Given the life sciences industry’s recent success raising the preemption defense in product liability litigation, it perhaps is not surprising that the defense is under increased scrutiny and that the plaintiffs’ bar is pressing to have new limits imposed.
On Sept. 12, 2007, Senator Patrick Leahy (D-Vt.) called a Senate Judiciary Committee hearing entitled “Regulatory Preemption: Are Federal Agencies Usurping Congressional and State Authority?” 110th Cong. 1–47 (Senate Judiciary Committee Sept. 12, 2007). The witnesses testifying for and against preemption echoed many of the public policy themes common in litigation briefs.
Perhaps more importantly, the plaintiffs’ bar was active in negotiations regarding the PDUFA reauthorization legislation, and the FDA Amendments Act of 2007 (H.R. 3580; Public Law Number 110-085), and succeeded in adding a provision that may have a deleterious impact on preemption in prescription drug cases. The bill was signed by the President Sept. 27, 2007, after Senator Henry A. Waxman (who filed an amicus brief opposing preemption in Riegel) reportedly insisted on a last-minute amendment to provide pharmaceutical plaintiffs with new ammunition when faced with a preemption defense.
Section 901 of the bill amends 21 U.S.C. section 355 regarding the new drug approval process. It provides new authority for the FDA to require postmarket studies and clinical trials and new provisions regarding labeling. More particularly, within a paragraph specifying a process by which the FDA can initiate a dialogue with a manufacturer about strengthening warnings, the bill contains a “Rule of Construction” (subparagraph (4)(I)) that plaintiffs’ lawyers undoubtedly hope will limit use of the preemption defense in prescription drug failure-to-warn-cases—perhaps even in cases already in progress, like the Colaccico and McNellis cases pending before the Third Circuit.
H.R. 3580’s section 901 follows,
Postmarket Studies and Clinical Trials; Labeling—
(1) IN GENERAL–A responsible person may not introduce or deliver for introduction into interstate commerce the new drug involved if the person is in violation of a requirement established under paragraph
(3) or (4) with respect to the drug.
(2) DEFINITIONS–For purposes of this subsection:
(A) RESPONSIBLE PERSON–The term ‘responsible person’ means a person who—
(i) has submitted to the Secretary a covered application that is pending; or
(ii) is the holder of an approved covered application.
(B) COVERED APPLICATION–The term ‘covered application’ means—
(i) an application under subsection (b) for a drug that is subject to section 503(b); and
(ii) an application under section 351 of the Public Health Service Act.
(C) NEW SAFETY INFORMATION; SERIOUS RISK–The terms ‘new safety information,’ ‘serious risk,’ and ‘signal of a serious risk’ have the meanings given such terms in section 505-1(b).
(3) STUDIES AND CLINICAL TRIALS—
(A) IN GENERAL–For any or all of the purposes specified in subparagraph (B), the Secretary may, subject to subparagraph (D), require a responsible person for a drug to conduct a postapproval study or studies of the drug, or a postapproval clinical trial or trials of the drug, on the basis of scientific data deemed appropriate by the Secretary, including information regarding chemically-related or pharmacologically-related drugs.
(B) PURPOSES OF STUDY OR CLINICAL TRIAL–The purposes referred to in this subparagraph with respect to a postapproval study or postapproval clinical trial are the following:
(i) To assess a known serious risk related to the use of the drug involved.
(ii) To assess signals of serious risk related to the use of the drug.
(iii) To identify an unexpected serious risk when available data indicates the potential for a serious risk.
(C) ESTABLISHMENT OF REQUIREMENT AFTER APPROVAL OF COVERED APPLICATION–The Secre- tary may require a postapproval study or studies or postapproval clinical trial or trials for a drug for which an approved covered application is in effect as of the date on which the Secretary seeks to establish such requirement only if the Secretary becomes aware of new safety information.
(D) DETERMINATION BY SECRETARY—
(i) POSTAPPROVAL STUDIES–The Secretary may not require the responsible person to conduct a study under this paragraph, unless the Secretary makes a determination that the reports under subsection (k)(1) and the active postmarket risk identification and analysis system as available under subsection (k)(3) will not be sufficient to meet the purposes set forth in subparagraph (B).
(ii) POSTAPPROVAL CLINICAL TRIALS–The Secretary may not require the responsible person to conduct a clinical trial under this paragraph, unless the Secretary makes a determination that a postapproval study or studies will not be sufficient to meet the purposes set forth in subparagraph (B).
(E) NOTIFICATION; TIMETABLES; PERIODIC REPORTS—
(i) NOTIFICATION–The Secretary shall notify the responsible person regarding a requirement under this paragraph to conduct a postapproval study or clinical trial by the target dates for communication of feedback from the review team to the responsible person regarding proposed labeling and postmarketing study commitments as set forth in the letters described in section 101(c) of the Food and Drug Administration Amendments Act of 2007.
