Research into pediatric uses for drugs and biological products
New drugs and biological products
In general
A person that submits, on or after
under section 355 of this title for a new active ingredient, new indication, new dosage form, new dosing regimen, or new route of administration, or
under section 262 of title 42 for a new active ingredient, new indication, new dosage form, new dosing regimen, or new route of administration,
shall submit with the application the assessments described in paragraph (2).
Assessments
In general
The assessments referred to in paragraph (1) shall contain data, gathered using appropriate formulations for each age group for which the assessment is required, that are adequate—
to assess the safety and effectiveness of the drug or the biological product for the claimed indications in all relevant pediatric subpopulations; and
to support dosing and administration for each pediatric subpopulation for which the drug or the biological product is safe and effective.
Similar course of disease or similar effect of drug or biological product
In general
Extrapolation between age groups
Information on extrapolation
Deferral
In general
On the initiative of the Secretary or at the request of the applicant, the Secretary may defer submission of some or all assessments required under paragraph (1) until a specified date after approval of the drug or issuance of the license for a biological product if—
the Secretary finds that—
the drug or biological product is ready for approval for use in adults before pediatric studies are complete;
pediatric studies should be delayed until additional safety or effectiveness data have been collected; or
there is another appropriate reason for deferral; and
the applicant submits to the Secretary—
certification of the grounds for deferring the assessments;
a pediatric study plan as described in subsection (e);
evidence that the studies are being conducted or will be conducted with due diligence and at the earliest possible time; and
a timeline for the completion of such studies.
Deferral extension
In general
On the initiative of the Secretary or at the request of the applicant, the Secretary may grant an extension of a deferral approved under subparagraph (A) for submission of some or all assessments required under paragraph (1) if—
the Secretary determines that the conditions described in subclause (II) or (III) of subparagraph (A)(i) continue to be met; and
the applicant submits a new timeline under subparagraph (A)(ii)(IV) and any significant updates to the information required under subparagraph (A)(ii).
Timing and information
Annual review
In general
On an annual basis following the approval of a deferral under subparagraph (A), the applicant shall submit to the Secretary the following information:
Information detailing the progress made in conducting pediatric studies.
If no progress has been made in conducting such studies, evidence and documentation that such studies will be conducted with due diligence and at the earliest possible time.
Projected completion date for pediatric studies.
The reason or reasons why a deferral or deferral extension continues to be necessary.
Public availability
Not later than 90 days after the submission to the Secretary of the information submitted through the annual review under clause (i), the Secretary shall make available to the public in an easily accessible manner, including through the Internet Web site of the Food and Drug Administration—
such information;
the name of the applicant for the product subject to the assessment;
the date on which the product was approved; and
the date of each deferral or deferral extension under this paragraph for the product.
Waivers
Full waiver
On the initiative of the Secretary or at the request of an applicant, the Secretary shall grant a full waiver, as appropriate, of the requirement to submit assessments for a drug or biological product under this subsection if the applicant certifies and the Secretary finds that—
necessary studies are impossible or highly impracticable (because, for example, the number of patients is so small or the patients are geographically dispersed);
there is evidence strongly suggesting that the drug or biological product would be ineffective or unsafe in all pediatric age groups; or
the drug or biological product—
does not represent a meaningful therapeutic benefit over existing therapies for pediatric patients; and
is not likely to be used in a substantial number of pediatric patients.
Partial waiver
On the initiative of the Secretary or at the request of an applicant, the Secretary shall grant a partial waiver, as appropriate, of the requirement to submit assessments for a drug or biological product under this subsection with respect to a specific pediatric age group if the applicant certifies and the Secretary finds that—
necessary studies are impossible or highly impracticable (because, for example, the number of patients in that age group is so small or patients in that age group are geographically dispersed);
there is evidence strongly suggesting that the drug or biological product would be ineffective or unsafe in that age group;
the drug or biological product—
does not represent a meaningful therapeutic benefit over existing therapies for pediatric patients in that age group; and
is not likely to be used by a substantial number of pediatric patients in that age group; or
the applicant can demonstrate that reasonable attempts to produce a pediatric formulation necessary for that age group have failed.
Pediatric formulation not possible
Labeling requirement
Marketed drugs and biological products
In general
The Secretary may (by order in the form of a letter) require the sponsor or holder of an approved application for a drug under section 355 of this title or the holder of a license for a biological product under section 262 of title 42 to submit by a specified date the assessments described in subsection (a)(2), if the Secretary finds that—
the drug or biological product is used for a substantial number of pediatric patients for the labeled indications; and
adequate pediatric labeling could confer a benefit on pediatric patients;
there is reason to believe that the drug or biological product would represent a meaningful therapeutic benefit over existing therapies for pediatric patients for 1 or more of the claimed indications; or
the absence of adequate pediatric labeling could pose a risk to pediatric patients.
