PRIA, Government Policy, Made Personal

Summary

Allows patients with life‑threatening illnesses who have no approved options and who cannot join a clinical trial to try certain experimental drugs. To qualify, a doctor must say the patient has a life‑threatening condition, has tried all approved treatments, and cannot enter a trial. The doctor must be in good standing and not paid by the drug maker to give that opinion. The patient (or a legal representative) must give written informed consent. The drug must have finished a Phase 1 trial, not be approved for any use, be still in development (not abandoned or on clinical hold), and either have a formal approval application filed or be in a trial meant to be the main proof for approval and have an active IND. "Phase 1" means the early safety trial. If these rules are met, giving the drug under this path is exempt from many usual FDA rules, but the sponsor must still follow certain investigational drug requirements (for example, regulations at 21 C.F.R. 312.6, 312.7, and 312.8(d)(1)). The FDA generally may not use health outcomes from these uses to delay or hurt the drug’s approval unless the FDA’s center director finds the outcome is critical to safety and gives a written public‑health reason, or unless the sponsor asks the FDA to use those outcomes. The drug sponsor must send the FDA an annual summary showing doses supplied, patients treated, why the drug was used, and any known serious harms. The FDA will post an annual report on its website about how outcomes were or were not used in reviews.

Title 21, §360bbb–0a

Food and Drugs, Source: USLM XML via OLRC

(a)Definitions

For purposes of this section

(1)

(2)the term “eligible investigational drug” means an investigational drug (as such term is used in section 360bbb of this title)—

(A)for which a Phase 1 clinical trial has been completed;

(B)that has not been approved or licensed for any use under section 355 of this title or section 351 of the Public Health Service Act [42 U.S.C. 262];

(C)(i)for which an application has been filed under section 355(b) of this title or section 351(a) of the Public Health Service Act [42 U.S.C. 262(a)]; or

(ii)that is under investigation in a clinical trial that—

(I)is intended to form the primary basis of a claim of effectiveness in support of approval or licensure under section 355 of this title or section 351 of the Public Health Service Act [42 U.S.C. 262]; and

(II)is the subject of an active investigational new drug application under section 355(i) of this title or section 351(a)(3) of the Public Health Service Act [42 U.S.C. 262(a)(3)], as applicable; and

(D)the active development or production of which is ongoing and has not been discontinued by the manufacturer or placed on clinical hold under section 355(i) of this title; and

(3)the term “phase 1 trial” means a phase 1 clinical investigation of a drug as described in section 312.21 of title 21, Code of Federal Regulations (or any successor regulations).

(b)Exemptions

Eligible investigational drugs provided to eligible patients in compliance with this section are exempt from section 352(f), 353(b)(4), 355(a), and 355(i) of this title, section 351(a) of the Public Health Service Act [42 U.S.C. 262(a)], and parts 50, 56, and 312 of title 21, Code of Federal Regulations (or any successor regulations), provided that the sponsor of such eligible investigational drug or any person who manufactures, distributes, prescribes, dispenses, introduces or delivers for introduction into interstate commerce, or provides to an eligible patient an eligible investigational drug pursuant to this section is in compliance with the applicable requirements set forth in section 312.6, 312.7, and 312.8(d)(1) of title 21, Code of Federal Regulations (or any successor regulations) that apply to investigational drugs.

(c)Use of clinical outcomes

(1)In general

Notwithstanding any other provision of this chapter, the Public Health Service Act [42 U.S.C. 201 et seq.], or any other provision of Federal law, the Secretary may not use a clinical outcome associated with the use of an eligible investigational drug pursuant to this section to delay or adversely affect the review or approval of such drug under section 355 of this title or section 351 of the Public Health Service Act [42 U.S.C. 262] unless—

(A)the Secretary makes a determination, in accordance with paragraph (2), that use of such clinical outcome is critical to determining the safety of the eligible investigational drug; or

(B)the sponsor requests use of such outcomes.

(2)Limitation

If the Secretary makes a determination under paragraph (1)(A), the Secretary shall provide written notice of such determination to the sponsor, including a public health justification for such determination, and such notice shall be made part of the administrative record. Such determination shall not be delegated below the director of the agency center that is charged with the premarket review of the eligible investigational drug.

(d)Reporting

(1)In general

The manufacturer or sponsor of an eligible investigational drug shall submit to the Secretary an annual summary of any use of such drug under this section. The summary shall include the number of doses supplied, the number of patients treated, the uses for which the drug was made available, and any known serious adverse events. The Secretary shall specify by regulation the deadline of submission of such annual summary and may amend section 312.33 of title 21, Code of Federal Regulations (or any successor regulations) to require the submission of such annual summary in conjunction with the annual report for an applicable investigational new drug application for such drug.

(2)Posting of information

The Secretary shall post an annual summary report of the use of this section on the internet website of the Food and Drug Administration, including the number of drugs for which clinical outcomes associated with the use of an eligible investigational drug pursuant to this section was—

(A)used in accordance with subsection (c)(1)(A);

(B)used in accordance with subsection (c)(1)(B); and

(C)not used in the review of an application under section 355 of this title or section 351 of the Public Health Service Act [42 U.S.C. 262].

Notes & Related Subsidiaries

Editorial Notes

References in Text

The Public Health Service Act, referred to in subsec. (c)(1), is act July 1, 1944, ch. 373, 58 Stat. 682, which is classified generally to chapter 6A (§ 201 et seq.) of Title 42, The Public Health and Welfare. For complete classification of this Act to the Code, see

Short Title

note set out under section 201 of Title 42 and Tables.

Statutory Notes and Related Subsidiaries

Limitation of Liability Pub. L. 115–176, § 2(b), May 30, 2018, 132 Stat. 1374, provided that: “(1) Alleged acts or omissions.—With respect to any alleged act or omission with respect to an eligible investigational drug provided to an eligible patient pursuant to section 561B of the Federal Food, Drug, and Cosmetic Act [21 U.S.C. 360bbb–0a] and in compliance with such section, no liability in a cause of action shall lie against—“(A) a sponsor or manufacturer; or “(B) a prescriber, dispenser, or other individual entity (other than a sponsor or manufacturer), unless the relevant conduct constitutes reckless or willful misconduct, gross negligence, or an intentional tort under any applicable State law. “(2) Determination not to provide drug.—No liability shall lie against a sponsor manufacturer, prescriber, dispenser or other individual entity for its determination not to provide access to an eligible investigational drug under section 561B of the Federal Food, Drug, and Cosmetic Act. “(3) Limitation.—Except as set forth in paragraphs (1) and (2), nothing in this section shall be construed to modify or otherwise affect the right of any person to bring a private action under any State or Federal product liability, tort, consumer protection, or warranty law.”

§360bbb–0a Investigational Drugs for Use by Eligible Patients