[Federal Register Volume 79, Number 127 (Wednesday, July 2, 2014)]
[Notices]
[Pages 37747-37750]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2014-15367]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Food and Drug Administration
[Docket No. FDA-2013-N-1525]
Bulk Drug Substances That May Be Used To Compound Drug Products
in Accordance With Section 503A of the Federal Food, Drug, and Cosmetic
Act; Revised Request for Nominations
AGENCY: Food and Drug Administration, HHS.
ACTION: Notice; revised request for nominations.
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SUMMARY: The Food and Drug Administration (FDA or Agency) is preparing
to develop a list of bulk drug substances (active ingredients) that may
be used to compound drug products in accordance with section 503A of
the Federal Food, Drug, and Cosmetic Act (the FD&C Act), although they
are neither the subject of a United States Pharmacopeia (USP) or
National Formulary (NF) monograph nor components of FDA-approved drugs.
In response to a notice published in the Federal Register of December
4, 2013, interested groups and individuals previously nominated a wide
variety of substances for this list. However, many of those nominations
either were for a substance that is already the subject of a USP
monograph or a component of an FDA-approved drug, were not for bulk
drug substances used in compounding as active ingredients, or did not
include sufficient information to justify inclusion of the nominated
substance on the list. To improve the efficiency of the process for
developing the list of bulk drug substances that may be used to
compound drug products under section 503A, FDA is providing more
detailed information on what it needs to evaluate a nomination. Because
the deadline for nominations has passed, FDA is reopening the
nomination process so that interested persons can submit nominations of
bulk drug substances that are not the subject of a USP or NF monograph
or a component of an FDA-approved drug. Interested persons will also
have the opportunity to provide adequate support to justify placement
of the substances on the list. Bulk drug substances that were
previously nominated will not be further considered unless they are
renominated and those nominations are adequately supported. Substances
that are already eligible for use in compounding or that are not
adequately supported will not be placed on the list.
DATES: Submit written or electronic nominations for the bulk drug
substances list by September 30, 2014.
ADDRESSES: You may submit nominations, identified by Docket No. FDA-
2013-N-1525, by any of the following methods.
Electronic Submissions
Submit electronic nominations in the following way:
Federal eRulemaking Portal: http://www.regulations.gov.
Follow the instructions for submitting ``comments.''
Written Submissions
Submit written nominations in the following ways:
Mail/Hand delivery/Courier (for paper submissions):
Division of Dockets Management (HFA-305), Food and Drug Administration,
5630 Fishers Lane, rm. 1061, Rockville, MD 20852.
Instructions: All submissions received must include the Agency name
and Docket No. FDA-2013-N-1525 for this request for nominations. All
nominations received may be posted without change to http://www.regulations.gov, including any personal information provided. For
additional information on submitting nominations, see the ``Request for
Nominations'' heading of the SUPPLEMENTARY INFORMATION section of this
document.
Docket: For access to the docket to read background documents or
nominations received, go to http://www.regulations.gov and insert the
docket number, found in brackets in the heading of this document, into
the ``Search'' box and follow the prompts and/or go to the Division of
Dockets Management, 5630 Fishers Lane, Rm. 1061, Rockville, MD 20852.
FOR FURTHER INFORMATION CONTACT: Emily Helms Williams, Center for Drug
Evaluation and Research, Food and Drug Administration, 10903 New
Hampshire Ave., Bldg. 51, Rm. 6280, Silver Spring, MD 20993-0002, 301-
796-3381.
SUPPLEMENTARY INFORMATION:
I. Background
Section 503A of the FD&C Act (21 U.S.C. 353a) describes the
conditions under which a compounded drug product may be entitled to an
exemption from certain sections of the FD&C Act. Those conditions
include that the licensed pharmacist or licensed physician compounds
the drug product using bulk drug substances that (1) comply with the
standards of an applicable USP or NF monograph, if a monograph exists,
and the USP chapter on pharmacy compounding; (2) if such a monograph
does not exist, are drug substances that are components of drugs
approved by the Secretary; or (3) if such a monograph does not exist
and the drug substance is not a component of a drug approved by the
Secretary, that appear on a list developed by the Secretary through
regulations issued by the Secretary under subsection (c) of section
503A. See section 503A(b)(1)(A)(i) of the FD&C Act. Under section
503A(c)(2), the criteria for determining which substances should appear
on the 503A bulk drugs list ``shall include historical use, reports in
peer reviewed medical literature, or other criteria the Secretary may
identify.''
