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The FDA Process for The FDA Process for Approving Generic DrugsApproving Generic Drugs
Gary J. Buehler, R.Ph.Gary J. Buehler, R.Ph. Dale Conner, Pharm. D.Dale Conner, Pharm. D.
DirectorDirector Director, Division of Director, Division of
BioequivalenceBioequivalence
Office of Generic DrugsOffice of Generic Drugs
Center for Drug Evaluation & Research U.S. Food & Drug Administration
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Did you know that generic Did you know that generic drugs...drugs...
• Are safe and effective alternatives to brand Are safe and effective alternatives to brand name prescriptionsname prescriptions
• Can help both consumers and the Can help both consumers and the government reduce the cost of prescription government reduce the cost of prescription drugsdrugs
• Are currently used in 50% of all Are currently used in 50% of all prescriptions dispensedprescriptions dispensed
• Save an average of $50 for every Save an average of $50 for every prescription soldprescription sold
Center for Drug Evaluation & Research U.S. Food & Drug Administration
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Hatch-Waxman Amendments Hatch-Waxman Amendments to FFD&C Act - 1984to FFD&C Act - 1984
• Considered one of the most successful Considered one of the most successful pieces of legislation ever passedpieces of legislation ever passed
• Created the generic drug industryCreated the generic drug industry
• Increased availability of genericsIncreased availability of generics• 1984 12% prescriptions were generic1984 12% prescriptions were generic
• 2000 44% prescriptions were generic - yet only 2000 44% prescriptions were generic - yet only 8% of revenue for prescription drugs8% of revenue for prescription drugs
• Compromise legislation to benefit both Compromise legislation to benefit both brand and generic firmsbrand and generic firms
Continued
Center for Drug Evaluation & Research U.S. Food & Drug Administration
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Hatch-Waxman Amendments Hatch-Waxman Amendments to FFD&C Act - 1984to FFD&C Act - 1984
• Allowed generic firms to rely on findings Allowed generic firms to rely on findings of safety and efficacy of innovator drug of safety and efficacy of innovator drug after expiration of patents and after expiration of patents and exclusivities (do not have to repeat exclusivities (do not have to repeat expensive clinical and pre-clinical trials)expensive clinical and pre-clinical trials)
• Allowed patent extensions and Allowed patent extensions and exclusivities to innovator firmsexclusivities to innovator firms
Center for Drug Evaluation & Research U.S. Food & Drug Administration
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Brand Name Drug Generic DrugNDA Requirements ANDA Requirements
1. Chemistry 1. Chemistry2. Manufacturing 2. Manufacturing3. Controls 3. Controls4. Labeling 4. Labeling5. Testing 5. Testing6. Animal Studies7. Clinical Studies 6. Bioequivalence8. Bioavailability
NDA vs. ANDA Review ProcessNDA vs. ANDA Review Process
Center for Drug Evaluation & Research U.S. Food & Drug Administration
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What are the requirements for What are the requirements for a generic drug?a generic drug?
• LabelingLabeling
• Chemistry/MicrobiologyChemistry/Microbiology
• BioequivalenceBioequivalence
• LegalLegal
Center for Drug Evaluation & Research U.S. Food & Drug Administration
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How do we assure the quality How do we assure the quality of generic drugs?of generic drugs?
• First 5 steps of review process are identical First 5 steps of review process are identical to NDA processto NDA process
• Bioequivalence for complicated products is Bioequivalence for complicated products is discussed with the same staff that reviewed discussed with the same staff that reviewed the brand productthe brand product
• FDA has experience with the productFDA has experience with the product
• Scientific literature publishedScientific literature published
• Product is known to be safeProduct is known to be safe
Center for Drug Evaluation & Research U.S. Food & Drug Administration
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Generic Generic Drug Drug Review Review ProcessProcess
Bioequivalence Review
Labeling Review
Chemistry & Micro Review
Request for Plant Inspection
APPLICANT
ANDA
Acceptable &
Complete
Application Review
N Chem/Micro
OK?
Labeling
OK?Bioequivalence
OK?
PreApproval
Inspection Results
OK?
Not Approvable
Letter
Approval Withheld until
Results Satisfactory
Bio Deficiency LetterAPPROVED
ANDA
NN N
N
Y Y Y
Y
Y
Refuse to Receive Letter
Center for Drug Evaluation & Research U.S. Food & Drug Administration
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What are the requirements for What are the requirements for a generic drug?a generic drug?
