidance. Regarding the approach set forth in the draft guidance,
                in addition to any other issues addressed, FDA requests that commenters
                consider the following issues when submitting comments:
                 1. Are there additional considerations for certain types of drug
                products with special handling, such as sterile injectables, drugs with
                boxed warnings, drugs with REMS (Risk Evaluation and Mitigation
                Strategy), controlled substances, or drugs that do not meet the
                definition of ``product'' under the DSCSA (21 U.S.C. 360eee(13))? Are
                there additional considerations for combination products related to the
                content of the guidance (e.g., supplement, labeling, NDC) that would
                warrant additional guidance for use of this approach for those
                products? To the extent that interested parties believe that different
                or additional considerations from those described in the draft guidance
                should apply to such an approach for combination products, we are
                interested in input on that, as well.
                 2. The draft guidance uses ``MMA product'' to describe FDA-approved
                drugs that were originally intended to be marketed in a foreign country
                and also authorized for sale in that foreign country. Is this new term
                adequate and understandable? Is there another term that would provide
                more clarity regarding the products discussed in the guidance?
                 3. The draft guidance describes how an NDC could be obtained for
                MMA products. What is the effect of a manufacturer using a new labeler
                code as opposed to a new product code to distinguish these products,
                such as for reimbursement?
                 4. The draft guidance recommends a labeling statement in the FDA-
                approved labeling for the MMA product, including the carton and
                container label, to assist pharmacists and others in accurately
                identifying, dispensing, and billing for these products. FDA seeks
                comment on the specific wording that could be included in the statement
                to differentiate MMA products from other drugs that are not the subject
                of the guidance, if finalized, and to help ensure MMA products are
                easily identifiable to pharmacists and not confusing to patients. FDA
                also seeks comment on other types of distinguishing characteristics on
                the carton and container label that would further enable pharmacists to
                identify an MMA product and distinguish it from other packages of the
                FDA-approved drug, without confusing patients and consistent with other
                applicable requirements relating to carton and container labeling.
                Additionally, would other possible mechanisms, such as a Dear
                Healthcare Provider letter, provide further clarity and reduce
                confusion for pharmacists and other healthcare providers as well as
                patients?
                 5. We request comment about how much, on average, the labeling and
                packaging changes described in the draft guidance would cost drug
                manufacturers and repackagers or relabelers. Are there other ways to
                [[Page 70559]]
                distinguish the appearance of an MMA product? We also request comment
                about alternative labeling approaches that would display the required
                information with equal prominence but may result in lower costs.
                 6. The draft guidance describes procedures for manufacturers of
                drug products approved under new drug applications or biologics license
                applications to obtain an additional NDC for an MMA product. FDA is
                interested as to whether manufacturers of generic drugs approved under
                an abbreviated new drug application confront similar pricing issues
                such that it would be appropriate to provide guidance on a similar
                approach for generic drugs. To the extent that interested parties
                believe that different considerations should apply to such an approach
                for generic drugs from those described in the draft guidance, input is
                requested on that as well.
                 7. There are complex considerations that impact biosimilar
                development, market entry, and uptake. We are interested in the
                possible impacts of MMA products that are biological products on
                biosimilar development, market entry, and uptake.
                 8. Similarly, there are complex considerations impacting generic
                drug market entry. We are interested in the possible impacts of MMA
                products on generic drug development and market entry.
                 9. Are there voluntary steps a manufacturer may take in addition to
                the requirements in the DSCSA to ensure the security of the supply
                chain for products imported pursuant to the guidance?
                 10. Are there any potential risks associated with the importation
                of products as described in the draft guidance that could be addressed
                by a rulemaking? For example, to what extent, if any, are there
                additional procedures that might better protect against entities
                seeking to introduce counterfeit drugs in the United States? If so,
                please be specific about the potential risk and how it could be
                addressed through rulemaking.
                III. Paperwork Reduction Act of 1995
                 FDA has tentatively concluded that there are no new collections of
                information in this draft guidance. This draft guidance refers to
                previously approved collections of information found in the FD&C Act
                and FDA regulations. These collections of information are subject to
                review by the Office of Management and Budget (OMB) under the Paperwork
                Reduction Act of 1995 (44 U.S.C. 3501-3520). In accordance with the
                Paperwork Reduction Act, if FDA's tentative conclusion changes, prior
                to publication of any final guidance document FDA intends to solicit
                public comment and obtain OMB approval for any information collections
                recommended in this guidance that are new or that would represent
                material modifications to those previously approved collections of
                information found in FDA regulations or guidances.
                 The collections of information in 21 CFR part 314 (new drug
                applications) have been approved under OMB control number 0910-0001;
                the collections of information in 21 CFR part 601 (biologics license
                applications) have been approved under OMB control number 0910-0338;
                the collections of information in 21 CFR part 207 (domestic and foreign
                facility registration, including assignment of an NDC) have been
                approved under OMB control number 0910-0045; the collections of
                information in 21 CFR part 1 (general enforcement regulations) have
                been approved under OMB control number 0910-0046; the collections of
                information in 21 CFR part 201 (labeling) have been approved under OMB
                control number 0910-0572; the collections of information pertaining to
                current good manufacturing practice requirements for finished
                pharmaceuticals and combination products under 21 CFR parts 4, 210,
                211, 610, and 680 have been approved under OMB control numbers 0910-
                0139 and 0910-0834; and the collections of information pertaining to
                suspect product identification and notification under section 582 of
                the FD&C Act have been approved under OMB control number 0910-0806.
                IV. Electronic Access
                 Persons with access to the internet may obtain the draft guidance
                at https://www.fda.gov/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/default.htm, https://www.fda.gov/vaccines-blood-biologics/guidance-compliance-regulatory-information-biologics/biologics-guidances, or https://www.regulations.gov.
                 Dated: December 11, 2019.
                Brett P. Giroir,
                Acting Commissioner of Food and Drugs.
                [FR Doc. 2019-27475 Filed 12-18-19; 8:45 am]
                 BILLING CODE 4164-01-P
                

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