Section 503A refers to the definition of ``bulk drug substance'' in
FDA regulations at Sec. 207.3(a)(4) (21 CFR 207.3(a)(4)). See section
503A(b)(1)(A) of the FD&C Act. As defined in
[[Page 37748]]
Sec. 207.3(a)(4), a ``bulk drug substance'' is any substance that is
represented for use in a drug and that, when used in the manufacturing,
processing, or packaging of a drug, becomes an active ingredient or a
finished dosage form of the drug, but the term does not include
intermediates used in the synthesis of such substances.
An ``active ingredient'' is any component that is intended to
furnish pharmacological activity or other direct effect in the
diagnosis, cure, mitigation, treatment, or prevention of disease, or to
affect the structure or any function of the body of man or other
animals. The term includes those components that may undergo chemical
change in the manufacture of the drug product and be present in the
drug product in a modified form intended to furnish the specified
activity or effect. See 21 CFR 210.3(b)(7).
Any component other than an active ingredient is an ``inactive
ingredient.'' See 21 CFR 210.3(b)(8). Inactive ingredients used in
compounded drug products, which commonly include flavorings, dyes,
diluents, or other excipients, need not appear on the Secretary's list
of bulk drug substances to be eligible for use in compounding drug
products and will not be included on the list.
In a notice dated November 27, 2013 (the November 27, 2013,
notice), published in the Federal Register of December 4, 2013 (78 FR
72841), FDA requested nominations for specific bulk drug substances for
the Agency to consider placing on the list. In response to that
request, 115 comments were submitted to the docket, most of which
nominated substances for inclusion on the bulk drug substances list.
Some comments nominated several hundred substances, and approximately
10 comments nominated thousands of substances, including en bloc
nominations of substances listed in the British Pharmacopeia, the
European Pharmacopeia, the Japanese Pharmacopeia, the Food Chemicals
Codex, the Homeopathic Pharmacopeia of the United States, and the USP
Dietary Supplements Compendium. Several submissions referenced a
spreadsheet entitled ``OTC Active Ingredients,'' available on FDA's Web
site at http://www.fda.gov/downloads/AboutFDA/CentersOffices/CDER/UCM135688.pdf. Those submissions nominated all of the ingredients on
the spreadsheet, which numbered over 1,700 entries.\1\
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\1\ The total number of unique ingredients on the spreadsheet
available on FDA's Web site and the nominations that mirrored that
document is lower than this total because the same substances were
listed separately for different indications, according to how they
are listed in the over-the-counter (OTC) monographs and regulations.
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However, many of the nominated substances are typically inactive
ingredients or foods. Some commonly used inactive ingredients are
occasionally used as the active ingredient in a drug product. See 55 FR
46914 at 46916, November 7, 1990 (noting that 21 CFR 310.545 only
affects the use of the listed ingredients as active ingredients for the
specific indications, and that some of the ingredients listed in the
rule, such as sorbitol, sugars, and eucalyptol, have valid uses as
inactive ingredients). Ingredients commonly used as inactive
ingredients in compounded drug products, such as flavorings, dyes,
diluents, or other excipients, need not appear on the Secretary's list
of bulk drug substances to be eligible for use as an inactive
ingredient in compounded drug products, should not be nominated, and
will not be included on the list. All nominations must demonstrate how
the ingredient is used as an active ingredient in a particular
compounded drug product.
Additionally, many of the nominated substances are already eligible
for use in compounded drug products, namely, those that are components
of approved products or are the subject of a USP or NF monograph.
Substances that are in one of those two categories need not appear on
the list of bulk drug substances to be used in compounded drug
products.
Further, many of the nominations did not include sufficient
information for the Agency to evaluate whether the substance is
appropriate for use in compounded drug products. As stated previously,
under section 503A(c)(2) of the FD&C Act, the criteria for determining
which substances should appear on the 503A bulk drugs list shall
include historical use, reports in peer reviewed medical literature, or
other criteria the Secretary may identify. Based on this statutory
language and prior consultations with the USP and the Pharmacy
Compounding Advisory Committee,\2\ FDA is proposing to examine the
following four criteria when determining whether a bulk drug substance
is appropriate for use in compounded drug products: (1) The physical
and chemical characterization of the substance; (2) any safety issues
raised by the use of the substance in compounded drug products; (3)
historical use of the substance in compounded drug products, including
information about the medical condition(s) the substance has been used
to treat and any references in peer-reviewed medical literature; and
(4) the available evidence of effectiveness or lack of effectiveness of
a drug product compounded with the substance, if any such evidence
exists. Therefore, to qualify for placement on the list, it is
necessary to identify this information about the nominated substances.
FDA will evaluate the nominated substances in consultation with the
Pharmacy Compounding Advisory Committee.
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\2\ See 64 FR 996, January 7, 1999 (proposed rule listing bulk
drug substances that may be used in pharmacy compounding). This
proposed rule was withdrawn in the November 27, 2013, notice but
sets forth additional background about the criteria used in the
evaluation of nominated bulk drug substances.
