Cannabis and the Often Overlooked Drug Exclusion Rule

Earlier this week, several major news outlets (CNN, Fox Business, and Bloomberg) reported that Coca-Cola is considering making a move into “cannabis drinks” — as evidenced by supposed talks with Aurora Cannabis, Inc., a Canadian owned and operated company that sells a variety of cannabis products including several strains of dried cannabis as well as several oils.  The company finally issued a statement, in response to many media inquiries:  “We have no interest in marijuana or cannabis. Along with many others in the beverage industry, we are closely watching the growth of non-psychoactive CBD as an ingredient in functional wellness beverages around the world.  The space is evolving quickly. No decisions have been made at this time.”

Caution might well be warranted with respect to products for sale in the United States, because of the often-overlooked drug exclusion rule at FDA.  Coca-Cola has sophisticated FDA counsel, and I am sure they are on top of this issue.  But others watching legal and real-world developments relating to sale of cannabis may not be aware of the rule, which presents a significant legal impediment to the sale of CBD in any form other than approved new drugs (even if no medical claims are made).

Many people don’t know about the drug exclusion rule . . .

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The Patent Dance: A Reasonable Response to the Specter of Reasonable Royalties

Based on the dispute between Celltrion and Genentech over Celltrion’s biosimilar version of Rituxan (rituximab), it should be clear that interpretive disputes relating to the patent dance in the 2010 biosimilar law are far from over.  The patent dance is indeed the gift that keeps on giving.  And some of the interpretive conundrums lead to ridiculous results, at least, if you’re at all interested in saving litigants money.  Look at what Genentech recently found itself doing.

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Biosimilar Patent Litigation: the “Finish What You Started” Rule

As earlier posts on this blog have noted (here and here), the Supreme Court’s 2017 ruling in Sandoz v. Amgen effectively put an end to arguments that biosimilar applicants can be forced to participate in the “patent dance” with biologics innovators.  Even still, there are lots of interesting issues relating to the patent litigation provisions of the 2010 biosimilars law.  Here’s one percolating in the courts right now:  can a biosimilar company start to dance and then change its mind?  Or does it have to finish what it started?

This arises in a dispute between Genentech and Celltrion over a biosimilar copy of Rituxan (rituximab).  There’s a second issue in this dispute, which I will describe in another blog post.  First some background, and then I’ll unpack the litigation.

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Whither FDA’s drug approval paradigm? — A Debate from Recent FDA Law SSRN Postings

A series of thoughtful articles in the spring tackled some basic questions about the drug development and approval paradigm.  I’ll be reviewing other SSRN postings in later posts, but the articles described below work well together — presenting fundamental questions about how drugs should be studied (when and by whom), how the resulting information is processed, and what information (how much and what type) should be required before drugs are permitted on the market.  And they tee up what might be a spirited debate about what, exactly, a “public health” approach to new drug approval might mean.

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FDA Law SSRN Reading List – February and March 2018, 2/3

Continuing with FDA-related scholarship posted on SSRN in February and March:  Professor Noah explores the possibility of “reverse switches” from over-the-counter (OTC) status back to prescription status (or perhaps, he suggests “behind the counter” status) in response to new safety information.  Professor Paradise explains the provisions of the 21st Century Cures Act that contemplate greater patient involvement in medical product development, and Professors Evans and Ossorio evaluate the 21st Century Cures Act exclusion of clinical decision software from the agency’s medical device authority.

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SSRN Reading List February and March, 1 of 3

Many scholars posted articles relating to FDA law in February and March.  To do these articles justice, I am breaking my report into three parts.  Below, Rachel Sachs takes on drug prices by proposing we no longer require payers to cover new drugs simply because FDA has approved the drugs; Laurie Beyranevand and Diana Winters would have the states step in where FDA has not been, in their view, aggressive enough (thus, banning substances in food that are deemed safe by their manufacturers but not reviewed by FDA, and banning use of antibiotics in food-producing animals for purposes of growth enhancement); and Robin Feldman and colleagues publish a succinct new summary of their empirical research on citizen petitions that relate to pending generic drug applications.

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Pediatric Exclusivity (3 of 3): Amgen v. Hargan

My last entry described the facts leading to Amgen’s suit against FDA over denial of pediatric exclusivity for Sensipar.  Below I describe what’s at issue in the case.  At bottom, this litigation relates to a federal agency developing a new standard (a new interpretation of its statute) that it will apply when ruling on applications for a benefit, after its prior interpretation suffered a defeat in federal court.  Rather than announcing the standard publicly, the plaintiff in this case argues, the agency applied the standard in non-public rulings for more than a decade.  Not only does the standard conflict with the statute, plaintiff adds, but the agency has not been consistent in its application of the standard.  Thus the dispute is more about how a federal agency is operating than it is about the law of pediatric exclusivity.

