{"identifier":"/us/usc/t21/s353d","title_num":"21","num":"§ 353d.","heading":"Process to update labeling for certain generic drugs","status":null,"guid":"idc92a6f13-f339-11ed-b7d6-eb7e2ad38908","source_credit":"(June 25, 1938, ch. 675, § 503D, as added Pub. L. 116–260, div. BB, title III, § 324, Dec. 27, 2020, 134 Stat. 2933.)","seq_in_title":152,"parent_identifier":"/us/usc/t21/ch9/schV/ptA","ancestors":[{"identifier":"/us/usc/t21","level":"title","num":"Title 21—","heading":"FOOD AND DRUGS","status":null,"is_section":false},{"identifier":"/us/usc/t21/ch9","level":"chapter","num":"CHAPTER 9—","heading":"FEDERAL FOOD, DRUG, AND COSMETIC ACT","status":null,"is_section":false},{"identifier":"/us/usc/t21/ch9/schV","level":"subchapter","num":"SUBCHAPTER V—","heading":"DRUGS AND DEVICES","status":null,"is_section":false},{"identifier":"/us/usc/t21/ch9/schV/ptA","level":"part","num":"Part A—","heading":"Drugs and Devices","status":null,"is_section":false}],"xml":"<section xmlns=\"http://xml.house.gov/schemas/uslm/1.0\" xmlns:xsi=\"http://www.w3.org/2001/XMLSchema-instance\" xmlns:dc=\"http://purl.org/dc/elements/1.1/\" xmlns:dcterms=\"http://purl.org/dc/terms/\" style=\"-uslm-lc:I80\" id=\"idf2187250-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d\"><num value=\"353d\">§ 353d.</num><heading> Process to update labeling for certain generic drugs</heading><subsection style=\"-uslm-lc:I19\" class=\"indent2 firstIndent-2\" id=\"idf2189961-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d/a\"><num value=\"a\" class=\"bold\">(a)</num><heading class=\"bold\"> Definitions</heading><chapeau style=\"-uslm-lc:I11\" class=\"indent0\">For purposes of this section:</chapeau><paragraph style=\"-uslm-lc:I12\" class=\"indent1\" id=\"idf2189962-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d/a/1\"><num value=\"1\">(1)</num><chapeau> The term “covered drug” means a drug approved under <ref href=\"/us/usc/t21/s355/c\">section 355(c) of this title</ref>—</chapeau><subparagraph style=\"-uslm-lc:I13\" class=\"indent2\" id=\"idf2189963-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d/a/1/A\"><num value=\"A\">(A)</num><content> for which there are no unexpired patents included in the list under <ref href=\"/us/usc/t21/s355/j/7\">section 355(j)(7) of this title</ref> and no unexpired period of exclusivity;</content>\n</subparagraph>\n<subparagraph style=\"-uslm-lc:I13\" class=\"indent2\" id=\"idf2189964-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d/a/1/B\"><num value=\"B\">(B)</num><content> for which the approval of the application has been withdrawn for reasons other than safety or effectiveness; and</content>\n</subparagraph>\n<subparagraph style=\"-uslm-lc:I13\" class=\"indent2\" id=\"idf2189965-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d/a/1/C\"><num value=\"C\">(C)</num><chapeau> for which—</chapeau><clause style=\"-uslm-lc:I14\" class=\"indent3\" id=\"idf2189966-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d/a/1/C/i\"><num value=\"i\">(i)</num><subclause style=\"-uslm-lc:I14\" class=\"indent3\" id=\"idf2189967-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d/a/1/C/i/I\"><num value=\"I\">(I)</num><content> there is new scientific evidence available pertaining to new or existing conditions of use that is not reflected in the approved labeling;</content>\n</subclause>\n<subclause style=\"-uslm-lc:I14\" class=\"indent3\" id=\"idf2189968-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d/a/1/C/i/II\"><num value=\"II\">(II)</num><content> the approved labeling does not reflect current legal and regulatory requirements for content or format; or</content>\n</subclause>\n<subclause style=\"-uslm-lc:I14\" class=\"indent3\" id=\"idf2189969-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d/a/1/C/i/III\"><num value=\"III\">(III)</num><content> there is a relevant accepted use in clinical practice that is not reflected in the approved labeling; and</content>\n</subclause>\n</clause>\n<clause style=\"-uslm-lc:I14\" class=\"indent3\" id=\"idf218996a-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d/a/1/C/ii\"><num value=\"ii\">(ii)</num><content> updating the approved labeling would benefit the public health.