83_FR_27723 83 FR 27609 - Alternative or Streamlined Mechanisms for Complying With the Current Good Manufacturing Practice Requirements for Combination Products; Proposed List Under the 21st Century Cures Act

83 FR 27609 - Alternative or Streamlined Mechanisms for Complying With the Current Good Manufacturing Practice Requirements for Combination Products; Proposed List Under the 21st Century Cures Act

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Food and Drug Administration

Federal Register Volume 83, Issue 114 (June 13, 2018)

Page Range27609-27614
FR Document2018-12634

As required by the 21st Century Cures Act (Cures Act), the Food and Drug Administration (FDA or Agency) is proposing a list of alternative or streamlined mechanisms for complying with the current good manufacturing practice (CGMP) requirements for combination products. Combination products are products composed of two or more different types of medical products (drug, device, and/or biological product).

Federal Register, Volume 83 Issue 114 (Wednesday, June 13, 2018)
[Federal Register Volume 83, Number 114 (Wednesday, June 13, 2018)]
[Notices]
[Pages 27609-27614]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2018-12634]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Food and Drug Administration

[Docket No. FDA-2018-N-2065]


Alternative or Streamlined Mechanisms for Complying With the 
Current Good Manufacturing Practice Requirements for Combination 
Products; Proposed List Under the 21st Century Cures Act

AGENCY: Food and Drug Administration, HHS.

ACTION: Notice.

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SUMMARY: As required by the 21st Century Cures Act (Cures Act), the 
Food and Drug Administration (FDA or Agency) is proposing a list of 
alternative or streamlined mechanisms for complying with the current 
good manufacturing practice (CGMP) requirements for combination 
products. Combination products are products composed of two or more 
different types of medical products (drug, device, and/or biological 
product).

DATES: Submit either electronic or written comments on this notice by 
September 11, 2018 to ensure that the Agency considers your comment on 
this proposed list before it begins work on the final list.

ADDRESSES: You may submit comments as follows. Please note that late, 
untimely filed comments will not be considered. Electronic comments 
must be submitted on or before September 11, 2018. The https://www.regulations.gov electronic filing system will accept comments until 
midnight Eastern Time at the end of September 11, 2018. Comments 
received by mail/hand delivery/courier (for written/paper submissions) 
will be considered timely if they are postmarked or the delivery 
service acceptance receipt is on or before that date.

Electronic Submissions

    Submit electronic comments in the following way:
     Federal eRulemaking Portal: https://www.regulations.gov. 
Follow the instructions for submitting comments. Comments submitted 
electronically, including attachments, to https://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 https://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): Dockets Management Staff (HFA-305), Food and Drug 
Administration, 5630 Fishers Lane, Rm. 1061, Rockville, MD 20852.
     For written/paper comments submitted to the Dockets 
Management Staff, FDA will post your comment, as well as any 
attachments, except for information submitted, marked and

[[Page 27610]]

identified, as confidential, if submitted as detailed in 
``Instructions.''
    Instructions: All submissions received must include the Docket No. 
FDA-2018-N-2065 for ``Alternative or Streamlined Mechanisms for 
Complying with Current Good Manufacturing Practice (CGMP) Requirements 
for Combination Products.'' Received comments, those filed in a timely 
manner (see ADDRESSES), will be placed in the docket and, except for 
those submitted as ``Confidential Submissions,'' publicly viewable at 
https://www.regulations.gov or at the Dockets Management Staff 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 https://www.regulations.gov. 
Submit both copies to the Dockets Management Staff. 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: https://www.thefederalregister.org/fdsys/pkg/FR-2015-09-18/pdf/2015-23389.pdf.
    Docket: For access to the docket to read background documents or 
the electronic and written/paper comments received, go to https://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 Dockets Management Staff, 5630 Fishers Lane, 
Rm. 1061, Rockville, MD 20852.

FOR FURTHER INFORMATION CONTACT: Melissa Burns, Office of Combination 
Products, Food and Drug Administration, 10903 New Hampshire Ave., Bldg. 
32, Rm. 5125, Silver Spring, MD 20993, 301-795-5616, 
[email protected].

SUPPLEMENTARY INFORMATION: 

I. Background

    In December 2016, the Cures Act (Pub. L. 114-255) was signed into 
law. Section 3038(c) of the Cures Act mandated that FDA publish in the 
Federal Register a list identifying types of combination products and 
manufacturing processes for which ``good manufacturing processes'' may 
be adopted that vary from the requirements set forth in Sec.  4.4 (21 
CFR 4.4) or that FDA proposes can satisfy the requirements in Sec.  4.4 
through ``alternative or streamlined mechanisms,'' and to review this 
list periodically. In accordance with this statutory mandate, FDA is 
publishing a proposed list in section II of this document, which 
addresses processes for single-entity and co-packaged combination 
products that can satisfy requirements in Sec.  4.4 through alternative 
or streamlined mechanisms (hereafter ``mechanisms'').
    On January 22, 2013, FDA issued a final rule on CGMP requirements 
for combination products (see 78 FR 4307 and part 4 (21 CFR part 4, 
subpart A)). Prior to issuance of the final rule, although CGMP 
regulations were in place to establish requirements for drugs, devices, 
biological products, and human cells, tissues, or cellular or tissue-
based products (HCT/Ps), there were no regulations to clarify and 
explain the application of these CGMP requirements to combination 
products. The final rule clarified which CGMP requirements apply to 
combination products. It also established a transparent and streamlined 
regulatory framework for combination product manufacturers to use when 
demonstrating compliance with applicable CGMP requirements.
    A combination product is a product composed of two or more 
different types of medical products (i.e., a combination of a drug, 
device, and/or biological product). The drugs, devices, and biological 
products included in combination products are referred to as 
``constituent parts'' of the combination product. Combination products 
include ``single-entity'' combination products that are physically, 
chemically, or otherwise combined or mixed and produced as a single 
entity (Sec.  3.2(e)(1) (21 CFR 3.2(e)(1)) (e.g., prefilled syringes 
and drug-eluting stents) and ``co-packaged'' combination products where 
two or more separate products are packaged together in a single package 
or as a unit and composed of drug and device products, device and 
biological products, or biological and drug products (Sec.  3.2(e)(2)) 
(e.g., a surgical or first-aid kit).\1\ Section 4.4 outlines how 
manufacturers of single-entity and co-packaged combination products 
(hereafter ``CP manufacturers'') can demonstrate compliance with 
applicable CGMP requirements, including through implementation of a 
streamlined approach to meet the requirements of both the drug CGMP and 
the device Quality System (QS) regulation by designing and implementing 
a CGMP operating system that demonstrates compliance with either of the 
following:
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    \1\ There are also ``cross-labeled'' combination products (Sec.  
3.2(e)(3) and (4)). With respect to cross-labeled combination 
products, part 4, subpart A was intended to clarify only that the 
CGMP requirements applicable to the drugs, devices, or biological 
products also apply to these types of articles when they are 
constituent parts of such combination products. Constituent parts of 
cross-labeled combination products need only comply with the 
requirements otherwise applicable to that type of product (e.g., 21 
CFR parts 210 and 211 for a drug constituent part or 21 CFR part 820 
for a device constituent part). The ``streamlined approach'' and 
related mechanisms described in this notice are generally not 
relevant or applicable to cross-labeled combination products. 
However, to the extent that the constituent parts of a cross-labeled 
combination product are manufactured at the same facility, the 
manufacturing process would be akin to when the manufacture of the 
constituent parts of a co-packaged combination product occurs at the 
same facility. Accordingly, as discussed in the combination product 
CGMP guidance (Ref. 1), for cross-labeled combination products 
manufactured at the same facility, the Agency does not intend to 
object to the use of a streamlined CGMP operating system for the 
manufacture of the combination product rather than distinct systems 
for the manufacture of each constituent part that is occurring at 
that facility.
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     The drug CGMP regulations in parts 210 and 211 (21 CFR 
parts 210 and 211) and the following specified provisions from the 
device QS regulation (Sec.  4.4(b)(1), ``drug CGMP-based streamlined 
approach''): (1) Sec.  820.20 (21 CFR 820.20) Management 
responsibility, (2) Sec.  820.30 (21 CFR 820.30) Design controls, (3) 
Sec.  820.50 (21 CFR 820.50) Purchasing controls, (4) Sec.  820.100 (21 
CFR 820.100) Corrective and preventive action, (5) Sec.  820.170 (21 
CFR 820.170) Installation, and (6) Sec.  820.200 (21 CFR 820.200) 
Servicing; or
     The device QS regulation in part 820 (21 CFR part 820) and 
the following specified provisions from the drug CGMP regulations 
(Sec.  4.4(b)(2), ``device QS regulation-based streamlined approach''): 
(1) Sec.  211.84 (21 CFR 211.84) Testing and approval or rejection of 
components, drug product containers, and closures; (2) Sec.  211.103 
(21 CFR 211.103) Calculation of yield; (3) Sec.  211.132 (21 CFR 
211.132) Tamper-evident packaging requirements for

[[Page 27611]]

over-the-counter (OTC) human drug products; (4) Sec.  211.137 (21 CFR 
211.137) Expiration dating; (5) Sec.  211.165 (21 CFR 211.165) Testing 
and release for distribution; (6) Sec.  211.166 (21 CFR 211.166) 
Stability testing; (7) Sec.  211.167 (21 CFR 211.167) Special testing 
requirements; and (8) Sec.  211.170 (21 CFR 211.170) Reserve samples.
    If the combination product includes a biological product 
constituent part, the CGMP operating system must also demonstrate 
compliance with applicable CGMP requirements for biological products in 
parts 600 through 680 (21 CFR parts 600 through 680), and if the 
combination product includes an HCT/P, the CGMP operating system must 
also demonstrate compliance with the applicable current good tissue 
practice requirements in part 1271 (21 CFR part 1271).
    Following publication of the final rule, FDA reviewed data and 
rationales provided by manufacturers who proposed various means of 
addressing CGMP considerations for combination products. FDA also 
considered feedback on its draft guidance on CGMP requirements for 
combination products, published in January 2015, in which stakeholders 
requested further guidance on circumstances in which flexible 
approaches may be available and how to engage with FDA on them. The 
final ``Guidance for Industry and FDA Staff: Current Good Manufacturing 
Practice Requirements for Combination Products'' includes discussion of 
existing mechanisms to comply with the final rule and of circumstances 
in which FDA did not intend to object to manufacturers applying 
practices that vary from the requirements set forth in the rule (Ref. 
1). The Agency continues to apply a risk-based approach to evaluating 
methods for ensuring the quality of combination products and to welcome 
proposals from manufacturers for how to enhance the efficiency of 
development and manufacturing activities, while ensuring the safety and 
effectiveness of the combination products produced.

