GT Legal Food Talk Episode 26: Crossing Borders – Regulation of Food in the United States and Canada with Stikeman’s Sara Zborovski [Podcast]
In this episode of Legal Food Talk, host Justin Prochnow welcomes Sara Zborovski, one of his attorney counterparts from Canada with Stikeman Elliott to discuss the outlook on food regulation in 2025 for the United States and Canada.
Like a baseball or hockey game played between teams from Canada and the United States, they stand at attention while both national anthems play, discussing some of the potential political implications on food regulation in 2025, including a new administration in the United States and Justin Trudeau’s recent actions to prorogue Parliament in Canada.
They then discuss the wave of FDA guidance issues by the FDA at the end of 2024 and the start of 2025, including FDA’s revised definition of “healthy,” the removal of coconut as a food allergen, new action levels for lead in food intended for infants and children, and the proper naming of plant-based food alternatives.
This episode is a shining example of international cooperation and the best collaboration between the United States and Canada since Canadian bacon and pineapple!
This Week in 340B: January 7 – 13, 2025
Find this week’s updates on 340B litigation to help you stay in the know on how 340B cases are developing across the country. Each week we comb through the dockets of more than 50 340B cases to provide you with a quick summary of relevant updates from the prior week in this industry-shaping body of litigation.
Issues at Stake: Contract Pharmacy; Other
In two appealed cases challenging a proposed Louisiana law governing contract pharmacy arrangements, the appellants filed their opening brief.
In a breach of contract case related to the Medicare 340B cuts, the court terminated the action without prejudice.
Matt David, associate in McDermott’s Los Angeles office, also contributed to this blog post.
December 2024 Bounty Hunter Plaintiff Claims
California’s Proposition 65 (“Prop. 65”), the Safe Drinking Water and Toxic Enforcement Act of 1986, requires, among other things, sellers of products to provide a “clear and reasonable warning” if use of the product results in a knowing and intentional exposure to one of more than 900 different chemicals “known to the State of California” to cause cancer or reproductive toxicity, which are included on The Proposition 65 List. For additional background information, see the Special Focus article, California’s Proposition 65: A Regulatory Conundrum.
Because Prop. 65 permits enforcement of the law by private individuals (the so-called bounty hunter provision), this section of the statute has long been a source of significant claims and litigation in California. It has also gone a long way in helping to create a plaintiff’s bar that specializes in such lawsuits. This is because the statute allows recovery of attorney’s fees, in addition to the imposition of civil penalties as high as $2,500 per day per violation. Thus, the costs of litigation and settlement can be substantial.
The purpose of Keller and Heckman’s latest publication, Prop 65 Pulse, is to provide our readers with an idea of the ongoing trends in bounty hunter activity.
In December of 2024, product manufacturers, distributors, and retailers were the targets of 394 new Notices of Violation (“Notices”) and amended Notices, alleging a violation of Prop. 65 for failure to provide a warning for their products. This was based on the alleged presence of the following chemicals in these products. Noteworthy trends and categories from Notices sent in December 2024 are excerpted and discussed below. A complete list of Notices sent in December 2024 can be found on the California Attorney General’s website, located here: 60-Day Notice Search.
