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FDA Announces Public Hearing on Off-Label Communications; Registration Deadline October 19, 2016

The US Food and Drug Administration (FDA) will hold a public hearing on November 9 and 10, 2016, to obtain input on manufacturer communications regarding unapproved uses of approved or cleared medical products (off-label promotions).

In Depth

The US Food and Drug Administration (FDA) will hold a public hearing on November 9 and 10, 2016, to obtain input on manufacturer communications regarding unapproved uses of approved or cleared medical products (off-label promotions).

FDA has broad authority to proscribe the content of product labeling and impose restrictions on the off-label promotion of drugs, medical devices and other regulated products. However, the First Amendment to the US Constitution and other laws restrict the extent to which FDA can prohibit truthful and non-misleading statements about unapproved or off-label uses of such products. Despite well-established constitutional protections on the dissemination of scientific speech and truthful and non-misleading commercial speech, the number of prosecutions, indictments and settlements arising from off-label promotion of drugs and medical devices has increased significantly in the past ten years. The number of warning letters related to unapproved use of medical devices and off-label claims for drugs has also increased in the same timeframe. Manufacturers and other stakeholders have called for additional guidance and greater limits on FDA’s application of speech-related enforcement principles, such as the “intended use” doctrine, to hold companies liable for the dissemination of truthful and non-misleading claims regarding off-label uses or unapproved uses of medical devices and other products.

In response to recent speech-related court decisions such as United States v. Caronia, 703 F.3d 149 (2d Cir. 2012) (holding that the government may not prohibit or criminalize truthful off-label promotional speech); Amarin Pharma, Inc. v. FDA,  119 F. Supp. 3d 196 (S.D.N.Y. 2015) (holding that the government may not pursue misbranding provisions under the Federal Food, Drug and Cosmetic Act for statements that were truthful and non-misleading); and United States v. Vascular Solutions, Inc., Cr. No. 14-926 (W.D. Tex. 2016) (jury finding that speech that is “solely truthful and not misleading” cannot be basis for misbranding charge), FDA is requesting public comment on the regulation of manufacturer communications regarding off-label or unapproved uses of approved medical products. FDA intends to address and prioritize “Manufacturer Communications Regarding Unapproved, Unlicensed, or Uncleared Uses of Approved, Licensed, or Cleared Human Drugs, Biologics, Animal Drugs and Medical Devices” in a guidance document.    

The agency is requesting comments from stakeholders on the following broad questions:

(1) How increased off-label promotions could impact public health, and whether the impact would differ across different categories of medical products

(2) The extent to which increased off-label promotion would affect incentives for firms to seek FDA approval or clearance for new uses

(3) The effect of increased availability of information regarding unapproved uses on firms’ incentives to seek FDA approval or clearance for new uses

(4) Standards the agency should apply to off-label communications to minimize the potential that they are misleading or harmful

(5) Factors the agency should consider in evaluating whether off-label promotions are truthful and non-misleading

(6) Whether firms should disclose data from human studies to ensure quality and integrity of communications and scientific information, and how transparency of this information should be monitored

(7) How the agency should monitor off-label promotions and what actions it should take with respect to those that are false or misleading or otherwise raise public health issues

(8)  Changes FDA should consider to 21 C.F.R. §§ 201.128 and 801.4 pursuant to its notice of proposed rulemaking

The hearing is an important step in what will undoubtedly be a longer-term process of reconciling FDA’s product approval process and speech restrictions with evolving First Amendment precedent. The hearing is a meaningful opportunity for manufacturers, marketers and other stakeholders to provide information, data and feedback to FDA on critical issues that will shape future policies on marketing communications. Comments may be submitted online.

Important Dates and Information

Registration Deadline: October 19, 2016
Registration Link: http://www.fda.gov/NewsEvents/MeetingsConferencesWorkshops/ucm489499.htm

Public Hearing Dates: November 9 and 10, 2016

FDA White Oak Campus
10903 New Hampshire Avenue
Bldg. 31, Great Room (Rm. 1503)
Silver Spring, MD 20993

© 2017 McDermott Will & Emery

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About this Author

Veleka Peeples-Dyer, McDermott Will Emery, life sciences industry, FDA attorney, drug safety lawyer, health care fraud counsel,
Partner

Veleka Peeples-Dyer is a partner in the law firm of McDermott Will & Emery LLP and is based in the Firm's Washington, D.C., office. She is an experienced attorney with an extensive background in the Life Sciences Industry, including Food and Drug Administration (FDA) regulation, clinical trials, manufacturing and supply, drug safety, licensing, product acquisition due diligence, health care fraud and abuse and compliance matters. Additionally, Veleka’s experience includes conducting internal investigations, developing and implementing legal and compliance...

202-756-8639
Partner

    ernessa T. Pollard is a partner in the law firm of McDermott Will & Emery LLP and is based in the Washington, D.C., office. Vernessa serves as co-head of the Firm’s Food and Drug Administration (FDA) practice.

    Vernessa advises companies on regulatory, compliance, enforcement and legislative matters involving pharmaceuticals, medical devices, digital and mobile health, health IT solutions and services, and emerging technologies and software. She also advises national and international food and cosmetic producers and retailers on regulatory and compliance issues related to food and cosmetic marketing and safety.

    Vernessa regularly counsels companies on product approvals and premarket strategy, Good Manufacturing Practice (GMP) and Quality System (QS) requirements, advertising and promotion, adverse event reporting, FDA Warning Letters, FDA inspections, recalls, import detentions and corporate compliance programs. She has represented companies and executives in FDA and Department of Justice (DOJ) investigations and enforcement matters. She also conducts due diligence evaluations and analyses of FDA regulatory issues relating to mergers and acquisitions.

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    Anisa Mohanty, McDermott Law Firm, Health Care Attorney
    Associate

    Anisa Mohanty advises life sciences companies on regulatory, compliance, enforcement, policy, and legislative matters arising under the Federal Food, Drug, and Cosmetic Act (FDCA). She counsels pharmaceutical, medical device, and consumer product companies on premarket pathways, advertising and promotion, and current Good Manufacturing Practice (cGMP) and Quality System requirements. Anisa also assists clients with US Food and Drug Administration (FDA) engagement strategies and responding to FDA administrative and enforcement actions. 

    202-756-8286