80_FR_65972 80 FR 65765 - Bulk Drug Substances That Can Be Used To Compound Drug Products in Accordance With Section 503A of the Federal Food, Drug, and Cosmetic Act; Establishment of a Public Docket

80 FR 65765 - Bulk Drug Substances That Can Be Used To Compound Drug Products in Accordance With Section 503A of the Federal Food, Drug, and Cosmetic Act; Establishment of a Public Docket

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Food and Drug Administration

Federal Register Volume 80, Issue 207 (October 27, 2015)

Page Range65765-65768
FR Document2015-27271

The Food and Drug Administration (FDA or Agency) is developing a list of bulk drug substances (active ingredients) that can be used to compound drug products in accordance with the Federal Food, Drug, and Cosmetic Act (the FD&C Act), although they are neither the subject of an applicable United States Pharmacopeia (USP) or National Formulary (NF) monograph nor components of FDA-approved drugs (503A bulks list). The Agency previously solicited nominations for the list, but some of the nominated substances were not supported by sufficient information for FDA to evaluate them. FDA is establishing a public docket where these substances can be renominated with sufficient supporting information or to receive nominations of bulk drug substances that were not previously nominated for consideration for inclusion on the 503A bulks list. Interested parties can also submit comments on nominated substances via this docket.

Federal Register, Volume 80 Issue 207 (Tuesday, October 27, 2015)
[Federal Register Volume 80, Number 207 (Tuesday, October 27, 2015)]
[Notices]
[Pages 65765-65768]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2015-27271]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Food and Drug Administration

[Docket No. FDA-2015-N-3534]


Bulk Drug Substances That Can Be Used To Compound Drug Products 
in Accordance With Section 503A of the Federal Food, Drug, and Cosmetic 
Act; Establishment of a Public Docket

AGENCY: Food and Drug Administration, HHS.

ACTION: Notice; establishment of public docket.

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SUMMARY: The Food and Drug Administration (FDA or Agency) is developing 
a list of bulk drug substances (active ingredients) that can be used to 
compound drug products in accordance with the Federal Food, Drug, and 
Cosmetic Act (the FD&C Act), although they are neither the subject of 
an applicable United States Pharmacopeia (USP) or National Formulary 
(NF) monograph nor components of FDA-approved drugs (503A bulks list). 
The Agency previously solicited nominations for the list, but some of 
the nominated substances were not supported by sufficient information 
for FDA to evaluate them. FDA is establishing a public docket where 
these substances can be renominated with sufficient supporting 
information or to receive nominations of bulk drug substances that were 
not previously nominated for consideration for inclusion on the 503A 
bulks list. Interested parties can also submit comments on nominated 
substances via this docket.

DATES: Nominations and comments may be submitted to this docket at any 
time.

ADDRESSES: You may submit comments as follows:

Electronic Submissions

    Submit electronic comments in the following way:
     Federal eRulemaking Portal: http://www.regulations.gov. 
Follow the instructions for submitting comments. Comments submitted 
electronically, including attachments, to http://www.regulations.gov 
will be posted to the docket unchanged. Because your comment will be 
made public, you are solely responsible for ensuring that your comment 
does not include any confidential information that you or a third party 
may not wish to be posted, such as medical information, your or anyone 
else's Social Security number, or confidential business information, 
such as a manufacturing process. Please note that if you include your 
name, contact information, or other information that identifies you in 
the body of your comments, that information will be posted on http://www.regulations.gov.
     If you want to submit a comment with confidential 
information that you do not wish to be made available to the public, 
submit the comment as a written/paper submission and in the manner 
detailed (see ``Written/Paper Submissions'' and ``Instructions'').

Written/Paper Submissions

    Submit written/paper submissions as follows:
     Mail/Hand delivery/Courier (for written/paper 
submissions): Division of Dockets Management (HFA-305), Food and Drug 
Administration, 5630 Fishers Lane, Rm. 1061, Rockville, MD 20852.
     For written/paper comments submitted to the Division of 
Dockets Management, FDA will post your comment, as well as any 
attachments, except for information submitted, marked and identified, 
as confidential, if submitted as detailed in ``Instructions.''
    Instructions: All submissions received must include the Docket No. 
FDA-2015-N-3534 for ``Bulk Drug Substances That Can Be Used To Compound 
Drug Products in Accordance With Section 503A of the Federal Food, 
Drug, and Cosmetic Act; Establishment of a Public Docket.'' Received 
comments will be placed in the docket and, except for those submitted 
as ``Confidential Submissions,'' publicly viewable at http://www.regulations.gov or at the Division of Dockets Management between 9 
a.m. and 4 p.m., Monday through Friday.
     Confidential Submissions--To submit a comment with 
confidential information that you do not wish to be made publicly 
available, submit your comments only as a written/paper submission. You 
should submit two copies total. One copy will include the information 
you claim to be confidential with a heading or cover note that states 
``THIS DOCUMENT CONTAINS CONFIDENTIAL INFORMATION.'' The Agency will 
review this copy, including the claimed confidential information, in 
its consideration of comments. The second copy, which will have the 
claimed confidential information redacted/blacked out, will be 
available for public viewing and posted on http://www.regulations.gov. 
Submit both copies to the Division of Dockets Management. If you do not 
wish your name and contact information to be made publicly available, 
you can provide this information on the cover sheet and not in the body 
of your comments and you must identify this information as 
``confidential.'' Any information marked as ``confidential'' will not 
be disclosed except in accordance with 21 CFR 10.20 and other 
applicable disclosure law. For more information about FDA's posting of 
comments to public dockets, see 80 FR 56469, September 18, 2015, or 
access the information at: http://www.fda.gov/regulatoryinformation/dockets/default.htm.
    Docket: For access to the docket to read background documents or 
the electronic and written/paper comments received, go to http://www.regulations.gov and insert the docket number, found in brackets in 
the heading of this document, into the ``Search'' box and follow the 
prompts and/or go to the Division of Dockets Management, 5630 Fishers 
Lane, Rm. 1061, Rockville, MD 20852.

FOR FURTHER INFORMATION CONTACT: Philantha Bowen, Center for Drug 
Evaluation and Research, Food and Drug Administration, 10903 New 
Hampshire Ave., Bldg. 51, Rm. 5175, Silver Spring, MD 20993-0002, 301-
796-2466.

