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October 5, 2006

Politicizing the Nomination of the FDA Commissioner

by @ 7:35 am.  Filed under FDA

I know I’ a little late in posting on this but thought it was important enough to address it now. I really hate to see the process of getting a new FDA commissioner reduced to political bickering.

Senate HELP Committee Approves Von Eschenbach Nomination To Head FDA; Some Senators Say They Will Place Hold On Nomination
Senate panel clears FDA nominee - Yahoo! News

Seems some Senators are now holding up the nomination because Sen. Jim DeMint (R-S.C.) want a specific product pulled from the market (RU-486, aka Mifeprex (mifepristone)) and Sen. David Vitter (R-La.) wants to hold up the nomination until the FDA allows drug imports from overseas.

In the Case of Senator Clinton and Senator Patty Murray they only wanted the FDA to live up to their own commitment and make a decision regarding Plan B. They did not insist that a product be approved.

My opinion is if these Senators want to make legislate, then introduce legislation, don’t use these as excuses for holding up a nominee.

See Eye on FDA’s post entitled No holds Barred for another blog posting on this.

Other Resources

Yahoo! News Search Results for senate fda nomination Eschenbach
Senate fda nomination Eschenbach - Google News

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    September 14, 2006

    Iomai get FDA okay for Flu vaccine patch

    by @ 11:31 am.  Filed under FDA, Drug Development, Pharma News

    The FDA has given the okay to Iomai to test their flu vaccine in a patch based delivery system. They will compare it against the standard flu shot.

    United Press International - Health Business - FDA OK’s trial of Iomai’s flu vaccine patch:

    I find this an interesting delivery system for vaccines and this could be a major step forward. THeir are some people I know who don’t get the flu shot each year mainly because they have a fear of needles. I do know though that getting any sort of medicine across the skin barrier is difficult and one of the primary reason there aren’t more drugs delivered by patches.

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    September 12, 2006

    Potential New Drug for Prevention of Premature Births

    by @ 8:13 am.  Filed under FDA, Drug Development, Pharma

    Adeza has a new drug to help prevent premature births and is seen is a promising drug as reported by Forbes.

    Adeza Shares Seen As Attractive Following FDA News - Forbes.com:

    The article covers that the Reproductive Health Drugs Advisory Committee has recommended for approval Gestiva indicated to prevent premature births. Premature births occur much more frequently now than in past years mainly due to advancements made in fertility treatments; currently about 12% of all births are premature (less than 37 weeks gestation). Also, premature births tend to be very costly to the health care system. According to this site March of Dimes put the cost in 2003 of $11 billion for preterm birth.

    Further Resources

    Press Release from Adeza on FDA recommendation for approval
    Adezas Gestiva recommended for FDA approval - Pharmaceutical Business Review

    FDA questions effectiveness of Gestiva at preventing preterm labor

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    September 7, 2006

    FDA Warns Consumers About Some Canadian Websites

    by @ 9:46 am.  Filed under Health News, FDA

    I was remiss in not posting about this earlier. The FDA has listed several “Canadian” websites and a list of drugs that are likely counterfeit.

    FDA Warns Consumers Not to Buy or Use Prescription Drugs from Various Canadian Websites that Apparently Sell Counterfeit Products

    Among those listed are some of the most common prescription drugs.

    Here is the list of websites run by Mediplan:

    I do want to say that drugs in Canada are safe but that some of these websites online are not truly Canadian based and their backgrounds are difficult to establish. Also, even if they are, some seem to be purchasing cheap drugs from countries who may not meet the good manufacturing guidelines the FDA uses.

    This is a major problem not only in Canada but world-wide. Drug counterfeiting is a high priority with the FDA and progress is being made with the use of RFID tags, but much more work remains to be done.

    You always have to ask if the risk (counterfeit drug, sub-optimal doses, potential contamination, etc.) are worth the savings that may occur. I would not get drugs from Canada via an online website for any of my family members. A better use of your time would be to find help from either the pharmaceuticals company that makes your drug (many offer assistance programs but don’t advertise that fact) or go the Partnership for Prescription Assistance website. Here they explain the various programs and what it takes to qualify for them.

    Other Resources from the FDA website

    Importing Prescription Drugs from Foreign Sources
    Consumer Education: Buying Medicines From Outside of the United States
    Buying Medicines and Medical Products Online
    Combating Counterfeit Drugs
    Generic Drug Prices in the U.S. Are Lower Than Drug Prices in Canada

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    August 30, 2006

    FDA Advisers Usually Recommend Approval

    by @ 8:25 am.  Filed under FDA, Drug Development

    A recent article came across my desk and I thought it misrepresented the facts and wanted to make some comments on it. The article was in the Signs on San Diego site.

