COVID-19 Related Medical Devices: FDA Finalizes Transition Plan Guidance

On March 27, 2023, the U.S. Food & Drug Administration (FDA) released two final guidance documents to assist with transitioning medical devices: (i) that were subject to certain enforcement policies issued during the COVID-19 Public Health Emergency (PHE), and (ii) that were issued emergency use authorizations (EUAs). These guidance documents finalize the corresponding draft guidance documents that were issued on December 23, 2021. In a previous post, we discussed several key takeaways from the draft versions of these transition guidance documents.

“Transition Plan for Medical Devices That Fall Within Enforcement Policies Issued During the Coronavirus Disease 2019 (COVID-19) Public Health Emergency” Final Guidance

In the “Transition Plan for Medical Devices That Fall Within Enforcement Policies Issued During the Coronavirus Disease 2019 (COVID-19) Public Health Emergency” final guidance, the FDA discusses the transition plan for medical devices that were subject to certain enforcement policies issued during the PHE. FDA confirms that the policies listed in the guidance, which are set forth in List 1 thereto, will remain in effect until 180 days after the end of the PHE. The PHE declaration is scheduled to expire on May 11, 2023. Therefore, the enforcement policies identified in List 1 will no longer be in effect after November 7, 2023.

In the guidance, the FDA provides recommendations for a “phased transition process” with respect to devices that fall within the expiring COVID-19 PHE enforcement policies. The FDA summarizes the three phases of the 180-day transition plan as follows:

  • Phase 1 (May 11, 2023): Manufacturers should follow adverse event reporting requirements as described in 21 C.F.R. § 803.
  • Phase 2 (August 9, 2023): If planning to continue to distribute their devices after Phase 2, manufacturers need to adhere to registration and listing requirements (21 C.F.R. § 807 Subparts B-D) and should adhere to requirements associated with reports of corrections and removals (21 C.F.R § 806).
  • Phase 3 (November 7, 2023): In Phase 3 the enforcement policies identified in List 1 will no longer be in effect. FDA states it does not intend to object to continued distribution of devices where a required marketing submission has been submitted and accepted by FDA before the start of Phase 3, and FDA has not taken a final action on the marketing submission. FDA further indicates that it does not intend to object to the devices not complying with certain unique device identification (UDI) systems requirements and other applicable labeling requirements described in 21 C.F.R. § 801.

FDA recommends manufacturers submit a “Transition Implementation Plan” with their marketing submissions (if needed) that addresses the manufacturer’s plans for addressing devices already distributed, which plans need to include actions to be taken in the event either a positive or negative decision by the FDA on the marketing submission. Furthermore, FDA strongly encourages manufacturers to complete and submit these submissions well in advance of the start of Phase 3. This is recommended to avoid potential delays created by a large influx of new submissions.

“Transition Plan for Medical Devices Issued Emergency Use Authorizations (EUAs) Related to Coronavirus Disease 2019 (COVID-19)” Final Guidance

In the “Transition Plan for Medical Devices Issued Emergency Use Authorizations (EUAs) Related to Coronavirus Disease 2019 (COVID-19)” final guidance (“EUA Guidance”), the FDA confirms that the end of the PHE will not automatically terminate EUAs. Instead, these EUAs will remain in effect until the relevant EUA declaration is terminated, or the FDA otherwise revokes a specific EUA. 

The EUA Guidance includes recommendations for certain reusable life-supporting or life-sustaining devices, devices distributed after the EUA termination date, laboratory developed tests, and EUA-authorized in vitro diagnostics subject to Clinical Laboratory Improvement Amendments of 1988 categorization and waivers. With respect to certain reusable life-supporting or life-sustaining devices, FDA requests manufacturers of such devices to submit information regarding whether or not they intend to submit marketing submissions to continue distributing the device(s) after the applicable EUA termination date.

Furthermore, FDA states in the EUA Guidance that it will not object to the continued distribution of devices after the device’s applicable EUA termination date if (1) the manufacturer has submitted a marketing submission that is accepted by FDA prior to the EUA termination date, and (2) FDA has not taken final action on the marketing submission. Therefore, it is recommended that manufacturers of these devices submit marketing submissions well in advance of the EUA termination date.

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FDA Passes New Cannabis Guidance for Clinical Research | Beveridge & Diamond PC

Critical Takeaways

  • What Happened: The Food items and Drug Administration (Food and drug administration) finalized a 2020 draft guidance detailing the agency’s suggestions for scientific analysis for building hashish and cannabis-derived human medication.
  • Who’s Impacted: Individuals associated in the clinical study of hashish can rely on this Food and drug administration guidance for suggested sources of cannabis for medical analysis and sources for facts on high-quality and control status issues. The steerage also suggests strategies for researchers to work out the THC dissimilarities concerning “hemp” and “cannabis.” The guidance can help tell stakeholders, lawmakers, and other folks in the hashish field by addressing particular issues elevated about drugs made up of cannabis and crucial Fda regulatory principles.