</content>\n</clause>\n</subparagraph>\n</paragraph>\n<paragraph style=\"-uslm-lc:I12\" class=\"indent1\" id=\"idf218996b-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d/a/2\"><num value=\"2\">(2)</num><content> The term “period of exclusivity”, with respect to a drug approved under <ref href=\"/us/usc/t21/s355/c\">section 355(c) of this title</ref>, means any period of exclusivity under clause (ii), (iii), or (iv) of <ref href=\"/us/usc/t21/s355/c/3/E\">section 355(c)(3)(E) of this title</ref>, clause (ii), (iii), or (iv) of <ref href=\"/us/usc/t21/s355/j/5/F\">section 355(j)(5)(F) of this title</ref>, or section 355a, 355f, or 360cc of this title.</content>\n</paragraph>\n<paragraph style=\"-uslm-lc:I12\" class=\"indent1\" id=\"idf218996c-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d/a/3\"><num value=\"3\">(3)</num><content> The term “generic version” means a drug approved under <ref href=\"/us/usc/t21/s355/j\">section 355(j) of this title</ref> whose reference listed drug is a covered drug.</content>\n</paragraph>\n<paragraph style=\"-uslm-lc:I12\" class=\"indent1\" id=\"idf218996d-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d/a/4\"><num value=\"4\">(4)</num><content> The term “relevant accepted use” means a use for a drug in clinical practice that is supported by scientific evidence that appears to the Secretary to meet the standards for approval under <ref href=\"/us/usc/t21/s355\">section 355 of this title</ref>.</content>\n</paragraph>\n<paragraph style=\"-uslm-lc:I12\" class=\"indent1\" id=\"idf218c07e-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d/a/5\"><num value=\"5\">(5)</num><content> The term “selected drug” means a covered drug for which the Secretary has determined through the process under subsection (c) that the labeling should be changed.</content>\n</paragraph>\n</subsection>\n<subsection style=\"-uslm-lc:I19\" class=\"indent2 firstIndent-2\" id=\"idf218c07f-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d/b\"><num value=\"b\" class=\"bold\">(b)</num><heading class=\"bold\"> Identification of covered drugs</heading><chapeau style=\"-uslm-lc:I11\" class=\"indent0\">The Secretary may identify covered drugs for which labeling updates would provide a public health benefit. To assist in identifying covered drugs, the Secretary may do one or both of the following:</chapeau><paragraph style=\"-uslm-lc:I12\" class=\"indent1\" id=\"idf218c080-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d/b/1\"><num value=\"1\">(1)</num><content> Enter into cooperative agreements or contracts with public or private entities to review the available scientific evidence concerning such drugs.</content>\n</paragraph>\n<paragraph style=\"-uslm-lc:I12\" class=\"indent1\" id=\"idf218c081-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d/b/2\"><num value=\"2\">(2)</num><chapeau> Seek public input concerning such drugs, including input on whether there is a relevant accepted use in clinical practice that is not reflected in the approved labeling of such drugs or whether new scientific evidence is available regarding the conditions of use for such drug, by—</chapeau><subparagraph style=\"-uslm-lc:I13\" class=\"indent2\" id=\"idf218c082-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d/b/2/A\"><num value=\"A\">(A)</num><content> holding one or more public meetings;</content>\n</subparagraph>\n<subparagraph style=\"-uslm-lc:I13\" class=\"indent2\" id=\"idf218c083-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d/b/2/B\"><num value=\"B\">(B)</num><content> opening a public docket for the submission of public comments; or</content>\n</subparagraph>\n<subparagraph style=\"-uslm-lc:I13\" class=\"indent2\" id=\"idf218c084-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d/b/2/C\"><num value=\"C\">(C)</num><content> other means, as the Secretary determines appropriate.