SUPPLEMENTARY INFORMATION:

I. Background

    Section 503A of the FD&C Act (21 U.S.C. 353a) describes the 
conditions under which a compounded drug

[[Page 65766]]

product may be entitled to an exemption from certain sections of the 
FD&C Act. Those conditions include that a licensed pharmacist in a 
State licensed pharmacy or Federal facility or a licensed physician 
compounds the drug product using bulk drug substances that: (1) Comply 
with the standards of an applicable USP or NF monograph, if a monograph 
exists, and the USP chapter on pharmacy compounding; (2) if such a 
monograph does not exist, are drug substances that are components of 
drugs approved by the Secretary; or (3) if such a monograph does not 
exist and the drug substance is not a component of a drug approved by 
the Secretary, that appear on a list developed by the Secretary through 
regulations issued by the Secretary under subsection (c) of section 
503A. See section 503A(b)(1)(A)(i) of the FD&C Act. Under section 
503A(c)(2) of the FD&C Act, the criteria for determining which 
substances should appear on the 503A bulks list ``shall include 
historical use, reports in peer reviewed medical literature, or other 
criteria the Secretary may identify.''
    Section 503A refers to the definition of ``bulk drug substance'' in 
FDA regulations at Sec.  207.3(a)(4) (21 CFR 207.3(a)(4)). See section 
503A(b)(1)(A) of the FD&C Act. As defined in Sec.  207.3(a)(4), a 
``bulk drug substance'' is any substance that is represented for use in 
a drug and that, when used in the manufacturing, processing, or 
packaging of a drug, becomes an active ingredient or a finished dosage 
form of the drug, but the term does not include intermediates used in 
the synthesis of such substances.
    An ``active ingredient'' is any component that is intended to 
furnish pharmacological activity or other direct effect in the 
diagnosis, cure, mitigation, treatment, or prevention of disease, or to 
affect the structure or any function of the body of man or other 
animals. The term includes those components that may undergo chemical 
change in the manufacture of the drug product and be present in the 
drug product in a modified form intended to furnish the specified 
activity or effect. See 21 CFR 210.3(b)(7).
    Any component other than an active ingredient is an ``inactive 
ingredient.'' See 21 CFR 210.3(b)(8). Inactive ingredients used in 
compounded drug products, which commonly include flavorings, dyes, 
diluents, or other excipients, need not appear on the Secretary's list 
of bulk drug substances to be eligible for use in compounding drug 
products and will not be included on the list.
    In a notice dated November 27, 2013 (the November 27, 2013, 
notice), published in the Federal Register of December 4, 2013 (78 FR 
72841), FDA invited all interested persons to nominate bulk drug 
substances for inclusion on a list of bulk drug substances that can be 
used for compounding under section 503A of the FD&C Act. Over 2,000 
substances were nominated. However, many of the nominations were for 
substances that can be used for compounding without being on the list 
because they are the subject of an applicable USP or NF monograph or 
are a component of an FDA-approved drug. In addition, many of the 
nominations were not for bulk drug substances used in compounding as 
active ingredients, or did not include sufficient information to allow 
FDA to evaluate the substance for inclusion on the list. To improve the 
efficiency of the process for developing the 503A bulks list, FDA 
reopened the nomination process in July 2014 (79 FR 37742, July 2, 
2014) and provided more detailed information on what it needs to 
evaluate nominations for the list. FDA stated that bulk drug substances 
that were previously nominated would not be considered further unless 
they were re-nominated with adequate support to permit a meaningful 
evaluation. Substances that were already eligible for use in 
compounding or that were not adequately supported would not be 
evaluated for placement on the list.
    In response to the July 2, 2014, request for nominations, 
approximately 740 unique substances were nominated. Of the nominated 
substances, approximately 275 are already eligible for use in 
compounding because they are either components of an approved drug or 
the subject of an applicable USP or NF monograph. At least nine of the 
nominated substances are not eligible for inclusion on the list because 
they are either a finished drug product, a biological product subject 
to licensure in a biologics license application (BLA), a 
radiopharmaceutical drug product, a substance with no currently 
accepted medical use that is included on Schedule I of the Controlled 
Substances Act (21 U.S.C. 812(c)), or they appear on the list published 
by FDA of substances that have been withdrawn or removed from the 
market because such drug products or components of such drug products 
have been found to be unsafe or not effective. Of the substances that 
are not components of an FDA-approved drug or the subject of an 
applicable USP or NF monograph, not biological products subject to 
licensure in a BLA, not radiopharmaceuticals, do not appear on Schedule 
I, and do not appear on the withdrawn or removed list, approximately 
390 substances were nominated with insufficient supporting evidence for 
FDA to evaluate them.

II. Establishment of a Docket

    As described in section III.B of the draft guidance entitled, 
``Interim Policy on Compounding Using Bulk Drug Substances Under 
Section 503A of the Federal Food, Drug, and Cosmetic Act,'' FDA is 
establishing a public docket so that interested parties can comment on 
nominated bulk drug substances, nominate bulk drug substances that were 
not previously nominated for the 503A bulks list, or renominate with 
adequate supporting information bulk drug substances that were 
previously nominated but that were not supported by sufficient 
information for FDA to evaluate them. Docket No. FDA-2013-N-1525 is 
closed for comment. Therefore, this new docket can be used for 
commenting on nominations submitted to that docket as well as for 
submitting new nominations.
    As stated previously, under section 503A(c)(2) of the FD&C Act, the 
criteria for determining which substances should appear on the 503A 
bulk drugs list shall include historical use, reports in peer reviewed 
medical literature, or other criteria the Secretary may identify. Based 
on this statutory language and consultations with the USP and the 
Pharmacy Compounding Advisory Committee (PCAC),\1\ FDA is considering 
the use of the following four criteria to determine whether a bulk drug 
substance is appropriate for use in compounding: (1) The physical and 
chemical characterization of the substance; (2) any safety issues 
raised by the use of the substance in compounded drug products; (3) 
historical use of the substance in compounded drug products, including 
information about the medical condition(s) the substance has been used 
to treat and any references in peer-reviewed medical literature; and 
(4) the available evidence of effectiveness or lack of effectiveness of 
a drug product compounded with the substance, if any such evidence 
exists. Therefore, to be considered for placement on the 503A bulks 
list, this information should be submitted for each nominated 
substance. FDA will

