{"identifier":"/us/usc/t21/s356c","title_num":"21","num":"§ 356c.","heading":"Discontinuance or interruption in the production of life-saving drugs","status":null,"guid":"id280661ac-93e5-11e7-9024-a70e43310041","source_credit":"(June 25, 1938, ch. 675, § 506C, as added Pub. L. 105–115, title I, § 131(a), Nov. 21, 1997, 111 Stat. 2332; amended Pub. L. 112–144, title X, § 1001(a), July 9, 2012, 126 Stat. 1099; Pub. L. 114–255, div. A, title III, § 3101(a)(2)(E), Dec. 13, 2016, 130 Stat. 1153.)","seq_in_title":165,"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=\"ide4aabb62-ec7d-11e6-944b-93361b188886\" identifier=\"/us/usc/t21/s356c\"><num value=\"356c\">§ 356c.</num><heading> Discontinuance or interruption in the production of life-saving drugs</heading><subsection style=\"-uslm-lc:I19\" class=\"indent2 firstIndent-2\" id=\"ide4aabb63-ec7d-11e6-944b-93361b188886\" identifier=\"/us/usc/t21/s356c/a\"><num value=\"a\" class=\"bold\">(a)</num><heading class=\"bold\"> In general</heading><chapeau>A manufacturer of a drug—</chapeau><paragraph style=\"-uslm-lc:I12\" class=\"indent1\" id=\"ide4aabb64-ec7d-11e6-944b-93361b188886\" identifier=\"/us/usc/t21/s356c/a/1\"><num value=\"1\">(1)</num><chapeau> that is—</chapeau><subparagraph style=\"-uslm-lc:I13\" class=\"indent2\" id=\"ide4aabb65-ec7d-11e6-944b-93361b188886\" identifier=\"/us/usc/t21/s356c/a/1/A\"><num value=\"A\">(A)</num><content> life-supporting;</content>\n</subparagraph>\n<subparagraph style=\"-uslm-lc:I13\" class=\"indent2\" id=\"ide4aabb66-ec7d-11e6-944b-93361b188886\" identifier=\"/us/usc/t21/s356c/a/1/B\"><num value=\"B\">(B)</num><content> life-sustaining; or</content>\n</subparagraph>\n<subparagraph style=\"-uslm-lc:I13\" class=\"indent2\" id=\"ide4aabb67-ec7d-11e6-944b-93361b188886\" identifier=\"/us/usc/t21/s356c/a/1/C\"><num value=\"C\">(C)</num><content> intended for use in the prevention or treatment of a debilitating disease or condition, including any such drug used in emergency medical care or during surgery; and</content>\n</subparagraph>\n</paragraph>\n<paragraph style=\"-uslm-lc:I12\" class=\"indent1\" id=\"ide4aabb68-ec7d-11e6-944b-93361b188886\" identifier=\"/us/usc/t21/s356c/a/2\"><num value=\"2\">(2)</num><content> that is not a radio pharmaceutical drug product or any other product as designated by the Secretary,</content>\n</paragraph>\n\n<continuation style=\"-uslm-lc:I10\" class=\"indent0 firstIndent0\">shall notify the Secretary, in accordance with subsection (b), of a permanent discontinuance in the manufacture of the drug or an interruption of the manufacture of the drug that is likely to lead to a meaningful disruption in the supply of that drug in the United States, and the reasons for such discontinuance or interruption.</continuation>\n</subsection>\n<subsection style=\"-uslm-lc:I19\" class=\"indent2 firstIndent-2\" id=\"ide4aabb69-ec7d-11e6-944b-93361b188886\" identifier=\"/us/usc/t21/s356c/b\"><num value=\"b\" class=\"bold\">(b)</num><heading class=\"bold\"> Timing</heading><chapeau>A notice required under subsection (a) shall be submitted to the Secretary—</chapeau><paragraph style=\"-uslm-lc:I12\" class=\"indent1\" id=\"ide4aabb6a-ec7d-11e6-944b-93361b188886\" identifier=\"/us/usc/t21/s356c/b/1\"><num value=\"1\">(1)</num><content> at least 6 months prior to the date of the discontinuance or interruption; or</content>\n</paragraph>\n<paragraph style=\"-uslm-lc:I12\" class=\"indent1\" id=\"ide4aabb6b-ec7d-11e6-944b-93361b188886\" identifier=\"/us/usc/t21/s356c/b/2\"><num value=\"2\">(2)</num><content> if compliance with paragraph (1) is not possible, as soon as practicable.