(ii) TIMETABLE; PERIODIC REPORTS–For each study or clinical trial required to be conducted under this paragraph, the Secretary shall require that the responsible person submit a timetable for completion of the study or clinical trial. With respect to each study required to be conducted under this paragraph or otherwise undertaken by the responsible person to investigate a safety issue, the Secretary shall require the responsible person to periodically report to the Secretary on the status of such study including whether any difficulties in completing the study have been encountered. With respect to each clinical trial required to be conducted under this paragraph or otherwise undertaken by the responsible person to investigate a safety issue, the Secretary shall require the responsible person to periodically report to the Secretary on the status of such clinical trial including whether enrollment has begun, the number of participants enrolled, the expected completion date, whether any difficulties completing the clinical trial have been encountered, and registration information with respect to the requirements under section 402(j) of the Public Health Service Act. If the responsible person fails to comply with such timetable or violates any other requirement of this subparagraph, the responsible person shall be considered in violation of this subsection, unless the responsible person demonstrates good cause for such noncompliance or such other violation. The Secretary shall determine what constitutes good cause under the preceding sentence.
(F) DISPUTE RESOLUTION–The responsible person may appeal a requirement to conduct a study or clinical trial under this paragraph using dispute resolution procedures established by the Secretary in regulation and guidance.
(4) SAFETY LABELING CHANGES REQUESTED BY SECRETARY—
(A) NEW SAFETY INFORMATION–If the Secretary becomes aware of new safety information that the Secretary believes should be included in the labeling of the drug, the Secretary shall promptly notify the responsible person or, if the same drug approved under section 505(b) is not currently marketed, the holder of an approved application under 505(j).
(B) RESPONSE TO NOTIFICATION–Following notification pursuant to subparagraph (A), the responsible person or the holder of the approved application under section 505(j) shall within 30 days—
(i) submit a supplement proposing changes to the approved labeling to reflect the new safety information, including changes to boxed warnings, contraindications, warnings, precautions,or adverse reactions; or
(ii) notify the Secretary that the responsible person or the holder of the approved application under section 505(j) does not believe a labeling change is warranted and submit a statement detailing the reasons why such a change is not warranted.
(C) REVIEW–Upon receipt of such supplement, the Secretary shall promptly review and act upon such supplement. If the Secretary disagrees with the proposed changes in the supplement or with the statement setting forth the reasons why no labeling change is necessary, the Secretary shall initiate discussions to reach agreement on whether the labeling for the drug should be modified to reflect the new safety information, and if so, the contents of such labeling changes.
(D) DISCUSSIONS–Such discussions shall not extend for more than 30 days after the response to the notification under subparagraph (B), unless the Secretary determines an extension of such discussion period is warranted.
(E) ORDER–Within 15 days of the conclusion of the discussions under subparagraph (D), the Secretary may issue an order directing the responsible person or the holder of the approved application under section 505(j) to make such a labeling change as the Secretary deems appropriate to address the new safety information. Within 15 days of such an order, the responsible person or the holder of the approved application under section 505(j) shall submit a supplement containing the labeling change.
(F) DISPUTE RESOLUTION–Within 5 days of receiving an order under subparagraph (E), the responsible person or the holder of the approved application under section 505(j) may appeal using dispute resolution procedures established by the Secretary in regulation and guidance.
(G) VIOLATION–If the responsible person or the holder of the approved application under section 505(j) has not submitted a supplement within 15 days of the date of such order under subparagraph
(E), and there is no appeal or dispute resolution proceeding pending, the responsible person or holder shall be considered to be in violation of this subsection. If at the conclusion of any dispute resolution procedures the Secretary determines that a supplement must be submitted and such a supplement is not submitted within 15 days of the date of that determination, the responsible person or holder shall be in violation of this subsection.
(H) PUBLIC HEALTH THREAT–Notwithstanding subparagraphs (A) through (F), if the Secretary concludes that such a labeling change is necessary to protect the public health, the Secretary may accelerate the timelines in such subparagraphs.
(I) RULE OF CONSTRUCTION–This paragraph shall not be construed to affect the responsibility of the responsible person or the holder of the approved application under section 505(j) to maintain its label in accordance with existing requirements, including subpart B of part 201 and sections 314.70 and 601.12 of title 21, Code of Federal Regulations (or any successor regulations).
(5) NON-DELEGATION–Determinations by the Secretary under this subsection for a drug shall be made by individuals at or above the level of individuals empowered to approve a drug (such as division directors within the Center for Drug Evaluation and Research).