    SignOnSanDiego.com > News > Health — Study: FDA advisers typically recommend approval for drugs and devices

    The article implies that something improper may be occurring with the process of having external experts make recommendations on drugs and devices I would point out that the whole drug development process involves weeding out those candidates that do not preform well at early stages. It is in the best interest of the company developing the drug that they be able to make a go-no go decision as soon as possible. Therefore, only the drug candidates that have a very high potential to be approved make it to the point of filing an new drug application (NDA). It is not surprising to me that the majority of those get approved. It should also be noted that just because an expert panel recommends approval, does NOT necessarily mean it will be approved.

    While I do acknowledge that there have been some conflicts of interest that were not made transparent in the past, I think there has been some progress made in this regard. I just hope that reason prevails and this isn’t used as another bullet against the FDA.

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    August 24, 2006

    Plan B Approved!

    by @ 2:29 pm.  Filed under Health News, FDA, Pharma News

    Wow!! I certainly didn’t expect this to happen so quickly! I am glad to see the FDA finally approved Plan B after years of putting off the decision due to political pressure.

    FDA Grants OTC Status to Barr’s Plan B(R) Emergency Contraceptive: Financial News - Yahoo! Finance

    I thought that the approval would drag on for at least 6-8 more months and that there would be haggling over the packaging information. I can only say I feel this is a move in the right direction for the FDA.

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    August 18, 2006

    Barr Labs to Resubmit Plan B OTC Application

    by @ 9:36 am.  Filed under Health News, FDA, Pharma News

    This very short article today is interesting.

    Barr refiles morning-after pill bid, FDA says - Yahoo! News:

    Barr will re-file its application to sell Plan B. No details were made public and nothing was said about why or what may be different. My best guess is that Barr i going to change the age from 16 to 18 since the FDA has basically state that they would support that. Also, they will likely be submitting new packaging for the over-the-counter product in order to readily differentiate it from the prescription version.

    Another interesting aspect will be how different the two version need to be. Will just different packaging be enough? I am curious if the topic of making the pill a different shape or color will come up. This would most likely further delay the approval. Given how things have gone in the past, this would not surprise me.

    Another interesting item is that this announcement is not yet on Barr’s website. Maybe they are keeping their head low to avoid further publicity.

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    August 9, 2006

    Acting FDA Commissioner to Provide an Overview on the FDA’s Initiatives

    by @ 1:26 pm.  Filed under FDA

    Dr. von Eschenbach, the acting FDA Commissioner will be giving an address today to outline his views of where the FDA should be moving in the future.

    Acting FDA Commissioner to Provide an Overview on the FDA’s Initiatives for Protecting and Advancing Public Health Innovations at IBC’s 11th Annual Drug Discovery Technology(R) & Development World Congress

    I’m looking forward to hearing what is said and maybe more importantly, what is not said.

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    August 7, 2006

    Washington Times Wants Recess Appointment of von Eschenbach?!

    by @ 10:49 am.  Filed under FDA

    I don’t normally read the Washington Times, but did see a headline on Findory and had to see what they were saying. Basically, the editorial says that Bush should use a recess appointment for Dr. von Eschenbach as commissioner of the FDA.

    A chief for the FDA - Editorials/Op-Ed - The Washington Times, America’s Newspaper:

    I find this article to be misleading and very counter-productive. The FDA needs a strong clear leader to be able to fight for the agency on capitol hill and to set a direction for the agency. Having someone in charge who was appointed in a round about way to avoid congressional approval certainly won’t start him off on a good footing with Congress.

    The editorial makes a lot out of Dr. von Eschenbachs credentials and I don’t think anyone would debate those; it’s a way of creating positive spin without dealing with the real issue. That is will the agency be making decisions based on strong scientific evidence from the experts in the field or will they be used for political pandering. Note that I avoid the term “sound science”. This phrase is a republican code word for “only science that agrees with us”. For more on this, read “The Republican War on Science” (Chris Mooney). He talks about this in chapter six.

    I hate to even quote from the article and give them more exposure but feel the need to correct some misrepresentations.

    But leadership in limbo undermines authority. It has made it hard for the agency to move forward or respond to congressional overseers who are more interested in promoting their careers than the public health.

    How does poking your finger in the eye of the very folks who are overseeing your agency give a leader any authority? I think the senators are indeed protecting the public from the FDA making poor decisions based on politics rather than solid scientific evidence. The former commissioner has admitted under oath that he violated the agency’s own procedures and processes by making a unilateral decision counter to the scientific experts within his own agency.

    The holdup can be blamed on Sens. Hillary Clinton and Patty Murray, who, as today’s Op-Ed “Distorting science” notes, are blocking his nomination until the FDA agrees to make the contraceptive Plan B, or “morning-after” pill, available without a prescription and without any restrictions on age or access.