</content>\n</paragraph>\n</subsection>\n<subsection style=\"-uslm-lc:I19\" class=\"indent2 firstIndent-2\" id=\"ide4aabb6c-ec7d-11e6-944b-93361b188886\" identifier=\"/us/usc/t21/s356c/c\"><num value=\"c\" class=\"bold\">(c)</num><heading class=\"bold\"> Distribution</heading><content><p style=\"-uslm-lc:I11\" class=\"indent0\">To the maximum extent practicable, the Secretary shall distribute, through such means as the Secretary deems appropriate, information on the discontinuance or interruption of the manufacture of the drugs described in subsection (a) to appropriate organizations, including physician, health provider, and patient organizations, as described in <ref href=\"/us/usc/t21/s356e\">section 356e of this title</ref>.</p>\n</content>\n</subsection>\n<subsection style=\"-uslm-lc:I19\" class=\"indent2 firstIndent-2\" id=\"ide4aabb6d-ec7d-11e6-944b-93361b188886\" identifier=\"/us/usc/t21/s356c/d\"><num value=\"d\" class=\"bold\">(d)</num><heading class=\"bold\"> Confidentiality</heading><content><p style=\"-uslm-lc:I11\" class=\"indent0\">Nothing in this section shall be construed as authorizing the Secretary to disclose any information that is a trade secret or confidential information subject to <ref href=\"/us/usc/t5/s552/b/4\">section 552(b)(4) of title 5</ref> or <ref href=\"/us/usc/t18/s1905\">section 1905 of title 18</ref>.</p>\n</content>\n</subsection>\n<subsection style=\"-uslm-lc:I19\" class=\"indent2 firstIndent-2\" id=\"ide4aabb6e-ec7d-11e6-944b-93361b188886\" identifier=\"/us/usc/t21/s356c/e\"><num value=\"e\" class=\"bold\">(e)</num><heading class=\"bold\"> Coordination with Attorney General</heading><chapeau>Not later than 30 days after the receipt of a notification described in subsection (a), the Secretary shall—</chapeau><paragraph style=\"-uslm-lc:I12\" class=\"indent1\" id=\"ide4aabb6f-ec7d-11e6-944b-93361b188886\" identifier=\"/us/usc/t21/s356c/e/1\"><num value=\"1\">(1)</num><content> determine whether the notification pertains to a controlled substance subject to a production quota under <ref href=\"/us/usc/t21/s826\">section 826 of this title</ref>; and</content>\n</paragraph>\n<paragraph style=\"-uslm-lc:I12\" class=\"indent1\" id=\"ide4aabb70-ec7d-11e6-944b-93361b188886\" identifier=\"/us/usc/t21/s356c/e/2\"><num value=\"2\">(2)</num><chapeau> if necessary, as determined by the Secretary—</chapeau><subparagraph style=\"-uslm-lc:I13\" class=\"indent2\" id=\"ide4aabb71-ec7d-11e6-944b-93361b188886\" identifier=\"/us/usc/t21/s356c/e/2/A\"><num value=\"A\">(A)</num><content> notify the Attorney General that the Secretary has received such a notification;</content>\n</subparagraph>\n<subparagraph style=\"-uslm-lc:I13\" class=\"indent2\" id=\"ide4aabb72-ec7d-11e6-944b-93361b188886\" identifier=\"/us/usc/t21/s356c/e/2/B\"><num value=\"B\">(B)</num><content> request that the Attorney General increase the aggregate and individual production quotas under <ref href=\"/us/usc/t21/s826\">section 826 of this title</ref> applicable to such controlled substance and any ingredient therein to a level the Secretary deems necessary to address a shortage of a controlled substance based on the best available market data; and</content>\n</subparagraph>\n<subparagraph style=\"-uslm-lc:I13\" class=\"indent2\" id=\"ide4aabb73-ec7d-11e6-944b-93361b188886\" identifier=\"/us/usc/t21/s356c/e/2/C\"><num value=\"C\">(C)</num><content> if the Attorney General determines that the level requested is not necessary to address a shortage of a controlled substance, the Attorney General shall provide to the Secretary a written response detailing the basis for the Attorney General’s determination.</content>\n</subparagraph>\n\n<continuation style=\"-uslm-lc:I17\" class=\"indent1 firstIndent0\">The Secretary shall make the written response provided under subparagraph (C) available to the public on the Internet Web site of the Food and Drug Administration.