</content>\n</subparagraph>\n</paragraph>\n</subsection>\n<subsection style=\"-uslm-lc:I19\" class=\"indent2 firstIndent-2\" id=\"idf218c085-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d/c\"><num value=\"c\" class=\"bold\">(c)</num><heading class=\"bold\"> Selection of drugs for updating</heading><content><p style=\"-uslm-lc:I11\" class=\"indent0\">If the Secretary determines, with respect to a covered drug, that the available scientific evidence meets the standards under <ref href=\"/us/usc/t21/s355\">section 355 of this title</ref> for adding or modifying information to the labeling or providing supplemental information to the labeling regarding the use of the covered drug, the Secretary may initiate the process under subsection (d).</p>\n</content>\n</subsection>\n<subsection style=\"-uslm-lc:I19\" class=\"indent2 firstIndent-2\" id=\"idf218c086-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d/d\"><num value=\"d\" class=\"bold\">(d)</num><heading class=\"bold\"> Initiation of the process of updating</heading><chapeau style=\"-uslm-lc:I11\" class=\"indent0\">If the Secretary determines that labeling changes are appropriate for a selected drug pursuant to subsection (c), the Secretary shall provide notice to the holders of approved applications for a generic version of such drug that—</chapeau><paragraph style=\"-uslm-lc:I12\" class=\"indent1\" id=\"idf218e797-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d/d/1\"><num value=\"1\">(1)</num><content> summarizes the findings supporting the determination of the Secretary that the available scientific evidence meets the standards under <ref href=\"/us/usc/t21/s355\">section 355 of this title</ref> for adding or modifying information or providing supplemental information to the labeling of the covered drug pursuant to subsection (c);</content>\n</paragraph>\n<paragraph style=\"-uslm-lc:I12\" class=\"indent1\" id=\"idf218e798-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d/d/2\"><num value=\"2\">(2)</num><content> provides a clear statement regarding the additional, modified, or supplemental information for such labeling, according to the determination by the Secretary (including, as applicable, modifications to add the relevant accepted use to the labeling of the drug as an additional indication for the drug); and</content>\n</paragraph>\n<paragraph style=\"-uslm-lc:I12\" class=\"indent1\" id=\"idf218e799-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d/d/3\"><num value=\"3\">(3)</num><content> states whether the statement under paragraph (2) applies to the selected drug as a class of covered drugs or only to a specific drug product.</content>\n</paragraph>\n</subsection>\n<subsection style=\"-uslm-lc:I19\" class=\"indent2 firstIndent-2\" id=\"idf218e79a-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d/e\"><num value=\"e\" class=\"bold\">(e)</num><heading class=\"bold\"> Response to notification</heading><chapeau style=\"-uslm-lc:I11\" class=\"indent0\">Within 30 days of receipt of notification provided by the Secretary pursuant to subsection (d), the holder of an approved application for a generic version of the selected drug shall—</chapeau><paragraph style=\"-uslm-lc:I12\" class=\"indent1\" id=\"idf218e79b-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d/e/1\"><num value=\"1\">(1)</num><content> agree to change the approved labeling to reflect the additional, modified, or supplemental information the Secretary has determined to be appropriate; or</content>\n</paragraph>\n<paragraph style=\"-uslm-lc:I12\" class=\"indent1\" id=\"idf218e79c-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d/e/2\"><num value=\"2\">(2)</num><content> notify the Secretary that the holder of the approved application does not believe that the requested labeling changes are warranted and submit a statement detailing the reasons why such changes are not warranted.