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Pediatric Exclusivity (2 of 3): Amgen v. Hargan

A prior post provided an overview of pediatric exclusivity — how it works and why it was designed this way.  This is the first of two posts describing Amgen’s suit against FDA regarding the agency’s denial of pediatric exclusivity for Sensipar (cinacalcet hydrochloride).  I’ll start, today, with the back story — the facts and Amgen’s complaint.

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FDA Law SSRN Reading List – December ’17 & January ’18

Very few folks posted papers in December and January relating to FDA law, but hopefully the February law journal submission cycle will yield a rich crop.  Here are two essays and one article of potential interest – one each on medical devices, biological products, and food.  (I am excluding my own paper.)

Sarah Duranske, Reforming Regenerative Medicine Regulation

In this article forthcoming in the Georgia State Law Review, Duranske (currently a fellow at Stanford) (* edited to correct the spelling of her last name!) evaluates proposals for regulation of regenerative medicine.  She has several interesting ideas tucked in here, any of which could have been the basis for an article in its own right.  Section I contains a nice overview of the current regulatory paradigm for therapies that fall within the umbrella of “regenerative medicine” — including the recently enacted accelerated approval pathway for “regenerative medicine advanced therapies.”  Section II responds to deregulation arguments, arguing that FDA regulation is necessary to protect patients and to ensure the development of meaningful data.  Much of this retreads familiar ground, but the discussion of “Baptists and bootleggers” alliances with respect to regenerative medicine is very interesting.  This phenomenon is pervasive in food and drug law and merits more discussion in scholarship.  Section III is where the article gets interesting.  Here, she considers proposals for “adaptive licensing” of regenerative products.  The basic idea is that FDA would approve a product on the basis of less evidence, but would restrict access while the sponsor gathered more evidence from clinical use.  She characterizes adaptive licensing as a type of adaptive management — a particular type of process that an agency might use to produce a regulatory outcome. She then assesses the suitability of regenerative medicine for adaptive licensing by running it through the various rationales in the administrative law literature for adaptive management at agencies.  This leads her to the conclusion that the benefits of adaptive licensing do not outweigh its risks.  Section IV contains a brief discussion of her proposals — for instance, shifting some regenerative therapies to the more loose regulatory paradigm governing human tissue and cell products.  But I wanted to read much more about her ideas.

Jane R. Bambauer, Dr. Robot

In this essay published in the UC Davis Law Review, Professor Bambauer considers whether health and medical artificial intelligence (AI) should be regulated more like physicians or medical devices.  When the application is a “knowledge” app rather than a “measurement” app, she argues, physicians are the better analogy.  Some of the duties of a physician (such as the duty of competence and the duty of confidentiality) translate well, but she is more guarded about other rules (rules of informed consent, for instance, and the duty to disclose conflicts of interest).

Laurie Beyranevand, Regulating Inherently Subjective Food Labeling Claims

In this essay published in Environmental Law, Professor Beyranevand essentially argues that FDA should ban claims like “natural” and “healthy” in food labeling.  The statute imposes clear rules governing specific types of claims, such as “health claims” and “nutrient content claims.”  She is focused on claims that are not covered by these specific claims-authorizing provisions of the statute.  And she argues that FDA should subject these claims to a standard of “significant scientific agreement” — that is, permitting them only if there is significant scientific agreement.  The FDCA already uses this standard for health claims, which generally characterize a specific relationship between a food product and a health condition or disease.  She also believes it would be virtually impossible to support a claim like “natural” and “healthy” under this standard.  So, in essence, she is arguing for a ban.  Finally, although the federal courts have concluded that the First Amendment requires FDA to consider disclaimers for health claims that lack significant scientific agreement, she contends that the First Amendment is no impediment to the proposal.  I think the idea is that if a claim is inherently subjective, then a disclaimer isn’t going to clear things up (there’s x amount of data, but not y).  It’s just going to confuse consumers more.

Pediatric Exclusivity 101

Shortly before Alex Azar’s confirmation hearing (to be Secretary of HHS), a reporter called me with questions.  She had an angle she wanted to pursue: that Lilly had “gamed” a patent, using pediatric exclusivity, under Azar’s watch.  I explained pediatric exclusivity – what it was designed for, how it works, and how Lilly seemed to have used it precisely as designed. I mentioned the constraints that apply to company requests for pediatric exclusivity and told her that they were meaningful, mentioning Amgen’s ongoing litigation against FDA regarding exclusivity for Sensipar.

My explanation had little impact; the story ran as initially conceived.  Judge Moss ruled in the Sensipar dispute in late January, however, and Amgen has confirmed that it plans to appeal the ruling.  This is therefore the first of two posts on the issue of pediatric exclusivity.  Below I explain how pediatric exclusivity works; in the next post I will explain the Sensipar dispute.

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