II. Proposed List of Mechanisms for Complying With Sec.  4.4 CGMP 
Requirements for Combination Products

A. Introduction

    The following is a proposed list of mechanisms for demonstrating 
compliance with relevant combination product CGMP requirements, as 
described below. Where applicable, reference is made to sections of the 
``Guidance for Industry and FDA Staff: Current Good Manufacturing 
Practice Requirements for Combination Products'' for additional 
information (Ref. 1). FDA will continue to evaluate this list in light 
of Agency experience and stakeholder input. Manufacturers are welcome 
to propose other approaches not described, and FDA continues to 
encourage dialogue with the Agency on various means of demonstrating 
CGMP compliance for combination products.
    For each mechanism described below, CP manufacturers should 
consider what documentation would be sufficient to support that the 
mechanism, including the specific approach for implementing it, assures 
appropriate control of the manufacture of the combination product to 
ensure safety and effectiveness of the product. Appropriate evidence 
and an explanation of the rationale to support the approach should be 
accessible at the manufacturing facility for review during facility 
inspections. For additional discussion on how to interact with FDA 
regarding the mechanisms described below, see section III.

B. Mechanisms for Complying With Drug CGMP Requirements (Part 211) 
Specified in Sec.  4.4 2
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    \2\ Several drug CGMP mechanisms included in this proposed list 
depend upon use of a more broadly defined batch. FDA notes that 
approaches that depend upon broadly defined batches may increase the 
number of distributed products implicated when corrective actions 
are necessary to address postmarket issues.
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    FDA interprets the mechanisms identified in the sections below as a 
means to demonstrate compliance with the specified part 211 
requirements identified in Sec.  4.4:
1. Section 211.165 Testing and Release for Distribution
    Use of product samples that are not finished combination products 
(but that are representative of the finished combination product with 
respect to the characteristics and attributes being tested) when 
performing testing required by Sec.  211.165 to determine whether the 
drug constituent part meets final specifications. To meet the 
requirements of Sec.  211.165, the CP manufacturer would need to 
establish, including where appropriate through bridging studies and 
other quantitative means, that any differences in the manufacturing 
process for the representative samples as compared to the finished 
combination product do not affect the drug constituent part. For 
example, as part of product release testing, drug-eluting lead 
manufacturers could perform release testing for identity, potency, or 
other quality attributes on a representative lead tip assembly that 
contains the drug constituent part, but does not contain the full 
electronic and mechanical assembly, so long as they can establish that 
the differences in the manufacturing process do not impact the drug 
constituent part and the sample is representative of the finished 
combination product with respect to the quality attributes being 
tested.
    (See also Section IV.B.5 of Reference 1 for additional information 
on testing and release for combination products.)
2. Section 211.166 Stability Testing
    Use of bracketing and matrixing approaches to stability studies for 
combination products. Principles for bracketing and matrixing 
approaches to meet the requirements of Sec.  211.166 have already been 
addressed by the Agency with regard to drug products (Ref. 2), and such 
principles can also be applied to combination products. For example, 
when assessing stability for a prefilled syringe that is marketed in 
various fill volumes, one of the approaches that a CP manufacturer 
could utilize, if appropriate, is bracketing based on the smallest and 
the largest fill volume of product configurations. In determining the 
extremes for a bracketing approach and/or when justifying the use of a 
matrix design for single-entity combination products, it is important 
that the drug-device interactions and variations in the manufacturing 
processes are considered. For co-packaged combination products, such 
approaches can be applied to the drug constituent part of the product.
    Leveraging stability data for an already marketed combination 
product. Such mechanisms can be considered when the new combination 
product is a modification of an already marketed product and the 
modification does not impact the stability of the drug constituent 
part. For example, when developing new lengths of a drug-coated 
catheter product for which the catheter materials, drug coating, 
manufacturing process, and packaging configurations are largely 
unchanged from existing marketed sizes, the CP manufacturer would 
generally be able to leverage existing stability data to establish 
initial product shelf life or to support reduced stability data 
requirements, so long as characteristics of the product that could 
impact stability (materials, packaging configuration, etc.) remain the 
same. However, if the device constituent part of a drug-coated catheter 
includes a new material that is in contact with the drug coating, for 
example, new stability studies would generally be needed under Sec.  
211.166.

[[Page 27612]]

    (See also Section IV.B.6 of Reference 1 for additional information 
on stability requirements for combination products.)
3. Section 211.167 Special Testing Requirements
    Defining ``batch'' based on the drug constituent part rather than 
the finished combination product for purposes of special testing 
requirements for pyrogens and endotoxins. For example, a manufacturer 
of a combination product that has a sub-assembly coated with a drug, 
which is then incorporated into several ``batches'' or ``lots'' of the 
overall combination product, may be able to define a batch for purposes 
of pyrogen and endotoxin testing as a batch of that sub-assembly for 
purposes of meeting the requirements of Sec.  211.167. As with the 
other mechanisms described in this list, this mechanism would only 
potentially be available if there would be no impact on the drug 
constituent part from subsequent manufacturing processes, including 
when the constituent parts are combined to produce the final 
combination product. CP manufacturers should consider whether such 
risks may be introduced later in the production process (after the 
batch has been defined). This approach will most frequently apply for 
co-packaged combination products or single-entity combination products 
for which only a component or sub-assembly of the overall product is in 
contact with the drug constituent part.
    (See also Section IV.B.7 of Reference 1 for additional information 
on special testing requirements for combination products.)
4. Section 211.170 Reserve Samples
    Keeping reserve samples that are representative of the finished 
combination product. CP manufacturers may use validated surrogates as 
representative samples to meet the requirements of Sec.  211.170, 
provided the surrogate is appropriate, both in terms of the 
manufacturing process and the characteristics of the container closure. 
For example, maintaining only a sub-assembly of a coated single-entity 
combination product or only the drug constituent part of a co-packaged 
combination product as a reserve sample would generally be permissible 
under the regulation when: (1) All manufacturing process steps after 
the coating step or the fill for the drug constituent part are shown 
not to affect the drug constituent part, (2) the immediate container 
closure has essentially the same characteristics as that for the drug 
constituent part as packaged in the combination product for 
distribution, and (3) the representative samples are suitable for all 
required testing of the drug constituent part for which the reserve 
samples are being kept.
    Using samples from representative lots of a larger batch for 
retention of reserve samples. To meet the requirements of Sec.  
211.170, CP manufacturers may be able to use bracketing and matrixing 
approaches to retain reserve samples from certain lots to adequately 
represent the broadly defined batch of the combination product. For 
example, CP manufacturers might be able to retain reserve samples of 
appropriately varied sizes of a drug-coated combination product from 
within a broadly defined batch that includes multiple lots of different 
sizes.
    (See also Section IV.B.8 of Reference 1 for additional information 
on reserve sample requirements for combination products.)

C. Mechanisms for Complying With Device Quality System Requirements 
(Part 820) Specified in Sec.  4.4

    FDA interprets the mechanisms identified in the sections below as a 
means to demonstrate compliance with the specified part 820 
requirements identified in Sec.  4.4:
1. Section 820.30 Design Controls
    Using existing pharmaceutical development practices and 
documentation that align with the design control principles and 
requirements of Sec.  820.30. Robust pharmaceutical development 
practices would address many design control requirements to assure 
compliance with Sec.  820.30, where applicable. CP manufacturers need 
to demonstrate how development processes and terminology align with 
design control principles and requirements in Sec.  820.30, when 
required, including, where necessary, developing additional design 
control elements. When evaluating the adequacy of existing 
pharmaceutical development processes, particular attention should be 
given to postmarket management of design changes to the combination 
product and the alignment of change control practices with the 
principles and requirements of Sec.  820.30, as applicable.
2. Exemption of Combination Products From Device QS Regulation
    Exemption of the combination product from all or certain provisions 
of the device QS regulation (part 820) if the device constituent part 
of the combination product is itself exempt from such requirements and 
use of the device constituent part falls within the scope of the 
relevant exemption, including with respect to the device constituent 
part's intended use. Some devices are exempt from all or certain 
provisions of the device QS regulation (see, for example, liquid 
medication dispensers such as cups and droppers that fall within the 
scope of Sec.  880.6430 (21 CFR 880.6430), provided the use of the 
device is not a new intended use or does not otherwise raise different 
safety and effectiveness questions (see, for example, limitations to 
the exemption under 21 CFR 880.9). Consistent with this, for the 
combination product to be exempt from the associated provisions of the 
device QS regulation, we interpret this exemption to mean that the use 
of the device in the combination product must not be a new intended use 
or otherwise raise different safety and effectiveness questions for the 
device. This circumstance will most frequently apply to co-packaged 
combination products. For example, an oral dosing syringe (a liquid 
medication dispenser under Sec.  880.6430) that is co-packaged with a 
drug may be exempt from certain provisions of the device QS regulation 
(and hence the combination product may also be exempt from such 
provisions); however, incorporation of such a dispenser into a primary 
container closure system or co-packaging of such a dispenser with an 
emergency-use product, for example, may constitute a new intended use 
for the dispenser or raise different safety and effectiveness questions 
for the dispenser, such that the relevant exemption would not apply.
    (See also Section III.C.3 of Reference 1 for additional information 
on the exemption from provisions of the device QS regulation for 
combination products.)