[[Page 65767]]

evaluate the nominated substances in consultation with the USP and the 
PCAC.
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    \1\ See 64 FR 996, January 7, 1999 (proposed rule listing bulk 
drug substances that may be used in pharmacy compounding). This 
proposed rule was withdrawn in the November 27, 2013, notice but 
sets forth additional background about the criteria used in the 
evaluation of nominated bulk drug substances. The criteria were 
discussed with the PCAC, the membership of which includes a USP 
representative, at its meeting on February 22, 2015.
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    Interested groups and individuals may nominate specific bulk drug 
substances for inclusion on the 503A bulks list, renominate previously 
nominated substances with additional information, or comment on 
nominated substances. Nominations will only be evaluated if they are 
for specific active ingredients that: (1) Meet the definition of a bulk 
drug substance in Sec.  207.3(a)(4); (2) are not components of FDA-
approved drug products; and (3) are not substances that are the subject 
of an applicable USP or NF monograph. To fully evaluate a bulk drug 
substance using the criteria identified above, FDA needs the following 
information about both the nominated bulk drug substance and the drug 
product(s) that will be compounded using such substance:

A. Confirmation That the Nominated Substance Is a Bulk Drug Substance 
and Is Not Already Eligible for 503A Compounding

     A statement that the nominated substance is an active 
ingredient that meets the definition of ``bulk drug substance'' in 
Sec.  207.3(a)(4), and an explanation of why the substance is 
considered an active ingredient when it is used in the identified 
compounded drug product(s), citing to specific sources that describe 
the active properties of the substance.
     A statement that the nominator has searched for the active 
ingredient in all three sections of the Orange Book (for prescription 
drug products, over-the-counter drug products, and discontinued drug 
products), available at http://www.accessdata.fda.gov/scripts/cder/ob/docs/queryai.cfm, and the drug substance did not appear in any of those 
searches, confirming that the substance is not a component of any FDA-
approved product.
     A statement that the nominator has searched applicable USP 
and NF drug monographs, available at http://www.uspnf.com, and the drug 
substance is not the subject of such a monograph.

B. General Background on the Bulk Drug Substance

     Ingredient name;
     Chemical name;
     Common name(s);
     Identifying codes, as available, from FDA's Unique 
Ingredient Identifiers (UNII) used in the FDA/USP Substance 
Registration System, available at http://fdasis.nlm.nih.gov/srs/. 
Because substance names can vary, this code, where available, will be 
used by the Agency to confirm the exact substance nominated and to 
identify multiple nominations of the same substance so the information 
can be reviewed together.
     Chemical grade of the ingredient;
     Description of the strength, quality, stability, and 
purity of the ingredient, and a copy of a certificate of analysis that 
is representative of the characteristics of the nominated ingredient;
     Information about how the ingredient is supplied (e.g., 
powder, liquid); and
     Information about recognition of the substance in foreign 
pharmacopeias and the status of its registration(s) in other countries, 
including whether information has been submitted to the USP for 
consideration of monograph development.

C. Information on the Drug Product That Will Be Compounded With the 
Bulk Drug Substance

     Information about the dosage form(s) into which the bulk 
drug substance will be compounded;
     Information about the strength(s) of the compounded drug 
product(s);
     Information about the anticipated route(s) of 
administration of the compounded product(s);
     A bibliography of safety and efficacy data for the drug 
compounded using the nominated substance, if available,\2\ including 
any relevant peer-reviewed medical literature; and
---------------------------------------------------------------------------

    \2\ FDA recognizes that the available safety and efficacy data 
supporting consideration of a bulk drug substance for inclusion on 
the list may not be of the same type, amount, or quality as is 
required to support a new drug application.
---------------------------------------------------------------------------

     Information about the past and proposed use(s) of the 
compounded drug product(s), including the rationale for its use and why 
the compounded product(s), as opposed to an FDA-approved product, is 
necessary. Information on the rationale for use of the bulk drug 
substance and why a compounded drug product is necessary must be 
specific to the compounded drug product at issue. General or 
boilerplate statements regarding the need for compounded drug products 
or the benefits of compounding generally will not be considered 
sufficient to address this issue.

D. Process for Submitting Nominations and Comments

    Because the prior deadline for submitting nominations has passed, 
FDA is opening this docket so that interested persons can submit 
nominations of bulk drug substances and provide adequate support for 
FDA to evaluate whether those substances should be placed on the 503A 
bulks list. Bulk drug substances that were previously nominated and for 
which inadequate information was provided \3\ need to be renominated 
with the information identified above to be considered for inclusion on 
the 503A bulks list. Nominators are encouraged to submit as much of the 
information identified in this document as possible. Unless adequate 
supporting data is received for a bulk drug substance, FDA will be 
unable to consider it further for inclusion on the list.
---------------------------------------------------------------------------

    \3\ As referenced above, a list of the substances in this 
category is available at http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/PharmacyCompounding/UCM467373.pdf.
---------------------------------------------------------------------------

    For efficient consolidation and review of nominations, nominators 
are encouraged to submit their nominations in an editable Excel file. 
Specifically, nominators are encouraged to format their nominations as 
follows:

------------------------------------------------------------------------
     Column A--What information is        Column B--Put data specific to
               requested?                    the nominated substance
------------------------------------------------------------------------
What is the name of the nominated        Provide the ingredient name.
 ingredient?
Is the ingredient an active ingredient   Provide an explanation for why
 that meets the definition of ``bulk      it is considered an active
 drug substance'' in Sec.                 ingredient when it is used in
 207.3(a)(4)?                             specific compounded drug
                                          products, and provide
                                          citations to specific sources
                                          that describe its active
                                          properties.
Is the ingredient listed in any of the   Confirm whether the ingredient
 three sections of the Orange Book?       is a component of an FDA-
                                          approved product.
Were any drug monographs for the         Confirm whether the ingredient
 ingredient found in the USP or NF        is the subject of an
 monographs?                              applicable USP or NF
                                          monograph.
What is the chemical name of the         Chemical name.
 substance?
What is the common name of the           Common name.
 substance?
Does the substance have a UNII code?     UNII code.

