81_FR_12956 81 FR 12908 - Agency Information Collection Activities; Submission for Office of Management and Budget Review; Comment Request; Guidance for Industry on Individual Patient Expanded Access Applications: Form FDA 3926

81 FR 12908 - Agency Information Collection Activities; Submission for Office of Management and Budget Review; Comment Request; Guidance for Industry on Individual Patient Expanded Access Applications: Form FDA 3926

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Food and Drug Administration

Federal Register Volume 81, Issue 48 (March 11, 2016)

Page Range12908-12910
FR Document2016-05491

The Food and Drug Administration (FDA) is announcing that a proposed collection of information has been submitted to the Office of Management and Budget (OMB) for review and clearance under the Paperwork Reduction Act of 1995.

Federal Register, Volume 81 Issue 48 (Friday, March 11, 2016)
[Federal Register Volume 81, Number 48 (Friday, March 11, 2016)]
[Notices]
[Pages 12908-12910]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2016-05491]


-----------------------------------------------------------------------

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Food and Drug Administration

[Docket No. FDA-2015-D-0268]


Agency Information Collection Activities; Submission for Office 
of Management and Budget Review; Comment Request; Guidance for Industry 
on Individual Patient Expanded Access Applications: Form FDA 3926

AGENCY: Food and Drug Administration, HHS.

ACTION: Notice.

-----------------------------------------------------------------------

SUMMARY: The Food and Drug Administration (FDA) is announcing that a 
proposed collection of information has been submitted to the Office of 
Management and Budget (OMB) for review and clearance under the 
Paperwork Reduction Act of 1995.

DATES: Fax written comments on the collection of information by April 
11, 2016.

ADDRESSES: To ensure that comments on the information collection are 
received, OMB recommends that written comments be faxed to the Office 
of Information and Regulatory Affairs, OMB, Attn: FDA Desk Officer, 
FAX: 202-395-7285, or emailed to [email protected]. All 
comments should be identified with the OMB control number 0910-New and 
title ``Individual Patient Expanded Access Applications: Form FDA 
3926.'' Also include the FDA docket number found in brackets in the 
heading of this document.

FOR FURTHER INFORMATION CONTACT: FDA PRA Staff, Office of Operations, 
Food and Drug Administration, 8455 Colesville Rd., COLE-14526, Silver 
Spring, MD 20993-0002, [email protected].

SUPPLEMENTARY INFORMATION: In compliance with 44 U.S.C. 3507, FDA has 
submitted the following proposed collection of information to OMB for 
review and clearance.

Guidance for Industry on Individual Patient Expanded Access 
Applications: Form FDA 3926--OMB Control Number 0910--NEW

I. Background

    In the Federal Register of February 10, 2015 (80 FR 7318), FDA 
announced the availability of a draft guidance for industry entitled 
``Individual Patient Expanded Access Applications: Form FDA 3926.'' In 
the draft guidance, FDA provided draft Form FDA 3926 (Individual 
Patient Expanded Access--Investigational New Drug Application (IND)) at 
Appendix 1 and described this draft form, which FDA stated it intended 
to make available for licensed physicians to use for expanded access 
requests for individual patient INDs as an alternative to Form FDA 1571 
(Investigational New Drug Application (IND)).
    As described in the final guidance, Form FDA 3926 provides a 
streamlined means to request expanded access to an investigational drug 
outside of a clinical investigation, or to an approved drug where 
availability is limited by a risk evaluation and mitigation strategy 
(REMS), for an individual patient who has a serious or immediately 
life-threatening disease or condition and there is no comparable or 
satisfactory alternative therapy to diagnose, monitor, or treat the 
disease or condition. Form FDA 3926 may also be used for certain 
followup submissions to an individual patient expanded access IND.
    FDA may permit expanded access to an investigational new drug 
outside of a clinical investigation, or to an approved drug where 
availability is limited by a REMS, for an individual patient when the 
applicable criteria in Sec.  312.305(a) (21 CFR 312.305(a)) (which 
apply to all types of expanded access) and the criteria in Sec.  
312.310(a) (21 CFR 312.310(a)) (which apply specifically to individual 
patient expanded access, including for emergency use) are met. The 
physician may satisfy some of the submission requirements by referring 
to information in an existing IND, ordinarily the one held by the 
investigational drug's manufacturer, if the physician obtains 
permission from that IND holder. If permission is obtained, the 
physician should then provide to FDA a letter of authorization (LOA) 
from the existing IND holder that permits FDA to reference that IND.
    Section 312.305(b) sets forth the submission requirements for all 
types of expanded access requests. One of the requirements under Sec.  
312.305(b)(2) is that a ``cover sheet'' must be included ``meeting the 
requirements of Sec.  312.23(a).'' This provision applies to several 
types of submissions under 21 CFR part 312, ranging from commercial 
INDs under Sec.  312.23 that involve large groups of patients enrolled 
in clinical trials to requests from physicians to use an 
investigational drug for an individual patient. Form FDA 1571 is 
currently used by sponsors for all types of IND submissions to meet the 
requirements in Sec.  312.23(a). FDA intends to accept submission of a 
completed Form FDA 3926 to comply with the IND submission requirements 
in Sec. Sec.  312.23, 312.305(b), and 312.310(b). FDA intends to 
consider a completed Form FDA 3926 with the box in Field 10 checked and 
the form signed by the physician to be a request in accordance with 
Sec.  312.10 for a waiver of any additional requirements in part 312 
for an IND submission, including additional information currently 
provided in Form FDA 1571 and Form FDA 1572 (Statement of Investigator, 
which provides the identity and qualifications of the investigator 
conducting the clinical investigation).
    Under Sec.  312.310(d), in an emergency situation that requires the 
patient to be treated before a written submission can be made, the 
request to use the investigational drug for individual patient expanded 
access may be made by telephone (or other rapid means of communication) 
to the appropriate FDA review division. Authorization of the emergency 
use may be given by an FDA official over the telephone, provided the 
physician explains how the expanded access use will meet the 
requirements of Sec. Sec.  312.305 and 312.310 and agrees to submit an 
expanded access application within 15 working days of FDA's initial 
authorization of the expanded access use (Sec.  312.310(d)). The 
physician may choose to use Form FDA 3926 for the expanded access 
application.
    As explained in the instructions for Form FDA 3926, the following 
information would be submitted to FDA by those using Form FDA 3926:
     Initials for the patient and date of submission.
     Type of submission (initial or followup submission).
     Clinical information, including indication, brief clinical 
history of the patient (age, gender, weight, allergies, diagnosis, 
prior therapy, response to prior therapy), and the reason for

