{"identifier":"/us/usc/t21/s360bbb","title_num":"21","num":"§ 360bbb.","heading":"Expanded access to unapproved therapies and diagnostics","status":null,"guid":"id37152e88-4155-11e7-a62f-f6f64c68eb16","source_credit":"(June 25, 1938, ch. 675, § 561, as added Pub. L. 105–115, title IV, § 402, Nov. 21, 1997, 111 Stat. 2365; amended Pub. L. 109–482, title I, § 102(f)(2), Jan. 15, 2007, 120 Stat. 3685.)","seq_in_title":217,"parent_identifier":"/us/usc/t21/ch9/schV/ptE","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/ptE","level":"part","num":"Part E—","heading":"General Provisions Relating to 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=\"idae52495a-ec38-11e5-9fc5-818d616f3d7f\" identifier=\"/us/usc/t21/s360bbb\"><num value=\"360bbb\">§ 360bbb.</num><heading> Expanded access to unapproved therapies and diagnostics</heading><subsection style=\"-uslm-lc:I19\" class=\"indent2 firstIndent-2\" id=\"idae52495b-ec38-11e5-9fc5-818d616f3d7f\" identifier=\"/us/usc/t21/s360bbb/a\"><num value=\"a\" class=\"bold\">(a)</num><heading class=\"bold\"> Emergency situations</heading><content><p style=\"-uslm-lc:I11\" class=\"indent0\">The Secretary may, under appropriate conditions determined by the Secretary, authorize the shipment of investigational drugs or investigational devices for the diagnosis, monitoring, or treatment of a serious disease or condition in emergency situations.</p>\n</content>\n</subsection>\n<subsection style=\"-uslm-lc:I19\" class=\"indent2 firstIndent-2\" id=\"idae52495c-ec38-11e5-9fc5-818d616f3d7f\" identifier=\"/us/usc/t21/s360bbb/b\"><num value=\"b\" class=\"bold\">(b)</num><heading class=\"bold\"> Individual patient access to investigational products intended for serious diseases</heading><chapeau>Any person, acting through a physician licensed in accordance with State law, may request from a manufacturer or distributor, and any manufacturer or distributor may, after complying with the provisions of this subsection, provide to such physician an investigational drug or investigational device for the diagnosis, monitoring, or treatment of a serious disease or condition if—</chapeau><paragraph style=\"-uslm-lc:I12\" class=\"indent1\" id=\"idae52495d-ec38-11e5-9fc5-818d616f3d7f\" identifier=\"/us/usc/t21/s360bbb/b/1\"><num value=\"1\">(1)</num><content> the licensed physician determines that the person has no comparable or satisfactory alternative therapy available to diagnose, monitor, or treat the disease or condition involved, and that the probable risk to the person from the investigational drug or investigational device is not greater than the probable risk from the disease or condition;</content>\n</paragraph>\n<paragraph style=\"-uslm-lc:I12\" class=\"indent1\" id=\"idae52495e-ec38-11e5-9fc5-818d616f3d7f\" identifier=\"/us/usc/t21/s360bbb/b/2\"><num value=\"2\">(2)</num><content> the Secretary determines that there is sufficient evidence of safety and effectiveness to support the use of the investigational drug or investigational device in the case described in paragraph (1);</content>\n</paragraph>\n<paragraph style=\"-uslm-lc:I12\" class=\"indent1\" id=\"idae52495f-ec38-11e5-9fc5-818d616f3d7f\" identifier=\"/us/usc/t21/s360bbb/b/3\"><num value=\"3\">(3)</num><content> the Secretary determines that provision of the investigational drug or investigational device will not interfere with the initiation, conduct, or completion of clinical investigations to support marketing approval; and</content>\n</paragraph>\n<paragraph style=\"-uslm-lc:I12\" class=\"indent1\" id=\"idae524960-ec38-11e5-9fc5-818d616f3d7f\" identifier=\"/us/usc/t21/s360bbb/b/4\"><num value=\"4\">(4)</num><content> the sponsor, or clinical investigator, of the investigational drug or investigational device submits to the Secretary a clinical protocol consistent with the provisions of section 355(i) or 360j(g) of this title, including any regulations promulgated under section 355(i) or 360j(g) of this title, describing the use of the investigational drug or investigational device in a single patient or a small group of patients.