</continuation>\n</paragraph>\n</subsection>\n<subsection style=\"-uslm-lc:I19\" class=\"indent2 firstIndent-2\" id=\"ide4aabb74-ec7d-11e6-944b-93361b188886\" identifier=\"/us/usc/t21/s356c/f\"><num value=\"f\" class=\"bold\">(f)</num><heading class=\"bold\"> Failure to meet requirements</heading><chapeau>If a person fails to submit information required under subsection (a) in accordance with subsection (b)—</chapeau><paragraph style=\"-uslm-lc:I12\" class=\"indent1\" id=\"ide4aabb75-ec7d-11e6-944b-93361b188886\" identifier=\"/us/usc/t21/s356c/f/1\"><num value=\"1\">(1)</num><content> the Secretary shall issue a letter to such person informing such person of such failure;</content>\n</paragraph>\n<paragraph style=\"-uslm-lc:I12\" class=\"indent1\" id=\"ide4aabb76-ec7d-11e6-944b-93361b188886\" identifier=\"/us/usc/t21/s356c/f/2\"><num value=\"2\">(2)</num><content> not later than 30 calendar days after the issuance of a letter under paragraph (1), the person who receives such letter shall submit to the Secretary a written response to such letter setting forth the basis for noncompliance and providing information required under subsection (a); and</content>\n</paragraph>\n<paragraph style=\"-uslm-lc:I12\" class=\"indent1\" id=\"ide4aabb77-ec7d-11e6-944b-93361b188886\" identifier=\"/us/usc/t21/s356c/f/3\"><num value=\"3\">(3)</num><content> not later than 45 calendar days after the issuance of a letter under paragraph (1), the Secretary shall make such letter and any response to such letter under paragraph (2) available to the public on the Internet Web site of the Food and Drug Administration, with appropriate redactions made to protect information described in subsection (d), except that, if the Secretary determines that the letter under paragraph (1) was issued in error or, after review of such response, the person had a reasonable basis for not notifying as required under subsection (a), the requirements of this paragraph shall not apply.</content>\n</paragraph>\n</subsection>\n<subsection style=\"-uslm-lc:I19\" class=\"indent2 firstIndent-2\" id=\"ide4aabb78-ec7d-11e6-944b-93361b188886\" identifier=\"/us/usc/t21/s356c/g\"><num value=\"g\" class=\"bold\">(g)</num><heading class=\"bold\"> Expedited inspections and reviews</heading><chapeau>If, based on notifications described in subsection (a) or any other relevant information, the Secretary concludes that there is, or is likely to be, a drug shortage of a drug described in subsection (a), the Secretary may—</chapeau><paragraph style=\"-uslm-lc:I12\" class=\"indent1\" id=\"ide4aabb79-ec7d-11e6-944b-93361b188886\" identifier=\"/us/usc/t21/s356c/g/1\"><num value=\"1\">(1)</num><content> expedite the review of a supplement to a new drug application submitted under <ref href=\"/us/usc/t21/s355/b\">section 355(b) of this title</ref>, an abbreviated new drug application submitted under <ref href=\"/us/usc/t21/s355/j\">section 355(j) of this title</ref>, or a supplement to such an application submitted under <ref href=\"/us/usc/t21/s355/j\">section 355(j) of this title</ref>, that could help mitigate or prevent such shortage; or</content>\n</paragraph>\n<paragraph style=\"-uslm-lc:I12\" class=\"indent1\" id=\"ide4aabb7a-ec7d-11e6-944b-93361b188886\" identifier=\"/us/usc/t21/s356c/g/2\"><num value=\"2\">(2)</num><content> expedite an inspection or reinspection of an establishment that could help mitigate or prevent such drug shortage.