[[Page 12909]]

requesting the proposed treatment, including an explanation of why the 
patient lacks other therapeutic options.
     Treatment information, including the investigational 
drug's name and the name of the entity supplying the drug (generally 
the manufacturer), the applicable FDA review division (if known), and 
the treatment plan. This should include the planned dose, route and 
schedule of administration, planned duration of treatment, monitoring 
procedures, and planned modifications to the treatment plan in the 
event of toxicity.
     LOA, generally obtained from the entity that is the 
sponsor of the IND (e.g., commercial sponsor/drug manufacturer) being 
referenced, if applicable.
     Physician's qualification statement. An appropriate 
statement includes medical school attended, year of graduation, medical 
specialty, state medical license number, current employment, and job 
title. Alter na tively, the relevant portion of the physician's 
curriculum vitae may be attached.
     Physician's contact information, including name, physical 
address, email address, telephone number, facsimile number, and 
physician's IND number, if previously issued by FDA.
     Contents of submission (for followup/additional 
submissions), including the type of submission being made. FDA intends 
to accept Form FDA 3926 for certain followup/additional submissions, 
which include the following: Initial Written IND Safety Report (Sec.  
312.32(c)); Follow-up to a Written IND Safety Report (Sec.  312.32(d)); 
Annual Report (Sec.  312.33); Summary of Expanded Access Use (treatment 
completed) (Sec.  312.310(c)(2)); Change in Treatment Plan (Sec.  
312.30); General Correspondence or Response to FDA Request for 
Information (Sec.  312.41); and Response to Clinical Hold (Sec.  
312.42(e)).
     Request for authorization to use Form FDA 3926 for 
individual patient expanded access application.
     Signature of the physician certifying that treatment will 
not begin until 30 days after FDA receives the completed application 
and all required material unless the submitting physician receives 
earlier notification from FDA that the treatment may proceed. The 
physician agrees not to begin or continue clinical investigations 
covered by the IND if those studies are placed on clinical hold. The 
physician also certifies that informed consent will be obtained in 
compliance with Federal requirements (including FDA's regulations in 21 
CFR part 50) and that an institutional review board (IRB) that complies 
with all Federal requirements (including FDA's regulations in 21 CFR 
part 56) will be responsible for initial and continuing review and 
approval of the expanded access use. The physician also acknowledges 
that in the case of an emergency request, treatment may begin without 
prior IRB approval, provided the IRB is notified of the emergency 
treatment within 5 working days of treatment. The physician agrees to 
conduct the investigation in accordance with all other applicable 
regulatory requirements.
    In the Federal Register of February 10, 2015 (80 FR 7318), FDA 
published a 60-day notice requesting public comment on the proposed 
collection of information. Twelve comments were received. However, FDA 
received no comments concerning the accuracy of FDA's estimate of the 
burden of the proposed collection of information. FDA received several 
comments on ways to enhance the quality, utility, and clarity of FDA 
Form 3926 through, for example, the addition of instructions for 
completing the form and use of the form for certain followup 
submissions.
    (Comment 1) Five comments requested instructions, clarification, or 
directions concerning the use and submission of Form FDA 3926.
    (Response) FDA updated instructions based on information originally 
included in the draft guidance that will be provided in conjunction 
with final Form FDA 3926. Clarifying language on form fields has been 
added to the instructions and the guidance.
    (Comment 2) One comment asked for clarification regarding Field 1 
of Form FDA 3926 to indicate that the requesting physician should 
provide this information (not the patient).
    (Response) Clarification on Field 1 has been added to the form 
instructions to state that the patient need not initial the form. This 
is to indicate that the requesting physician should enter the patient's 
initials.
    (Comment 3) One comment stated that the information requested in 
Field 3 of draft Form FDA 3926 could become lengthy to complete and 
asked if a PDF could be attached to the form to provide this 
information.
    (Response) This information is now requested in Field 5. Field 5 
has been enlarged to accommodate more handwritten information. The 
space also has been updated to allow expansion when information is 
entered electronically in the fillable PDF. Clarifying language has 
been added to the form and instructions.
    (Comment 4) Three comments requested electronic submission 
capability to expedite applications.
    (Response) FDA is determining whether electronic submissions are 
feasible. FDA intends to provide additional information via its Web 
site should this become an option.
    (Comment 5) Several comments concerned the use of FDA Form 3926 for 
followup submissions. One comment suggested that FDA develop a new form 
for followup submissions (rather than requiring the use of Form FDA 
1571). Three comments asked that instructions be developed for ongoing 
patient reporting (i.e., followup submissions).
    (Response) FDA has revised the guidance, instructions, and Form FDA 
3926 so that the form may be used instead of Form FDA 1571 for certain 
followup submissions to an existing single patient expanded access IND. 
Form FDA 3926, the instructions, and the guidance identify the types of 
followup submissions that qualify and provide additional information on 
how to use Form FDA 3926 for such submissions.

