83_FR_55939 83 FR 55723 - Agency Information Collection Activities; Proposed Collection; Comment Request; Individual Patient Expanded Access Applications: Form FDA 3926

83 FR 55723 - Agency Information Collection Activities; Proposed Collection; Comment Request; Individual Patient Expanded Access Applications: Form FDA 3926

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Food and Drug Administration

Federal Register Volume 83, Issue 216 (November 7, 2018)

Page Range55723-55726
FR Document2018-24321

The Food and Drug Administration (FDA, Agency, or we) is announcing an opportunity for public comment on the proposed collection of certain information by the Agency. Under the Paperwork Reduction Act of 1995 (PRA), Federal Agencies are required to publish notice in the Federal Register concerning each proposed collection of information, including each proposed extension of an existing collection of information, and to allow 60 days for public comment in response to the notice. This notice solicits comments on individual patient expanded access applications.

Federal Register, Volume 83 Issue 216 (Wednesday, November 7, 2018)
[Federal Register Volume 83, Number 216 (Wednesday, November 7, 2018)]
[Notices]
[Pages 55723-55726]
From the Federal Register Online  [www.thefederalregister.org]
[FR Doc No: 2018-24321]


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

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Food and Drug Administration

[Docket No. FDA-2018-N-3758]


Agency Information Collection Activities; Proposed Collection; 
Comment Request; Individual Patient Expanded Access Applications: Form 
FDA 3926

AGENCY: Food and Drug Administration, HHS.

ACTION: Notice.

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

SUMMARY: The Food and Drug Administration (FDA, Agency, or we) is 
announcing an opportunity for public comment on the proposed collection 
of certain information by the Agency. Under the Paperwork Reduction Act 
of 1995 (PRA), Federal Agencies are required to publish notice in the 
Federal Register concerning each proposed collection of information, 
including each proposed extension of an existing collection of 
information, and to allow 60 days for public comment in response to the 
notice. This notice solicits comments on individual patient expanded 
access applications.

DATES: Submit either electronic or written comments on the collection 
of information by January 7, 2019.

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 January 7, 2019. The https://www.regulations.gov electronic filing system will accept comments until 
11:59 p.m. Eastern Time at the end of January 7, 2019. 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

[[Page 55724]]

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 identified, 
as confidential, if submitted as detailed in ``Instructions.''
    Instructions: All submissions received must include the Docket No. 
FDA-2018-N-3758 for ``Agency Information Collection Activities; 
Proposed Collection; Comment Request; Guidance for Industry on 
Individual Patient Expanded Access Applications: Form FDA 3926.'' 
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: Domini Bean, Office of Operations, 
Food and Drug Administration, Three White Flint North, 10A-12M, 11601 
Landsdown St., North Bethesda, MD 20852, 301-796-5733, 
PRAStaff@fda.hhs.gov.

SUPPLEMENTARY INFORMATION: Under the PRA (44 U.S.C. 3501-3520), Federal 
Agencies must obtain approval from the Office of Management and Budget 
(OMB) for each collection of information they conduct or sponsor. 
``Collection of information'' is defined in 44 U.S.C. 3502(3) and 5 CFR 
1320.3(c) and includes Agency requests or requirements that members of 
the public submit reports, keep records, or provide information to a 
third party. Section 3506(c)(2)(A) of the PRA (44 U.S.C. 3506(c)(2)(A)) 
requires Federal Agencies to provide a 60-day notice in the Federal 
Register concerning each proposed collection of information, including 
each proposed extension of an existing collection of information, 
before submitting the collection to OMB for approval. To comply with 
this requirement, FDA is publishing notice of the proposed collection 
of information set forth in this document.
    With respect to the following collection of information, FDA 
invites comments on these topics: (1) Whether the proposed collection 
of information is necessary for the proper performance of FDA's 
functions, including whether the information will have practical 
utility; (2) the accuracy of FDA's estimate of the burden of the 
proposed collection of information, including the validity of the 
methodology and assumptions used; (3) ways to enhance the quality, 
utility, and clarity of the information to be collected; and (4) ways 
to minimize the burden of the collection of information on respondents, 
including through the use of automated collection techniques, when 
appropriate, and other forms of information technology.

Guidance for Industry on Individual Patient Expanded Access 
Applications: Form FDA 3926

OMB Control Number 0910-0814--Extension

    This information collection supports Agency regulations, associated 
guidance, and Form FDA 3926 concerning individual patient expanded 
access. Individual patient expanded access allows an individual patient 
who has a serious or immediately life-threatening disease or condition 
and there is no comparable or satisfactory alternative therapy to 
diagnose, monitor, or treat the disease or condition, the use of an 
investigational new drug (IND) outside of a clinical investigation, or 
the use of an approved drug where availability is limited by a risk 
evaluation and mitigation strategy. When applicable criteria in Sec.  
312.305(a) (21 CFR 312.305(a)) (which apply to all types of expanded 
access) and the criteria in Sec.  312.310(a) (21 CFR 312.310(a)) (which 
apply specifically to individual patient expanded access, including for 
emergency use) are met, FDA may permit expanded access.
    Section 312.305(b) sets forth the submission requirements for all 
types of expanded access requests. To assist respondents with 
requirements in Sec.  312.305 we developed Form FDA 3926 (Individual 
Patient Expanded Access Investigational New Drug Application) and the 
guidance document entitled, ``Individual Patient Expanded Access 
Applications: Form FDA 3926.''
    The physician may satisfy some of the submission requirements by 
referring to information in an existing IND, ordinarily the one held by 
the investigational drug's manufacturer, if the physician obtains 
permission from that IND holder. If permission is obtained, the 
physician should then provide to FDA a letter of authorization (LOA) 
from the existing IND holder that permits FDA to reference that IND.
    One of the requirements under Sec.  312.305(b)(2) is that a ``cover 
sheet'' must be included ``meeting the requirements of Sec.  
312.23(a).'' This provision applies to several types of submissions 
under part 312 (21 CFR part 312), ranging from commercial INDs under 
Sec.  312.23 that involve large groups of patients enrolled in clinical 
trials to requests from physicians to use an investigational drug for 
an individual

