The U.S. Food and Drug Administration (FDA) is taking two actions to further enhance the agency’s ongoing efforts to prevent and resolve drug shortages.
The FDA has released a strategic plan called for in the Food and Drug Administration Safety and Innovation Act (FDASIA) of 2012 to improve the agency’s response to imminent or existing shortages, and for longer term approaches for addressing the underlying causes of drug shortages. The plan also highlights opportunities for drug manufacturers and others to prevent drug shortages by promoting and sustaining quality manufacturing.
Second, the FDA issued a proposed rule requiring all manufacturers of certain medically important prescription drugs and biologic products to notify the FDA of a permanent discontinuance or a temporary interruption of manufacturing likely to disrupt their supply. The proposed rule implements the expanded early notification requirements included in FDASIA.
The strategic plan, which was required by FDASIA and has been sent to Congress, describes actions the FDA will undertake to improve its current efforts to respond to early notifications of a potential shortage. These include improving the FDA’s communications about shortages, clarifying manufacturers’ roles and responsibilities by encouraging them to engage in certain practices that will reduce the likelihood of a shortage, updating the FDA’s internal procedures for responding to early notifications of potential shortages.
The plan also describes efforts the FDA is considering to address the manufacturing and quality issues that are most often the root cause of drug shortages. These include broader use of manufacturing metrics to assist in the evaluation of manufacturing quality, as well as incentives for high-quality manufacturing; internal organization improvements to focus on quality; and risk-based approaches to identify early warning signals for manufacturing and quality problems.
Early notification gives the FDA time to work with manufacturers to investigate the issue leading to the manufacturing disruption, identify other manufacturers who can make up all or part of the shortfall, and expedite inspections and reviews of submissions from manufacturers of drugs that may prevent or mitigate a shortage.
Early notification from manufacturers about possible shortages, as required by FDASIA, has enabled the FDA to work with manufacturers to restore production of many lifesaving therapies. Since the Executive Order, there has been a 6-fold increase in notifications to the FDA.
The notifications received under the existing requirements have resulted in real progress in addressing shortages. The FDA helped prevent 195 drug shortages in 2011 and 282 drug shortages in 2012, leading to a reduced number of new shortages in 2012. The expanded early notification requirements would further enhance the FDA’s ability to address issues prior to the occurrence of a shortage.
“The complex issue of drug shortages continues to be a high priority for the FDA, and early notification is a critical tool that helps mitigate or prevent looming shortages,” said Janet Woodcock, MD, Director of the FDA’s Center for Drug Evaluation and Research (CDER). “The FDA continues to take all steps it can within its authority, but the FDA alone cannot solve shortages. Success depends upon a commitment from all stakeholders.” ■