• Same active ingredient(s)Same active ingredient(s)
• Same route of administrationSame route of administration
• Same dosage formSame dosage form
• Same strengthSame strength
• Same conditions of useSame conditions of use
Compared to reference listed drug (RLD) Compared to reference listed drug (RLD) - (brand name product)- (brand name product)
Center for Drug Evaluation & Research U.S. Food & Drug Administration
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LabelingLabeling
• ““Same” as brand name labelingSame” as brand name labeling
• May delete portions of labeling May delete portions of labeling protected by patent or exclusivityprotected by patent or exclusivity
• May differ in excipients, PK data and May differ in excipients, PK data and how suppliedhow supplied
Center for Drug Evaluation & Research U.S. Food & Drug Administration
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ChemistryChemistry
• Components and compositionComponents and composition
• Manufacturing and controlsManufacturing and controls
• Batch formulation and recordsBatch formulation and records
• Description of facilitiesDescription of facilities
• Specs and testsSpecs and tests
• PackagingPackaging
• StabilityStability
Center for Drug Evaluation & Research U.S. Food & Drug Administration
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Manufacturing Compliance Manufacturing Compliance ProgramsPrograms
• Purpose - To assure quality of Purpose - To assure quality of marketed drug productsmarketed drug products
• Mechanisms - Product TestingMechanisms - Product Testing
– SurveillanceSurveillance
– Manufacturing/Testing plant inspectionsManufacturing/Testing plant inspections
– Assess firm’s compliance with good Assess firm’s compliance with good manufacturing processesmanufacturing processes
Center for Drug Evaluation & Research U.S. Food & Drug Administration
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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
PUBLIC HEALTH SERVICEFOOD AND DRUG ADMINISTRATION
CENTER FOR DRUG EVALUATION AND RESEARCHOFFICE OF GENERIC DRUGS
APPROVEDDRUG PRODUCTS
WITHTHERAPEUTIC EQUIVALENCE EVALUATIONS
23rd EDITIONTHE PRODUCTS IN THIS LIST HAVE BEEN APPROVED UNDER
SECTION 505 OF THE FEDERAL FOOD, DRUG, ANDCOSMETIC ACT.
2003
Electronic Orange Book - http://www.fda.gov/cder/ob/
Center for Drug Evaluation & Research U.S. Food & Drug Administration
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• All FDA approved drug products listed All FDA approved drug products listed (NDA’s, OTC’s & ANDA’s) (NDA’s, OTC’s & ANDA’s)
– Therapeutic equivalence codesTherapeutic equivalence codes ““A” = SubstitutableA” = Substitutable
““B” = Inequivalent, NOT SubstitutableB” = Inequivalent, NOT Substitutable
– Expiration dates: patent and exclusivityExpiration dates: patent and exclusivity
– Reference Listed Drugs/brand drugs Reference Listed Drugs/brand drugs identified by FDA for generic companies identified by FDA for generic companies to compare with their proposed productsto compare with their proposed products
“Orange BookOrange Book”
Center for Drug Evaluation & Research U.S. Food & Drug Administration
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Definition of BioequivalenceDefinition of Bioequivalence
Pharmaceutical equivalents whose rate Pharmaceutical equivalents whose rate
and extent of absorption are not and extent of absorption are not
statistically different when statistically different when
administered to patients or subjects administered to patients or subjects
at the same molar dose under similar at the same molar dose under similar
experimental conditionsexperimental conditions
Center for Drug Evaluation & Research U.S. Food & Drug Administration
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Purpose of BEPurpose of BE
• Therapeutic equivalence (TE)Therapeutic equivalence (TE)
• Bioequivalent products can be Bioequivalent products can be substituted for each other without any substituted for each other without any adjustment in dose or other additional adjustment in dose or other additional therapeutic monitoringtherapeutic monitoring
• The most efficient method of assuring The most efficient method of assuring TE is to assure that the formulations TE is to assure that the formulations perform in an equivalent mannerperform in an equivalent manner
Center for Drug Evaluation & Research U.S. Food & Drug Administration
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Model of Oral Dosage Form Model of Oral Dosage Form PerformancePerformance
TherapeuticEffect
Dosage Form
Gut WallDrug in Solution
BloodSite of Activity
Pharmacokinetic MeasurementDosage Form
Performance
Clinical/PD Measurement
ln DoseDose
Center for Drug Evaluation & Research U.S. Food & Drug Administration
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Clinical/PD Dose-ResponseClinical/PD Dose-Response
Cli
nic
al/P
D R
esp
onse
Log Dose
Center for Drug Evaluation & Research U.S. Food & Drug Administration
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Plasma Concentration-DosePlasma Concentration-Dose
Dose
Pla
sma
Con
c.