History

On January 24, 2023, the Food and drug administration announced new assistance entitled “Cannabis and Hashish-Derived Compounds: Top quality Criteria for Clinical Investigation.” The non-binding guidance discusses a few critical cannabis-associated subjects:

  • Sourcing cannabis for medical analysis
  • How to estimate percent delta-9 tetrahydrocannabinol (THC) all through the study cycle and,
  • Normal high quality considerations for creating human medications that contain hashish and cannabis-derived compounds.

Typically, to be viewed as “hemp,” a merchandise have to incorporate much less than .3 p.c delta-9 THC by dry bodyweight. Anything at all earlier mentioned .3 per cent delta-9 THC is regarded as hashish (or marijuana), a Plan I controlled substance. Human medications that incorporate hemp, hashish, and hashish-derived compounds are commonly subject to the exact same authorities and demands, together with excellent expectations, as Fda-regulated drug solutions that contains any other material.

The target of FDA’s hottest steering is to assist clinical exploration for the growth of hashish and cannabis-derived human prescription drugs. The direction does not handle the progress of thoroughly artificial variations of substances that take place in cannabis and does not deal with other Food and drug administration-regulated items.

Sourcing of Cannabis

The National Institute on Drug Abuse (NIDA) Drug Offer Plan was the only legal resource for scientists to purchase cannabis for many many years. The NIDA Drug Supply Application continues to be a resource of cannabis in excess of the .3 percent delta-9 THC threshold for clinical study. In 2020, the Drug Enforcement Company (DEA) adopted new procedures to permit the registration of new companies to plant, increase, cultivate, or harvest cannabis. There was confusion, even so, over no matter whether medical studies could use these new producers. This guidance intends to make clear that confusion and presents that:

  • For hashish in excess of the .3 {bf0515afdcaddba073662ceb89fbb62b6b1bf123143c0e06b788e1946e8c353f} delta-9 THC threshold and not part of an investigational new drug (IND) software – the NIDA Drug Provide Program and other sources authorized by DEA to supply Routine I cannabis resources for research can be made use of.
  • For any cannabis resources (earlier mentioned or beneath the .3 per cent threshold) as part of an IND software- other resources can be utilised matter to the approval of the software.

When the sourcing of hashish for medical analysis has been a apparent location of problem for individuals associated in the scientific research of hashish, the Food and drug administration also presented direction on additional nuanced problems that this sector faces.

Calculation of THC

Farmers and researchers have extended been involved about the calculation of THC, provided the unpredictable nature of the plant. Uncontrollable environmental factors as properly as extraction and manufacturing processes can influence the THC concentration and press lawful hemp into a managed substance. The steering endorses that experts calculate the THC material in their proposed hashish or hashish-derived investigational drug merchandise early in the enhancement procedure to decide their product’s probable abuse legal responsibility and command standing. The direction also discusses the very best calculation approaches all over the lifecycle of medical scientific studies.

Common High-quality Things to consider

As section of an IND for any drug, scientists are envisioned to display that they can continually manufacture a quality product or service. In each stage of clinical investigation, they must post enough details to show the drug’s identity, excellent, purity, and potency. The direction includes added concepts and tips that are specially related for acquiring prescription drugs that consist of cannabis and cannabis-derived compounds:

  • Hashish and cannabis-derived compounds are held to the same regulatory benchmarks as any other botanical uncooked content, botanical drug compound, or botanical drug product. This incorporates making sure batch-to-batch consistency, conducting microbiological exams and sterility assessments, and screening for raw components (between other unique necessities on p. 6 of the guidance).

  • Top quality assessments, particular to dosage type, should be done.
  • Impurities for obviously taking place compounds should be managed.
  • Researchers ought to not count on posted literature in area of details from a total toxicology system, as the certain botanical drug product below evaluate might differ from that of the released examine.
  • Evaluate the metabolic profile of big cannabinoids in human beings early for security.

Impacts

This Fda guidance allows presents clarity to the cannabis marketplace on hashish and hashish-derived drug progress in the wake of Congress passing the Healthcare Marijuana and Cannabidiol Analysis Expansion Act. Stakeholders have been eagerly awaiting updates from the Fda and other federal businesses with regards to the sale and promoting of cannabis-derived merchandise as effectively as a scientific assessment of cannabis to aid reevaluate the substance’s plan under the Controlled Substances Act. As a high precedence of the Biden Administration, we will most likely see numerous important regulatory updates for cannabis in 2023.

Businesses can submit on the web or published comments on this steerage at any time. The tips in this steering are not required or binding – researchers may possibly use an different strategy as extensive as it satisfies the necessities of the relevant statutes and polices.

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