III. Interacting With FDA on Mechanisms for Complying With CGMP for 
Combination Products

1. Process for Interacting With FDA

    In some cases, CP manufacturers may interact with FDA to gain 
approval or otherwise notify FDA of a manufacturing change. In other 
cases, although a submission or notification is not required, CP 
manufacturers may want to discuss potential use of CGMP mechanisms with 
FDA. CP manufacturers are encouraged to interact early with FDA on 
contemplated CGMP mechanisms.
     Pre-Submissions and Meeting Requests. CP manufacturers who 
want to obtain FDA feedback prior to submitting a premarket application 
or a postmarket supplement or who otherwise want to obtain feedback on

[[Page 27613]]

their approach may interact with FDA via the existing established 
process applicable to the lead Center \3\ for the combination product. 
For combination products reviewed under a new drug application (NDA) or 
a biologics license application (BLA), such interactions will generally 
be through Type C meetings (Ref. 3).\4\ For combination products 
reviewed under an abbreviated new drug application (ANDA), these 
interactions will generally be through pre-ANDA meetings (Ref. 4).\5\ 
For combination products reviewed under a device premarket submission 
(e.g., a premarket approval application (PMA), de novo classification, 
or premarket notification (510(k)), these interactions will generally 
be via the pre-submission process (Ref. 5).
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    \3\ A combination product is assigned to an Agency center 
(Center for Biologics Evaluation and Research, Center for Drug 
Evaluation and Research, or Center for Devices and Radiological 
Health) that will have primary jurisdiction (i.e., the ``lead 
Center'') for that combination product's review and regulation. 
Assignment of a combination product to a lead Center is based on a 
determination of which constituent part provides the primary mode of 
action of the combination product (21 U.S.C. 353(g)).
    \4\ When final, this guidance will represent the FDA's current 
thinking on this topic.
    \5\ When final, this guidance will represent the FDA's current 
thinking on this topic.
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    Regardless of the type of submission, such interactions should be 
focused on a general discussion of the mechanism and CGMP approach the 
CP manufacturer wishes to pursue and associated justification to 
support the approach. Only representative data is typically appropriate 
in these interactions; complete data should be included in the 
subsequent premarket submission or postmarket supplement, if required, 
and/or be maintained at the manufacturing facility, as appropriate.\6\
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    \6\ Note that when discussing a mechanism for complying with 
CGMP requirements for which the CP manufacturer is leveraging 
information in master file(s), the master file holder must submit a 
letter of authorization to permit FDA to review such information 
(see 21 CFR 314.420(d) and 21 CFR 814.20(c)). The specific 
information within the master file that is being leveraged should be 
clearly identified to FDA.
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     Premarket Review. CP manufacturers should include in their 
original submission for NDAs, BLAs, ANDAs, and PMAs information on any 
mechanisms for complying with CGMP requirements. For PMAs, this 
information should be included in the manufacturing section of the PMA. 
For information regarding where to place information in NDAs, BLAs, or 
ANDAs, refer to ``eCTD Technical Conformance Guide'' (Ref. 6).
     Postmarket Supplements or Notifications to FDA. Postmarket 
changes to implement a combination product CGMP mechanism for NDAs, 
ANDAs, BLAs, and PMAs, may require submission of a supplement or 
notification to FDA.\7\ CP manufacturers should consult related 
guidances relevant to the type of constituent part of the combination 
product (Refs. 7 to 9).\8\ If a CP manufacturer has questions on the 
appropriate submission type or the need for a submission, they can 
contact the lead Center for assistance.
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    \7\ Requirements for postmarket supplements are contained, for 
example, in 21 CFR 314.70 (NDAs), 21 CFR 601.12 (BLAs), and 21 CFR 
814.39 (PMAs). Any questions on whether FDA review is required for a 
postmarket CGMP mechanism should be directed to the lead Center.
    \8\ With reference to Ref. 8, when final, this guidance will 
represent the FDA's current thinking on this topic.
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2. Content Suggestions
    When submitting information on a CGMP mechanism, along with any 
submission requirements applicable to the submission type, the 
following content should be included:
     Applicable CGMP regulation. Identify the CGMP regulation 
applicable to the described mechanism. For example, if a submission 
includes a mechanism related to stability testing, indicate that Sec.  
211.166 is the applicable CGMP requirement.
     Applicable Products. If the mechanism is to be applied to 
multiple products and/or product configurations, list all related 
sizes, strengths, etc., as well as all related application numbers.
     Related Interactions with FDA. If the CP manufacturer has 
had previous interactions with FDA relevant to the proposed mechanism, 
either for the product addressed in the submission or for related 
products, the CP manufacturer should provide reference to those 
interactions. Where applicable, the CP manufacturer may cross-reference 
previously submitted information.
     Justification and Scientific Data. Include a rationale to 
support that the proposed mechanism assures adequate manufacturing 
control to ensure product safety and effectiveness. When describing a 
CGMP mechanism in a premarket or postmarket submission, the description 
should be accompanied by data necessary to support the approach. When 
proposing a change from a CGMP approach that was reviewed previously by 
FDA, such justification should include analysis of how the proposed 
approach compares to the previously reviewed approach as an effective 
manufacturing control, including representative data, as appropriate, 
to substantiate the analysis.
3. FDA Engagement
    CP manufacturers are encouraged to discuss combination product CGMP 
mechanisms with FDA. Any questions on how to engage FDA in such 
discussions should be directed to the lead Center for the product or 
the Office of Combination Products, as needed.
4. FDA Review
    FDA may review information from a CP manufacturer related to a 
mechanism for complying with CGMP requirements for combination products 
in premarket applications, postmarket supplements or notifications, 
pre-submissions and meetings, and during facility inspections. FDA may 
determine that the data and rationale presented by a CP manufacturer 
for a particular mechanism are insufficient to demonstrate that the 
mechanism, as proposed or implemented, meets the applicable CGMP 
requirement. FDA generally will notify the CP manufacturer and/or 
applicant in writing of any such determination.

IV. Other Issues for Consideration

    We have developed this proposed list of mechanisms based on 
information submitted to FDA by CP manufacturers as well as FDA 
experience with manufacturing processes and CGMP compliance approaches 
that have been shown through appropriate data and rationales to support 
the manufacture of safe and effective products. FDA requests comment 
from stakeholders who believe there are additional types of combination 
products and/or manufacturing processes where different approaches may 
be appropriate. When providing such feedback, the suggested approach 
should be:
     Applicable to a type or range of combination products 
(e.g., not just a single CP manufacturer's product). Commenters should 
indicate to which types of combination products or manufacturing 
processes they believe the suggested approach should apply.
     Supported by adequate data and rationales to demonstrate 
that such an approach would continue to support manufacturing of safe 
and effective combination products. Commenters should summarize the 
data and rationale that support the suggested approach.

Any confidential information submitted to FDA via the docket should be 
appropriately identified (see Instructions above, in ADDRESSES).

V. Paperwork Reduction Act

    This notice refers to previously approved collections of 
information

[[Page 27614]]

found in FDA regulations. These collections of information are subject 
to review by the Office of Management and Budget (OMB) under the 
Paperwork Reduction Act of 1995 (44 U.S.C. 3501-3520). We note that the 
information collected under the underlying CGMP regulations for drugs, 
devices, and biological products, including current good tissue 
practices for HCT/Ps, found in parts 211, 820, 600 through 680, and 
1271, have already been approved and are in effect. The provisions of 
part 211 are approved under the OMB control number 0910-0139. The 
provisions of part 820 are approved under OMB control number 0910-0073. 
The provisions of parts 606 and 640 are approved under OMB control 
number 0910-0116. The provisions of part 610 are approved under OMB 
control number 0910-0116 and OMB control number 0910-0338 (also for 
part 680). The provisions of part 1271, subparts C and D, are approved 
under OMB control number 0910-0543.
    We note that the information collected under the related submission 
types have already been approved and are in effect. The collections of 
information regarding formal meetings with sponsors and applicants have 
been approved under OMB control number 0910-0429. The collections of 
information regarding new drug approvals (NDA) and abbreviated new drug 
applications (ANDA) have been approved under OMB control number 0910-
0001. The collections of information regarding pre-ANDAs have been 
approved under OMB control number 0910-0797. The collections of 
information regarding pre-submissions have been approved under OMB 
control number 0910-0756. The collections of information regarding PMAs 
have been approved under OMB control number 0910-0231. The collections 
of information for premarket notification (510(k)) have been approved 
under OMB control number 0910-0120. The collections of information for 
the de novo classification process have been approved under OMB control 
number 0910-0844. The collections of information regarding biologics 
license applications have been approved under OMB control number 0910-
0338.