Center for Drug Evaluation & Research U.S. Food & Drug Administration
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Approaches to Determining Approaches to Determining Bioequivalence (21 CFR 320.24)Bioequivalence (21 CFR 320.24)
• In vivo measurement of active In vivo measurement of active moiety or moieties in biologic fluidmoiety or moieties in biologic fluid
• In vivo pharmacodynamic In vivo pharmacodynamic comparisoncomparison
• In vivo limited clinical comparisonIn vivo limited clinical comparison• In vitro comparisonIn vitro comparison
• Any other approach deemed Any other approach deemed appropriate by FDAappropriate by FDA
FeV1 Albuterol
Blanching StudyTopical Corticosteroid
Topicals Nasal Suspensions
Questran - Binding StudiesNasal Solutions-Sprayer EvaluationPropofol - Droplet Size
Center for Drug Evaluation & Research U.S. Food & Drug Administration
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• Single-dose, two-way crossover, fastedSingle-dose, two-way crossover, fasted
• Single-dose, two-way crossover, fedSingle-dose, two-way crossover, fed
• AlternativesAlternatives
– Single-dose, parallel, fastedSingle-dose, parallel, fasted
– Single-dose, replicate designSingle-dose, replicate design
– Multiple-dose, two-way Multiple-dose, two-way crossover, fastedcrossover, fasted
– Clinical endpoint studyClinical endpoint study
Study DesignsStudy Designs
Long Half-Life (wash-out)
Amiodarone, Etidronate
Highly Variable Drugs
Less Sensitive
Clozapine (Patient Trials)
Chemotherapy Trials
Topicals
Nasal Suspensions
Center for Drug Evaluation & Research U.S. Food & Drug Administration
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Waivers of In Vivo Study Waivers of In Vivo Study RequirementsRequirements
• DefinitionDefinition
• Criteria (21 CFR 320.22)Criteria (21 CFR 320.22)
– In vivo bioequivalence is self-evidentIn vivo bioequivalence is self-evident
– Parenteral solutionsParenteral solutions
– Inhalational anestheticsInhalational anesthetics
– Topical (skin) solutionTopical (skin) solution
– Oral solutionOral solution
– Different proportional strength of product Different proportional strength of product with demonstrated BEwith demonstrated BE
Center for Drug Evaluation & Research U.S. Food & Drug Administration
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Statistical Analysis Statistical Analysis (Two One-sided Tests Procedure)(Two One-sided Tests Procedure)
• AUC and CmaxAUC and Cmax
– 90% Confidence Intervals (CI) must fit 90% Confidence Intervals (CI) must fit between 80%-125%between 80%-125%
Center for Drug Evaluation & Research U.S. Food & Drug Administration
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Statistical Analysis Statistical Analysis 80 - 125 %80 - 125 %
• What does this mean?What does this mean?
• Can there be a 46% difference?Can there be a 46% difference?
• What is a point estimate?What is a point estimate?
• What is a confidence interval?What is a confidence interval?
Center for Drug Evaluation & Research U.S. Food & Drug Administration
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Statistical AnalysisStatistical Analysis
• Bioequivalence criteriaBioequivalence criteria
– Two one-sided tests procedureTwo one-sided tests procedure
• Test (T) is not significantly less than Test (T) is not significantly less than referencereference
• Reference (R) is not significantly less than Reference (R) is not significantly less than testtest
• Significant difference is 20% (Significant difference is 20% ( = 0.05 = 0.05 significance level)significance level)
– T/R = 80/100 = 80%T/R = 80/100 = 80%
– R/T = 80% (all data expressed as T/R so R/T = 80% (all data expressed as T/R so this becomes 100/80 = 125%)this becomes 100/80 = 125%)
Center for Drug Evaluation & Research U.S. Food & Drug Administration
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Possible BE Results (90% CI)Possible BE Results (90% CI)
T/R (%)80% 125%
Center for Drug Evaluation & Research U.S. Food & Drug Administration
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Narrow Therapeutic Range (NTI) Narrow Therapeutic Range (NTI) DrugsDrugs
• Drug Products that are subject to Drug Products that are subject to therapeutic drug concentration or therapeutic drug concentration or pharmacodynamic monitoringpharmacodynamic monitoring
– Examples are: Digoxin, Lithium, Examples are: Digoxin, Lithium, Phenytoin, WarfarinPhenytoin, Warfarin
• Traditional bioequivalence limit of 80-Traditional bioequivalence limit of 80-125% is unchanged for these 125% is unchanged for these productsproducts
Center for Drug Evaluation & Research U.S. Food & Drug Administration
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Contacting the OGDContacting the OGD
Contact: Contact: Office of Generic DrugsOffice of Generic Drugs
FDA/CDER (HFD-600)FDA/CDER (HFD-600)
7500 Standish Place7500 Standish Place
Rockville, MD 20855Rockville, MD 20855
phone: 301-827-5845phone: 301-827-5845
Web site: Web site:
www.fda.gov/cder/ogd/index.htmwww.fda.gov/cder/ogd/index.htm