II. Burden Estimate

    As discussed previously in this document, Form FDA 3926 will be 
available for licensed physicians to use as a streamlined means to 
request expanded access to an investigational drug outside of a 
clinical investigation, or to an approved drug where availability is 
limited by a REMS, for an individual patient who has a serious or 
immediately life-threatening disease or condition and there is no 
comparable or satisfactory alternative therapy to diagnose, monitor, or 
treat the disease or condition, and to submit certain followup reports. 
One of the requirements under Sec.  312.305(b)(2) is that a ``cover 
sheet'' must be included ``meeting the requirements of Sec.  
312.23(a).'' This provision applies to several types of submissions 
under part 312, ranging from commercial INDs under Sec.  312.23 that 
involve large groups of patients enrolled in clinical trials to 
requests from physicians to use an investigational drug for an 
individual patient. Form FDA 1571 is currently used by sponsors for all 
types of IND submissions. However, FDA is concerned that physicians 
requesting expanded access for an individual patient may have 
encountered difficulty in completing Form FDA 1571 and the associated 
documents because the form is not tailored to requests for individual 
patient expanded access.
    The submission requirements for all types of expanded access 
requests for investigational drugs are provided under Sec.  312.305(b) 
of FDA's expanded access regulations. Additional submission 
requirements for individual

[[Page 12910]]

patient expanded access requests are provided under Sec.  312.310(b), 
and the requirements for requesting individual patient expanded access 
for emergency use are provided under Sec.  312.310(d). FDA currently 
has OMB approval under control number 0910-0014 for individual patient 
expanded access information collection under Sec. Sec.  312.305(b), 
312.310(b), and 312.310(d). The submission requirements concerning the 
use of Form FDA 3926 for certain followup reports are provided under 
Sec. Sec.  312.32(c), 312.32(d), 312.33, 312.310(c)(2), 312.30, 312.41, 
and 312.42(e).
    The estimates for ``number of respondents,'' ``number of responses 
per respondent,'' and ``total annual responses'' were obtained from the 
Center for Drug Evaluation and Research (CDER) reports and data 
management systems and from other sources familiar with the number of 
submissions received for individual patient expanded access use under 
part 312. The estimates for ``average burden per response'' were based 
on information provided by CDER and other Department of Health and 
Human Services personnel who are familiar with preparing and reviewing 
expanded access submissions by practicing physicians.
    Based on data for the number of submissions to FDA during 2011, 
2012, and 2013, we originally estimated that approximately 790 licensed 
physicians would use Form 3926 to submit 1.46 requests per physician 
(respondent) for individual patient expanded access, for a total of 
1,153 responses annually. In response to comments received, FDA 
clarifies in the final guidance and in the form instructions that 
licensed physicians may also use Form FDA 3926 for certain followup 
submissions. Based on data for the number of followup submissions 
during 2011, 2012, and 2013, FDA estimates that about 790 physicians 
will each use Form FDA 3926 to submit 1.57 followup submissions per 
physician, for approximately 1,241 followup responses annually. Based 
on these estimates, FDA calculates the total annual responses to be 
2,394 (1,153 requests for individual patient expanded access and 1,241 
followup submissions) by 790 physicians for an average of 3.03 
responses per respondent. FDA estimates the average burden per response 
to be 45 minutes (0.75 hour). Based on this estimate, FDA calculates 
the total burden to be 1,795 hours. Under OMB control number 0910-0014, 
FDA currently has OMB approval of 17,592 hours for these submissions. 
The use of FDA Form 3926 will reduce the current burden by 15,797 
hours.
    FDA estimates the burden of this collection of information as 
follows:

                                                      Table 1--Estimated Annual Reporting Burden 1
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                      Number of
 Guidance on individual patient expanded access      Number of      responses per     Total annual       Average burden per response       Total hours
           applications: Form FDA 3926              respondents       respondent       responses
--------------------------------------------------------------------------------------------------------------------------------------------------------
Expanded access submission for treatment of an               790             3.03            2,394   0.75 (45 minutes).................           1,795
 individual patient, including submission of
 Form FDA 3926.
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ There are no capital costs or operating and maintenance costs associated with this collection of information.


    Dated: March 8, 2016.
Leslie Kux,
Associate Commissioner for Policy.
[FR Doc. 2016-05491 Filed 3-10-16; 8:45 am]
 BILLING CODE 4164-01-P



                                                    12908                           Federal Register / Vol. 81, No. 48 / Friday, March 11, 2016 / Notices

                                                    acrylamide. The guidance is intended to                 Spring, MD 20993–0002, PRAStaff@                      (LOA) from the existing IND holder that
                                                    suggest a range of possible approaches                  fda.hhs.gov.                                          permits FDA to reference that IND.
                                                    to reducing acrylamide levels and not to                                                                         Section 312.305(b) sets forth the
                                                                                                            SUPPLEMENTARY INFORMATION:    In                      submission requirements for all types of
                                                    identify specific recommended
                                                                                                            compliance with 44 U.S.C. 3507, FDA                   expanded access requests. One of the
                                                    approaches.
                                                                                                            has submitted the following proposed                  requirements under § 312.305(b)(2) is
                                                    II. Electronic Access                                   collection of information to OMB for                  that a ‘‘cover sheet’’ must be included
                                                       Persons with access to the Internet                  review and clearance.                                 ‘‘meeting the requirements of
                                                    may obtain the guidance at either                       Guidance for Industry on Individual                   § 312.23(a).’’ This provision applies to
                                                    http://www.fda.gov/FoodGuidances or                     Patient Expanded Access Applications:                 several types of submissions under 21
                                                    http://www.regulations.gov. Use the                     Form FDA 3926—OMB Control Number                      CFR part 312, ranging from commercial
                                                    FDA Web site listed in the previous                     0910—NEW                                              INDs under § 312.23 that involve large
                                                    sentence to find the most current                                                                             groups of patients enrolled in clinical
                                                    version of the guidance.                                I. Background                                         trials to requests from physicians to use
                                                      Dated: March 1, 2016.                                    In the Federal Register of February                an investigational drug for an individual
                                                    Leslie Kux,                                             10, 2015 (80 FR 7318), FDA announced                  patient. Form FDA 1571 is currently
                                                                                                            the availability of a draft guidance for              used by sponsors for all types of IND
                                                    Associate Commissioner for Policy.
                                                                                                            industry entitled ‘‘Individual Patient                submissions to meet the requirements in
                                                    [FR Doc. 2016–05490 Filed 3–10–16; 8:45 am]
                                                                                                            Expanded Access Applications: Form                    § 312.23(a). FDA intends to accept
                                                    BILLING CODE 4164–01–P                                                                                        submission of a completed Form FDA
                                                                                                            FDA 3926.’’ In the draft guidance, FDA
                                                                                                            provided draft Form FDA 3926                          3926 to comply with the IND
                                                                                                            (Individual Patient Expanded Access—                  submission requirements in §§ 312.23,
                                                    DEPARTMENT OF HEALTH AND                                                                                      312.305(b), and 312.310(b). FDA intends
                                                    HUMAN SERVICES                                          Investigational New Drug Application
                                                                                                            (IND)) at Appendix 1 and described this               to consider a completed Form FDA 3926
                                                    Food and Drug Administration                            draft form, which FDA stated it                       with the box in Field 10 checked and
                                                                                                            intended to make available for licensed               the form signed by the physician to be
                                                    [Docket No. FDA–2015–D–0268]                                                                                  a request in accordance with § 312.10
                                                                                                            physicians to use for expanded access
                                                                                                            requests for individual patient INDs as               for a waiver of any additional
                                                    Agency Information Collection                                                                                 requirements in part 312 for an IND
                                                    Activities; Submission for Office of                    an alternative to Form FDA 1571
                                                                                                            (Investigational New Drug Application                 submission, including additional
                                                    Management and Budget Review;                                                                                 information currently provided in Form
                                                    Comment Request; Guidance for                           (IND)).
                                                                                                                                                                  FDA 1571 and Form FDA 1572
                                                    Industry on Individual Patient                             As described in the final guidance,