VI. References

    The following references are on display in the Dockets Management 
Staff (see ADDRESSES) and are available for viewing by interested 
persons between 9 a.m. and 4 p.m., Monday through Friday; they are also 
available electronically at https://www.regulations.gov. FDA has 
verified the website addresses, as of the date this document publishes 
in the Federal Register, but websites are subject to change over time.

1. ``Guidance for Industry and FDA Staff: Current Good Manufacturing 
Practice Requirements for Combination Products,'' January 2017. 
https://www.fda.gov/RegulatoryInformation/Guidances/ucm126198.htm.
2. ``Guidance for Industry: Q1D Bracketing and Matrixing Designs for 
Stability Testing of New Drug Substances and Products,'' January 
2003. https://www.fda.gov/downloads/Drugs/Guidances/ucm073379.pdf.
3. ``Draft Guidance for Industry: Formal Meetings Between the FDA 
and Sponsors or Applicants of PDUFA Products,'' December 2017. 
https://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/UCM590547.pdf.
4. ``Draft Guidance for Industry: Formal Meetings Between FDA and 
ANDA Applicants of Complex Products Under GDUFA,'' October 2017. 
https://www.fda.gov/downloads/drugs/guidancecomplianceregulatoryinformation/guidances/ucm578366.pdf.
5. ``Guidance for Industry and Food and Drug Administration Staff: 
Requests for Feedback on Medical Device Submissions: The Pre-
Submission Program and Meetings with Food and Drug Administration 
Staff,'' September 2017. https://www.fda.gov/downloads/medicaldevices/deviceregulationandguidance/guidancedocuments/ucm311176.pdf.
6. ``eCTD Technical Conformance Guide,'' November 2017. https://www.fda.gov/downloads/Drugs/UCM465411.pdf.
7. ``Guidance for Industry: Changes to an Approved NDA or ANDA,'' 
April 2004. https://www.fda.gov/downloads/drugs/guidancecomplianceregulatoryinformation/guidances/ucm077097.pdf.
8. ``Draft Guidance for Industry: Chemistry, Manufacturing, and 
Controls Changes to an Approved Application: Certain Biological 
Products,'' December 2017. https://www.fda.gov/downloads/BiologicsBloodVaccines/GuidanceComplianceRegulatoryInformation/Guidances/General/UCM590118.pdf.
9. ``Guidance for Industry and FDA Staff: 30-Day Notices, 135-Day 
Premarket Approval (PMA) Supplements and 75-Day Humanitarian Device 
Exemption (HDE) Supplements for Manufacturing Method or Process 
Changes,'' April 2011. https://www.fda.gov/downloads/MedicalDevices/DeviceRegulationandGuidance/GuidanceDocuments/UCM080194.pdf.


    Dated: June 7, 2018.
Leslie Kux,
Associate Commissioner for Policy.
[FR Doc. 2018-12634 Filed 6-12-18; 8:45 am]
 BILLING CODE 4164-01-P



                                                                                    Federal Register / Vol. 83, No. 114 / Wednesday, June 13, 2018 / Notices                                                                                               27609

                                                                                               TABLE 1—ESTIMATED ANNUAL REPORTING BURDEN 1—Continued
                                                                                                                                                                                                                                 Average
                                                                                                                                                                        Number of
                                                                                                                                             Number of                                            Total annual                 burden per
                                                                          Type of information                                                                         responses per                                                                    Total hours
                                                                                                                                            respondents                                            responses                    response
                                                                                                                                                                        respondent                                               (hours)

                                              Recommended information to be included when firms                                                              236                          10                    2,360       20 ...................           47,200
                                                choose to disseminate HCEI materials to payors about
                                                approved or cleared medical devices.
                                              Recommended information to be included when firms                                                              717                            2                   1,434       .5 (30 minutes)                     717
                                                choose to disseminate information about unapproved
                                                products or unapproved uses of approved or cleared
                                                products.
                                              Followup information to payors regarding previously com-                                                       359                           2                       718      2 .....................           1,436
                                                municated about unapproved products or unapproved
                                                uses of approved or cleared products.

                                                   Total ..............................................................................    ........................   ........................   ........................   ........................       137,353
                                                 1 There   are no capital costs or operating and maintenance costs associated with this collection of information.


                                                This guidance also refers to                                            DEPARTMENT OF HEALTH AND                                                     service acceptance receipt is on or
                                              previously approved collections of                                        HUMAN SERVICES                                                               before that date.
                                              information found in FDA regulations.                                                                                                                  Electronic Submissions
                                              The collections of information in 21                                      Food and Drug Administration
                                              CFR 314.81(b)(3)(i) (Form FDA 2253)                                       [Docket No. FDA–2018–N–2065]
                                                                                                                                                                                                       Submit electronic comments in the
                                              have been approved under OMB control                                                                                                                   following way:
                                              number 0910–0001.                                                         Alternative or Streamlined                                                     • Federal eRulemaking Portal:
                                                                                                                        Mechanisms for Complying With the                                            https://www.regulations.gov. Follow the
                                                FDA is issuing this final guidance                                                                                                                   instructions for submitting comments.
                                                                                                                        Current Good Manufacturing Practice
                                              subject to OMB approval of the                                                                                                                         Comments submitted electronically,
                                                                                                                        Requirements for Combination
                                              collections of information. Before                                                                                                                     including attachments, to https://
                                                                                                                        Products; Proposed List Under the
                                              implementing the information                                                                                                                           www.regulations.gov will be posted to
                                                                                                                        21st Century Cures Act
                                              collection provisions of the guidance,                                                                                                                 the docket unchanged. Because your
                                              FDA will publish a notice in the Federal                                  AGENCY:           Food and Drug Administration,                              comment will be made public, you are
                                              Register announcing OMB’s decision to                                     HHS.                                                                         solely responsible for ensuring that your
                                              approve, modify, or disapprove the                                        ACTION:       Notice.                                                        comment does not include any
                                              collections of information, including                                                                                                                  confidential information that you or a
                                              OMB control number(s) for newly                                           SUMMARY:    As required by the 21st                                          third party may not wish to be posted,
                                              approved collections.                                                     Century Cures Act (Cures Act), the Food                                      such as medical information, your or
                                                                                                                        and Drug Administration (FDA or                                              anyone else’s Social Security number, or
                                              III. Electronic Access                                                    Agency) is proposing a list of alternative                                   confidential business information, such
                                                                                                                        or streamlined mechanisms for                                                as a manufacturing process. Please note
                                                Persons with access to the internet                                     complying with the current good
                                              may obtain the guidance at https://                                                                                                                    that if you include your name, contact
                                                                                                                        manufacturing practice (CGMP)                                                information, or other information that
                                              www.fda.gov/Drugs/Guidance                                                requirements for combination products.
                                              ComplianceRegulatoryInformation/                                                                                                                       identifies you in the body of your
                                                                                                                        Combination products are products                                            comments, that information will be
                                              Guidances/default.htm, https://                                           composed of two or more different types                                      posted on https://www.regulations.gov.
                                              www.fda.gov/BiologicsBloodVaccines/                                       of medical products (drug, device, and/                                        • If you want to submit a comment
                                              GuidanceComplianceRegulatory                                              or biological product).                                                      with confidential information that you
                                              Information/Guidances/default.htm,                                        DATES: Submit either electronic or                                           do not wish to be made available to the
                                              https://www.fda.gov/MedicalDevices/                                       written comments on this notice by                                           public, submit the comment as a
                                              DeviceRegulationandGuidance/                                              September 11, 2018 to ensure that the                                        written/paper submission and in the
                                              GuidanceDocuments/default.htm, or                                         Agency considers your comment on this                                        manner detailed (see ‘‘Written/Paper
                                              https://www.regulations.gov.                                              proposed list before it begins work on                                       Submissions’’ and ‘‘Instructions’’).
                                                Dated: June 7, 2018.                                                    the final list.
                                                                                                                                                                                                     Written/Paper Submissions
                                              Leslie Kux,                                                               ADDRESSES: You may submit comments
                                                                                                                        as follows. Please note that late,                                             Submit written/paper submissions as
                                              Associate Commissioner for Policy.
                                                                                                                        untimely filed comments will not be                                          follows:
                                              [FR Doc. 2018–12632 Filed 6–12–18; 8:45 am]
                                                                                                                        considered. Electronic comments must                                           • Mail/Hand delivery/Courier (for
                                              BILLING CODE 4164–01–P                                                    be submitted on or before September 11,                                      written/paper submissions): Dockets
                                                                                                                        2018. The https://www.regulations.gov                                        Management Staff (HFA–305), Food and
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                                                                                                                        electronic filing system will accept                                         Drug Administration, 5630 Fishers
                                                                                                                        comments until midnight Eastern Time                                         Lane, Rm. 1061, Rockville, MD 20852.
                                                                                                                        at the end of September 11, 2018.                                              • For written/paper comments
                                                                                                                        Comments received by mail/hand                                               submitted to the Dockets Management
                                                                                                                        delivery/courier (for written/paper                                          Staff, FDA will post your comment, as
                                                                                                                        submissions) will be considered timely                                       well as any attachments, except for
                                                                                                                        if they are postmarked or the delivery                                       information submitted, marked and


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                                              27610                        Federal Register / Vol. 83, No. 114 / Wednesday, June 13, 2018 / Notices