</content>\n</paragraph>\n</subsection>\n<subsection style=\"-uslm-lc:I19\" class=\"indent2 firstIndent-2\" id=\"idae524961-ec38-11e5-9fc5-818d616f3d7f\" identifier=\"/us/usc/t21/s360bbb/c\"><num value=\"c\" class=\"bold\">(c)</num><heading class=\"bold\"> Treatment investigational new drug applications and treatment investigational device exemptions</heading><chapeau>Upon submission by a sponsor or a physician of a protocol intended to provide widespread access to an investigational drug or investigational device for eligible patients (referred to in this subsection as an “expanded access protocol”), the Secretary shall permit such investigational drug or investigational device to be made available for expanded access under a treatment investigational new drug application or treatment investigational device exemption if the Secretary determines that—</chapeau><paragraph style=\"-uslm-lc:I12\" class=\"indent1\" id=\"idae524962-ec38-11e5-9fc5-818d616f3d7f\" identifier=\"/us/usc/t21/s360bbb/c/1\"><num value=\"1\">(1)</num><content> under the treatment investigational new drug application or treatment investigational device exemption, the investigational drug or investigational device is intended for use in the diagnosis, monitoring, or treatment of a serious or immediately life-threatening disease or condition;</content>\n</paragraph>\n<paragraph style=\"-uslm-lc:I12\" class=\"indent1\" id=\"idae524963-ec38-11e5-9fc5-818d616f3d7f\" identifier=\"/us/usc/t21/s360bbb/c/2\"><num value=\"2\">(2)</num><content> there is no comparable or satisfactory alternative therapy available to diagnose, monitor, or treat that stage of disease or condition in the population of patients to which the investigational drug or investigational device is intended to be administered;</content>\n</paragraph>\n<paragraph style=\"-uslm-lc:I12\" class=\"indent1\" id=\"idae524964-ec38-11e5-9fc5-818d616f3d7f\" identifier=\"/us/usc/t21/s360bbb/c/3\"><num value=\"3\">(3)</num><subparagraph style=\"-uslm-lc:I12\" class=\"indent1\" id=\"idae524965-ec38-11e5-9fc5-818d616f3d7f\" identifier=\"/us/usc/t21/s360bbb/c/3/A\"><num value=\"A\">(A)</num><content> the investigational drug or investigational device is under investigation in a controlled clinical trial for the use described in paragraph (1) under an investigational drug application in effect under <ref href=\"/us/usc/t21/s355/i\">section 355(i) of this title</ref> or investigational device exemption in effect under <ref href=\"/us/usc/t21/s360j/g\">section 360j(g) of this title</ref>; or</content>\n</subparagraph>\n<subparagraph style=\"-uslm-lc:I12\" class=\"indent1\" id=\"idae524966-ec38-11e5-9fc5-818d616f3d7f\" identifier=\"/us/usc/t21/s360bbb/c/3/B\"><num value=\"B\">(B)</num><content> all clinical trials necessary for approval of that use of the investigational drug or investigational device have been completed;</content>\n</subparagraph>\n</paragraph>\n<paragraph style=\"-uslm-lc:I12\" class=\"indent1\" id=\"idae524967-ec38-11e5-9fc5-818d616f3d7f\" identifier=\"/us/usc/t21/s360bbb/c/4\"><num value=\"4\">(4)</num><content> the sponsor of the controlled clinical trials is actively pursuing marketing approval of the investigational drug or investigational device for the use described in paragraph (1) with due diligence;</content>\n</paragraph>\n<paragraph style=\"-uslm-lc:I12\" class=\"indent1\" id=\"idae524968-ec38-11e5-9fc5-818d616f3d7f\" identifier=\"/us/usc/t21/s360bbb/c/5\"><num value=\"5\">(5)</num><content> in the case of an investigational drug or investigational device described in paragraph (3)(A), the provision of the investigational drug or investigational device will not interfere with the enrollment of patients in ongoing clinical investigations under section 355(i) or 360j(g) of this title;</content>\n</paragraph>\n<paragraph style=\"-uslm-lc:I12\" class=\"indent1\" id=\"idae524969-ec38-11e5-9fc5-818d616f3d7f\" identifier=\"/us/usc/t21/s360bbb/c/6\"><num value=\"6\">(6)</num><content> in the case of serious diseases, there is sufficient evidence of safety and effectiveness to support the use described in paragraph (1); and</content>\n</paragraph>\n<paragraph style=\"-uslm-lc:I12\" class=\"indent1\" id=\"idae52496a-ec38-11e5-9fc5-818d616f3d7f\" identifier=\"/us/usc/t21/s360bbb/c/7\"><num value=\"7\">(7)</num><content> in the case of immediately life-threatening diseases, the available scientific evidence, taken as a whole, provides a reasonable basis to conclude that the investigational drug or investigational device may be effective for its intended use and would not expose patients to an unreasonable and significant risk of illness or injury.