[[Page 55725]]

patient. Sponsors currently use Form FDA 1571 for all types of IND 
submissions to meet the requirements in Sec.  312.23(a).
    Concerned that physicians requesting expanded access for an 
individual patient may encounter difficulty in completing Form FDA 1571 
and the associated documents because the form is not tailored to 
requests for individual patient expanded access, we developed Form FDA 
3926 to comply with the IND submission requirements in Sec. Sec.  
312.23, 312.305(b), and 312.310(b). Form FDA 3926 provides a 
streamlined means to request expanded access and is available for 
licensed physicians. FDA considers a completed Form FDA 3926 with the 
box in Field 10 checked and the form signed by the physician to be a 
request in accordance with Sec.  312.10 for a waiver of any additional 
requirements in part 312 for an IND submission, including additional 
information currently provided in Form FDA 1571 and Form FDA 1572 
(Statement of Investigator, which provides the identity and 
qualifications of the investigator conducting the clinical 
investigation).
    Under Sec.  312.310(d), in an emergency situation that requires the 
patient to be treated before a written submission can be made, the 
request to use the investigational drug for individual patient expanded 
access may be made by telephone (or other rapid means of communication) 
to the appropriate FDA review division. Authorization of the emergency 
use may be given by an FDA official over the telephone, provided the 
physician explains how the expanded access use will meet the 
requirements of Sec. Sec.  312.305 and 312.310 and agrees to submit an 
expanded access application within 15 working days of FDA's initial 
authorization of the expanded access use (Sec.  312.310(d)). The 
physician may choose to use Form FDA 3926 for the expanded access 
application.
    As explained in the instructions for Form FDA 3926 and discussed in 
the guidance document, the following information is submitted to FDA:
     Initials for the patient and date of submission.
     Type of submission (initial or follow-up submission).
     Clinical information, including indication, brief clinical 
history of the patient (age, gender, weight, allergies, diagnosis, 
prior therapy, response to prior therapy), and the reason for 
requesting the proposed treatment, including an explanation of why the 
patient lacks other therapeutic options.
     Treatment information, including the investigational 
drug's name and the name of the entity supplying the drug (generally 
the manufacturer), the applicable FDA review division (if known), and 
the treatment plan. This should include the planned dose, route and 
schedule of administration, planned duration of treatment, monitoring 
procedures, and planned modifications to the treatment plan in the 
event of toxicity.
     LOA, generally obtained from the entity that is the 
sponsor of the IND (e.g., commercial sponsor/drug manufacturer) being 
referenced, if applicable.
     Physician's qualification statement. An appropriate 
statement includes medical school attended, year of graduation, medical 
specialty, State medical license number, current employment, and job 
title. Alternatively, the relevant portion of the physician's 
curriculum vitae may be attached.
     Physician's contact information, including name, physical 
address, email address, telephone number, facsimile number, and 
physician's IND number, if previously issued by FDA.
     Contents of submission (for follow-up/additional 
submissions), including the type of submission being made. FDA accepts 
Form FDA 3926 for certain follow-up/additional submissions, which 
include the following: Initial Written IND Safety Report (Sec.  
312.32(c)); Followup to a Written IND Safety Report (Sec.  312.32(d)); 
Annual Report (Sec.  312.33); Summary of Expanded Access Use (treatment 
completed) (Sec.  312.310(c)(2)); Change in Treatment Plan (Sec.  
312.30); General Correspondence or Response to FDA Request for 
Information (Sec.  312.41); and Response to Clinical Hold (Sec.  
312.42(e)).
     Request for authorization to use Form FDA 3926 for 
individual patient expanded access application.
     Signature of the physician certifying that treatment will 
not begin until 30 days after FDA receives the completed application 
and all required material unless the submitting physician receives 
earlier notification from FDA that the treatment may proceed. The 
physician agrees not to begin or continue clinical investigations 
covered by the IND if those studies are placed on clinical hold. The 
physician also certifies that informed consent will be obtained in 
compliance with Federal requirements (including FDA's regulations in 21 
CFR part 50) and that an institutional review board (IRB) that complies 
with all Federal requirements (including FDA's regulations in 21 CFR 
part 56) will be responsible for initial and continuing review and 
approval of the expanded access use. The physician also acknowledges 
that in the case of an emergency request, treatment may begin without 
prior IRB approval, provided the IRB is notified of the emergency 
treatment within 5 working days of treatment. The physician agrees to 
conduct the investigation in accordance with all other applicable 
regulatory requirements.
    We estimate the burden of this collection of information as 
follows:

                                                     Table 1--Estimated Annual Reporting Burden \1\
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                  Number of
   Guidance on Individual Patient  Expanded       Number of     responses per   Total annual         Average  burden per  response          Total hours
     Access  Applications: Form FDA 3926         respondents     respondent       responses
--------------------------------------------------------------------------------------------------------------------------------------------------------
Expanded access submission elements included              790            3.03           2,394  0.75 (45 mins.)..........................           1,795
 in Form FDA 3926.
--------------------------------------------------------------------------------------------------------------------------------------------------------
\1\ There are no capital costs or operating and maintenance costs associated with this collection of information.