                                              identified, as confidential, if submitted               Administration, 10903 New Hampshire                    package or as a unit and composed of
                                              as detailed in ‘‘Instructions.’’                        Ave., Bldg. 32, Rm. 5125, Silver Spring,               drug and device products, device and
                                                 Instructions: All submissions received               MD 20993, 301–795–5616,                                biological products, or biological and
                                              must include the Docket No. FDA–                        melissa.burns@fda.hhs.gov.                             drug products (§ 3.2(e)(2)) (e.g., a
                                              2018–N–2065 for ‘‘Alternative or                        SUPPLEMENTARY INFORMATION:                             surgical or first-aid kit).1 Section 4.4
                                              Streamlined Mechanisms for Complying                                                                           outlines how manufacturers of single-
                                              with Current Good Manufacturing                         I. Background                                          entity and co-packaged combination
                                              Practice (CGMP) Requirements for                           In December 2016, the Cures Act                     products (hereafter ‘‘CP manufacturers’’)
                                              Combination Products.’’ Received                        (Pub. L. 114–255) was signed into law.                 can demonstrate compliance with
                                              comments, those filed in a timely                       Section 3038(c) of the Cures Act                       applicable CGMP requirements,
                                              manner (see ADDRESSES), will be placed                  mandated that FDA publish in the                       including through implementation of a
                                              in the docket and, except for those                     Federal Register a list identifying types              streamlined approach to meet the
                                              submitted as ‘‘Confidential                             of combination products and                            requirements of both the drug CGMP
                                              Submissions,’’ publicly viewable at                     manufacturing processes for which                      and the device Quality System (QS)
                                              https://www.regulations.gov or at the                   ‘‘good manufacturing processes’’ may be                regulation by designing and
                                              Dockets Management Staff between 9                      adopted that vary from the requirements                implementing a CGMP operating system
                                              a.m. and 4 p.m., Monday through                         set forth in § 4.4 (21 CFR 4.4) or that                that demonstrates compliance with
                                              Friday.                                                 FDA proposes can satisfy the                           either of the following:
                                                 • Confidential Submissions—To                        requirements in § 4.4 through                             • The drug CGMP regulations in parts
                                              submit a comment with confidential                      ‘‘alternative or streamlined                           210 and 211 (21 CFR parts 210 and 211)
                                              information that you do not wish to be                  mechanisms,’’ and to review this list                  and the following specified provisions
                                              made publicly available, submit your                    periodically. In accordance with this                  from the device QS regulation
                                              comments only as a written/paper                        statutory mandate, FDA is publishing a                 (§ 4.4(b)(1), ‘‘drug CGMP-based
                                              submission. You should submit two                       proposed list in section II of this                    streamlined approach’’): (1) § 820.20 (21
                                              copies total. One copy will include the                 document, which addresses processes                    CFR 820.20) Management responsibility,
                                              information you claim to be confidential                for single-entity and co-packaged                      (2) § 820.30 (21 CFR 820.30) Design
                                              with a heading or cover note that states                combination products that can satisfy                  controls, (3) § 820.50 (21 CFR 820.50)
                                              ‘‘THIS DOCUMENT CONTAINS                                requirements in § 4.4 through                          Purchasing controls, (4) § 820.100 (21
                                              CONFIDENTIAL INFORMATION.’’ The                         alternative or streamlined mechanisms                  CFR 820.100) Corrective and preventive
                                              Agency will review this copy, including                 (hereafter ‘‘mechanisms’’).                            action, (5) § 820.170 (21 CFR 820.170)
                                              the claimed confidential information, in                   On January 22, 2013, FDA issued a                   Installation, and (6) § 820.200 (21 CFR
                                              its consideration of comments. The                      final rule on CGMP requirements for                    820.200) Servicing; or
                                                                                                      combination products (see 78 FR 4307                      • The device QS regulation in part
                                              second copy, which will have the
                                                                                                      and part 4 (21 CFR part 4, subpart A)).                820 (21 CFR part 820) and the following
                                              claimed confidential information
                                                                                                      Prior to issuance of the final rule,                   specified provisions from the drug
                                              redacted/blacked out, will be available
                                                                                                      although CGMP regulations were in                      CGMP regulations (§ 4.4(b)(2), ‘‘device
                                              for public viewing and posted on
                                                                                                      place to establish requirements for                    QS regulation-based streamlined
                                              https://www.regulations.gov. Submit
                                                                                                      drugs, devices, biological products, and               approach’’): (1) § 211.84 (21 CFR 211.84)
                                              both copies to the Dockets Management
                                                                                                      human cells, tissues, or cellular or                   Testing and approval or rejection of
                                              Staff. If you do not wish your name and
                                                                                                      tissue-based products (HCT/Ps), there                  components, drug product containers,
                                              contact information to be made publicly
                                                                                                      were no regulations to clarify and                     and closures; (2) § 211.103 (21 CFR
                                              available, you can provide this
                                                                                                      explain the application of these CGMP                  211.103) Calculation of yield; (3)
                                              information on the cover sheet and not                                                                         § 211.132 (21 CFR 211.132) Tamper-
                                                                                                      requirements to combination products.
                                              in the body of your comments and you                                                                           evident packaging requirements for
                                                                                                      The final rule clarified which CGMP
                                              must identify this information as
                                                                                                      requirements apply to combination
                                              ‘‘confidential.’’ Any information marked                products. It also established a                           1 There are also ‘‘cross-labeled’’ combination
                                              as ‘‘confidential’’ will not be disclosed               transparent and streamlined regulatory                 products (§ 3.2(e)(3) and (4)). With respect to cross-
                                              except in accordance with 21 CFR 10.20                  framework for combination product
                                                                                                                                                             labeled combination products, part 4, subpart A
                                              and other applicable disclosure law. For                                                                       was intended to clarify only that the CGMP
                                                                                                      manufacturers to use when                              requirements applicable to the drugs, devices, or
                                              more information about FDA’s posting                    demonstrating compliance with                          biological products also apply to these types of
                                              of comments to public dockets, see 80                   applicable CGMP requirements.                          articles when they are constituent parts of such
                                              FR 56469, September 18, 2015, or access                                                                        combination products. Constituent parts of cross-
                                                                                                         A combination product is a product                  labeled combination products need only comply
                                              the information at: https://www.gpo.gov/                composed of two or more different types                with the requirements otherwise applicable to that
                                              fdsys/pkg/FR-2015-09-18/pdf/2015-                       of medical products (i.e., a combination               type of product (e.g., 21 CFR parts 210 and 211 for
                                              23389.pdf.                                              of a drug, device, and/or biological                   a drug constituent part or 21 CFR part 820 for a
                                                 Docket: For access to the docket to                                                                         device constituent part). The ‘‘streamlined
                                                                                                      product). The drugs, devices, and                      approach’’ and related mechanisms described in
                                              read background documents or the                        biological products included in                        this notice are generally not relevant or applicable
                                              electronic and written/paper comments                   combination products are referred to as                to cross-labeled combination products. However, to
                                              received, go to https://                                ‘‘constituent parts’’ of the combination               the extent that the constituent parts of a cross-
                                              www.regulations.gov and insert the                                                                             labeled combination product are manufactured at
                                                                                                      product. Combination products include                  the same facility, the manufacturing process would
                                              docket number, found in brackets in the                 ‘‘single-entity’’ combination products                 be akin to when the manufacture of the constituent
                                              heading of this document, into the                      that are physically, chemically, or                    parts of a co-packaged combination product occurs
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                                              ‘‘Search’’ box and follow the prompts                   otherwise combined or mixed and                        at the same facility. Accordingly, as discussed in
                                              and/or go to the Dockets Management                                                                            the combination product CGMP guidance (Ref. 1),
                                                                                                      produced as a single entity (§ 3.2(e)(1)               for cross-labeled combination products
                                              Staff, 5630 Fishers Lane, Rm. 1061,                     (21 CFR 3.2(e)(1)) (e.g., prefilled                    manufactured at the same facility, the Agency does
                                              Rockville, MD 20852.                                    syringes and drug-eluting stents) and                  not intend to object to the use of a streamlined
                                                                                                                                                             CGMP operating system for the manufacture of the
                                              FOR FURTHER INFORMATION CONTACT:                        ‘‘co-packaged’’ combination products                   combination product rather than distinct systems
                                              Melissa Burns, Office of Combination                    where two or more separate products                    for the manufacture of each constituent part that is
                                              Products, Food and Drug                                 are packaged together in a single                      occurring at that facility.