Waivers
Full waiver
At the request of an applicant, the Secretary shall grant a full waiver, as appropriate, of the requirement to submit assessments under this subsection if the applicant certifies and the Secretary finds that—
necessary studies are impossible or highly impracticable (because, for example, the number of patients in that age group is so small or patients in that age group are geographically dispersed); or
there is evidence strongly suggesting that the drug or biological product would be ineffective or unsafe in all pediatric age groups.
Partial waiver
At the request of an applicant, the Secretary shall grant a partial waiver, as appropriate, of the requirement to submit assessments under this subsection with respect to a specific pediatric age group if the applicant certifies and the Secretary finds that—
necessary studies are impossible or highly impracticable (because, for example, the number of patients in that age group is so small or patients in that age group are geographically dispersed);
there is evidence strongly suggesting that the drug or biological product would be ineffective or unsafe in that age group;
the drug or biological product—
does not represent a meaningful therapeutic benefit over existing therapies for pediatric patients in that age group; and
is not likely to be used in a substantial number of pediatric patients in that age group; and
the absence of adequate labeling could not pose significant risks to pediatric patients; or
the applicant can demonstrate that reasonable attempts to produce a pediatric formulation necessary for that age group have failed.
Pediatric formulation not possible
Labeling requirement
Effect of subsection
Meaningful therapeutic benefit
For the purposes of paragraph (4)(A)(iii)(I) and (4)(B)(iii)(I) of subsection (a) and paragraphs (1)(B) and (2)(B)(iii)(I)(aa) of subsection (b), a drug or biological product shall be considered to represent a meaningful therapeutic benefit over existing therapies if the Secretary determines that—
if approved, the drug or biological product could represent an improvement in the treatment, diagnosis, or prevention of a disease, compared with marketed products adequately labeled for that use in the relevant pediatric population; or
the drug or biological product is in a class of products or for an indication for which there is a need for additional options.
Submission of assessments
If a person fails to submit a required assessment described in subsection (a)(2), fails to meet the applicable requirements in subsection (a)(3), or fails to submit a request for approval of a pediatric formulation described in subsection (a) or (b), in accordance with applicable provisions of subsections (a) and (b), the following shall apply:
Beginning 270 days after
The drug or biological product that is the subject of an assessment described in subsection (a)(2), applicable requirements in subsection (a)(3), or request for approval of a pediatric formulation, may be considered misbranded solely because of that failure and subject to relevant enforcement action (except that the drug or biological product shall not be subject to action under section 333 of this title), but such failure shall not be the basis for a proceeding—
to withdraw approval for a drug under section 355(e) of this title; or
to revoke the license for a biological product under section 262 of title 42.
Pediatric study plans
In general
Timing; content; meeting
Timing
An applicant shall submit the initial pediatric plan under paragraph (1)—
before the date on which the applicant submits the assessments under subsection (a)(2); and
not later than—
60 calendar days after the date of the end-of-Phase 2 meeting (as such term is used in section 312.47 of title 21, Code of Federal Regulations, or successor regulations); or
such other time as may be agreed upon between the Secretary and the applicant.
Nothing in this section shall preclude the Secretary from accepting the submission of an initial pediatric plan earlier than the date otherwise applicable under this subparagraph.
Content of initial plan
The initial pediatric study plan shall include—
an outline of the pediatric study or studies that the applicant plans to conduct (including, to the extent practicable study objectives and design, age groups, relevant endpoints, and statistical approach);
any request for a deferral, partial waiver, or waiver under this section, if applicable, along with any supporting information; and
other information specified in the regulations promulgated under paragraph (7).
Meeting
The Secretary—
shall meet with the applicant to discuss the initial pediatric study plan as soon as practicable, but not later than 90 calendar days after the receipt of such plan under subparagraph (A);
may determine that a written response to the initial pediatric study plan is sufficient to communicate comments on the initial pediatric study plan, and that no meeting is necessary; and
if the Secretary determines that no meeting is necessary, shall so notify the applicant and provide written comments of the Secretary as soon as practicable, but not later than 90 calendar days after the receipt of the initial pediatric study plan.