</content>\n</paragraph>\n</subsection>\n<subsection style=\"-uslm-lc:I19\" class=\"indent2 firstIndent-2\" id=\"idf218e79d-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d/f\"><num value=\"f\" class=\"bold\">(f)</num><heading class=\"bold\"> Review of application holder’s response</heading><paragraph style=\"-uslm-lc:I79\" class=\"indent3 firstIndent-2\" id=\"idf218e79e-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d/f/1\"><num value=\"1\" class=\"bold\">(1)</num><heading class=\"bold\"> In general</heading><content><p style=\"-uslm-lc:I12\" class=\"indent1\">Upon receipt of the application holder’s response, the Secretary shall promptly review each statement received under subsection (e)(2) and determine which labeling changes pursuant to the Secretary’s notice under subsection (d) are appropriate, if any. If the Secretary disagrees with the reasons why such labeling changes are not warranted, the Secretary shall provide opportunity for discussions with the application holders to reach agreement on whether the labeling for the covered drug should be updated to reflect available scientific evidence, and if so, the content of such labeling changes.</p>\n</content>\n</paragraph>\n<paragraph style=\"-uslm-lc:I79\" class=\"indent3 firstIndent-2\" id=\"idf2190eaf-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d/f/2\"><num value=\"2\" class=\"bold\">(2)</num><heading class=\"bold\"> Changes to labeling</heading><chapeau style=\"-uslm-lc:I12\" class=\"indent1\">After considering all responses from the holder of an approved application under paragraph (1) or (2) of subsection (e), and any discussion under paragraph (1), the Secretary may order such holder to make the labeling changes the Secretary determines are appropriate. Such holder of an approved application shall—</chapeau><subparagraph style=\"-uslm-lc:I13\" class=\"indent2\" id=\"idf2190eb0-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d/f/2/A\"><num value=\"A\">(A)</num><content> update its paper labeling for the drug at the next printing of that labeling;</content>\n</subparagraph>\n<subparagraph style=\"-uslm-lc:I13\" class=\"indent2\" id=\"idf2190eb1-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d/f/2/B\"><num value=\"B\">(B)</num><content> update any electronic labeling for the drug within 30 days of such order; and</content>\n</subparagraph>\n<subparagraph style=\"-uslm-lc:I13\" class=\"indent2\" id=\"idf2190eb2-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d/f/2/C\"><num value=\"C\">(C)</num><content> submit the revised labeling through the form, “Supplement—Changes Being Effected”.</content>\n</subparagraph>\n</paragraph>\n</subsection>\n<subsection style=\"-uslm-lc:I19\" class=\"indent2 firstIndent-2\" id=\"idf2190eb3-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d/g\"><num value=\"g\" class=\"bold\">(g)</num><heading class=\"bold\"> Violation</heading><content><p style=\"-uslm-lc:I11\" class=\"indent0\">If the holder of an approved application for the generic version of the selected drug does not comply with the requirements of subsection (f)(2), such generic version of the selected drug shall be deemed to be misbranded under <ref href=\"/us/usc/t21/s352\">section 352 of this title</ref>.</p>\n</content>\n</subsection>\n<subsection style=\"-uslm-lc:I19\" class=\"indent2 firstIndent-2\" id=\"idf2190eb4-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d/h\"><num value=\"h\" class=\"bold\">(h)</num><heading class=\"bold\"> Limitations; generic drugs</heading><paragraph style=\"-uslm-lc:I79\" class=\"indent3 firstIndent-2\" id=\"idf2190eb5-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d/h/1\"><num value=\"1\" class=\"bold\">(1)</num><heading class=\"bold\"> In general</heading><content><p style=\"-uslm-lc:I12\" class=\"indent1\">With respect to any labeling change required under this section, the generic version shall be deemed to have the same conditions of use and the same labeling as its reference listed drug for purposes of clauses (i) and (v) of <ref href=\"/us/usc/t21/s355/j/2/A\">section 355(j)(2)(A) of this title</ref>. Any labeling change so required shall not have any legal effect for the applicant that is different than the legal effect that would have resulted if a supplemental application had been submitted and approved to conform the labeling of the generic version to a change in the labeling of the reference drug.