</content>\n</paragraph>\n</subsection>\n<subsection style=\"-uslm-lc:I19\" class=\"indent2 firstIndent-2\" id=\"ide4aabb7b-ec7d-11e6-944b-93361b188886\" identifier=\"/us/usc/t21/s356c/h\"><num value=\"h\" class=\"bold\">(h)</num><heading class=\"bold\"> Definitions</heading><chapeau>For purposes of this section—</chapeau><paragraph style=\"-uslm-lc:I12\" class=\"indent1\" id=\"ide4aabb7c-ec7d-11e6-944b-93361b188886\" identifier=\"/us/usc/t21/s356c/h/1\"><num value=\"1\">(1)</num><chapeau> the term “drug”—</chapeau><subparagraph style=\"-uslm-lc:I13\" class=\"indent2\" id=\"ide4aabb7d-ec7d-11e6-944b-93361b188886\" identifier=\"/us/usc/t21/s356c/h/1/A\"><num value=\"A\">(A)</num><content> means a drug (as defined in <ref href=\"/us/usc/t21/s321/g\">section 321(g) of this title</ref>) that is intended for human use and that is subject to <ref href=\"/us/usc/t21/s353/b/1\">section 353(b)(1) of this title</ref>; and</content>\n</subparagraph>\n<subparagraph style=\"-uslm-lc:I13\" class=\"indent2\" id=\"ide4aabb7e-ec7d-11e6-944b-93361b188886\" identifier=\"/us/usc/t21/s356c/h/1/B\"><num value=\"B\">(B)</num><content> does not include biological products (as defined in <ref href=\"/us/usc/t42/s262\">section 262 of title 42</ref>), unless otherwise provided by the Secretary in the regulations promulgated under subsection (i);</content>\n</subparagraph>\n</paragraph>\n<paragraph style=\"-uslm-lc:I12\" class=\"indent1\" id=\"ide4aabb7f-ec7d-11e6-944b-93361b188886\" identifier=\"/us/usc/t21/s356c/h/2\"><num value=\"2\">(2)</num><content> the term “drug shortage” or “shortage”, with respect to a drug, means a period of time when the demand or projected demand for the drug within the United States exceeds the supply of the drug; and</content>\n</paragraph>\n<paragraph style=\"-uslm-lc:I12\" class=\"indent1\" id=\"ide4aabb80-ec7d-11e6-944b-93361b188886\" identifier=\"/us/usc/t21/s356c/h/3\"><num value=\"3\">(3)</num><chapeau> the term “meaningful disruption”—</chapeau><subparagraph style=\"-uslm-lc:I13\" class=\"indent2\" id=\"ide4aabb81-ec7d-11e6-944b-93361b188886\" identifier=\"/us/usc/t21/s356c/h/3/A\"><num value=\"A\">(A)</num><content> means a change in production that is reasonably likely to lead to a reduction in the supply of a drug by a manufacturer that is more than negligible and affects the ability of the manufacturer to fill orders or meet expected demand for its product; and</content>\n</subparagraph>\n<subparagraph style=\"-uslm-lc:I13\" class=\"indent2\" id=\"ide4aabb82-ec7d-11e6-944b-93361b188886\" identifier=\"/us/usc/t21/s356c/h/3/B\"><num value=\"B\">(B)</num><content> does not include interruptions in manufacturing due to matters such as routine maintenance or insignificant changes in manufacturing so long as the manufacturer expects to resume operations in a short period of time.</content>\n</subparagraph>\n</paragraph>\n</subsection>\n<subsection style=\"-uslm-lc:I19\" class=\"indent2 firstIndent-2\" id=\"ide4aabb83-ec7d-11e6-944b-93361b188886\" identifier=\"/us/usc/t21/s356c/i\"><num value=\"i\" class=\"bold\">(i)</num><heading class=\"bold\"> Regulations</heading><paragraph style=\"-uslm-lc:I79\" class=\"indent3 firstIndent-2\" id=\"ide4aabb84-ec7d-11e6-944b-93361b188886\" identifier=\"/us/usc/t21/s356c/i/1\"><num value=\"1\" class=\"bold\">(1)</num><heading class=\"bold\"> In general</heading><content><p style=\"-uslm-lc:I12\" class=\"indent1\">Not later than 18 months after <date date=\"2012-07-09\">July 9, 2012</date>, the Secretary shall adopt a final regulation implementing this section.</p>\n</content>\n</paragraph>\n<paragraph style=\"-uslm-lc:I79\" class=\"indent3 firstIndent-2\" id=\"ide4aabb85-ec7d-11e6-944b-93361b188886\" identifier=\"/us/usc/t21/s356c/i/2\"><num value=\"2\" class=\"bold\">(2)</num><heading class=\"bold\"> Contents</heading><content><p style=\"-uslm-lc:I12\" class=\"indent1\">Such regulation shall define, for purposes of this section, the terms “life-supporting”, “life-sustaining”, and “intended for use in the prevention or treatment of a debilitating disease or condition”.