[[Page 65768]]

 
What is the chemical grade of the        Provide the chemical grade.
 substance?
What is the strength, quality,           Provide the strength, quality,
 stability, and purity of the             stability, and purity
 ingredient?                              information and attach a
                                          certificate of analysis.
How is the ingredient supplied?          Describe how the ingredient is
                                          supplied (e.g., powder,
                                          liquid).
Is the substance recognized in foreign   List the foreign pharmacopeias
 pharmacopeias or registered in other     or other countries in which it
 countries?                               is registered.
Has information been submitted about     Put yes, no, or unknown. If
 the substance to the USP for             yes, state the status of the
 consideration of drug monograph          monograph, if known.
 development?
What dosage form(s) will be compounded   State the dosage form(s).
 using the bulk drug substance?
What strength(s) will be compounded      List the strength(s) of the
 from the nominated substance?            drug product(s) that will be
                                          compounded from the nominated
                                          substance, or a range of
                                          strengths, if known.
What are the anticipated route(s) of     List the route(s) of
 administration of the compounded drug    administration of the
 product(s)?                              compounded drug product(s).
Are there safety and efficacy data on    Provide a bibliography of
 compounded drugs using the nominated     safety and efficacy data for
 substance?                               the drug compounded using the
                                          nominated substance, if
                                          available, including any
                                          relevant peer-reviewed medical
                                          literature.
Has the bulk drug substance been used    Describe past uses of the bulk
 previously to compound drug              drug substance in compounding.
 product(s)?
What is the proposed use for the drug    Provide information on the
 product(s) to be compounded with the     proposed use of the compounded
 nominated substance?                     drug product.
What is the reason for use of a          Provide a rationale for the use
 compounded drug product rather than an   of a compounded drug product.
 FDA-approved product?
Is there any other relevant              Provide any other information
 information?                             you would like FDA to consider
                                          in evaluating the nomination.
------------------------------------------------------------------------

    In addition to nominating new substances or renominating substances 
previously nominated without sufficient supporting information, 
individuals and organizations will be able to comment via the docket 
established by this notice on substances nominated for the 503A bulks 
list that have not yet been addressed in a Notice of Proposed 
Rulemaking (NPRM). Comments may be submitted regarding nominations 
submitted to both this docket and Docket No. FDA-2013-N-1525. Comments 
may provide any relevant information about particular bulk drug 
substances, including that in support of, or in opposition to, the 
placement of a nominated bulk drug substance on the 503A bulks list. 
However, comments submitted should not address the 503A bulks list 
generally or other matters related to the Agency's regulation of 
compounding. Comments about nominated substances that have been 
addressed by the Agency in an NPRM should be submitted to the docket 
for the proposed rulemaking in which the substance is addressed.
    Please do not submit comments that have already been submitted to 
other dockets. Such submissions are duplicative and not helpful to the 
Agency. If comments on particular documents or issues are submitted to 
this docket rather than the docket specifically opened for the 
particular document or issue, the comment might not be considered as 
the specific documents are being finalized and issues considered. FDA 
will not respond to questions submitted to this docket.
    Information in the docket will be publicly available. Therefore, we 
remind nominators and commenters not to submit personal or confidential 
information.

    Dated: October 21, 2015.
Leslie Kux,
Associate Commissioner for Policy.
[FR Doc. 2015-27271 Filed 10-26-15; 8:45 am]
BILLING CODE 4164-01-P



                                                                           Federal Register / Vol. 80, No. 207 / Tuesday, October 27, 2015 / Notices                                         65765