</p>\n</content>\n</paragraph>\n<paragraph style=\"-uslm-lc:I79\" class=\"indent3 firstIndent-2\" id=\"idf21935c6-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d/h/2\"><num value=\"2\" class=\"bold\">(2)</num><heading class=\"bold\"> Supplemental applications</heading><content><p style=\"-uslm-lc:I12\" class=\"indent1\">Changes to labeling made in accordance with this section shall not be eligible for an exclusivity period under this chapter.</p>\n</content>\n</paragraph>\n<paragraph style=\"-uslm-lc:I79\" class=\"indent3 firstIndent-2\" id=\"idf21935c7-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d/h/3\"><num value=\"3\" class=\"bold\">(3)</num><heading class=\"bold\"> Selection of drugs</heading><content><p style=\"-uslm-lc:I12\" class=\"indent1\">The Secretary shall not identify a drug as a covered drug or select a drug label for updating under subsection (b) or (c) solely based on the availability of new safety information. Upon identification of a drug as a covered drug under subsection (b), the Secretary may then consider the availability of new safety information (as defined in <ref href=\"/us/usc/t21/s355–1/b\">section 355–1(b) of this title</ref>) in determining whether the drug is a selected drug and in determining what labeling changes are appropriate.</p>\n</content>\n</paragraph>\n</subsection>\n<subsection style=\"-uslm-lc:I19\" class=\"indent2 firstIndent-2\" id=\"idf21935c8-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d/i\"><num value=\"i\" class=\"bold\">(i)</num><heading class=\"bold\"> Rules of construction</heading><paragraph style=\"-uslm-lc:I79\" class=\"indent3 firstIndent-2\" id=\"idf21935c9-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d/i/1\"><num value=\"1\" class=\"bold\">(1)</num><heading class=\"bold\"> Approval standards</heading><content><p style=\"-uslm-lc:I12\" class=\"indent1\">This section shall not be construed as altering the applicability of the standards for approval of an application under <ref href=\"/us/usc/t21/s355\">section 355 of this title</ref>. No order shall be issued under this subsection unless the scientific evidence supporting the changed labeling meets the standards for approval applicable to any change to labeling under <ref href=\"/us/usc/t21/s355\">section 355 of this title</ref>.</p>\n</content>\n</paragraph>\n<paragraph style=\"-uslm-lc:I79\" class=\"indent3 firstIndent-2\" id=\"idf2195cda-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d/i/2\"><num value=\"2\" class=\"bold\">(2)</num><heading class=\"bold\"> Removal of information</heading><content><p style=\"-uslm-lc:I12\" class=\"indent1\">Nothing in this section shall be construed to give the Secretary additional authority to remove approved indications for drugs, other than the authority described in this section.</p>\n</content>\n</paragraph>\n<paragraph style=\"-uslm-lc:I79\" class=\"indent3 firstIndent-2\" id=\"idf2195cdb-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d/i/3\"><num value=\"3\" class=\"bold\">(3)</num><heading class=\"bold\"> Secretary authority</heading><content><p style=\"-uslm-lc:I12\" class=\"indent1\">Nothing in this section shall be construed to limit the authority of the Secretary to require labeling changes under section 355(<i>o</i>) of this title.</p>\n</content>\n</paragraph>\n<paragraph style=\"-uslm-lc:I79\" class=\"indent3 firstIndent-2\" id=\"idf2195cdc-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d/i/4\"><num value=\"4\" class=\"bold\">(4)</num><heading class=\"bold\"> Maintenance of labeling</heading><content><p style=\"-uslm-lc:I12\" class=\"indent1\">Nothing in this section shall be construed to affect the responsibility of the holder of an approved application under <ref href=\"/us/usc/t21/s355/j\">section 355(j) of this title</ref> to maintain its labeling in accordance with existing requirements, including subpart B of part 201 and sections 314.70 and 314.97 of title 21, Code of Federal Regulations (or any successor regulations).