</p>\n</content>\n</paragraph>\n<paragraph style=\"-uslm-lc:I79\" class=\"indent3 firstIndent-2\" id=\"ide4aabb86-ec7d-11e6-944b-93361b188886\" identifier=\"/us/usc/t21/s356c/i/3\"><num value=\"3\" class=\"bold\">(3)</num><heading class=\"bold\"> Inclusion of biological products</heading><subparagraph style=\"-uslm-lc:I18\" class=\"indent4 firstIndent-2\" id=\"ide4aabb87-ec7d-11e6-944b-93361b188886\" identifier=\"/us/usc/t21/s356c/i/3/A\"><num value=\"A\" class=\"bold\">(A)</num><heading class=\"bold\"> In general</heading><content><p style=\"-uslm-lc:I13\" class=\"indent2\">The Secretary may by regulation apply this section to biological products (as defined in <ref href=\"/us/usc/t42/s262\">section 262 of title 42</ref>), including plasma products derived from human plasma protein and their recombinant analogs, if the Secretary determines such inclusion would benefit the public health. Such regulation shall take into account any supply reporting programs and shall aim to reduce duplicative notification.</p>\n</content>\n</subparagraph>\n<subparagraph style=\"-uslm-lc:I18\" class=\"indent4 firstIndent-2\" id=\"ide4aabb88-ec7d-11e6-944b-93361b188886\" identifier=\"/us/usc/t21/s356c/i/3/B\"><num value=\"B\" class=\"bold\">(B)</num><heading class=\"bold\"> Rule for vaccines</heading><chapeau>If the Secretary applies this section to vaccines pursuant to subparagraph (A), the Secretary shall—</chapeau><clause style=\"-uslm-lc:I14\" class=\"indent3\" id=\"ide4aabb89-ec7d-11e6-944b-93361b188886\" identifier=\"/us/usc/t21/s356c/i/3/B/i\"><num value=\"i\">(i)</num><content> consider whether the notification requirement under subsection (a) may be satisfied by submitting a notification to the Centers for Disease Control and Prevention under the vaccine shortage notification program of such Centers; and</content>\n</clause>\n<clause style=\"-uslm-lc:I14\" class=\"indent3\" id=\"ide4aabb8a-ec7d-11e6-944b-93361b188886\" identifier=\"/us/usc/t21/s356c/i/3/B/ii\"><num value=\"ii\">(ii)</num><content> explain the determination made by the Secretary under clause (i) in the regulation.</content>\n</clause>\n</subparagraph>\n</paragraph>\n<paragraph style=\"-uslm-lc:I79\" class=\"indent3 firstIndent-2\" id=\"ide4aabb8b-ec7d-11e6-944b-93361b188886\" identifier=\"/us/usc/t21/s356c/i/4\"><num value=\"4\" class=\"bold\">(4)</num><heading class=\"bold\"> Procedure</heading><chapeau>In promulgating a regulation implementing this section, the Secretary shall—</chapeau><subparagraph style=\"-uslm-lc:I13\" class=\"indent2\" id=\"ide4aabb8c-ec7d-11e6-944b-93361b188886\" identifier=\"/us/usc/t21/s356c/i/4/A\"><num value=\"A\">(A)</num><content> issue a notice of proposed rulemaking that includes the proposed regulation;</content>\n</subparagraph>\n<subparagraph style=\"-uslm-lc:I13\" class=\"indent2\" id=\"ide4aabb8d-ec7d-11e6-944b-93361b188886\" identifier=\"/us/usc/t21/s356c/i/4/B\"><num value=\"B\">(B)</num><content> provide a period of not less than 60 days for comments on the proposed regulation; and</content>\n</subparagraph>\n<subparagraph style=\"-uslm-lc:I13\" class=\"indent2\" id=\"ide4aabb8e-ec7d-11e6-944b-93361b188886\" identifier=\"/us/usc/t21/s356c/i/4/C\"><num value=\"C\">(C)</num><content> publish the final regulation not less than 30 days before the regulation’s effective date.</content>\n</subparagraph>\n</paragraph>\n<paragraph style=\"-uslm-lc:I79\" class=\"indent3 firstIndent-2\" id=\"ide4aabb8f-ec7d-11e6-944b-93361b188886\" identifier=\"/us/usc/t21/s356c/i/5\"><num value=\"5\" class=\"bold\">(5)</num><heading class=\"bold\"> Restrictions</heading><content><p style=\"-uslm-lc:I12\" class=\"indent1\">Notwithstanding any other provision of Federal law, in implementing this section, the Secretary shall only promulgate regulations as described in paragraph (4).