</content>\n</paragraph>\n\n<continuation style=\"-uslm-lc:I10\" class=\"indent0 firstIndent0\">A protocol submitted under this subsection shall be subject to the provisions of section 355(i) or 360j(g) of this title, including regulations promulgated under section 355(i) or 360j(g) of this title. The Secretary may inform national, State, and local medical associations and societies, voluntary health associations, and other appropriate persons about the availability of an investigational drug or investigational device under expanded access protocols submitted under this subsection. The information provided by the Secretary, in accordance with the preceding sentence, shall be the same type of information that is required by <ref href=\"/us/usc/t42/s282/i/3\">section 282(i)(3) of title 42</ref>.</continuation>\n</subsection>\n<subsection style=\"-uslm-lc:I19\" class=\"indent2 firstIndent-2\" id=\"idae52496b-ec38-11e5-9fc5-818d616f3d7f\" identifier=\"/us/usc/t21/s360bbb/d\"><num value=\"d\" class=\"bold\">(d)</num><heading class=\"bold\"> Termination</heading><content><p style=\"-uslm-lc:I11\" class=\"indent0\">The Secretary may, at any time, with respect to a sponsor, physician, manufacturer, or distributor described in this section, terminate expanded access provided under this section for an investigational drug or investigational device if the requirements under this section are no longer met.</p>\n</content>\n</subsection>\n<subsection style=\"-uslm-lc:I19\" class=\"indent2 firstIndent-2\" id=\"idae52496c-ec38-11e5-9fc5-818d616f3d7f\" identifier=\"/us/usc/t21/s360bbb/e\"><num value=\"e\" class=\"bold\">(e)</num><heading class=\"bold\"> Definitions</heading><content><p style=\"-uslm-lc:I11\" class=\"indent0\">In this section, the terms “investigational drug”, “investigational device”, “treatment investigational new drug application”, and “treatment investigational device exemption” shall have the meanings given the terms in regulations prescribed by the Secretary.</p>\n</content>\n</subsection>\n<sourceCredit id=\"idae52496d-ec38-11e5-9fc5-818d616f3d7f\">(<ref href=\"/us/act/1938-06-25/ch675\">June 25, 1938, ch. 675</ref>, § 561, as added <ref href=\"/us/pl/105/115/tIV\">Pub. L. 105–115, title IV</ref>, § 402, <date date=\"1997-11-21\">Nov. 21, 1997</date>, <ref href=\"/us/stat/111/2365\">111 Stat. 2365</ref>; amended <ref href=\"/us/pl/109/482/tI\">Pub. L. 109–482, title I</ref>, § 102(f)(2), <date date=\"2007-01-15\">Jan. 15, 2007</date>, <ref href=\"/us/stat/120/3685\">120 Stat. 3685</ref>.)</sourceCredit>\n<notes type=\"uscNote\" id=\"idae52496e-ec38-11e5-9fc5-818d616f3d7f\">\n<note style=\"-uslm-lc:I74\" topic=\"amendments\" id=\"idae52496f-ec38-11e5-9fc5-818d616f3d7f\"><heading class=\"centered smallCaps\">Amendments</heading><p style=\"-uslm-lc:I21\" class=\"indent0\">2007—Subsec. (c). <ref href=\"/us/pl/109/482\">Pub. L. 109–482</ref> substituted “section 282(i)(3)” for “section 282(j)(3)” in concluding provisions.</p>\n</note>\n<note style=\"-uslm-lc:I74\" topic=\"effectiveDateOfAmendment\" id=\"idae524970-ec38-11e5-9fc5-818d616f3d7f\"><heading class=\"centered smallCaps\">Effective Date of 2007 Amendment</heading><p style=\"-uslm-lc:I21\" class=\"indent0\">Amendment by <ref href=\"/us/pl/109/482\">Pub. L. 109–482</ref> applicable only with respect to amounts appropriated for fiscal year 2007 or subsequent fiscal years, see <ref href=\"/us/pl/109/482/s109\">section 109 of Pub. L. 109–482</ref>, set out as a note under <ref href=\"/us/usc/t42/s281\">section 281 of Title 42</ref>, The Public Health and Welfare.</p>\n</note>\n<note style=\"-uslm-lc:I74\" topic=\"effectiveDate\" id=\"idae524971-ec38-11e5-9fc5-818d616f3d7f\"><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</notes>\n</section>","provision":null,"duplicates":[],"release":{"label":"115-35","currency_date":"2017-05-17","congress":115,"law_num":35,"excluded_laws":[],"update_num":null,"seq":99,"is_partial":false,"caveat":null,"titles_affected":["01","02","05","05a","06","07","08","10","12","15","16","19","20","21","22","23","26","28","30","31","33","36","38","40","41","42","43","48","49","50","51","54"],"ingested_titles":[]},"served_from":{"label":"115-35","currency_date":"2017-05-17","congress":115,"law_num":35,"excluded_laws":[],"update_num":null,"seq":99,"is_partial":false,"caveat":null,"titles_affected":["01","02","05","05a","06","07","08","10","12","15","16","19","20","21","22","23","26","28","30","31","33","36","38","40","41","42","43","48","49","50","51","54"],"ingested_titles":[]},"content_first_seen":{"label":"114-115","currency_date":"2015-12-28","congress":114,"law_num":115,"excluded_laws":[],"update_num":null,"seq":62,"is_partial":false,"caveat":null,"titles_affected":["02","07","08","10","15","20","21","23","25","26","29","31","40","42","47","49","50"],"ingested_titles":[]},"is_exact":true,"note":null}