                                              Attn: OPRE Reports Clearance Officer.                   nominations of bulk drug substances                   the docket and, except for those
                                              Email address: OPREinfocollection@                      that were not previously nominated for                submitted as ‘‘Confidential
                                              acf.hhs.gov. All requests should be                     consideration for inclusion on the 503A               Submissions,’’ publicly viewable at
                                              identified by the title of the information              bulks list. Interested parties can also               http://www.regulations.gov or at the
                                              collection.                                             submit comments on nominated                          Division of Dockets Management
                                                The Department specifically requests                  substances via this docket.                           between 9 a.m. and 4 p.m., Monday
                                              comments on (a) whether the proposed                    DATES: Nominations and comments may                   through Friday.
                                              collection of information is necessary                  be submitted to this docket at any time.                 • Confidential Submissions—To
                                              for the proper performance of the                       ADDRESSES: You may submit comments
                                                                                                                                                            submit a comment with confidential
                                              functions of the agency, including                      as follows:                                           information that you do not wish to be
                                              whether the information shall have                                                                            made publicly available, submit your
                                              practical utility; (b) the accuracy of the              Electronic Submissions                                comments only as a written/paper
                                              agency’s estimate of the burden of the                    Submit electronic comments in the                   submission. You should submit two
                                              proposed collection of information; (c)                 following way:                                        copies total. One copy will include the
                                              the quality, utility, and clarity of the                  • Federal eRulemaking Portal: http://               information you claim to be confidential
                                              information to be collected; and (d)                    www.regulations.gov. Follow the                       with a heading or cover note that states
                                              ways to minimize the burden of the                      instructions for submitting comments.                 ‘‘THIS DOCUMENT CONTAINS
                                              collection of information on                            Comments submitted electronically,                    CONFIDENTIAL INFORMATION.’’ The
                                              respondents, including through the use                  including attachments, to http://                     Agency will review this copy, including
                                              of automated collection techniques or                   www.regulations.gov will be posted to                 the claimed confidential information, in
                                              other forms of information technology.                  the docket unchanged. Because your                    its consideration of comments. The
                                              Consideration will be given to                          comment will be made public, you are                  second copy, which will have the
                                              comments and suggestions submitted                      solely responsible for ensuring that your             claimed confidential information
                                              within 60 days of this publication.                     comment does not include any                          redacted/blacked out, will be available
                                                                                                      confidential information that you or a                for public viewing and posted on
                                              Robert Sargis,
                                                                                                      third party may not wish to be posted,                http://www.regulations.gov. Submit
                                              Reports Clearance Officer.                                                                                    both copies to the Division of Dockets
                                              [FR Doc. 2015–27239 Filed 10–26–15; 8:45 am]
                                                                                                      such as medical information, your or
                                                                                                      anyone else’s Social Security number, or              Management. If you do not wish your
                                              BILLING CODE 4184–01–P
                                                                                                      confidential business information, such               name and contact information to be
                                                                                                      as a manufacturing process. Please note               made publicly available, you can
                                                                                                      that if you include your name, contact                provide this information on the cover
                                              DEPARTMENT OF HEALTH AND                                                                                      sheet and not in the body of your
                                              HUMAN SERVICES                                          information, or other information that
                                                                                                      identifies you in the body of your                    comments and you must identify this
                                                                                                      comments, that information will be                    information as ‘‘confidential.’’ Any
                                              Food and Drug Administration
                                                                                                      posted on http://www.regulations.gov.                 information marked as ‘‘confidential’’
                                              [Docket No. FDA–2015–N–3534]                                                                                  will not be disclosed except in
                                                                                                        • If you want to submit a comment
                                                                                                      with confidential information that you                accordance with 21 CFR 10.20 and other
                                              Bulk Drug Substances That Can Be                                                                              applicable disclosure law. For more
                                              Used To Compound Drug Products in                       do not wish to be made available to the
                                                                                                      public, submit the comment as a                       information about FDA’s posting of
                                              Accordance With Section 503A of the                                                                           comments to public dockets, see 80 FR
                                              Federal Food, Drug, and Cosmetic Act;                   written/paper submission and in the
                                                                                                      manner detailed (see ‘‘Written/Paper                  56469, September 18, 2015, or access
                                              Establishment of a Public Docket                                                                              the information at: http://www.fda.gov/
                                                                                                      Submissions’’ and ‘‘Instructions’’).
                                              AGENCY:    Food and Drug Administration,                                                                      regulatoryinformation/dockets/
                                                                                                      Written/Paper Submissions                             default.htm.
                                              HHS.
                                                                                                         Submit written/paper submissions as                   Docket: For access to the docket to
                                              ACTION:   Notice; establishment of public
                                                                                                      follows:                                              read background documents or the
                                              docket.
                                                                                                         • Mail/Hand delivery/Courier (for                  electronic and written/paper comments
                                              SUMMARY:    The Food and Drug                           written/paper submissions): Division of               received, go to http://
                                              Administration (FDA or Agency) is                       Dockets Management (HFA–305), Food                    www.regulations.gov and insert the
                                              developing a list of bulk drug                          and Drug Administration, 5630 Fishers                 docket number, found in brackets in the
                                              substances (active ingredients) that can                Lane, Rm. 1061, Rockville, MD 20852.                  heading of this document, into the
                                              be used to compound drug products in                       • For written/paper comments                       ‘‘Search’’ box and follow the prompts
                                              accordance with the Federal Food, Drug,                 submitted to the Division of Dockets                  and/or go to the Division of Dockets
                                              and Cosmetic Act (the FD&C Act),                        Management, FDA will post your                        Management, 5630 Fishers Lane, Rm.
                                              although they are neither the subject of                comment, as well as any attachments,                  1061, Rockville, MD 20852.
                                              an applicable United States                             except for information submitted,                     FOR FURTHER INFORMATION CONTACT:
                                              Pharmacopeia (USP) or National                          marked and identified, as confidential,               Philantha Bowen, Center for Drug
                                              Formulary (NF) monograph nor                            if submitted as detailed in                           Evaluation and Research, Food and
                                              components of FDA-approved drugs                        ‘‘Instructions.’’                                     Drug Administration, 10903 New
                                              (503A bulks list). The Agency                              Instructions: All submissions received             Hampshire Ave., Bldg. 51, Rm. 5175,
                                              previously solicited nominations for the                must include the Docket No. FDA–                      Silver Spring, MD 20993–0002, 301–
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                                              list, but some of the nominated                         2015–N–3534 for ‘‘Bulk Drug                           796–2466.
                                              substances were not supported by                        Substances That Can Be Used To                        SUPPLEMENTARY INFORMATION:
                                              sufficient information for FDA to                       Compound Drug Products in
                                              evaluate them. FDA is establishing a                    Accordance With Section 503A of the                   I. Background
                                              public docket where these substances                    Federal Food, Drug, and Cosmetic Act;                   Section 503A of the FD&C Act (21
                                              can be renominated with sufficient                      Establishment of a Public Docket.’’                   U.S.C. 353a) describes the conditions
                                              supporting information or to receive                    Received comments will be placed in                   under which a compounded drug


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                                              65766                        Federal Register / Vol. 80, No. 207 / Tuesday, October 27, 2015 / Notices