</p>\n</content>\n</paragraph>\n</subsection>\n<sourceCredit id=\"ide4aabb90-ec7d-11e6-944b-93361b188886\">(<ref href=\"/us/act/1938-06-25/ch675\">June 25, 1938, ch. 675</ref>, § 506C, as added <ref href=\"/us/pl/105/115/tI\">Pub. L. 105–115, title I</ref>, § 131(a), <date date=\"1997-11-21\">Nov. 21, 1997</date>, <ref href=\"/us/stat/111/2332\">111 Stat. 2332</ref>; amended <ref href=\"/us/pl/112/144/tX\">Pub. L. 112–144, title X</ref>, § 1001(a), <date date=\"2012-07-09\">July 9, 2012</date>, <ref href=\"/us/stat/126/1099\">126 Stat. 1099</ref>; <ref href=\"/us/pl/114/255/dA/tIII\">Pub. L. 114–255, div. A, title III</ref>, § 3101(a)(2)(E), <date date=\"2016-12-13\">Dec. 13, 2016</date>, <ref href=\"/us/stat/130/1153\">130 Stat. 1153</ref>.)</sourceCredit>\n<notes type=\"uscNote\" id=\"ide4aabb91-ec7d-11e6-944b-93361b188886\">\n<note style=\"-uslm-lc:I74\" topic=\"amendments\" id=\"ide4aabb92-ec7d-11e6-944b-93361b188886\"><heading class=\"centered smallCaps\">Amendments</heading><p style=\"-uslm-lc:I21\" class=\"indent0\">2016—Subsec. (c). <ref href=\"/us/pl/114/255\">Pub. L. 114–255</ref>, § 3101(a)(2)(E)(i), substituted “discontinuance” for “discontinuation”.</p>\n<p style=\"-uslm-lc:I21\" class=\"indent0\">Subsec. (g)(1). <ref href=\"/us/pl/114/255\">Pub. L. 114–255</ref>, § 3101(a)(2)(E)(ii), substituted “<ref href=\"/us/usc/t21/s355/j\">section 355(j) of this title</ref>, that could help” for “<ref href=\"/us/usc/t21/s355/j\">section 355(j) of this title</ref> that could help”.</p>\n<p style=\"-uslm-lc:I21\" class=\"indent0\">2012—<ref href=\"/us/pl/112/144\">Pub. L. 112–144</ref> amended section generally. Prior to amendment, section related to discontinuance of life saving products.</p>\n</note>\n<note style=\"-uslm-lc:I74\" topic=\"effectiveDate\" id=\"ide4aabb93-ec7d-11e6-944b-93361b188886\"><heading class=\"centered smallCaps\">Effective Date</heading><p style=\"-uslm-lc:I21\" class=\"indent0\">Section effective 90 days after <date date=\"1997-11-21\">Nov. 21, 1997</date>, except as otherwise provided, see <ref href=\"/us/pl/105/115/s501\">section 501 of Pub. L. 105–115</ref>, set out as an Effective Date of 1997 Amendment note under <ref href=\"/us/usc/t21/s321\">section 321 of this title</ref>.</p>\n</note>\n<note style=\"-uslm-lc:I74\" topic=\"miscellaneous\" id=\"ide4aabb94-ec7d-11e6-944b-93361b188886\"><heading class=\"centered smallCaps\">Effect of Notification</heading><p><ref href=\"/us/pl/112/144/tX\">Pub. L. 112–144, title X</ref>, § 1001(b), <date date=\"2012-07-09\">July 9, 2012</date>, <ref href=\"/us/stat/126/1101\">126 Stat. 1101</ref>, provided that: <quotedContent origin=\"/us/pl/112/144/tX\">\n<inline>“The submission of a notification to the Secretary of Health and Human Services (referred to in this title [see Tables for classification] as the ‘Secretary’) for purposes of complying with the requirement in section 506C(a) of the Federal Food, Drug, and Cosmetic Act [<ref href=\"/us/usc/t21/s356c/a\">21 U.S.C. 356c(a)</ref>] (as amended by subsection (a)) shall not be construed—</inline>\n<paragraph style=\"-uslm-lc:I22\" class=\"indent1\"><num value=\"1\">“(1)</num><content> as an admission that any product that is the subject of such notification violates any provision of the Federal Food, Drug, and Cosmetic Act (<ref href=\"/us/usc/t21/s301\">21 U.S.C. 301</ref> et seq.); or</content>\n</paragraph>\n<paragraph style=\"-uslm-lc:I22\" class=\"indent1\"><num value=\"2\">“(2)</num><content> as evidence of an intention to promote or market the product for an indication or use for which the product has not been approved by the Secretary.”