                                                                                                                                                                  (Statement of Investigator, which
                                                    Expanded Access Applications: Form                      Form FDA 3926 provides a streamlined
                                                                                                                                                                  provides the identity and qualifications
                                                    FDA 3926                                                means to request expanded access to an
                                                                                                                                                                  of the investigator conducting the
                                                                                                            investigational drug outside of a clinical
                                                    AGENCY:    Food and Drug Administration,                                                                      clinical investigation).
                                                                                                            investigation, or to an approved drug                    Under § 312.310(d), in an emergency
                                                    HHS.                                                    where availability is limited by a risk               situation that requires the patient to be
                                                    ACTION:   Notice.                                       evaluation and mitigation strategy                    treated before a written submission can
                                                                                                            (REMS), for an individual patient who                 be made, the request to use the
                                                    SUMMARY:    The Food and Drug
                                                                                                            has a serious or immediately life-                    investigational drug for individual
                                                    Administration (FDA) is announcing
                                                                                                            threatening disease or condition and                  patient expanded access may be made
                                                    that a proposed collection of
                                                                                                            there is no comparable or satisfactory                by telephone (or other rapid means of
                                                    information has been submitted to the
                                                                                                            alternative therapy to diagnose, monitor,             communication) to the appropriate FDA
                                                    Office of Management and Budget
                                                                                                            or treat the disease or condition. Form               review division. Authorization of the
                                                    (OMB) for review and clearance under
                                                                                                            FDA 3926 may also be used for certain                 emergency use may be given by an FDA
                                                    the Paperwork Reduction Act of 1995.
                                                                                                            followup submissions to an individual                 official over the telephone, provided the
                                                    DATES: Fax written comments on the                      patient expanded access IND.
                                                    collection of information by April 11,                                                                        physician explains how the expanded
                                                                                                               FDA may permit expanded access to                  access use will meet the requirements of
                                                    2016.                                                   an investigational new drug outside of                §§ 312.305 and 312.310 and agrees to
                                                    ADDRESSES: To ensure that comments on                   a clinical investigation, or to an                    submit an expanded access application
                                                    the information collection are received,                approved drug where availability is                   within 15 working days of FDA’s initial
                                                    OMB recommends that written                             limited by a REMS, for an individual                  authorization of the expanded access
                                                    comments be faxed to the Office of                      patient when the applicable criteria in               use (§ 312.310(d)). The physician may
                                                    Information and Regulatory Affairs,                     § 312.305(a) (21 CFR 312.305(a)) (which               choose to use Form FDA 3926 for the
                                                    OMB, Attn: FDA Desk Officer, FAX:                       apply to all types of expanded access)                expanded access application.
                                                    202–395–7285, or emailed to oira_                       and the criteria in § 312.310(a) (21 CFR                 As explained in the instructions for
                                                    submission@omb.eop.gov. All                             312.310(a)) (which apply specifically to              Form FDA 3926, the following
                                                    comments should be identified with the                  individual patient expanded access,                   information would be submitted to FDA
                                                    OMB control number 0910–New and                         including for emergency use) are met.                 by those using Form FDA 3926:
                                                    title ‘‘Individual Patient Expanded                     The physician may satisfy some of the                    • Initials for the patient and date of
asabaliauskas on DSK3SPTVN1PROD with NOTICES




                                                    Access Applications: Form FDA 3926.’’                   submission requirements by referring to               submission.
                                                    Also include the FDA docket number                      information in an existing IND,                          • Type of submission (initial or
                                                    found in brackets in the heading of this                ordinarily the one held by the                        followup submission).
                                                    document.                                               investigational drug’s manufacturer, if                  • Clinical information, including
                                                    FOR FURTHER INFORMATION CONTACT: FDA                    the physician obtains permission from                 indication, brief clinical history of the
                                                    PRA Staff, Office of Operations, Food                   that IND holder. If permission is                     patient (age, gender, weight, allergies,
                                                    and Drug Administration, 8455                           obtained, the physician should then                   diagnosis, prior therapy, response to
                                                    Colesville Rd., COLE–14526, Silver                      provide to FDA a letter of authorization              prior therapy), and the reason for


                                               VerDate Sep<11>2014   17:56 Mar 10, 2016   Jkt 238001   PO 00000   Frm 00051   Fmt 4703   Sfmt 4703   E:\FR\FM\11MRN1.SGM   11MRN1