                                              product may be entitled to an                              In a notice dated November 27, 2013                on Schedule I, and do not appear on the
                                              exemption from certain sections of the                  (the November 27, 2013, notice),                      withdrawn or removed list,
                                              FD&C Act. Those conditions include                      published in the Federal Register of                  approximately 390 substances were
                                              that a licensed pharmacist in a State                   December 4, 2013 (78 FR 72841), FDA                   nominated with insufficient supporting
                                              licensed pharmacy or Federal facility or                invited all interested persons to                     evidence for FDA to evaluate them.
                                              a licensed physician compounds the                      nominate bulk drug substances for
                                                                                                                                                            II. Establishment of a Docket
                                              drug product using bulk drug                            inclusion on a list of bulk drug
                                              substances that: (1) Comply with the                    substances that can be used for                          As described in section III.B of the
                                              standards of an applicable USP or NF                    compounding under section 503A of the                 draft guidance entitled, ‘‘Interim Policy
                                              monograph, if a monograph exists, and                   FD&C Act. Over 2,000 substances were                  on Compounding Using Bulk Drug
                                              the USP chapter on pharmacy                             nominated. However, many of the                       Substances Under Section 503A of the
                                              compounding; (2) if such a monograph                    nominations were for substances that                  Federal Food, Drug, and Cosmetic Act,’’
                                              does not exist, are drug substances that                can be used for compounding without                   FDA is establishing a public docket so
                                              are components of drugs approved by                     being on the list because they are the                that interested parties can comment on
                                              the Secretary; or (3) if such a monograph               subject of an applicable USP or NF                    nominated bulk drug substances,
                                              does not exist and the drug substance is                monograph or are a component of an                    nominate bulk drug substances that
                                              not a component of a drug approved by                   FDA-approved drug. In addition, many                  were not previously nominated for the
                                              the Secretary, that appear on a list                    of the nominations were not for bulk                  503A bulks list, or renominate with
                                              developed by the Secretary through                      drug substances used in compounding                   adequate supporting information bulk
                                              regulations issued by the Secretary                     as active ingredients, or did not include             drug substances that were previously
                                              under subsection (c) of section 503A.                   sufficient information to allow FDA to                nominated but that were not supported
                                              See section 503A(b)(1)(A)(i) of the FD&C                evaluate the substance for inclusion on               by sufficient information for FDA to
                                              Act. Under section 503A(c)(2) of the                    the list. To improve the efficiency of the            evaluate them. Docket No. FDA–2013–
                                              FD&C Act, the criteria for determining                  process for developing the 503A bulks                 N–1525 is closed for comment.
                                              which substances should appear on the                   list, FDA reopened the nomination                     Therefore, this new docket can be used
                                              503A bulks list ‘‘shall include historical              process in July 2014 (79 FR 37742, July               for commenting on nominations
                                              use, reports in peer reviewed medical                   2, 2014) and provided more detailed                   submitted to that docket as well as for
                                              literature, or other criteria the Secretary             information on what it needs to evaluate              submitting new nominations.
                                              may identify.’’                                         nominations for the list. FDA stated that                As stated previously, under section
                                                 Section 503A refers to the definition                bulk drug substances that were                        503A(c)(2) of the FD&C Act, the criteria
                                              of ‘‘bulk drug substance’’ in FDA                       previously nominated would not be                     for determining which substances
                                              regulations at § 207.3(a)(4) (21 CFR                    considered further unless they were re-               should appear on the 503A bulk drugs
                                              207.3(a)(4)). See section 503A(b)(1)(A)                 nominated with adequate support to                    list shall include historical use, reports
                                              of the FD&C Act. As defined in                          permit a meaningful evaluation.                       in peer reviewed medical literature, or
                                              § 207.3(a)(4), a ‘‘bulk drug substance’’ is             Substances that were already eligible for             other criteria the Secretary may identify.
                                              any substance that is represented for use               use in compounding or that were not                   Based on this statutory language and
                                              in a drug and that, when used in the                    adequately supported would not be                     consultations with the USP and the
                                              manufacturing, processing, or packaging                 evaluated for placement on the list.                  Pharmacy Compounding Advisory
                                              of a drug, becomes an active ingredient                    In response to the July 2, 2014,                   Committee (PCAC),1 FDA is considering
                                              or a finished dosage form of the drug,                  request for nominations, approximately                the use of the following four criteria to
                                              but the term does not include                           740 unique substances were nominated.                 determine whether a bulk drug
                                              intermediates used in the synthesis of                  Of the nominated substances,                          substance is appropriate for use in
                                              such substances.                                        approximately 275 are already eligible                compounding: (1) The physical and
                                                 An ‘‘active ingredient’’ is any                      for use in compounding because they                   chemical characterization of the
                                              component that is intended to furnish                   are either components of an approved                  substance; (2) any safety issues raised by
                                              pharmacological activity or other direct                drug or the subject of an applicable USP              the use of the substance in compounded
                                              effect in the diagnosis, cure, mitigation,              or NF monograph. At least nine of the                 drug products; (3) historical use of the
                                              treatment, or prevention of disease, or to              nominated substances are not eligible                 substance in compounded drug
                                              affect the structure or any function of                 for inclusion on the list because they are            products, including information about
                                              the body of man or other animals. The                   either a finished drug product, a                     the medical condition(s) the substance
                                              term includes those components that                     biological product subject to licensure               has been used to treat and any
                                              may undergo chemical change in the                      in a biologics license application (BLA),             references in peer-reviewed medical
                                              manufacture of the drug product and be                  a radiopharmaceutical drug product, a                 literature; and (4) the available evidence
                                              present in the drug product in a                        substance with no currently accepted                  of effectiveness or lack of effectiveness
                                              modified form intended to furnish the                   medical use that is included on                       of a drug product compounded with the
                                              specified activity or effect. See 21 CFR                Schedule I of the Controlled Substances               substance, if any such evidence exists.
                                              210.3(b)(7).                                            Act (21 U.S.C. 812(c)), or they appear on             Therefore, to be considered for
                                                 Any component other than an active                   the list published by FDA of substances               placement on the 503A bulks list, this
                                              ingredient is an ‘‘inactive ingredient.’’               that have been withdrawn or removed                   information should be submitted for
                                              See 21 CFR 210.3(b)(8). Inactive                        from the market because such drug                     each nominated substance. FDA will
                                              ingredients used in compounded drug                     products or components of such drug                      1 See 64 FR 996, January 7, 1999 (proposed rule
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                                              products, which commonly include                        products have been found to be unsafe                 listing bulk drug substances that may be used in
                                              flavorings, dyes, diluents, or other                    or not effective. Of the substances that              pharmacy compounding). This proposed rule was
                                              excipients, need not appear on the                      are not components of an FDA-approved                 withdrawn in the November 27, 2013, notice but
                                              Secretary’s list of bulk drug substances                drug or the subject of an applicable USP              sets forth additional background about the criteria
                                                                                                                                                            used in the evaluation of nominated bulk drug
                                              to be eligible for use in compounding                   or NF monograph, not biological                       substances. The criteria were discussed with the
                                              drug products and will not be included                  products subject to licensure in a BLA,               PCAC, the membership of which includes a USP
                                              on the list.                                            not radiopharmaceuticals, do not appear               representative, at its meeting on February 22, 2015.



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                                                                            Federal Register / Vol. 80, No. 207 / Tuesday, October 27, 2015 / Notices                                              65767