    Neither senator has ever said the FDA MUST APPROVE Plan B. They have said the FDA should make a decision one way or the other. Here is a quote from Hillary Clinton and Patty Murray which makes this clear:

    For more than two years, the FDA has dragged its feet on making a decision, putting ideology over science. It is past time for the FDA to stop dragging its heels and make a decision on Plan B. We will place a hold on the nomination of Dr. von Eschenbach until the FDA issues a decision on Plan B, yes or no.

    Here is a quote from Patty Murray:

    “This time around, we are being very firm,” said Sen. Patty Murray (D-WA). “The FDA needs to follow its own rules and make a decision, yes or no on Plan B, and their credibility is at stake. We will hold up this nomination until that decision is made.”

    The FDA had said they would come to a decision in a certain timeframe but then didn’t meet their own self-imposed deadline. This fiasco has been going on over three years. I also don’t think either senator has ever said there should be no age restrictions. The FDA keeps delaying making a decision and the announcement just one day before the hearing was another example. It only brought up new issues that could be used to further delay any action.

    The FDA and Dr. von Eschenbach have decided that women 18 and over should have such access while younger women can still get it with a prescription.

    That isn’t quite true. The FDA has asked Barr Labs to meet and have further discussions concerning these issues. No decision has been finalized. Here is the quote from the FDA’s website:

    In the letter to Duramed, the Agency communicated its plan to proceed working with the Sponsor in order to move Plan B from prescription only to over-the-counter status for woman ages 18 and older.

    Note that Duramed is a subsidiary of Barr Labs.

    The senators don’t want a permanent commissioner. They want a decision that makes their base happy.

    This is a case of the pot calling the kettle black. The whole reason the FDA has dragged their feet making a decision on Plan B is due to political pandering of the current administration to the religious right. This is what these Senators are trying to prevent. It should be noted that Dr von Eschenbach is a personal friend of President Bush.

    Capitulation to this ransom demand would open the FDA up to political manipulation of the rankest sort. This is not about science and health. If it were, Dr. von Eschenbach would be confirmed in a heartbeat. This is about attacking the administration, just as its opponents did when they blocked John Bolton’s nomination as U.N. ambassador.

    The FDA has already become politicized. What the editorial meant to say was that this would prevent the agency from becoming more politicized in the direction that the current administration wants.

    Here is another illuminating quote from an article on US Medicine.com. Note this was written in April 2006 before the recent confirmation hearings. Although a timeframe for the confirmation hearing was set, there is no such corresponding timeframe from the FDA on when they would make a decision.

    There is not as yet a timetable for confirmation hearings, or one for FDA to make a final decision on the Plan B application. A considerable amount of criticism has been directed at the agency for its handling of the application-both from Congress and from a number of professional medical organizations.

    A Government Accountability Office (GAO) report released in November documenting GAO’s investigation of FDA’s handling of the Plan B application showed a number of inconsistencies in that application review process, and included testimony from several FDA officials that they were asked by superiors to withhold their support of the application for reasons they believed to be political rather than medical.

    Here’s a link to the whole GAO report. I think the fact that the GAO report says that people within the agency felt the process was political rather than scientific means this nomination should indeed be held until after the FDA makes a decision on plan B.

    Other Resources

    RedOrbit - Health - EDITORIAL: Time for Plan B: An FDA Nomination Held Hostage for Understandable Reasons
    FDA Candidate’s Future Depends On Morning After Pill’s Fate
    FDA Chief Calls For Meeting With Barr Subsidiary, Says Age Restriction In Nonprescription Plan B Application Should Be Raised To 18

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    August 2, 2006

    FDA and Biomarkers

    by @ 10:22 am.  Filed under FDA, Drug Development

    There has been some talk recently of improving the drug development process by including the use of biomarkers. Now, I’ll be the first to admit this is somewhat out of my area of expertise; I’ve always been involved on the manufacturing side, but I wonder if the FDA will really quickly buy into this approach. I know from my experience in developing oncology drugs that the FDA wanted to see an increase in overall survival; that is the gold standard as it should be. The company I worked for suggested several surrogates mainly to get a good idea of who the drug may help and to determine more quickly if development should be discontinued. The feedback was that the FDA would not be considering such data in our filings.

    So, maybe biomarkers will work for other areas, but my experience in oncology was that the FDA still wanted to see overall survival. But then maybe it will slowly change as more evidence comes in.

    Resources:

    RedOrbit - Health - Research and Markets: The FDA is Encouraging the Use of Biomarkers in Clinical Trials and, in a Few Cases, Requiring the Development of Companion Diagnostics
    The FDA Is Encouraging The Use of Biomarkers In Clinical Trials
    Safety Biomarkers Help to Reduce Drug Attrition

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