    Based on a review of the information collection, we are retaining 
the currently approved burden estimate. The estimates for ``number of 
respondents,'' ``number of responses per respondent,'' and ``total 
annual responses'' were obtained from reports and data management 
systems from the Center for Drug Evaluation and Research (CDER) and 
from other sources familiar with the number of submissions received for 
individual patient expanded access use under part 312. The estimates 
for ``average burden per response'' were based on information CDER 
provided and personnel of the U.S. Department of Health and Human 
Services familiar with preparing and reviewing expanded access 
submissions by practicing physicians.

[[Page 55726]]

    Based on data from the Document Archiving, Reporting and Regulatory 
Tracking System for the number of submissions to FDA using FDA Form 
3926 during fiscal years 2015, 2016, and 2017, we estimate that 
approximately 790 licensed physicians would use FDA Form 3926 to submit 
1.46 requests per physician (respondent) for individual patient 
expanded access, for a total of 1,153 responses annually. Based on 
these estimates, FDA calculates the total annual responses to be 2,394 
(1,153 requests for individual patient expanded access and 1,241 
follow-up submissions) by 790 physicians for an average of 3.03 
responses per respondent. FDA estimates the average burden per response 
to be 45 minutes (0.75 hour). Based on this estimate, FDA calculates 
the total burden to be 1,795 hours.

    Dated: October 31, 2018.
Leslie Kux,
Associate Commissioner for Policy.
[FR Doc. 2018-24321 Filed 11-6-18; 8:45 am]
 BILLING CODE 4164-01-P



                                                                       Federal Register / Vol. 83, No. 216 / Wednesday, November 7, 2018 / Notices                                           55723