                                              evaluate the nominated substances in                        • A statement that the nominator has                   • A bibliography of safety and
                                              consultation with the USP and the                        searched applicable USP and NF drug                    efficacy data for the drug compounded
                                              PCAC.                                                    monographs, available at http://                       using the nominated substance, if
                                                Interested groups and individuals                      www.uspnf.com, and the drug substance                  available,2 including any relevant peer-
                                              may nominate specific bulk drug                          is not the subject of such a monograph.                reviewed medical literature; and
                                              substances for inclusion on the 503A                                                                              • Information about the past and
                                                                                                       B. General Background on the Bulk Drug
                                              bulks list, renominate previously                                                                               proposed use(s) of the compounded
                                                                                                       Substance
                                              nominated substances with additional                                                                            drug product(s), including the rationale
                                                                                                          • Ingredient name;                                  for its use and why the compounded
                                              information, or comment on nominated                        • Chemical name;
                                              substances. Nominations will only be                                                                            product(s), as opposed to an FDA-
                                                                                                          • Common name(s);                                   approved product, is necessary.
                                              evaluated if they are for specific active                   • Identifying codes, as available, from             Information on the rationale for use of
                                              ingredients that: (1) Meet the definition                FDA’s Unique Ingredient Identifiers
                                              of a bulk drug substance in § 207.3(a)(4);                                                                      the bulk drug substance and why a
                                                                                                       (UNII) used in the FDA/USP Substance                   compounded drug product is necessary
                                              (2) are not components of FDA-                           Registration System, available at http://
                                              approved drug products; and (3) are not                                                                         must be specific to the compounded
                                                                                                       fdasis.nlm.nih.gov/srs/. Because                       drug product at issue. General or
                                              substances that are the subject of an                    substance names can vary, this code,
                                              applicable USP or NF monograph. To                                                                              boilerplate statements regarding the
                                                                                                       where available, will be used by the                   need for compounded drug products or
                                              fully evaluate a bulk drug substance                     Agency to confirm the exact substance
                                              using the criteria identified above, FDA                                                                        the benefits of compounding generally
                                                                                                       nominated and to identify multiple                     will not be considered sufficient to
                                              needs the following information about                    nominations of the same substance so
                                              both the nominated bulk drug substance                                                                          address this issue.
                                                                                                       the information can be reviewed
                                              and the drug product(s) that will be                     together.                                              D. Process for Submitting Nominations
                                              compounded using such substance:                            • Chemical grade of the ingredient;                 and Comments
                                                                                                          • Description of the strength, quality,
                                              A. Confirmation That the Nominated                                                                                Because the prior deadline for
                                                                                                       stability, and purity of the ingredient,
                                              Substance Is a Bulk Drug Substance and                                                                          submitting nominations has passed,
                                                                                                       and a copy of a certificate of analysis
                                              Is Not Already Eligible for 503A                                                                                FDA is opening this docket so that
                                                                                                       that is representative of the
                                              Compounding                                                                                                     interested persons can submit
                                                                                                       characteristics of the nominated
                                                                                                                                                              nominations of bulk drug substances
                                                 • A statement that the nominated                      ingredient;
                                                                                                                                                              and provide adequate support for FDA
                                              substance is an active ingredient that                      • Information about how the
                                                                                                       ingredient is supplied (e.g., powder,                  to evaluate whether those substances
                                              meets the definition of ‘‘bulk drug                                                                             should be placed on the 503A bulks list.
                                              substance’’ in § 207.3(a)(4), and an                     liquid); and
                                                                                                          • Information about recognition of the              Bulk drug substances that were
                                              explanation of why the substance is                                                                             previously nominated and for which
                                              considered an active ingredient when it                  substance in foreign pharmacopeias and
                                                                                                       the status of its registration(s) in other             inadequate information was provided 3
                                              is used in the identified compounded                                                                            need to be renominated with the
                                              drug product(s), citing to specific                      countries, including whether
                                                                                                       information has been submitted to the                  information identified above to be
                                              sources that describe the active                                                                                considered for inclusion on the 503A
                                              properties of the substance.                             USP for consideration of monograph
                                                                                                       development.                                           bulks list. Nominators are encouraged to
                                                 • A statement that the nominator has                                                                         submit as much of the information
                                              searched for the active ingredient in all                C. Information on the Drug Product                     identified in this document as possible.
                                              three sections of the Orange Book (for                   That Will Be Compounded With the                       Unless adequate supporting data is
                                              prescription drug products, over-the-                    Bulk Drug Substance                                    received for a bulk drug substance, FDA
                                              counter drug products, and                                 • Information about the dosage                       will be unable to consider it further for
                                              discontinued drug products), available                   form(s) into which the bulk drug                       inclusion on the list.
                                              at http://www.accessdata.fda.gov/                        substance will be compounded;                            For efficient consolidation and review
                                              scripts/cder/ob/docs/queryai.cfm, and                      • Information about the strength(s) of               of nominations, nominators are
                                              the drug substance did not appear in                     the compounded drug product(s);                        encouraged to submit their nominations
                                              any of those searches, confirming that                     • Information about the anticipated                  in an editable Excel file. Specifically,
                                              the substance is not a component of any                  route(s) of administration of the                      nominators are encouraged to format
                                              FDA-approved product.                                    compounded product(s);                                 their nominations as follows:

                                                               Column A—What information is requested?                                     Column B—Put data specific to the nominated substance

                                              What is the name of the nominated ingredient?                                         Provide the ingredient name.
                                              Is the ingredient an active ingredient that meets the definition of ‘‘bulk            Provide an explanation for why it is considered an active ingredient
                                                 drug substance’’ in § 207.3(a)(4)?                                                   when it is used in specific compounded drug products, and provide
                                                                                                                                      citations to specific sources that describe its active properties.
                                              Is the ingredient listed in any of the three sections of the Orange                   Confirm whether the ingredient is a component of an FDA-approved
                                                Book?                                                                                 product.
                                              Were any drug monographs for the ingredient found in the USP or NF                    Confirm whether the ingredient is the subject of an applicable USP or
                                                monographs?                                                                           NF monograph.
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                                              What is the chemical name of the substance?                                           Chemical name.
                                              What is the common name of the substance?                                             Common name.
                                              Does the substance have a UNII code?                                                  UNII code.

                                                 2 FDA recognizes that the available safety and        of the same type, amount, or quality as is required    downloads/Drugs/
                                              efficacy data supporting consideration of a bulk         to support a new drug application.                     GuidanceComplianceRegulatoryInformation/
                                                                                                         3 As referenced above, a list of the substances in
                                              drug substance for inclusion on the list may not be                                                             PharmacyCompounding/UCM467373.pdf.
                                                                                                       this category is available at http://www.fda.gov/



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                                              65768                         Federal Register / Vol. 80, No. 207 / Tuesday, October 27, 2015 / Notices

                                                               Column A—What information is requested?                                     Column B—Put data specific to the nominated substance