                                                                                    Federal Register / Vol. 81, No. 48 / Friday, March 11, 2016 / Notices                                           12909

                                                    requesting the proposed treatment,                      complies with all Federal requirements                  (Response) FDA is determining
                                                    including an explanation of why the                     (including FDA’s regulations in 21 CFR                whether electronic submissions are
                                                    patient lacks other therapeutic options.                part 56) will be responsible for initial              feasible. FDA intends to provide
                                                       • Treatment information, including                   and continuing review and approval of                 additional information via its Web site
                                                    the investigational drug’s name and the                 the expanded access use. The physician                should this become an option.
                                                    name of the entity supplying the drug                   also acknowledges that in the case of an                (Comment 5) Several comments
                                                    (generally the manufacturer), the                       emergency request, treatment may begin                concerned the use of FDA Form 3926 for
                                                    applicable FDA review division (if                      without prior IRB approval, provided                  followup submissions. One comment
                                                    known), and the treatment plan. This                    the IRB is notified of the emergency                  suggested that FDA develop a new form
                                                    should include the planned dose, route                  treatment within 5 working days of                    for followup submissions (rather than
                                                    and schedule of administration, planned                 treatment. The physician agrees to                    requiring the use of Form FDA 1571).
                                                    duration of treatment, monitoring                       conduct the investigation in accordance               Three comments asked that instructions
                                                    procedures, and planned modifications                   with all other applicable regulatory                  be developed for ongoing patient
                                                    to the treatment plan in the event of                   requirements.                                         reporting (i.e., followup submissions).
                                                    toxicity.                                                  In the Federal Register of February                  (Response) FDA has revised the
                                                       • LOA, generally obtained from the                   10, 2015 (80 FR 7318), FDA published                  guidance, instructions, and Form FDA
                                                    entity that is the sponsor of the IND                   a 60-day notice requesting public                     3926 so that the form may be used
                                                    (e.g., commercial sponsor/drug                          comment on the proposed collection of                 instead of Form FDA 1571 for certain
                                                    manufacturer) being referenced, if                      information. Twelve comments were                     followup submissions to an existing
                                                    applicable.                                             received. However, FDA received no                    single patient expanded access IND.
                                                       • Physician’s qualification statement.               comments concerning the accuracy of                   Form FDA 3926, the instructions, and
                                                    An appropriate statement includes                       FDA’s estimate of the burden of the                   the guidance identify the types of
                                                    medical school attended, year of                        proposed collection of information. FDA               followup submissions that qualify and
                                                    graduation, medical specialty, state                    received several comments on ways to                  provide additional information on how
                                                    medical license number, current                         enhance the quality, utility, and clarity             to use Form FDA 3926 for such
                                                    employment, and job title.                              of FDA Form 3926 through, for example,                submissions.
                                                    Alternatively, the relevant portion of the              the addition of instructions for
                                                    physician’s curriculum vitae may be                                                                           II. Burden Estimate
                                                                                                            completing the form and use of the form
                                                    attached.                                               for certain followup submissions.                        As discussed previously in this
                                                       • Physician’s contact information,                      (Comment 1) Five comments                          document, Form FDA 3926 will be
                                                    including name, physical address, email                 requested instructions, clarification, or             available for licensed physicians to use
                                                    address, telephone number, facsimile                    directions concerning the use and                     as a streamlined means to request
                                                    number, and physician’s IND number, if                  submission of Form FDA 3926.                          expanded access to an investigational
                                                    previously issued by FDA.                                  (Response) FDA updated instructions                drug outside of a clinical investigation,
                                                       • Contents of submission (for                        based on information originally                       or to an approved drug where
                                                    followup/additional submissions),                       included in the draft guidance that will              availability is limited by a REMS, for an
                                                    including the type of submission being                  be provided in conjunction with final                 individual patient who has a serious or
                                                    made. FDA intends to accept Form FDA                    Form FDA 3926. Clarifying language on                 immediately life-threatening disease or
                                                    3926 for certain followup/additional                    form fields has been added to the                     condition and there is no comparable or
                                                    submissions, which include the                          instructions and the guidance.                        satisfactory alternative therapy to
                                                    following: Initial Written IND Safety                      (Comment 2) One comment asked for                  diagnose, monitor, or treat the disease or
                                                    Report (§ 312.32(c)); Follow-up to a                    clarification regarding Field 1 of Form               condition, and to submit certain
                                                    Written IND Safety Report (§ 312.32(d));                FDA 3926 to indicate that the requesting              followup reports. One of the
                                                    Annual Report (§ 312.33); Summary of                    physician should provide this                         requirements under § 312.305(b)(2) is
                                                    Expanded Access Use (treatment                          information (not the patient).                        that a ‘‘cover sheet’’ must be included
                                                    completed) (§ 312.310(c)(2)); Change in                    (Response) Clarification on Field 1                ‘‘meeting the requirements of
                                                    Treatment Plan (§ 312.30); General                      has been added to the form instructions               § 312.23(a).’’ This provision applies to
                                                    Correspondence or Response to FDA                       to state that the patient need not initial            several types of submissions under part
                                                    Request for Information (§ 312.41); and                 the form. This is to indicate that the                312, ranging from commercial INDs
                                                    Response to Clinical Hold (§ 312.42(e)).                requesting physician should enter the                 under § 312.23 that involve large groups
                                                       • Request for authorization to use                   patient’s initials.                                   of patients enrolled in clinical trials to
                                                    Form FDA 3926 for individual patient                       (Comment 3) One comment stated                     requests from physicians to use an
                                                    expanded access application.                            that the information requested in Field               investigational drug for an individual
                                                       • Signature of the physician                         3 of draft Form FDA 3926 could become                 patient. Form FDA 1571 is currently
                                                    certifying that treatment will not begin                lengthy to complete and asked if a PDF                used by sponsors for all types of IND
                                                    until 30 days after FDA receives the                    could be attached to the form to provide              submissions. However, FDA is
                                                    completed application and all required                  this information.                                     concerned that physicians requesting
                                                    material unless the submitting                             (Response) This information is now                 expanded access for an individual
                                                    physician receives earlier notification                 requested in Field 5. Field 5 has been                patient may have encountered difficulty
                                                    from FDA that the treatment may                         enlarged to accommodate more                          in completing Form FDA 1571 and the
                                                    proceed. The physician agrees not to                    handwritten information. The space also               associated documents because the form
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                                                    begin or continue clinical investigations               has been updated to allow expansion                   is not tailored to requests for individual
                                                    covered by the IND if those studies are                 when information is entered                           patient expanded access.
                                                    placed on clinical hold. The physician                  electronically in the fillable PDF.                      The submission requirements for all
                                                    also certifies that informed consent will               Clarifying language has been added to                 types of expanded access requests for
                                                    be obtained in compliance with Federal                  the form and instructions.                            investigational drugs are provided
                                                    requirements (including FDA’s                              (Comment 4) Three comments                         under § 312.305(b) of FDA’s expanded
                                                    regulations in 21 CFR part 50) and that                 requested electronic submission                       access regulations. Additional
                                                    an institutional review board (IRB) that                capability to expedite applications.                  submission requirements for individual