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                                                                           Federal Register / Vol. 83, No. 114 / Wednesday, June 13, 2018 / Notices                                              27611

                                              over-the-counter (OTC) human drug                       Requirements for Combination                           assembly that contains the drug
                                              products; (4) § 211.137 (21 CFR 211.137)                Products’’ for additional information                  constituent part, but does not contain
                                              Expiration dating; (5) § 211.165 (21 CFR                (Ref. 1). FDA will continue to evaluate                the full electronic and mechanical
                                              211.165) Testing and release for                        this list in light of Agency experience                assembly, so long as they can establish
                                              distribution; (6) § 211.166 (21 CFR                     and stakeholder input. Manufacturers                   that the differences in the
                                              211.166) Stability testing; (7) § 211.167               are welcome to propose other                           manufacturing process do not impact
                                              (21 CFR 211.167) Special testing                        approaches not described, and FDA                      the drug constituent part and the sample
                                              requirements; and (8) § 211.170 (21 CFR                 continues to encourage dialogue with                   is representative of the finished
                                              211.170) Reserve samples.                               the Agency on various means of                         combination product with respect to the
                                                 If the combination product includes a                demonstrating CGMP compliance for                      quality attributes being tested.
                                              biological product constituent part, the                combination products.                                     (See also Section IV.B.5 of Reference
                                              CGMP operating system must also                            For each mechanism described below,                 1 for additional information on testing
                                              demonstrate compliance with                             CP manufacturers should consider what                  and release for combination products.)
                                              applicable CGMP requirements for                        documentation would be sufficient to
                                              biological products in parts 600 through                support that the mechanism, including                  2. Section 211.166    Stability Testing
                                              680 (21 CFR parts 600 through 680), and                 the specific approach for implementing                   Use of bracketing and matrixing
                                              if the combination product includes an                  it, assures appropriate control of the                 approaches to stability studies for
                                              HCT/P, the CGMP operating system                        manufacture of the combination product                 combination products. Principles for
                                              must also demonstrate compliance with                   to ensure safety and effectiveness of the              bracketing and matrixing approaches to
                                              the applicable current good tissue                      product. Appropriate evidence and an                   meet the requirements of § 211.166 have
                                              practice requirements in part 1271 (21                  explanation of the rationale to support                already been addressed by the Agency
                                              CFR part 1271).                                         the approach should be accessible at the               with regard to drug products (Ref. 2),
                                                 Following publication of the final                   manufacturing facility for review during               and such principles can also be applied
                                              rule, FDA reviewed data and rationales                  facility inspections. For additional                   to combination products. For example,
                                              provided by manufacturers who                           discussion on how to interact with FDA                 when assessing stability for a prefilled
                                              proposed various means of addressing                    regarding the mechanisms described                     syringe that is marketed in various fill
                                              CGMP considerations for combination                     below, see section III.                                volumes, one of the approaches that a
                                              products. FDA also considered feedback                                                                         CP manufacturer could utilize, if
                                                                                                      B. Mechanisms for Complying With
                                              on its draft guidance on CGMP                                                                                  appropriate, is bracketing based on the
                                                                                                      Drug CGMP Requirements (Part 211)
                                              requirements for combination products,                                                                         smallest and the largest fill volume of
                                                                                                      Specified in § 4.4 2
                                              published in January 2015, in which                                                                            product configurations. In determining
                                              stakeholders requested further guidance                   FDA interprets the mechanisms                        the extremes for a bracketing approach
                                              on circumstances in which flexible                      identified in the sections below as a                  and/or when justifying the use of a
                                              approaches may be available and how to                  means to demonstrate compliance with                   matrix design for single-entity
                                              engage with FDA on them. The final                      the specified part 211 requirements                    combination products, it is important
                                              ‘‘Guidance for Industry and FDA Staff:                  identified in § 4.4:                                   that the drug-device interactions and
                                              Current Good Manufacturing Practice                     1. Section 211.165 Testing and Release                 variations in the manufacturing
                                              Requirements for Combination                            for Distribution                                       processes are considered. For co-
                                              Products’’ includes discussion of                                                                              packaged combination products, such
                                              existing mechanisms to comply with the                     Use of product samples that are not
                                                                                                      finished combination products (but that                approaches can be applied to the drug
                                              final rule and of circumstances in which                                                                       constituent part of the product.
                                              FDA did not intend to object to                         are representative of the finished
                                                                                                      combination product with respect to the                  Leveraging stability data for an
                                              manufacturers applying practices that                                                                          already marketed combination product.
                                              vary from the requirements set forth in                 characteristics and attributes being
                                                                                                      tested) when performing testing required               Such mechanisms can be considered
                                              the rule (Ref. 1). The Agency continues                                                                        when the new combination product is a
                                              to apply a risk-based approach to                       by § 211.165 to determine whether the
                                                                                                      drug constituent part meets final                      modification of an already marketed
                                              evaluating methods for ensuring the                                                                            product and the modification does not
                                              quality of combination products and to                  specifications. To meet the requirements
                                                                                                      of § 211.165, the CP manufacturer                      impact the stability of the drug
                                              welcome proposals from manufacturers                                                                           constituent part. For example, when
                                              for how to enhance the efficiency of                    would need to establish, including
                                                                                                      where appropriate through bridging                     developing new lengths of a drug-coated
                                              development and manufacturing                                                                                  catheter product for which the catheter
                                              activities, while ensuring the safety and               studies and other quantitative means,
                                                                                                      that any differences in the                            materials, drug coating, manufacturing
                                              effectiveness of the combination                                                                               process, and packaging configurations
                                              products produced.                                      manufacturing process for the
                                                                                                      representative samples as compared to                  are largely unchanged from existing
                                              II. Proposed List of Mechanisms for                     the finished combination product do not                marketed sizes, the CP manufacturer
                                              Complying With § 4.4 CGMP                               affect the drug constituent part. For                  would generally be able to leverage
                                              Requirements for Combination                            example, as part of product release                    existing stability data to establish initial
                                              Products                                                testing, drug-eluting lead manufacturers               product shelf life or to support reduced
                                                                                                      could perform release testing for                      stability data requirements, so long as
                                              A. Introduction                                                                                                characteristics of the product that could
                                                                                                      identity, potency, or other quality
                                                 The following is a proposed list of                  attributes on a representative lead tip                impact stability (materials, packaging
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                                              mechanisms for demonstrating                                                                                   configuration, etc.) remain the same.
                                              compliance with relevant combination                      2 Several drug CGMP mechanisms included in           However, if the device constituent part
                                              product CGMP requirements, as                           this proposed list depend upon use of a more           of a drug-coated catheter includes a new
                                              described below. Where applicable,                      broadly defined batch. FDA notes that approaches       material that is in contact with the drug
                                                                                                      that depend upon broadly defined batches may
                                              reference is made to sections of the                    increase the number of distributed products
                                                                                                                                                             coating, for example, new stability
                                              ‘‘Guidance for Industry and FDA Staff:                  implicated when corrective actions are necessary to    studies would generally be needed
                                              Current Good Manufacturing Practice                     address postmarket issues.                             under § 211.166.


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                                              27612                        Federal Register / Vol. 83, No. 114 / Wednesday, June 13, 2018 / Notices

                                                 (See also Section IV.B.6 of Reference                for distribution, and (3) the                          scope of the relevant exemption,
                                              1 for additional information on stability               representative samples are suitable for                including with respect to the device
                                              requirements for combination products.)                 all required testing of the drug                       constituent part’s intended use. Some
                                                                                                      constituent part for which the reserve                 devices are exempt from all or certain
                                              3. Section 211.167 Special Testing
                                                                                                      samples are being kept.                                provisions of the device QS regulation
                                              Requirements                                               Using samples from representative                   (see, for example, liquid medication
                                                 Defining ‘‘batch’’ based on the drug                 lots of a larger batch for retention of                dispensers such as cups and droppers
                                              constituent part rather than the finished               reserve samples. To meet the                           that fall within the scope of § 880.6430
                                              combination product for purposes of                     requirements of § 211.170, CP                          (21 CFR 880.6430), provided the use of
                                              special testing requirements for                        manufacturers may be able to use                       the device is not a new intended use or
                                              pyrogens and endotoxins. For example,                   bracketing and matrixing approaches to                 does not otherwise raise different safety
                                              a manufacturer of a combination                         retain reserve samples from certain lots               and effectiveness questions (see, for
                                              product that has a sub-assembly coated                  to adequately represent the broadly                    example, limitations to the exemption
                                              with a drug, which is then incorporated                 defined batch of the combination                       under 21 CFR 880.9). Consistent with
                                              into several ‘‘batches’’ or ‘‘lots’’ of the             product. For example, CP manufacturers                 this, for the combination product to be
                                              overall combination product, may be                     might be able to retain reserve samples                exempt from the associated provisions
                                              able to define a batch for purposes of                  of appropriately varied sizes of a drug-               of the device QS regulation, we interpret
                                              pyrogen and endotoxin testing as a                      coated combination product from                        this exemption to mean that the use of
                                              batch of that sub-assembly for purposes                 within a broadly defined batch that                    the device in the combination product
                                              of meeting the requirements of                          includes multiple lots of different sizes.             must not be a new intended use or
                                              § 211.167. As with the other                               (See also Section IV.B.8 of Reference               otherwise raise different safety and
                                              mechanisms described in this list, this                 1 for additional information on reserve                effectiveness questions for the device.
                                              mechanism would only potentially be                     sample requirements for combination                    This circumstance will most frequently
                                              available if there would be no impact on                products.)                                             apply to co-packaged combination
                                              the drug constituent part from                                                                                 products. For example, an oral dosing
                                              subsequent manufacturing processes,                     C. Mechanisms for Complying With
                                                                                                      Device Quality System Requirements                     syringe (a liquid medication dispenser
                                              including when the constituent parts are                                                                       under § 880.6430) that is co-packaged
                                              combined to produce the final                           (Part 820) Specified in § 4.4
                                                                                                                                                             with a drug may be exempt from certain
                                              combination product. CP manufacturers                     FDA interprets the mechanisms                        provisions of the device QS regulation
                                              should consider whether such risks may                  identified in the sections below as a                  (and hence the combination product
                                              be introduced later in the production                   means to demonstrate compliance with                   may also be exempt from such
                                              process (after the batch has been                       the specified part 820 requirements                    provisions); however, incorporation of
                                              defined). This approach will most                       identified in § 4.4:                                   such a dispenser into a primary
                                              frequently apply for co-packaged
                                                                                                      1. Section 820.30 Design Controls                      container closure system or co-
                                              combination products or single-entity
                                                                                                         Using existing pharmaceutical                       packaging of such a dispenser with an
                                              combination products for which only a
                                                                                                      development practices and                              emergency-use product, for example,
                                              component or sub-assembly of the
                                                                                                      documentation that align with the                      may constitute a new intended use for
                                              overall product is in contact with the
                                                                                                      design control principles and                          the dispenser or raise different safety
                                              drug constituent part.
                                                 (See also Section IV.B.7 of Reference                requirements of § 820.30. Robust                       and effectiveness questions for the
                                              1 for additional information on special                 pharmaceutical development practices                   dispenser, such that the relevant
                                              testing requirements for combination                    would address many design control                      exemption would not apply.
                                                                                                                                                                (See also Section III.C.3 of Reference
                                              products.)                                              requirements to assure compliance with
                                                                                                                                                             1 for additional information on the
                                                                                                      § 820.30, where applicable. CP
                                              4. Section 211.170 Reserve Samples                                                                             exemption from provisions of the device
                                                                                                      manufacturers need to demonstrate how
                                                 Keeping reserve samples that are                                                                            QS regulation for combination
                                                                                                      development processes and terminology
                                              representative of the finished                                                                                 products.)
                                                                                                      align with design control principles and
                                              combination product. CP manufacturers                   requirements in § 820.30, when                         III. Interacting With FDA on
                                              may use validated surrogates as                         required, including, where necessary,                  Mechanisms for Complying With CGMP
                                              representative samples to meet the                      developing additional design control                   for Combination Products
                                              requirements of § 211.170, provided the                 elements. When evaluating the
                                              surrogate is appropriate, both in terms                                                                        1. Process for Interacting With FDA
                                                                                                      adequacy of existing pharmaceutical
                                              of the manufacturing process and the                    development processes, particular                         In some cases, CP manufacturers may
                                              characteristics of the container closure.               attention should be given to postmarket                interact with FDA to gain approval or
                                              For example, maintaining only a sub-                    management of design changes to the                    otherwise notify FDA of a
                                              assembly of a coated single-entity                      combination product and the alignment                  manufacturing change. In other cases,
                                              combination product or only the drug                    of change control practices with the                   although a submission or notification is
                                              constituent part of a co-packaged                       principles and requirements of § 820.30,               not required, CP manufacturers may
                                              combination product as a reserve                        as applicable.                                         want to discuss potential use of CGMP
                                              sample would generally be permissible                                                                          mechanisms with FDA. CP
                                              under the regulation when: (1) All                      2. Exemption of Combination Products                   manufacturers are encouraged to
                                              manufacturing process steps after the                   From Device QS Regulation                              interact early with FDA on
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                                              coating step or the fill for the drug                      Exemption of the combination                        contemplated CGMP mechanisms.
                                              constituent part are shown not to affect                product from all or certain provisions of                 • Pre-Submissions and Meeting
                                              the drug constituent part, (2) the                      the device QS regulation (part 820) if                 Requests. CP manufacturers who want
                                              immediate container closure has                         the device constituent part of the                     to obtain FDA feedback prior to
                                              essentially the same characteristics as                 combination product is itself exempt                   submitting a premarket application or a
                                              that for the drug constituent part as                   from such requirements and use of the                  postmarket supplement or who
                                              packaged in the combination product                     device constituent part falls within the               otherwise want to obtain feedback on