Agreed initial pediatric study plan
Deferral and waiver
Amendments to the plan
Internal committee
Required rulemaking
Review of pediatric study plans, assessments, deferrals, deferral extensions, and waivers
Review
Activity by committee
Documentation of committee action
Review of pediatric study plans, assessments, deferrals, deferral extensions, and waivers
Retrospective review of pediatric assessments, deferrals, and waivers
Tracking of assessments and labeling changes
The Secretary, in consultation with the committee referred to in paragraph (1), shall track and make available to the public in an easily accessible manner, including through posting on the Web site of the Food and Drug Administration—
the number of assessments conducted under this section;
the specific drugs and biological products and their uses assessed under this section;
the types of assessments conducted under this section, including trial design, the number of pediatric patients studied, and the number of centers and countries involved;
aggregated on an annual basis—
the total number of deferrals and deferral extensions requested and granted under this section and, if granted, the reasons for each such deferral or deferral extension;
the timeline for completion of the assessments;
the number of assessments completed and pending; and
the number of postmarket non-compliance letters issued pursuant to subsection (d), and the recipients of such letters;
the number of waivers requested and granted under this section and, if granted, the reasons for the waivers;
the number of pediatric formulations developed and the number of pediatric formulations not developed and the reasons any such formulation was not developed;
the labeling changes made as a result of assessments conducted under this section;
an annual summary of labeling changes made as a result of assessments conducted under this section for distribution pursuant to subsection (h)(2);
an annual summary of information submitted pursuant to subsection (a)(3)(B); and
the number of times the committee referred to in paragraph (1) made a recommendation to the Secretary under paragraph (4) regarding priority review, the number of times the Secretary followed or did not follow such a recommendation, and, if not followed, the reasons why such a recommendation was not followed.
Labeling changes
Dispute resolution
Request for labeling change and failure to agree
If, on or after
the Commissioner shall request that the sponsor of the application make any labeling change that the Commissioner determines to be appropriate; and
if the sponsor does not agree within 30 days after the Commissioner’s request to make a labeling change requested by the Commissioner, the Commissioner shall refer the matter to the Pediatric Advisory Committee.
Action by the Pediatric Advisory Committee
Not later than 90 days after receiving a referral under subparagraph (A)(ii), the Pediatric Advisory Committee shall—
review the pediatric study reports; and
make a recommendation to the Commissioner concerning appropriate labeling changes, if any.
Consideration of recommendations
Misbranding
No effect on authority
Other labeling changes
Dissemination of pediatric information
In general
Dissemination of information regarding labeling changes
Effect of subsection
Adverse event reporting
Reporting in first 18-month period
Reporting in subsequent periods
Preservation of authority
Effect
Scope of authority
Orphan drugs
Institute of Medicine study
In general
Content of study
Representative sample
New active ingredient
Non-interchangeable biosimilar biological product
Interchangeable biosimilar biological product
Source
(June 25, 1938, ch. 675, § 505B, as added Pub. L. 108–155, § 2(a),Notes
Amendments
Effective Date of 2012 Amendment
In general.—
Subject to paragraph (2), the amendments made by this section [amending this section] shall take effect 180 calendar days after the date of enactment of this Act [
Rule of construction.—
Paragraph (1) shall not be construed to affect the deadline for promulgation of proposed regulations under section 505B(e)(7) of the Federal Food, Drug, and Cosmetic Act [21 U.S.C. 355c(e)(7)], as added by subsection (a) of this section.”
Effective Date of 2007 Amendment
In general.—
Notwithstanding subsection (h) of section 505B of the Federal Food, Drug and Cosmetic Act [21 U.S.C. 355c(h)], as in effect on the day before the date of the enactment of this Act [
Certain assessments and waiver requests.—
An assessment pending on or after the date that is 1 year prior to the date of the enactment of this Act shall be subject to the tracking and disclosure requirements established under such section 505B, as in effect on or after such date of enactment, except that any such assessments submitted or waivers of such assessments requested before such date of enactment shall not be subject to subsections (a)(4)(C), (b)(2)(C), (f)(6)(F), and (h) of such section 505B.”
Effective Date
In General.—
Subject to subsection (b), this Act [enacting this section, amending sections 355, 355a, and 355b of this title and sections 262 and 284m of Title 42, The Public Health and Welfare, enacting provisions set out as a note under section 301 of this title, and amending provisions set out as notes under section 355a of this title and section 284m of Title 42] and the amendments made by this Act take effect on the date of enactment of this Act [
Applicability to New Drugs and Biological Products.—
In general.—
Subsection (a) of section 505B of the Federal Food, Drug, and Cosmetic Act [21 U.S.C. 355c(a)] (as added by section 2) shall apply to an application described in paragraph (1) of that subsection submitted to the Secretary of Health and Human Services on or after
Waivers and deferrals.—
Waiver or deferral granted.—
If, with respect to an application submitted to the Secretary of Health and Human Services between
Waiver and deferral not granted.—
If, with respect to an application submitted to the Secretary of Health and Human Services between
the date that is 1 year after the date of enactment of this Act; or
such date as the Secretary may specify under subsection (a)(3) of that section;
unless the Secretary grants a waiver under subsection (a)(4) of that section.
No Limitation of Authority.—
Neither the lack of guidance or regulations to implement this Act or the amendments made by this Act nor the pendency of the process for issuing guidance or regulations shall limit the authority of the Secretary of Health and Human Services under, or defer any requirement under, this Act or those amendments.”