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                                                    12910                            Federal Register / Vol. 81, No. 48 / Friday, March 11, 2016 / Notices

                                                    patient expanded access requests are                     received for individual patient                       followup submissions during 2011,
                                                    provided under § 312.310(b), and the                     expanded access use under part 312.                   2012, and 2013, FDA estimates that
                                                    requirements for requesting individual                   The estimates for ‘‘average burden per                about 790 physicians will each use
                                                    patient expanded access for emergency                    response’’ were based on information                  Form FDA 3926 to submit 1.57 followup
                                                    use are provided under § 312.310(d).                     provided by CDER and other                            submissions per physician, for
                                                    FDA currently has OMB approval under                     Department of Health and Human                        approximately 1,241 followup responses
                                                    control number 0910–0014 for                             Services personnel who are familiar                   annually. Based on these estimates, FDA
                                                    individual patient expanded access                       with preparing and reviewing expanded                 calculates the total annual responses to
                                                    information collection under                             access submissions by practicing                      be 2,394 (1,153 requests for individual
                                                    §§ 312.305(b), 312.310(b), and                           physicians.                                           patient expanded access and 1,241
                                                    312.310(d). The submission                                  Based on data for the number of                    followup submissions) by 790
                                                    requirements concerning the use of                       submissions to FDA during 2011, 2012,                 physicians for an average of 3.03
                                                    Form FDA 3926 for certain followup                       and 2013, we originally estimated that                responses per respondent. FDA
                                                    reports are provided under §§ 312.32(c),                 approximately 790 licensed physicians                 estimates the average burden per
                                                    312.32(d), 312.33, 312.310(c)(2), 312.30,                would use Form 3926 to submit 1.46                    response to be 45 minutes (0.75 hour).
                                                    312.41, and 312.42(e).                                   requests per physician (respondent) for               Based on this estimate, FDA calculates
                                                      The estimates for ‘‘number of                          individual patient expanded access, for               the total burden to be 1,795 hours.
                                                    respondents,’’ ‘‘number of responses per                 a total of 1,153 responses annually. In               Under OMB control number 0910–0014,
                                                    respondent,’’ and ‘‘total annual                         response to comments received, FDA                    FDA currently has OMB approval of
                                                    responses’’ were obtained from the                       clarifies in the final guidance and in the            17,592 hours for these submissions. The
                                                    Center for Drug Evaluation and Research                  form instructions that licensed                       use of FDA Form 3926 will reduce the
                                                    (CDER) reports and data management                       physicians may also use Form FDA                      current burden by 15,797 hours.
                                                    systems and from other sources familiar                  3926 for certain followup submissions.                  FDA estimates the burden of this
                                                    with the number of submissions                           Based on data for the number of                       collection of information as follows:

                                                                                                    TABLE 1—ESTIMATED ANNUAL REPORTING BURDEN 1
                                                                                                                                                 Number of                              Average
                                                          Guidance on individual patient expanded access                    Number of                            Total annual
                                                                                                                                               responses per                          burden per   Total hours
                                                                  applications: Form FDA 3926                              respondents                            responses
                                                                                                                                                 respondent                            response

                                                    Expanded access submission for treatment of an indi-                         790                  3.03           2,394        0.75 (45 min-      1,795
                                                      vidual patient, including submission of Form FDA 3926.                                                                        utes).
                                                       1 There   are no capital costs or operating and maintenance costs associated with this collection of information.


                                                      Dated: March 8, 2016.                                  including each proposed extension of an               www.regulations.gov will be posted to
                                                    Leslie Kux,                                              existing collection of information, and               the docket unchanged. Because your
                                                    Associate Commissioner for Policy.                       to allow 60 days for public comment in                comment will be made public, you are
                                                    [FR Doc. 2016–05491 Filed 3–10–16; 8:45 am]              response to the notice. This notice                   solely responsible for ensuring that your
                                                    BILLING CODE 4164–01–P
                                                                                                             invites comments on the information                   comment does not include any
                                                                                                             collection provisions of the regulation               confidential information that you or a
                                                                                                             requiring the manufacturer, packer, or                third party may not wish to be posted,
                                                    DEPARTMENT OF HEALTH AND                                 distributor of a dietary supplement to                such as medical information, your or
                                                    HUMAN SERVICES                                           notify us that it is marketing a dietary              anyone else’s Social Security number, or
                                                                                                             supplement product that bears on its                  confidential business information, such
                                                    Food and Drug Administration                             label or in its labeling a statement                  as a manufacturing process. Please note
                                                                                                             provided for in the Federal Food, Drug,               that if you include your name, contact
                                                    [Docket No. FDA–2009–N–0221]                             and Cosmetic Act (the FD&C Act). The                  information, or other information that
                                                                                                             notice also invites comment on a new                  identifies you in the body of your
                                                    Agency Information Collection
                                                                                                             electronic form that allows                           comments, that information will be
                                                    Activities; Proposed Collection;
                                                                                                             manufacturers, packers, and distributors              posted on http://www.regulations.gov.
                                                    Comment Request; Food Labeling;
                                                                                                             of dietary supplements to notify us via                 • If you want to submit a comment
                                                    Notification Procedures for Statements
                                                                                                             FDA’s Unified Registration and Listing                with confidential information that you
                                                    on Dietary Supplements
                                                                                                             System (FURLS).                                       do not wish to be made available to the
                                                    AGENCY:      Food and Drug Administration,               DATES: Submit either electronic or                    public, submit the comment as a
                                                    HHS.                                                     written comments on the collection of                 written/paper submission and in the
                                                    ACTION:   Notice.                                        information by May 10, 2016.                          manner detailed (see ‘‘Written/Paper
                                                                                                             ADDRESSES: You may submit comments                    Submissions’’ and ‘‘Instructions’’).
                                                    SUMMARY:   The Food and Drug                             as follows:
                                                    Administration (FDA or we) is                                                                                  Written/Paper Submissions
asabaliauskas on DSK3SPTVN1PROD with NOTICES




                                                    announcing an opportunity for public                     Electronic Submissions
                                                    comment on the proposed collection of                      Submit electronic comments in the                     Submit written/paper submissions as
                                                    certain information by the Agency.                       following way:                                        follows:
                                                    Under the Paperwork Reduction Act of                       • Federal eRulemaking Portal: http://                 • Mail/Hand delivery/Courier (for
                                                    1995 (the PRA), Federal Agencies are                     www.regulations.gov. Follow the                       written/paper submissions): Division of
                                                    required to publish notice in the                        instructions for submitting comments.                 Dockets Management (HFA–305), Food
                                                    Federal Register concerning each                         Comments submitted electronically,                    and Drug Administration, 5630 Fishers
                                                    proposed collection of information,                      including attachments, to http://                     Lane, Rm. 1061, Rockville, MD 20852.


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Document Created: 2016-03-11 01:51:23
Document Modified: 2016-03-11 01:51:23
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.
DatesFax written comments on the collection of information by April 11, 2016.
ContactFDA PRA Staff, Office of Operations, Food and Drug Administration, 8455 Colesville Rd., COLE-14526, Silver Spring, MD 20993-0002, [email protected]
FR Citation81 FR 12908 

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