</p>\n</content>\n</paragraph>\n</subsection>\n<subsection style=\"-uslm-lc:I19\" class=\"indent2 firstIndent-2\" id=\"idf2195cdd-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d/j\"><num value=\"j\" class=\"bold\">(j)</num><heading class=\"bold\"> Reports</heading><chapeau style=\"-uslm-lc:I11\" class=\"indent0\">Not later than 4 years after <date date=\"2020-12-27\">December 27, 2020</date>, and every 4 years thereafter, the Secretary shall prepare and submit to the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate, a report that—</chapeau><paragraph style=\"-uslm-lc:I12\" class=\"indent1\" id=\"idf21983ee-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d/j/1\"><num value=\"1\">(1)</num><chapeau> describes the actions of the Secretary under this section, including—</chapeau><subparagraph style=\"-uslm-lc:I13\" class=\"indent2\" id=\"idf21983ef-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d/j/1/A\"><num value=\"A\">(A)</num><content> the number of covered drugs and description of the types of drugs the Secretary has selected for labeling changes and the rationale for such recommended changes; and</content>\n</subparagraph>\n<subparagraph style=\"-uslm-lc:I13\" class=\"indent2\" id=\"idf21983f0-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d/j/1/B\"><num value=\"B\">(B)</num><content> the number of times the Secretary entered into discussions concerning a disagreement with an application holder or holders and a summary of the decision regarding a labeling change, if any; and</content>\n</subparagraph>\n</paragraph>\n<paragraph style=\"-uslm-lc:I12\" class=\"indent1\" id=\"idf21983f1-a8fe-11eb-afba-f8d9e14a0139\" identifier=\"/us/usc/t21/s353d/j/2\"><num value=\"2\">(2)</num><content> includes any recommendations of the Secretary for modifying the program under this section.</content>\n</paragraph>\n</subsection>\n<sourceCredit id=\"idf219ab02-a8fe-11eb-afba-f8d9e14a0139\">(<ref href=\"/us/act/1938-06-25/ch675/s503D\">June 25, 1938, ch. 675, § 503D</ref>, as added <ref href=\"/us/pl/116/260/dBB/tIII/s324\">Pub. L. 116–260, div. BB, title III, § 324</ref>, <date date=\"2020-12-27\">Dec. 27, 2020</date>, <ref href=\"/us/stat/134/2933\">134 Stat. 2933</ref>.)</sourceCredit>\n</section>","provision":null,"duplicates":[],"release":{"label":"118-3","currency_date":"2023-04-10","congress":118,"law_num":3,"excluded_laws":[],"update_num":null,"seq":302,"is_partial":false,"caveat":null,"titles_affected":["01","02","03","05","05a","06","07","08","10","12","15","16","18","19","20","21","22","23","25","26","28","29","30","31","33","34","35","36","37","38","40","41","42","43","44","46","47","48","49","50","51","54"],"ingested_titles":[]},"served_from":{"label":"118-3","currency_date":"2023-04-10","congress":118,"law_num":3,"excluded_laws":[],"update_num":null,"seq":302,"is_partial":false,"caveat":null,"titles_affected":["01","02","03","05","05a","06","07","08","10","12","15","16","18","19","20","21","22","23","25","26","28","29","30","31","33","34","35","36","37","38","40","41","42","43","44","46","47","48","49","50","51","54"],"ingested_titles":[]},"content_first_seen":{"label":"116-344not283","currency_date":"2021-01-13","congress":116,"law_num":344,"excluded_laws":[283],"update_num":null,"seq":228,"is_partial":true,"caveat":"Current through Public Law 116-344 (01/13/2021), except 116-283.","titles_affected":["01","02","05","05a","06","07","08","10","11","12","15","16","17","18","19","20","21","22","23","25","26","28","29","30","31","33","34","35","36","38","39","40","41","42","43","45","46","47","48","49","50","51","52","54"],"ingested_titles":[]},"is_exact":true,"note":null}