No. 71-1394.United States Court of Appeals, First Circuit.
December 23, 1971.
Gilbert H. Weil, New York City, with whom Edward B. Hanify, Boston, Mass., was on motions and memorandum in support for petitioner.
Howard S. Epstein and Ira H. Lessfield Attys., Dept. of Justice, and Eugene M. Pfieifer, Atty., Dept. of Health, Education and Welfare for respondents.
Petition for review from the FDA.
Page 564
[1] ON MOTIONS FOR RETRANSFER, FOR LEAVE TO ADDUCE ADDITIONAL EVIDENCE, AND FOR STAY PENDING REVIEWPage 565
in a single decertification proceeding, does not appear to me to comport with either the letter or spirit of § 2112(a). I accordingly deny the motion for retransfer.
[5] Bristol next argues that if I deny its motion to retransfer, it is still entitled to an order requiring the FDA to allow the introduction of additional evidence (1) to test the accuracy of facts adverted to in the November 17, 1971, order, (2) to test whether the order really relies on such facts, and (3) to determine if the order is unreasonable and arbitrary in applying to Bristol the regulatory requirement of well-controlled clinical studies of safety and effectiveness. Here as in American Cyanamid, the FDA ruled that Bristol had not presented substantial evidence of effectiveness which would entitle it to a hearing. As indicated in my opinion denying a stay to American Cyanamid, I consider it likely that the FDA will be found to have acted within its power in requiring data based in adequate and well-controlled studies and that the drug companies affected by the November 17 Order will be found to have been given ample opportunity to rebut the considerations upon which the general standard was predicated. Bristol’s motion to adduce new evidence is merely another mode of attacking the authority of FDA to require as a sine qua non data based on “adequate and well controlled clinical investigations”. [6] While the data in American Cyanamid consisted of testimonials and a physician survey, Bristol argues that its case warrants different treatment in that it did proffer some clinical studies. It submitted to the FDA two biocomparability studies of Tetrex-AP Syrup and Tetrex-APC. The studies, made on two groups of sixteen males apparently in the fall of 1969, but not submitted to the FDA until October 1970, purported to demonstrate that the antibiotic component of two of their fixed-combination drugs was as fully available in the blood as when separately administered. But the bioavailability of the other components was not tested either singly or in combination and no data were submitted as to Bristol’s two Syndecon products. Nor did Bristol conform with the testing protocol requirements of 21 CFR § 130.12(a)(5), issued on May 8, 1970.[*] Since the FDA relied on the failure of Bristol’s studies in these respects to conform to the “clinical studies” requirement, I find Bristol’s attempt to distinguis American Cyanamid unpersuasive. Finally, while the full court might rule that the FDA could not apply its regulatory standard to Bristol’s drugs, I think it unlikely that the FDA will be found to have exceeded its authority in refusing to depart from it. So thinking, I deny the motion for leave to introduce additional evidence. [7] It is apparent that, apart from the transfer issue and the fact that Bristol relies on the above-mentioned biocomparability studies of the antibiotic component in two of its drugs, this case raises the same issues as did American Cyanamid. I accordingly similary conclude that, while imminent withdrawal of the questioned drugs from the market will cause substantial loss to Bristol, it has not demonstrated sufficient likelihood of ultimately prevailing on the merits to warrant a stay.“This data does not relate to the bioavailability of the other ingredients in addition to tetracycline. Biocomparability may be accepted in lieu of clinical studies only for a product identical to one which has previously been established as efficacious by adequate clinical studies. No adequate clinical studies exist establishing the efficacy of any of these combination drugs.”
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