                                              Staff, 5630 Fishers Lane, Rm. 1061,                     adherence to those principles into its                DEPARTMENT OF HEALTH AND
                                              Rockville, MD 20852.                                    decision-making process.                              HUMAN SERVICES
                                                You may submit comments on any                           This draft guidance is being issued to
                                              guidance at any time (see 21 CFR                                                                              Food and Drug Administration
                                                                                                      fulfill a commitment made under the
                                              10.115(g)(5)). Submit written requests                  Prescription Drug User Fee V agreement                [Docket No. FDA–2018–N–3758]
                                              for single copies of the draft guidance to              (section IX.B.3 of the document entitled
                                              the Division of Drug Information, Center                ‘‘PDUFA Reauthorization Performance                   Agency Information Collection
                                              for Drug Evaluation and Research, Food                                                                        Activities; Proposed Collection;
                                                                                                      Goals and Procedures Fiscal Years 2013
                                              and Drug Administration, 10001 New                                                                            Comment Request; Individual Patient
                                                                                                      through 2017’’) to promote a better
                                              Hampshire Ave., Hillandale Building,                                                                          Expanded Access Applications: Form
                                                                                                      understanding and increased                           FDA 3926
                                              4th Floor, Silver Spring, MD 20993–
                                                                                                      consistency among the Agency, industry
                                              0002; or to the Office of                                                                                     AGENCY:   Food and Drug Administration,
                                                                                                      and other stakeholders regarding meta-
                                              Communication, Outreach, and                                                                                  HHS.
                                              Development, Center for Biologics                       analyses and their role in regulatory
                                                                                                      decision-making.                                      ACTION:   Notice.
                                              Evaluation and Research, Food and
                                              Drug Administration, 10903 New                             This draft guidance is being issued                SUMMARY:   The Food and Drug
                                              Hampshire Ave., Bldg. 71, Rm. 3128,                     consistent with FDA’s good guidance                   Administration (FDA, Agency, or we) is
                                              Silver Spring, MD 20993–0002. Send                      practices regulation (21 CFR 10.115).                 announcing an opportunity for public
                                              one self-addressed adhesive label to                    The draft guidance, when finalized, will              comment on the proposed collection of
                                              assist that office in processing your                   represent the current thinking of FDA                 certain information by the Agency.
                                              requests. See the SUPPLEMENTARY                         on ‘‘Meta-Analyses of Randomized                      Under the Paperwork Reduction Act of
                                              INFORMATION section for electronic                      Controlled Clinical Trials to Evaluate                1995 (PRA), Federal Agencies are
                                              access to the draft guidance document.                  the Safety of Human Drugs or Biological               required to publish notice in the
                                              FOR FURTHER INFORMATION CONTACT:                        Products.’’ It does not establish any                 Federal Register concerning each
                                              Scott N. Goldie, Office of Biostatistics,               rights for any person and is not binding              proposed collection of information,
                                              Center for Drug Evaluation and                          on FDA or the public. You can use an                  including each proposed extension of an
                                              Research, Food and Drug                                 alternative approach if it satisfies the              existing collection of information, and
                                              Administration, 10903 New Hampshire                     requirements of the applicable statutes               to allow 60 days for public comment in
                                              Ave., Bldg. 21, Rm. 3557, Silver Spring,                and regulations. This guidance is not                 response to the notice. This notice
                                              MD 20993–0002, 301–796–2055; or                         subject to Executive Order 12866.                     solicits comments on individual patient
                                              Stephen Ripley, Center for Biologics                                                                          expanded access applications.
                                              Evaluation and Research, Food and                       II. Paperwork Reduction Act of 1995                   DATES: Submit either electronic or
                                              Drug Administration, 10903 New                                                                                written comments on the collection of
                                                                                                        This draft guidance refers to                       information by January 7, 2019.
                                              Hampshire Ave., Bldg. 71, Rm. 7301,
                                                                                                      previously approved collections of
                                              Silver Spring, MD 20993–0002, 240–                                                                            ADDRESSES: You may submit comments
                                                                                                      information that are subject to review by             as follows. Please note that late,
                                              402–7911.
                                                                                                      the Office of Management and Budget                   untimely filed comments will not be
                                              SUPPLEMENTARY INFORMATION:                              (OMB) under the Paperwork Reduction                   considered. Electronic comments must
                                              I. Background                                           Act of 1995 (44 U.S.C. 3501–3520). The                be submitted on or before January 7,
                                                                                                      collections of information in 21 CFR                  2019. The https://www.regulations.gov
                                                FDA is announcing the availability of                 parts 312, 314, and 601 have been                     electronic filing system will accept
                                              a draft guidance for industry entitled                  approved under OMB control numbers                    comments until 11:59 p.m. Eastern Time
                                              ‘‘Meta-Analyses of Randomized                           0910–0014, 0910–0001, and 0910–0338                   at the end of January 7, 2019. Comments
                                              Controlled Clinical Trials to Evaluate                  respectively.                                         received by mail/hand delivery/courier
                                              the Safety of Human Drugs or Biological
                                                                                                                                                            (for written/paper submissions) will be
                                              Products.’’ Evaluating the safety of drug               III. Electronic Access
                                                                                                                                                            considered timely if they are
                                              products, both before approval and after
                                                                                                        Persons with access to the internet                 postmarked or the delivery service
                                              marketing, is a fundamental
                                                                                                      may obtain the draft guidance at either               acceptance receipt is on or before that
                                              responsibility of the FDA. This
                                                                                                      https://www.fda.gov/Drugs/Guidance                    date.
                                              evaluation often requires combining and
                                              integrating information from multiple                   ComplianceRegulatoryInformation/                      Electronic Submissions
                                              sources, and meta-analysis is a useful                  Guidances/default.htm, https://                         Submit electronic comments in the
                                              tool for this purpose.                                  www.fda.gov/BiologicsBloodVaccines/                   following way:
                                                This draft guidance describes general                 GuidanceComplianceRegulatory                            • Federal eRulemaking Portal:
                                              principles of design, conduct, and                      Information/Guidances/default.htm, or                 https://www.regulations.gov. Follow the
                                              reporting that FDA intends to apply to                  https://www.regulations.gov.                          instructions for submitting comments.
                                              meta-analyses conducted by the Agency,                    Dated: November 1, 2018.                            Comments submitted electronically,
                                              and to use as benchmarks when                           Leslie Kux,                                           including attachments, to https://
                                              evaluating meta-analyses conducted by                                                                         www.regulations.gov will be posted to
                                                                                                      Associate Commissioner for Policy.
                                              sponsors or third parties. The focus of                                                                       the docket unchanged. Because your
                                                                                                      [FR Doc. 2018–24316 Filed 11–6–18; 8:45 am]
                                              the draft guidance is on the evaluation                                                                       comment will be made public, you are
amozie on DSK3GDR082PROD with NOTICES1




                                              of safety. This draft guidance is not                   BILLING CODE 4164–01–P                                solely responsible for ensuring that your
                                              intended to be a reference guide on how                                                                       comment does not include any
                                              to conduct a meta-analysis. Rather, this                                                                      confidential information that you or a
                                              draft guidance document discusses the                                                                         third party may not wish to be posted,
                                              important principles underlying best                                                                          such as medical information, your or
                                              practices for safety meta-analyses and                                                                        anyone else’s Social Security number, or
                                              the way that FDA intends to factor                                                                            confidential business information, such


                                         VerDate Sep<11>2014   17:46 Nov 06, 2018   Jkt 247001   PO 00000   Frm 00036   Fmt 4703   Sfmt 4703   E:\FR\FM\07NON1.SGM   07NON1