</content>\n</paragraph>\n</quotedContent>\n</p>\n</note>\n<note style=\"-uslm-lc:I86\" topic=\"executiveOrder\" id=\"ide4aabb95-ec7d-11e6-944b-93361b188886\">\n<heading class=\"centered smallCaps\">Ex. Ord. No. 13588. Reducing Prescription Drug Shortages</heading>\n<p style=\"-uslm-lc:I21\" class=\"indent0\">Ex. Ord. No. 13588, <date date=\"2011-10-31\">Oct. 31, 2011</date>, 76 F.R. 68295, provided:</p>\n<p style=\"-uslm-lc:I21\" class=\"indent0\">By the authority vested in me as President by the Constitution and the laws of the United States of America, it is hereby ordered as follows:</p>\n<p style=\"-uslm-lc:I21\" class=\"indent0\"><inline class=\"small-caps\">Section</inline> 1. <i>Policy</i>. Shortages of pharmaceutical drugs pose a serious and growing threat to public health. While a very small number of drugs in the United States experience a shortage in any given year, the number of prescription drug shortages in the United States nearly tripled between 2005 and 2010, and shortages are becoming more severe as well as more frequent. The affected medicines include cancer treatments, anesthesia drugs, and other drugs that are critical to the treatment and prevention of serious diseases and life-threatening conditions.</p>\n<p style=\"-uslm-lc:I21\" class=\"indent0\">For example, over approximately the last 5 years, data indicates that the use of sterile injectable cancer treatments has increased by about 20 percent, without a corresponding increase in production capacity. While manufacturers are currently in the process of expanding capacity, it may be several years before production capacity has been significantly increased. Interruptions in the supplies of these drugs endanger patient safety and burden doctors, hospitals, pharmacists, and patients. They also increase health care costs, particularly because some participants in the market may use shortages as opportunities to hoard scarce drugs or charge exorbitant prices.</p>\n<p style=\"-uslm-lc:I21\" class=\"indent0\">The Food and Drug Administration (FDA) in the Department of Health and Human Services has been working diligently to address this problem through its existing regulatory framework. While the root problems and many of their solutions are outside of the FDA’s control, the agency has worked cooperatively with manufacturers to prevent or mitigate shortages by expediting review of certain regulatory submissions and adopting a flexible approach to drug manufacturing and importation regulations where appropriate. As a result, the FDA prevented 137 drug shortages in 2010 and 2011. Despite these successes, however, the problem of drug shortages has continued to grow.</p>\n<p style=\"-uslm-lc:I21\" class=\"indent0\">Many different factors contribute to drug shortages, and solving this critical public health problem will require a multifaceted approach. An important factor in many of the recent shortages appears to be an increase in demand that exceeds current manufacturing capacity. While manufacturers are in the process of expanding capacity, one important step is ensuring that the FDA and the public receive adequate advance notice of shortages whenever possible. The FDA cannot begin to work with manufacturers or use the other tools at its disposal until it knows there is a potential problem. Similarly, early disclosure of a shortage can help hospitals, doctors, and patients make alternative arrangements before a shortage becomes a crisis. However, drug manufacturers have not consistently provided the FDA with adequate notice of potential shortages.</p>\n<p style=\"-uslm-lc:I21\" class=\"indent0\">As part of my Administration’s broader effort to work with manufacturers, health care providers, and other stakeholders to prevent drug shortages, this order directs the FDA to take steps that will help to prevent and reduce current and future disruptions in the supply of lifesaving medicines.