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The November 27, 2013, notice requested that nominations include
``[i]nformation about the past and proposed use(s) of the compounded
product(s), including the rationale for its use or why the compounded
product(s), as opposed to an FDA-approved product, is necessary.''
However, many comments to the docket did not provide any information in
response to this request. The nominators of the en bloc submissions
provided no justification for listing any of the specific substances on
the list. To the extent information about the rationale for compounding
with a bulk drug substance was provided in individual nominations, many
of the comments to the docket included only a brief statement about the
use of the compounded drug product and a statement that the product is
not available as a commercially made drug. Such statements do not
provide sufficient information for FDA to determine whether the
nominated bulk drug substance is appropriate for use in compounded drug
products. Because the information submitted with previous nominations
was insufficient, FDA is unable to determine whether those substances
should be included on the list.
To improve the efficiency of the process for developing the list of
bulk drug substances that may be used to compound drug products under
section 503A, and because the deadline for submitting nominations has
passed, FDA is reopening the nomination process so that interested
persons have the opportunity to submit nominations of bulk drug
substances and provide adequate support for placing them on the list.
FDA will be able to evaluate only those bulk drug substances submitted
in response to this notice that are supported with adequate data and
information, as described in section II.
Bulk drug substances that were previously nominated will not be
[[Page 37749]]
further considered unless they are renominated and adequately
supported. Substances that are not adequately supported will not be
placed on the list. FDA expects the submissions for each bulk drug
substance to provide the information described in section II. For
example, nominations must include sufficient information to demonstrate
that a particular ingredient meets the definition of ``bulk drug
substance,'' as defined in Sec. 207.3(a)(4). See section 503A(b)(1)(A)
of the FD&C Act. The identification of an ingredient as an ``active
ingredient'' in a regulation, or on a spreadsheet such as the one
listing ``OTC Active Ingredients,'' is not sufficient to demonstrate
that a substance is a bulk drug substance for purposes of the 503A
list. En bloc nominations of substances listed in compendia,
pharmacopeia, or similar reference materials cannot be placed on the
list unless the Agency receives adequate information for each bulk drug
substance to justify its placement on the list. FDA will only be able
to consider bulk drug substances that are supported with the
information requested.
In section II, FDA identifies the type of information needed to
support a nomination to the 503A list.
II. Request for Nominations
Interested groups and individuals may nominate specific bulk
substances for inclusion on the list. Nominations will only be
evaluated if they are for specific active ingredients that meet the
definition of a bulk drug substance in Sec. 207.3(a)(4), are not for
components of approved products, and are not for the subject of a USP
or NF monograph. To fully evaluate a bulk drug substance, FDA needs the
following information about both the bulk drug substance being
nominated and the drug product(s) that will be compounded using such
substance:
A. Confirmation That the Nominated Substance Is a Bulk Drug Substance
and Is Not Already Eligible for 503A Compounding
A statement that the nominated substance is an active
ingredient that meets the definition of ``bulk drug substance'' in
Sec. 207.3(a)(4), and an explanation of why the substance is
considered an active ingredient when it is used in the identified
compounded drug product(s), citing to specific sources that describe
the active properties of the substance.
A statement that the nominator has searched for the active
ingredient in all three sections of the Orange Book (for prescription
drug products, over-the-counter drug products, and discontinued drug
products), available at http://www.accessdata.fda.gov/scripts/cder/ob/docs/queryai.cfm, and the drug substance did not appear in any of those
searches, confirming that the substance is not a component of any FDA-
approved product.
A statement that the nominator has searched USP and NF
monographs, available at http://www.uspnf.com, and the drug substance
is not the subject of such a monograph.
B. General Background on the Bulk Drug Substance
Ingredient name;
Chemical name;
Common name(s);
Identifying codes, as available, from FDA's Unique
Ingredient Identifiers (UNII) used in the FDA/USP Substance
Registration System, available at http://fdasis.nlm.nih.gov/srs/.
Because substance names can vary, this code, where available, will be
used by the Agency to confirm the exact substance nominated and to
identify multiple nominations of the same substance so the information
can be reviewed together.
Chemical grade of the ingredient;
Description of the strength, quality, stability, and
purity of the ingredient;
Information about how the ingredient is supplied (e.g.,
powder, liquid); and
Information about recognition of the substance in foreign
pharmacopeias and the status of its registration(s) in other countries,
including whether information has been submitted to USP for
consideration of monograph development.