                                              55724                    Federal Register / Vol. 83, No. 216 / Wednesday, November 7, 2018 / Notices

                                              as a manufacturing process. Please note                 in the body of your comments and you                  ways to minimize the burden of the
                                              that if you include your name, contact                  must identify this information as                     collection of information on
                                              information, or other information that                  ‘‘confidential.’’ Any information marked              respondents, including through the use
                                              identifies you in the body of your                      as ‘‘confidential’’ will not be disclosed             of automated collection techniques,
                                              comments, that information will be                      except in accordance with 21 CFR 10.20                when appropriate, and other forms of
                                              posted on https://www.regulations.gov.                  and other applicable disclosure law. For              information technology.
                                                • If you want to submit a comment                     more information about FDA’s posting
                                              with confidential information that you                  of comments to public dockets, see 80                 Guidance for Industry on Individual
                                              do not wish to be made available to the                 FR 56469, September 18, 2015, or access               Patient Expanded Access Applications:
                                              public, submit the comment as a                         the information at: https://www.gpo.gov/              Form FDA 3926
                                              written/paper submission and in the                     fdsys/pkg/FR-2015-09-18/pdf/2015-                     OMB Control Number 0910–0814—
                                              manner detailed (see ‘‘Written/Paper                    23389.pdf.                                            Extension
                                              Submissions’’ and ‘‘Instructions’’).                       Docket: For access to the docket to
                                                                                                                                                               This information collection supports
                                                                                                      read background documents or the
                                              Written/Paper Submissions                                                                                     Agency regulations, associated
                                                                                                      electronic and written/paper comments
                                                 Submit written/paper submissions as                                                                        guidance, and Form FDA 3926
                                                                                                      received, go to https://
                                              follows:                                                                                                      concerning individual patient expanded
                                                                                                      www.regulations.gov and insert the
                                                 • Mail/Hand Delivery/Courier (for                    docket number, found in brackets in the
                                                                                                                                                            access. Individual patient expanded
                                              written/paper submissions): Dockets                                                                           access allows an individual patient who
                                                                                                      heading of this document, into the
                                              Management Staff (HFA–305), Food and                                                                          has a serious or immediately life-
                                                                                                      ‘‘Search’’ box and follow the prompts
                                              Drug Administration, 5630 Fishers                                                                             threatening disease or condition and
                                                                                                      and/or go to the Dockets Management
                                              Lane, Rm. 1061, Rockville, MD 20852.                                                                          there is no comparable or satisfactory
                                                                                                      Staff, 5630 Fishers Lane, Rm. 1061,
                                                 • For written/paper comments                         Rockville, MD 20852.
                                                                                                                                                            alternative therapy to diagnose, monitor,
                                              submitted to the Dockets Management                                                                           or treat the disease or condition, the use
                                                                                                      FOR FURTHER INFORMATION CONTACT:
                                              Staff, FDA will post your comment, as                                                                         of an investigational new drug (IND)
                                              well as any attachments, except for                     Domini Bean, Office of Operations,                    outside of a clinical investigation, or the
                                              information submitted, marked and                       Food and Drug Administration, Three                   use of an approved drug where
                                              identified, as confidential, if submitted               White Flint North, 10A–12M, 11601                     availability is limited by a risk
                                              as detailed in ‘‘Instructions.’’                        Landsdown St., North Bethesda, MD                     evaluation and mitigation strategy.
                                                 Instructions: All submissions received               20852, 301–796–5733, PRAStaff@                        When applicable criteria in § 312.305(a)
                                              must include the Docket No. FDA–                        fda.hhs.gov.                                          (21 CFR 312.305(a)) (which apply to all
                                              2018–N–3758 for ‘‘Agency Information                    SUPPLEMENTARY INFORMATION: Under the                  types of expanded access) and the
                                              Collection Activities; Proposed                         PRA (44 U.S.C. 3501–3520), Federal                    criteria in § 312.310(a) (21 CFR
                                              Collection; Comment Request; Guidance                   Agencies must obtain approval from the                312.310(a)) (which apply specifically to
                                              for Industry on Individual Patient                      Office of Management and Budget                       individual patient expanded access,
                                              Expanded Access Applications: Form                      (OMB) for each collection of                          including for emergency use) are met,
                                              FDA 3926.’’ Received comments, those                    information they conduct or sponsor.                  FDA may permit expanded access.
                                              filed in a timely manner (see                           ‘‘Collection of information’’ is defined                 Section 312.305(b) sets forth the
                                              ADDRESSES), will be placed in the docket                in 44 U.S.C. 3502(3) and 5 CFR                        submission requirements for all types of
                                              and, except for those submitted as                      1320.3(c) and includes Agency requests                expanded access requests. To assist
                                              ‘‘Confidential Submissions,’’ publicly                  or requirements that members of the                   respondents with requirements in
                                              viewable at https://www.regulations.gov                 public submit reports, keep records, or               § 312.305 we developed Form FDA 3926
                                              or at the Dockets Management Staff                      provide information to a third party.                 (Individual Patient Expanded Access
                                              between 9 a.m. and 4 p.m., Monday                       Section 3506(c)(2)(A) of the PRA (44                  Investigational New Drug Application)
                                              through Friday.                                         U.S.C. 3506(c)(2)(A)) requires Federal                and the guidance document entitled,
                                                 • Confidential Submissions—To                        Agencies to provide a 60-day notice in                ‘‘Individual Patient Expanded Access
                                              submit a comment with confidential                      the Federal Register concerning each                  Applications: Form FDA 3926.’’
                                              information that you do not wish to be                  proposed collection of information,                      The physician may satisfy some of the
                                              made publicly available, submit your                    including each proposed extension of an               submission requirements by referring to
                                              comments only as a written/paper                        existing collection of information,                   information in an existing IND,
                                              submission. You should submit two                       before submitting the collection to OMB               ordinarily the one held by the
                                              copies total. One copy will include the                 for approval. To comply with this                     investigational drug’s manufacturer, if
                                              information you claim to be confidential                requirement, FDA is publishing notice                 the physician obtains permission from
                                              with a heading or cover note that states                of the proposed collection of                         that IND holder. If permission is
                                              ‘‘THIS DOCUMENT CONTAINS                                information set forth in this document.               obtained, the physician should then
                                              CONFIDENTIAL INFORMATION.’’ The                            With respect to the following                      provide to FDA a letter of authorization
                                              Agency will review this copy, including                 collection of information, FDA invites                (LOA) from the existing IND holder that
                                              the claimed confidential information, in                comments on these topics: (1) Whether                 permits FDA to reference that IND.
                                              its consideration of comments. The                      the proposed collection of information                   One of the requirements under
                                              second copy, which will have the                        is necessary for the proper performance               § 312.305(b)(2) is that a ‘‘cover sheet’’
                                              claimed confidential information                        of FDA’s functions, including whether                 must be included ‘‘meeting the
                                              redacted/blacked out, will be available                 the information will have practical                   requirements of § 312.23(a).’’ This
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                                              for public viewing and posted on                        utility; (2) the accuracy of FDA’s                    provision applies to several types of
                                              https://www.regulations.gov. Submit                     estimate of the burden of the proposed                submissions under part 312 (21 CFR
                                              both copies to the Dockets Management                   collection of information, including the              part 312), ranging from commercial
                                              Staff. If you do not wish your name and                 validity of the methodology and                       INDs under § 312.23 that involve large
                                              contact information to be made publicly                 assumptions used; (3) ways to enhance                 groups of patients enrolled in clinical
                                              available, you can provide this                         the quality, utility, and clarity of the              trials to requests from physicians to use
                                              information on the cover sheet and not                  information to be collected; and (4)                  an investigational drug for an individual