                                              What is the chemical grade of the substance?                                          Provide the chemical grade.
                                              What is the strength, quality, stability, and purity of the ingredient?               Provide the strength, quality, stability, and purity information and attach
                                                                                                                                      a certificate of analysis.
                                              How is the ingredient supplied?                                                       Describe how the ingredient is supplied (e.g., powder, liquid).
                                              Is the substance recognized in foreign pharmacopeias or registered in                 List the foreign pharmacopeias or other countries in which it is reg-
                                                 other countries?                                                                     istered.
                                              Has information been submitted about the substance to the USP for                     Put yes, no, or unknown. If yes, state the status of the monograph, if
                                                 consideration of drug monograph development?                                         known.
                                              What dosage form(s) will be compounded using the bulk drug sub-                       State the dosage form(s).
                                                 stance?
                                              What strength(s) will be compounded from the nominated substance?                     List the strength(s) of the drug product(s) that will be compounded from
                                                                                                                                      the nominated substance, or a range of strengths, if known.
                                              What are the anticipated route(s) of administration of the compounded                 List the route(s) of administration of the compounded drug product(s).
                                                drug product(s)?
                                              Are there safety and efficacy data on compounded drugs using the                      Provide a bibliography of safety and efficacy data for the drug com-
                                                nominated substance?                                                                  pounded using the nominated substance, if available, including any
                                                                                                                                      relevant peer-reviewed medical literature.
                                              Has the bulk drug substance been used previously to compound drug                     Describe past uses of the bulk drug substance in compounding.
                                                 product(s)?
                                              What is the proposed use for the drug product(s) to be compounded                     Provide information on the proposed use of the compounded drug
                                                 with the nominated substance?                                                        product.
                                              What is the reason for use of a compounded drug product rather than                   Provide a rationale for the use of a compounded drug product.
                                                 an FDA-approved product?
                                              Is there any other relevant information?                                              Provide any other information you would like FDA to consider in evalu-
                                                                                                                                      ating the nomination.



                                                 In addition to nominating new                           Information in the docket will be                   in compounding under the Federal
                                              substances or renominating substances                    publicly available. Therefore, we                     Food, Drug, and Cosmetic Act (the
                                              previously nominated without sufficient                  remind nominators and commenters not                  FD&C Act). When final, the guidance
                                              supporting information, individuals and                  to submit personal or confidential                    will reflect the Agency’s current
                                              organizations will be able to comment                    information.                                          thinking on the issues addressed by the
                                              via the docket established by this notice                  Dated: October 21, 2015.                            guidance.
                                              on substances nominated for the 503A                     Leslie Kux,                                           DATES:  Although you can comment on
                                              bulks list that have not yet been                        Associate Commissioner for Policy.                    any guidance at any time (see 21 CFR
                                              addressed in a Notice of Proposed                                                                              10.115(g)(5)), to ensure that the Agency
                                                                                                       [FR Doc. 2015–27271 Filed 10–26–15; 8:45 am]
                                              Rulemaking (NPRM). Comments may be                                                                             considers your comment on this draft
                                                                                                       BILLING CODE 4164–01–P
                                              submitted regarding nominations                                                                                guidance before it begins work on the
                                              submitted to both this docket and                                                                              final version of the guidance, submit
                                              Docket No. FDA–2013–N–1525.                                                                                    either electronic or written comments
                                                                                                       DEPARTMENT OF HEALTH AND
                                              Comments may provide any relevant                                                                              on the draft guidance by December 28,
                                                                                                       HUMAN SERVICES
                                              information about particular bulk drug                                                                         2015.
                                              substances, including that in support of,                Food and Drug Administration
                                              or in opposition to, the placement of a                                                                        ADDRESSES:     You may submit comments
                                              nominated bulk drug substance on the                     [Docket No. FDA–2015–D–3539]                          as follows:
                                              503A bulks list. However, comments                                                                             Electronic Submissions
                                              submitted should not address the 503A                    Interim Policy on Compounding Using
                                              bulks list generally or other matters                    Bulk Drug Substances Under Section                      Submit electronic comments in the
                                              related to the Agency’s regulation of                    503B of the Federal Food, Drug, and                   following way:
                                              compounding. Comments about                              Cosmetic Act; Draft Guidance for
                                                                                                                                                               • Federal eRulemaking Portal: http://
                                              nominated substances that have been                      Industry; Availability
                                                                                                                                                             www.regulations.gov. Follow the
                                              addressed by the Agency in an NPRM                       AGENCY:    Food and Drug Administration,              instructions for submitting comments.
                                              should be submitted to the docket for                    HHS.                                                  Comments submitted electronically,
                                              the proposed rulemaking in which the                                                                           including attachments, to http://
                                              substance is addressed.                                  ACTION:   Notice of availability.
                                                                                                                                                             www.regulations.gov will be posted to
                                                 Please do not submit comments that                    SUMMARY:  The Food and Drug                           the docket unchanged. Because your
                                              have already been submitted to other                     Administration (FDA or the Agency) is                 comment will be made public, you are
                                              dockets. Such submissions are                            announcing the availability of a draft                solely responsible for ensuring that your
                                              duplicative and not helpful to the                       guidance entitled ‘‘Interim Policy on                 comment does not include any
                                              Agency. If comments on particular                        Compounding Using Bulk Drug                           confidential information that you or a
                                              documents or issues are submitted to                     Substances Under Section 503B of the                  third party may not wish to be posted,
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                                              this docket rather than the docket                       Federal Food, Drug, and Cosmetic Act.’’               such as medical information, your or
                                              specifically opened for the particular                   The draft guidance describes FDA’s                    anyone else’s Social Security number, or
                                              document or issue, the comment might                     interim regulatory policy regarding                   confidential business information, such
                                              not be considered as the specific                        outsourcing facilities that compound                  as a manufacturing process. Please note
                                              documents are being finalized and                        human drug products using bulk drug                   that if you include your name, contact
                                              issues considered. FDA will not respond                  substances while FDA develops the list                information, or other information that
                                              to questions submitted to this docket.                   of bulk drug substances that can be used              identifies you in the body of your


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Document Created: 2015-12-14 15:35:52
Document Modified: 2015-12-14 15:35:52
CategoryRegulatory Information
CollectionFederal Register
sudoc ClassAE 2.7:
GS 4.107:
AE 2.106:
PublisherOffice of the Federal Register, National Archives and Records Administration
SectionNotices
ActionNotice; establishment of public docket.
DatesNominations and comments may be submitted to this docket at any time.
ContactPhilantha Bowen, Center for Drug Evaluation and Research, Food and Drug Administration, 10903 New Hampshire Ave., Bldg. 51, Rm. 5175, Silver Spring, MD 20993-0002, 301- 796-2466.
FR Citation80 FR 65765 

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