</p>\n<p style=\"-uslm-lc:I21\" class=\"indent0\"><inline class=\"small-caps\">Sec</inline>. 2. <i>Broader Reporting of Manufacturing Discontinuances</i>. To the extent permitted by law, the FDA shall use all appropriate administrative tools, including its authority to interpret and administer the reporting requirements in <ref href=\"/us/usc/t21/s356c\">21 U.S.C. 356c</ref>, to require drug manufacturers to provide adequate advance notice of manufacturing discontinuances that could lead to shortages of drugs that are life-supporting or life-sustaining, or that prevent debilitating disease.</p>\n<p style=\"-uslm-lc:I21\" class=\"indent0\"><inline class=\"small-caps\">Sec</inline>. 3. <i>Expedited Regulatory Review</i>. To the extent practicable, and consistent with its statutory responsibility to ensure the safety and effectiveness of the drug supply, the FDA shall take steps to expand its current efforts to expedite its regulatory reviews, including reviews of new drug suppliers, manufacturing sites, and manufacturing changes, whenever it determines that expedited review would help to avoid or mitigate existing or potential drug shortages. In prioritizing and allocating its limited resources, the FDA should consider both the severity of the shortage and the importance of the affected drug to public health.</p>\n<p style=\"-uslm-lc:I21\" class=\"indent0\"><inline class=\"small-caps\">Sec</inline>. 4. <i>Review of Certain Behaviors by Market Participants</i>. The FDA shall communicate to the Department of Justice (DOJ) any findings that shortages have led market participants to stockpile the affected drugs or sell them at exorbitant prices. The DOJ shall then determine whether these activities are consistent with applicable law. Based on its determination, DOJ, in coordination with other State and Federal regulatory agencies as appropriate, should undertake whatever enforcement actions, if any, it deems appropriate.</p>\n<p style=\"-uslm-lc:I21\" class=\"indent0\"><inline class=\"small-caps\">Sec</inline>. 5. <i>General Provisions</i>. (a) Nothing in this order shall be construed to impair or otherwise affect:</p>\n<p style=\"-uslm-lc:I22\" class=\"indent1\">(i) authority granted by law to an agency, or the head thereof; or</p>\n<p style=\"-uslm-lc:I22\" class=\"indent1\">(ii) functions of the Director of the Office of Management and Budget relating to budgetary, administrative, or legislative proposals.</p>\n<p style=\"-uslm-lc:I21\" class=\"indent0\">(b) This order shall be implemented consistent with applicable law and subject to the availability of appropriations.</p>\n<p style=\"-uslm-lc:I21\" class=\"indent0\">(c) This order is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person.</p>\n<signature>\n<name>Barack Obama.</name>\n</signature>\n</note>\n</notes>\n</section>","provision":null,"duplicates":[],"release":{"label":"115-55","currency_date":"2017-08-23","congress":115,"law_num":55,"excluded_laws":[],"update_num":null,"seq":110,"is_partial":false,"caveat":null,"titles_affected":["19","21","27","28a","32","38","42","48"],"ingested_titles":[]},"served_from":{"label":"115-55","currency_date":"2017-08-23","congress":115,"law_num":55,"excluded_laws":[],"update_num":null,"seq":110,"is_partial":false,"caveat":null,"titles_affected":["19","21","27","28a","32","38","42","48"],"ingested_titles":[]},"content_first_seen":{"label":"114-321","currency_date":"2016-12-16","congress":114,"law_num":321,"excluded_laws":[],"update_num":null,"seq":88,"is_partial":false,"caveat":null,"titles_affected":["05","15","21","26","28","29","38","42","48"],"ingested_titles":[]},"is_exact":true,"note":null}