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                                                                        Federal Register / Vol. 83, No. 216 / Wednesday, November 7, 2018 / Notices                                                 55725

                                              patient. Sponsors currently use Form                        As explained in the instructions for               accepts Form FDA 3926 for certain
                                              FDA 1571 for all types of IND                            Form FDA 3926 and discussed in the                    follow-up/additional submissions,
                                              submissions to meet the requirements in                  guidance document, the following                      which include the following: Initial
                                              § 312.23(a).                                             information is submitted to FDA:                      Written IND Safety Report (§ 312.32(c));
                                                 Concerned that physicians requesting                     • Initials for the patient and date of             Followup to a Written IND Safety
                                              expanded access for an individual                        submission.                                           Report (§ 312.32(d)); Annual Report
                                              patient may encounter difficulty in                         • Type of submission (initial or                   (§ 312.33); Summary of Expanded
                                              completing Form FDA 1571 and the                         follow-up submission).                                Access Use (treatment completed)
                                              associated documents because the form                       • Clinical information, including                  (§ 312.310(c)(2)); Change in Treatment
                                              is not tailored to requests for individual               indication, brief clinical history of the             Plan (§ 312.30); General Correspondence
                                              patient expanded access, we developed                    patient (age, gender, weight, allergies,              or Response to FDA Request for
                                              Form FDA 3926 to comply with the IND                     diagnosis, prior therapy, response to                 Information (§ 312.41); and Response to
                                              submission requirements in §§ 312.23,                    prior therapy), and the reason for                    Clinical Hold (§ 312.42(e)).
                                              312.305(b), and 312.310(b). Form FDA                     requesting the proposed treatment,
                                              3926 provides a streamlined means to                     including an explanation of why the                      • Request for authorization to use
                                              request expanded access and is                           patient lacks other therapeutic options.              Form FDA 3926 for individual patient
                                              available for licensed physicians. FDA                      • Treatment information, including                 expanded access application.
                                              considers a completed Form FDA 3926                      the investigational drug’s name and the                  • Signature of the physician
                                              with the box in Field 10 checked and                     name of the entity supplying the drug                 certifying that treatment will not begin
                                              the form signed by the physician to be                   (generally the manufacturer), the                     until 30 days after FDA receives the
                                              a request in accordance with § 312.10                    applicable FDA review division (if                    completed application and all required
                                              for a waiver of any additional                           known), and the treatment plan. This                  material unless the submitting
                                              requirements in part 312 for an IND                      should include the planned dose, route                physician receives earlier notification
                                              submission, including additional                         and schedule of administration, planned               from FDA that the treatment may
                                              information currently provided in Form                   duration of treatment, monitoring                     proceed. The physician agrees not to
                                              FDA 1571 and Form FDA 1572                               procedures, and planned modifications                 begin or continue clinical investigations
                                              (Statement of Investigator, which                        to the treatment plan in the event of                 covered by the IND if those studies are
                                              provides the identity and qualifications                 toxicity.                                             placed on clinical hold. The physician
                                              of the investigator conducting the                          • LOA, generally obtained from the                 also certifies that informed consent will
                                              clinical investigation).                                 entity that is the sponsor of the IND                 be obtained in compliance with Federal
                                                 Under § 312.310(d), in an emergency                   (e.g., commercial sponsor/drug                        requirements (including FDA’s
                                              situation that requires the patient to be                manufacturer) being referenced, if                    regulations in 21 CFR part 50) and that
                                              treated before a written submission can                  applicable.                                           an institutional review board (IRB) that
                                              be made, the request to use the                             • Physician’s qualification statement.             complies with all Federal requirements
                                              investigational drug for individual                      An appropriate statement includes                     (including FDA’s regulations in 21 CFR
                                              patient expanded access may be made                      medical school attended, year of                      part 56) will be responsible for initial
                                              by telephone (or other rapid means of                    graduation, medical specialty, State                  and continuing review and approval of
                                              communication) to the appropriate FDA                    medical license number, current                       the expanded access use. The physician
                                              review division. Authorization of the                    employment, and job title.                            also acknowledges that in the case of an
                                              emergency use may be given by an FDA                     Alternatively, the relevant portion of the
                                              official over the telephone, provided the                                                                      emergency request, treatment may begin
                                                                                                       physician’s curriculum vitae may be
                                              physician explains how the expanded                                                                            without prior IRB approval, provided
                                                                                                       attached.
                                                                                                                                                             the IRB is notified of the emergency
                                              access use will meet the requirements of                    • Physician’s contact information,
                                              §§ 312.305 and 312.310 and agrees to                     including name, physical address, email               treatment within 5 working days of
                                              submit an expanded access application                    address, telephone number, facsimile                  treatment. The physician agrees to
                                              within 15 working days of FDA’s initial                  number, and physician’s IND number, if                conduct the investigation in accordance
                                              authorization of the expanded access                     previously issued by FDA.                             with all other applicable regulatory
                                              use (§ 312.310(d)). The physician may                       • Contents of submission (for follow-              requirements.
                                              choose to use Form FDA 3926 for the                      up/additional submissions), including                    We estimate the burden of this
                                              expanded access application.                             the type of submission being made. FDA                collection of information as follows:

                                                                                              TABLE 1—ESTIMATED ANNUAL REPORTING BURDEN 1
                                                            Guidance on Individual Patient                                            Number of                               Average
                                                                                                                 Number of                             Total annual
                                                                  Expanded Access                                                   responses per                           burden per          Total hours
                                                                                                                respondents                             responses
                                                            Applications: Form FDA 3926                                               respondent                             response

                                              Expanded access submission elements included in                              790                  3.03          2,394    0.75 (45 mins.) ......          1,795
                                                Form FDA 3926.
                                                 1 There   are no capital costs or operating and maintenance costs associated with this collection of information.
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                                                Based on a review of the information                   and data management systems from the                  response’’ were based on information
                                              collection, we are retaining the                         Center for Drug Evaluation and Research               CDER provided and personnel of the
                                              currently approved burden estimate.                      (CDER) and from other sources familiar                U.S. Department of Health and Human
                                              The estimates for ‘‘number of                            with the number of submissions                        Services familiar with preparing and
                                              respondents,’’ ‘‘number of responses per                 received for individual patient                       reviewing expanded access submissions
                                              respondent,’’ and ‘‘total annual                         expanded access use under part 312.                   by practicing physicians.
                                              responses’’ were obtained from reports                   The estimates for ‘‘average burden per



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                                              55726                    Federal Register / Vol. 83, No. 216 / Wednesday, November 7, 2018 / Notices