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                                                                           Federal Register / Vol. 83, No. 114 / Wednesday, June 13, 2018 / Notices                                            27613

                                              their approach may interact with FDA                    product CGMP mechanism for NDAs,                       3. FDA Engagement
                                              via the existing established process                    ANDAs, BLAs, and PMAs, may require                        CP manufacturers are encouraged to
                                              applicable to the lead Center 3 for the                 submission of a supplement or                          discuss combination product CGMP
                                              combination product. For combination                    notification to FDA.7 CP manufacturers                 mechanisms with FDA. Any questions
                                              products reviewed under a new drug                      should consult related guidances                       on how to engage FDA in such
                                              application (NDA) or a biologics license                relevant to the type of constituent part               discussions should be directed to the
                                              application (BLA), such interactions                    of the combination product (Refs. 7 to                 lead Center for the product or the Office
                                              will generally be through Type C                        9).8 If a CP manufacturer has questions                of Combination Products, as needed.
                                              meetings (Ref. 3).4 For combination                     on the appropriate submission type or
                                              products reviewed under an abbreviated                  the need for a submission, they can                    4. FDA Review
                                              new drug application (ANDA), these                      contact the lead Center for assistance.                   FDA may review information from a
                                              interactions will generally be through                                                                         CP manufacturer related to a mechanism
                                              pre-ANDA meetings (Ref. 4).5 For                        2. Content Suggestions
                                                                                                                                                             for complying with CGMP requirements
                                              combination products reviewed under a                      When submitting information on a                    for combination products in premarket
                                              device premarket submission (e.g., a                    CGMP mechanism, along with any                         applications, postmarket supplements
                                              premarket approval application (PMA),                   submission requirements applicable to                  or notifications, pre-submissions and
                                              de novo classification, or premarket                    the submission type, the following                     meetings, and during facility
                                              notification (510(k)), these interactions               content should be included:                            inspections. FDA may determine that
                                              will generally be via the pre-submission                   • Applicable CGMP regulation.                       the data and rationale presented by a CP
                                              process (Ref. 5).                                       Identify the CGMP regulation applicable                manufacturer for a particular
                                                 Regardless of the type of submission,                to the described mechanism. For                        mechanism are insufficient to
                                              such interactions should be focused on                                                                         demonstrate that the mechanism, as
                                                                                                      example, if a submission includes a
                                              a general discussion of the mechanism                                                                          proposed or implemented, meets the
                                                                                                      mechanism related to stability testing,
                                              and CGMP approach the CP                                                                                       applicable CGMP requirement. FDA
                                                                                                      indicate that § 211.166 is the applicable
                                              manufacturer wishes to pursue and                                                                              generally will notify the CP
                                                                                                      CGMP requirement.
                                              associated justification to support the                                                                        manufacturer and/or applicant in
                                              approach. Only representative data is                      • Applicable Products. If the
                                                                                                      mechanism is to be applied to multiple                 writing of any such determination.
                                              typically appropriate in these
                                              interactions; complete data should be                   products and/or product configurations,                IV. Other Issues for Consideration
                                              included in the subsequent premarket                    list all related sizes, strengths, etc., as              We have developed this proposed list
                                              submission or postmarket supplement,                    well as all related application numbers.               of mechanisms based on information
                                              if required, and/or be maintained at the                   • Related Interactions with FDA. If                 submitted to FDA by CP manufacturers
                                              manufacturing facility, as appropriate.6                the CP manufacturer has had previous                   as well as FDA experience with
                                                 • Premarket Review. CP                               interactions with FDA relevant to the                  manufacturing processes and CGMP
                                              manufacturers should include in their                   proposed mechanism, either for the                     compliance approaches that have been
                                              original submission for NDAs, BLAs,                     product addressed in the submission or                 shown through appropriate data and
                                              ANDAs, and PMAs information on any                      for related products, the CP                           rationales to support the manufacture of
                                              mechanisms for complying with CGMP                      manufacturer should provide reference                  safe and effective products. FDA
                                              requirements. For PMAs, this                            to those interactions. Where applicable,               requests comment from stakeholders
                                              information should be included in the                   the CP manufacturer may cross-                         who believe there are additional types
                                              manufacturing section of the PMA. For                   reference previously submitted                         of combination products and/or
                                              information regarding where to place                    information.                                           manufacturing processes where
                                              information in NDAs, BLAs, or ANDAs,                       • Justification and Scientific Data.                different approaches may be
                                              refer to ‘‘eCTD Technical Conformance                   Include a rationale to support that the                appropriate. When providing such
                                              Guide’’ (Ref. 6).                                       proposed mechanism assures adequate                    feedback, the suggested approach
                                                 • Postmarket Supplements or                          manufacturing control to ensure product                should be:
                                              Notifications to FDA. Postmarket                        safety and effectiveness. When                           • Applicable to a type or range of
                                              changes to implement a combination                      describing a CGMP mechanism in a                       combination products (e.g., not just a
                                                                                                      premarket or postmarket submission,                    single CP manufacturer’s product).
                                                 3 A combination product is assigned to an Agency
                                                                                                      the description should be accompanied                  Commenters should indicate to which
                                              center (Center for Biologics Evaluation and             by data necessary to support the                       types of combination products or
                                              Research, Center for Drug Evaluation and Research,                                                             manufacturing processes they believe
                                              or Center for Devices and Radiological Health) that     approach. When proposing a change
                                              will have primary jurisdiction (i.e., the ‘‘lead        from a CGMP approach that was                          the suggested approach should apply.
                                              Center’’) for that combination product’s review and     reviewed previously by FDA, such                         • Supported by adequate data and
                                              regulation. Assignment of a combination product to      justification should include analysis of               rationales to demonstrate that such an
                                              a lead Center is based on a determination of which                                                             approach would continue to support
                                              constituent part provides the primary mode of           how the proposed approach compares to
                                              action of the combination product (21 U.S.C.            the previously reviewed approach as an                 manufacturing of safe and effective
                                              353(g)).                                                effective manufacturing control,                       combination products. Commenters
                                                 4 When final, this guidance will represent the
                                                                                                      including representative data, as                      should summarize the data and
                                              FDA’s current thinking on this topic.
                                                                                                      appropriate, to substantiate the analysis.             rationale that support the suggested
                                                 5 When final, this guidance will represent the
                                                                                                                                                             approach.
                                              FDA’s current thinking on this topic.
                                                                                                                                                             Any confidential information submitted
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                                                 6 Note that when discussing a mechanism for            7 Requirements for postmarket supplements are