C. Information on the Drug Product That Will Be Compounded With the
Bulk Drug Substance
Information about the dosage form(s) into which the bulk
drug substance will be compounded;
Information about the strength(s) of the compounded drug
product(s);
Information about the anticipated route(s) of
administration of the compounded product(s);
A bibliography of safety and efficacy data for the drug
compounded using the nominated substance, if available,\3\ including
any relevant peer-reviewed medical literature; and
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\3\ FDA recognizes that the available safety and efficacy data
supporting consideration of a bulk drug substance for inclusion on
the list may not be of the same type, amount, or quality as is
required to support a new drug application.
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Information about the past and proposed use(s) of the
compounded drug product(s), including the rationale for its use and why
the compounded product(s), as opposed to an FDA-approved product, is
necessary. Information on the rationale for use of the bulk drug
substance and why a compounded drug product is necessary must be
specific to the compounded drug product at issue. General or
boilerplate statements regarding the need for compounded drug products
or the benefits of compounding generally will not be considered
sufficient to address this issue.
D. Nomination Process
Because the deadline for submitting nominations has passed, FDA is
reopening the nomination process so that interested persons can submit
nominations of bulk drug substances and have the opportunity to provide
adequate support for placing them on the list. Bulk drug substances
that were previously nominated need to be renominated. Nominators are
encouraged to submit as much of the information identified in this
document as possible. Unless adequate supporting data is received for a
bulk drug substance, FDA will be unable to consider it further for
inclusion on the list. Individuals and organizations will be able to
comment on nominated substances after the nomination period has closed
or petition FDA to make additional list amendments after the list is
published, in accordance with 21 CFR 10.30.
For efficient consolidation and review of nominations, nominators
are encouraged to submit their nominations in an editable Excel file.
Specifically, nominators are encouraged to format their nominations as
follows:
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Column A--What information is Column B--Put data specific to
requested? the nominated substance
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What is the name of the nominated Provide the ingredient name.
ingredient?.
Is the ingredient an active ingredient Provide an explanation for why
that meets the definition of ``bulk it is considered an active
drug substance'' in Sec. ingredient when it is used in
207.3(a)(4)? specific compounded drug
products, and provide
citations to specific sources
that describe its active
properties.
[[Page 37750]]
Is the ingredient listed in any of the Confirm whether the ingredient
three sections of the Orange Book? is a component of an FDA-
approved product.
Were any monographs for the ingredient Confirm whether the ingredient
found in the USP or NF monographs? is the subject of a USP or NF
monograph.
What is the chemical name of the Chemical name.
substance?.
What is the common name of the Common name.
substance?.
Does the substance have a UNII Code?... UNII code.
What is the chemical grade of the Provide the chemical grade.
substance?.
What is the strength, quality, Provide the strength, quality,
stability, and purity of the stability, and purity
ingredient?. information.
How is the ingredient supplied?........ Describe how the ingredient is
supplied (e.g., powder,
liquid).
Is the substance recognized in foreign List the foreign pharmacopeias
pharmacopeias or registered in other or other countries in which it
countries? is registered.
Has information been submitted about Put yes, no, or unknown. If
the substance to the USP for yes, state the status of the
consideration of monograph monograph, if known.
development?
What dosage form(s) will be compounded State the dosage form(s).
using the bulk drug substance?
What strength(s) will be compounded List the strength(s) of the
from the nominated substance? drug product(s) that will be
compounded from the nominated
substance, or a range of
strengths, if known.
What are the anticipated route(s) of List the route(s) of
administration of the compounded drug administration of the
product(s)? compounded drug product(s).
Are there safety and efficacy data on Provide a bibliography of
compounded drugs using the nominated safety and efficacy data for
substance? the drug compounded using the
nominated substance, if
available, including any
relevant peer-reviewed medical
literature.
Has the bulk drug substance been used Describe past uses of the bulk
previously to compound drug drug substance in compounding.
product(s)?
What is the proposed use for the drug Provide information on the
product(s) to be compounded with the proposed use of the compounded
nominated substance? drug product.
What is the reason for use of a Provide a rationale for the use
compounded drug product rather than an of a compounded drug product.
FDA-approved product?
Is there any other relevant Provide any other information
information? you would like FDA to consider
in evaluating the nomination.
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Interested persons may submit either electronic nominations to
http://www.regulations.gov or written nominations to the Division of
Dockets Management (see ADDRESSES). It is only necessary to send one
set of nominations. Identify nominations with the docket number found
in the brackets in the heading of this document. Received nominations
may be seen in the Division of Dockets Management between 9 a.m. and 4
p.m., Monday through Friday, and will be posted to the docket at http://www.regulations.gov.
Dated: June 25, 2014.
Leslie Kux,
Assistant Commissioner for Policy.
[FR Doc. 2014-15367 Filed 7-1-14; 8:45 am]
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