                                                Based on data from the Document                       DATES:  Submit either electronic or                   Collection Activities; Proposed
                                              Archiving, Reporting and Regulatory                     written comments on the collection of                 Collection; Comment Request;
                                              Tracking System for the number of                       information by January 7, 2019.                       Recordkeeping Requirements for
                                              submissions to FDA using FDA Form                       ADDRESSES: You may submit comments                    Microbiological Testing and Corrective
                                              3926 during fiscal years 2015, 2016, and                as follows. Please note that late,                    Measures for Bottled Water.’’ Received
                                              2017, we estimate that approximately                    untimely filed comments will not be                   comments, those filed in a timely
                                              790 licensed physicians would use FDA                   considered. Electronic comments must                  manner (see ADDRESSES), will be placed
                                              Form 3926 to submit 1.46 requests per                   be submitted on or before January 7,                  in the docket and, except for those
                                              physician (respondent) for individual                   2019. The https://www.regulations.gov                 submitted as ‘‘Confidential
                                              patient expanded access, for a total of                 electronic filing system will accept                  Submissions,’’ publicly viewable at
                                              1,153 responses annually. Based on                      comments until 11:59 p.m. Eastern Time                https://www.regulations.gov or at the
                                              these estimates, FDA calculates the total               at the end of January 7, 2019. Comments               Dockets Management Staff between 9
                                              annual responses to be 2,394 (1,153                     received by mail/hand delivery/courier                a.m. and 4 p.m., Monday through
                                              requests for individual patient                         (for written/paper submissions) will be               Friday.
                                              expanded access and 1,241 follow-up                     considered timely if they are                            • Confidential Submissions—To
                                              submissions) by 790 physicians for an                   postmarked or the delivery service                    submit a comment with confidential
                                              average of 3.03 responses per                           acceptance receipt is on or before that               information that you do not wish to be
                                              respondent. FDA estimates the average                   date.                                                 made publicly available, submit your
                                              burden per response to be 45 minutes                                                                          comments only as a written/paper
                                                                                                      Electronic Submissions
                                              (0.75 hour). Based on this estimate, FDA                                                                      submission. You should submit two
                                              calculates the total burden to be 1,795                   Submit electronic comments in the                   copies total. One copy will include the
                                              hours.                                                  following way:                                        information you claim to be confidential
                                                                                                        • Federal eRulemaking Portal:                       with a heading or cover note that states
                                                Dated: October 31, 2018.
                                                                                                      https://www.regulations.gov. Follow the               ‘‘THIS DOCUMENT CONTAINS
                                              Leslie Kux,                                             instructions for submitting comments.                 CONFIDENTIAL INFORMATION.’’ The
                                              Associate Commissioner for Policy.                      Comments submitted electronically,                    Agency will review this copy, including
                                              [FR Doc. 2018–24321 Filed 11–6–18; 8:45 am]             including attachments, to https://                    the claimed confidential information, in
                                              BILLING CODE 4164–01–P                                  www.regulations.gov will be posted to                 its consideration of comments. The
                                                                                                      the docket unchanged. Because your                    second copy, which will have the
                                                                                                      comment will be made public, you are                  claimed confidential information
                                              DEPARTMENT OF HEALTH AND                                solely responsible for ensuring that your             redacted/blacked out, will be available
                                              HUMAN SERVICES                                          comment does not include any                          for public viewing and posted on
                                                                                                      confidential information that you or a                https://www.regulations.gov. Submit
                                              Food and Drug Administration                            third party may not wish to be posted,                both copies to the Dockets Management
                                                                                                      such as medical information, your or                  Staff. If you do not wish your name and
                                              [Docket No. FDA–2018–N–4130]                            anyone else’s Social Security number, or              contact information to be made publicly
                                                                                                      confidential business information, such               available, you can provide this
                                              Agency Information Collection                           as a manufacturing process. Please note
                                              Activities; Proposed Collection;                                                                              information on the cover sheet and not
                                                                                                      that if you include your name, contact                in the body of your comments and you
                                              Comment Request; Recordkeeping                          information, or other information that
                                              Requirements for Microbiological                                                                              must identify this information as
                                                                                                      identifies you in the body of your                    ‘‘confidential.’’ Any information marked
                                              Testing and Corrective Measures for                     comments, that information will be
                                              Bottled Water                                                                                                 as ‘‘confidential’’ will not be disclosed
                                                                                                      posted on https://www.regulations.gov.                except in accordance with 21 CFR 10.20
                                              AGENCY:    Food and Drug Administration,                  • If you want to submit a comment                   and other applicable disclosure law. For
                                              HHS.                                                    with confidential information that you                more information about FDA’s posting
                                                                                                      do not wish to be made available to the               of comments to public dockets, see 80
                                              ACTION:   Notice.                                       public, submit the comment as a                       FR 56469, September 18, 2015, or access
                                                                                                      written/paper submission and in the                   the information at: https://www.gpo.gov/
                                              SUMMARY:   The Food and Drug                            manner detailed (see ‘‘Written/Paper
                                              Administration (FDA or Agency) is                                                                             fdsys/pkg/FR-2015-09-18/pdf/2015-
                                                                                                      Submissions’’ and ‘‘Instructions’’).                  23389.pdf.
                                              announcing an opportunity for public
                                              comment on the proposed collection of                   Written/Paper Submissions                                Docket: For access to the docket to
                                              certain information by the Agency.                        Submit written/paper submissions as                 read background documents or the
                                              Under the Paperwork Reduction Act of                    follows:                                              electronic and written/paper comments
                                              1995 (PRA), Federal Agencies are                          • Mail/Hand Delivery/Courier (for                   received, go to https://
                                              required to publish notice in the                       written/paper submissions): Dockets                   www.regulations.gov and insert the
                                              Federal Register concerning each                        Management Staff (HFA–305), Food and                  docket number, found in brackets in the
                                              proposed collection of information,                     Drug Administration, 5630 Fishers                     heading of this document, into the
                                              including each proposed extension of an                 Lane, Rm. 1061, Rockville, MD 20852.                  ‘‘Search’’ box and follow the prompts
                                              existing collection of information, and                   • For written/paper comments                        and/or go to the Dockets Management
                                              to allow 60 days for public comment in                  submitted to the Dockets Management                   Staff, 5630 Fishers Lane, Rm. 1061,
                                              response to the notice. This notice                     Staff, FDA will post your comment, as                 Rockville, MD 20852.
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                                              solicits comments on the procedure by                   well as any attachments, except for                   FOR FURTHER INFORMATION CONTACT:
                                              which both domestic and foreign bottled                 information submitted, marked and                     Domini Bean, Office of Operations,
                                              water manufacturers that sell bottled                   identified, as confidential, if submitted             Food and Drug Administration, Three
                                              water in the United States maintain                     as detailed in ‘‘Instructions.’’                      White Flint North, 10A–12M, 11601
                                              records of microbiological testing and                    Instructions: All submissions received              Landsdown St., North Bethesda, MD
                                              corrective measures, in addition to                     must include the Docket No. FDA–                      20852, 301–796–5733, PRAStaff@
                                              existing recordkeeping requirements.                    2018–N–4130 for ‘‘Agency Information                  fda.hhs.gov.


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Document Created: 2018-11-07 00:05:05
Document Modified: 2018-11-07 00:05:05
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 the collection of information by January 7, 2019.
ContactDomini Bean, Office of Operations, Food and Drug Administration, Three White Flint North, 10A-12M, 11601 Landsdown St., North Bethesda, MD 20852, 301-796-5733, [email protected]
FR Citation83 FR 55723 

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