                                              complying with CGMP requirements for which the          contained, for example, in 21 CFR 314.70 (NDAs),       to FDA via the docket should be
                                              CP manufacturer is leveraging information in            21 CFR 601.12 (BLAs), and 21 CFR 814.39 (PMAs).        appropriately identified (see
                                              master file(s), the master file holder must submit a    Any questions on whether FDA review is required        Instructions above, in ADDRESSES).
                                              letter of authorization to permit FDA to review such    for a postmarket CGMP mechanism should be
                                              information (see 21 CFR 314.420(d) and 21 CFR           directed to the lead Center.                           V. Paperwork Reduction Act
                                              814.20(c)). The specific information within the           8 With reference to Ref. 8, when final, this

                                              master file that is being leveraged should be clearly   guidance will represent the FDA’s current thinking       This notice refers to previously
                                              identified to FDA.                                      on this topic.                                         approved collections of information


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                                              27614                        Federal Register / Vol. 83, No. 114 / Wednesday, June 13, 2018 / Notices

                                              found in FDA regulations. These                         document publishes in the Federal                      DEPARTMENT OF HEALTH AND
                                              collections of information are subject to               Register, but websites are subject to                  HUMAN SERVICES
                                              review by the Office of Management and                  change over time.
                                              Budget (OMB) under the Paperwork                                                                               Food and Drug Administration
                                                                                                      1. ‘‘Guidance for Industry and FDA Staff:
                                              Reduction Act of 1995 (44 U.S.C. 3501–                        Current Good Manufacturing Practice
                                              3520). We note that the information                                                                            [Docket No. FDA–2014–D–0223]
                                                                                                            Requirements for Combination
                                              collected under the underlying CGMP                           Products,’’ January 2017. https://               Humanitarian Device Exemption
                                              regulations for drugs, devices, and                           www.fda.gov/RegulatoryInformation/               Program; Draft Guidance for Industry
                                              biological products, including current                        Guidances/ucm126198.htm.                         and Food and Drug Administration
                                              good tissue practices for HCT/Ps, found                 2. ‘‘Guidance for Industry: Q1D Bracketing             Staff; Availability
                                              in parts 211, 820, 600 through 680, and                       and Matrixing Designs for Stability
                                              1271, have already been approved and                          Testing of New Drug Substances and               AGENCY:   Food and Drug Administration,
                                              are in effect. The provisions of part 211                     Products,’’ January 2003. https://www.           HHS.
                                              are approved under the OMB control                            fda.gov/downloads/Drugs/Guidances/               ACTION:   Notice of availability.
                                              number 0910–0139. The provisions of                           ucm073379.pdf.
                                              part 820 are approved under OMB                         3. ‘‘Draft Guidance for Industry: Formal               SUMMARY:   The Food and Drug
                                              control number 0910–0073. The                                 Meetings Between the FDA and Sponsors            Administration (FDA or Agency) is
                                              provisions of parts 606 and 640 are                           or Applicants of PDUFA Products,’’               announcing the availability of the draft
                                              approved under OMB control number                             December 2017. https://www.fda.gov/              guidance entitled ‘‘Humanitarian Device
                                              0910–0116. The provisions of part 610                         downloads/Drugs/GuidanceCompliance               Exemption (HDE) Program.’’ This draft
                                              are approved under OMB control                                RegulatoryInformation/Guidances/                 guidance concerns the HDE program as
                                              number 0910–0116 and OMB control                              UCM590547.pdf.                                   a whole and, among other topics, it
                                              number 0910–0338 (also for part 680).                   4. ‘‘Draft Guidance for Industry: Formal               explains the criteria FDA considers to
                                              The provisions of part 1271, subparts C                       Meetings Between FDA and ANDA                    determine if ‘‘probable benefit’’ has
                                              and D, are approved under OMB control                         Applicants of Complex Products Under             been demonstrated as part of the
                                              number 0910–0543.                                             GDUFA,’’ October 2017. https://
                                                                                                                                                             Agency’s decision-making process
                                                We note that the information                                www.fda.gov/downloads/drugs/guidance
                                                                                                                                                             regarding marketing authorization for a
                                              collected under the related submission                        complianceregulatoryinformation/
                                                                                                                                                             humanitarian use device (HUD). The
                                              types have already been approved and                          guidances/ucm578366.pdf.
                                                                                                      5. ‘‘Guidance for Industry and Food and Drug
                                                                                                                                                             draft guidance also incorporates recent
                                              are in effect. The collections of                                                                              amendments to the Federal Food, Drug,
                                              information regarding formal meetings                         Administration Staff: Requests for
                                                                                                            Feedback on Medical Device                       and Cosmetic Act (FD&C Act) that affect
                                              with sponsors and applicants have been                                                                         the HDE program and answers other
                                                                                                            Submissions: The Pre-Submission
                                              approved under OMB control number                                                                              common questions that we receive
                                                                                                            Program and Meetings with Food and
                                              0910–0429. The collections of                                                                                  about the program. This draft guidance
                                                                                                            Drug Administration Staff,’’ September
                                              information regarding new drug                                                                                 is not final nor is it in effect at this time.
                                                                                                            2017. https://www.fda.gov/downloads/
                                              approvals (NDA) and abbreviated new
                                                                                                            medicaldevices/deviceregulationand               DATES: Submit either electronic or
                                              drug applications (ANDA) have been                            guidance/guidancedocuments/                      written comments on the draft guidance
                                              approved under OMB control number                             ucm311176.pdf.                                   by August 13, 2018 to ensure that the
                                              0910–0001. The collections of                           6. ‘‘eCTD Technical Conformance Guide,’’
                                              information regarding pre-ANDAs have                                                                           Agency considers your comment on this
                                                                                                            November 2017. https://www.fda.gov/              draft guidance before it begins work on
                                              been approved under OMB control                               downloads/Drugs/UCM465411.pdf.
                                              number 0910–0797. The collections of                                                                           the final version of the guidance.
                                                                                                      7. ‘‘Guidance for Industry: Changes to an
                                              information regarding pre-submissions                                                                          ADDRESSES: You may submit comments
                                                                                                            Approved NDA or ANDA,’’ April 2004.
                                              have been approved under OMB control                          https://www.fda.gov/downloads/drugs/
                                                                                                                                                             on any guidance at any time as follows:
                                              number 0910–0756. The collections of                          guidancecomplianceregulatory                     Electronic Submissions
                                              information regarding PMAs have been                          information/guidances/ucm077097.pdf.
                                              approved under OMB control number                       8. ‘‘Draft Guidance for Industry: Chemistry,             Submit electronic comments in the
                                              0910–0231. The collections of                                 Manufacturing, and Controls Changes to           following way:
                                              information for premarket notification                        an Approved Application: Certain                   • Federal eRulemaking Portal:
                                              (510(k)) have been approved under                             Biological Products,’’ December 2017.            https://www.regulations.gov. Follow the
                                              OMB control number 0910–0120. The                             https://www.fda.gov/downloads/                   instructions for submitting comments.
                                              collections of information for the de                         BiologicsBloodVaccines/Guidance                  Comments submitted electronically,
                                              novo classification process have been                         ComplianceRegulatoryInformation/                 including attachments, to https://
                                              approved under OMB control number                             Guidances/General/UCM590118.pdf.                 www.regulations.gov will be posted to
                                              0910–0844. The collections of                           9. ‘‘Guidance for Industry and FDA Staff: 30-          the docket unchanged. Because your
                                              information regarding biologics license                       Day Notices, 135-Day Premarket                   comment will be made public, you are
                                              applications have been approved under                         Approval (PMA) Supplements and 75-               solely responsible for ensuring that your
                                              OMB control number 0910–0338.                                 Day Humanitarian Device Exemption                comment does not include any
                                                                                                            (HDE) Supplements for Manufacturing              confidential information that you or a
                                              VI. References                                                Method or Process Changes,’’ April 2011.         third party may not wish to be posted,
                                                The following references are on                             https://www.fda.gov/downloads/Medical            such as medical information, your or
                                              display in the Dockets Management                             Devices/DeviceRegulationandGuidance/             anyone else’s Social Security number, or
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                                              Staff (see ADDRESSES) and are available                       GuidanceDocuments/UCM080194.pdf.                 confidential business information, such
                                              for viewing by interested persons                         Dated: June 7, 2018.
                                                                                                                                                             as a manufacturing process. Please note
                                              between 9 a.m. and 4 p.m., Monday                                                                              that if you include your name, contact
                                                                                                      Leslie Kux,
                                              through Friday; they are also available                                                                        information, or other information that
                                              electronically at https://                              Associate Commissioner for Policy.                     identifies you in the body of your
                                              www.regulations.gov. FDA has verified                   [FR Doc. 2018–12634 Filed 6–12–18; 8:45 am]            comments, that information will be
                                              the website addresses, as of the date this              BILLING CODE 4164–01–P                                 posted on https://www.regulations.gov.


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Document Created: 2018-06-12 23:58:56
Document Modified: 2018-06-12 23:58:56
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.
DatesSubmit either electronic or written comments on this notice by September 11, 2018 to ensure that the Agency considers your comment on this proposed list before it begins work on the final list.
ContactMelissa Burns, Office of Combination Products, Food and Drug Administration, 10903 New Hampshire Ave., Bldg. 32, Rm. 5125, Silver Spring, MD 20993, 301-795-5616, [email protected]
FR Citation83 FR 27609 

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