Food and Drug
Product Category
Notice(s)
Alleged Chemicals
Fruits, Vegetables, and Mushrooms: Notices include farro porcini mushrooms, chopped spinach, capers, chili mango, flavored sunflower seeds, shiitake mushrooms, kale chips, flax seeds, artichoke quarters in brine, moringa, dried apricot, madras lentils, cactus chips, bamboo shoots, and stuffed manzanilla olives
38 Notices
Lead and Lead Compounds, and Cadmium and Cadmium Compounds
Prepared Foods: Notices include soup bowls, noodle bowls, salt & vinegar potato chips, bundt cake mix, flatbread mix, granola bars, crackers, nut butter, vegetable biryani, vegan chips, mushroom ravioli, gluten-free tortilla wraps, and plant-based ground meat
36 Notices
Lead and Lead Compounds, Cadmium, and Mercury
Seafood: Notices include Alaska pink salmon, tuna salad, mackerel in olive oil, sardines, seasoned squid, dried seaweed, fried anchovy, dried mackerel, ground shrimp, dried sea mustard seaweed, raw seaweed, and shrimp paste
32 Notices
Lead and Lead Compounds, Cadmium and Cadmium Compounds, and Mercury
Dietary Supplements: Notices include plant-based protein shakes, green powder superfood, greens, protein powder, electrolyte formula beverages, pre-workout beverages, ginkgo biloba powder and tea, and spirulina powder
26 Notices
Cadmium, Lead and Lead Compounds, Mercury and Mercury Compounds, and Perfluorooctanoic Acid (PFOA)
THC-containing Products: Notices include gummies, chocolates, soft gels, flavored beverages, and candies
13 Notices
Delta-9-tetrahydrocannabinol
Sauces: Notices include red mole, aged balsamic vinegar, sundried tomato paste, and basil pesto sauce
4 Notices
Lead and Lead Compounds
Packaged Liquids: Notices include vegetable stock and fruit-flavored beverages, and canned coconut water
4 Notices
Perfluorononanoic Acid (PFNA) and its salts, Perfluorooctanoic Acid (PFOA), and Bisphenol A (BPA)
Cosmetics and Personal Care
Product Category
Notice(s)
Alleged Chemicals
Personal Care Items: Notices include hair color, aloe vera lotions, skin toners, spot treatments, face masks, vitamin C serum, enzyme scrub, body cleaners, eye serums and creams, hair color treatments, hair gels, body wash and foaming cleansers, pain relief cream, body glow, and squirt blood
66 Notices
Diethanolamine
Cosmetics: Notices include mascara, cream makeup, matte lipstick, eyeliner pens, concealers, face primer, and cake makeup
36 Notices
Diethanolamine
Personal Care Products: Notices include shave gel, shave foam, and volumizing foam
3 Notices
Nitrous Oxide
Consumer Products
Product Category
Notice(s)
Alleged Chemicals
Plastic Pouches, Bags, and Accessories: Notices include children’s bags, beauty bags, bento bags, fanny packs, backpacks, wallets, picking bags, weight stabilizing bags, travel bags, rescuer guide packs, shoe covers, and cases for wheel sets
26 Notices
Di(2-ethylhexyl)phthalate (DEHP), Diisononyl phthalate (DINP), and Di-n-butyl phthalate (DBP)
Miscellaneous Consumer Products: Notices include orthodontic kits, keychains, back scratchers, safety flags, vinyl banners, engraved wax sealers, steering wheel covers, lamps, stethoscopes, salt and pepper shakers with PVC components, luggage tag, and vinyl roll holders
26 Notices
Di(2-ethylhexyl)phthalate (DEHP), Diisononyl phthalate (DINP), Di-n-butyl phthalate (DBP), and Lead
Hardware and Home Improvement Products: Notices include long handle hooks, garden hose splitters, coatings and paints, soldering wire, tools with PVC grips, pressure gauge, thermocouples, wing nuts, pop-up drains, propane tank adapter, and thread tape
23 Notices
Lead and Lead Compounds, Di(2-ethylhexyl)phthalate (DEHP), Diisononyl phthalate (DINP), and Perfluorooctanoic Acid (PFOA)
Clothing and Shoes: Notices include gloves made with leather, bucket hats, sandals with PVC components, golf gloves, weatherproof jackets, slides, fuzzy socks, and ski pants
22 Notices
Di(2-ethylhexyl)phthalate (DEHP), Chromium (hexavalent compounds), Perfluorooctanoic Acid (PFOA),
and Bisphenol A (BPA)
Glassware, Metals, and Ceramics: Notices include mugs, glass sets, blue multi-colored glass, metal and glass organizers, spoon rests, shakers, and soap dispenser/sponge holders
19 Notices
Lead and Lead Compounds
Miscellaneous Consumer Products: Notices include shower curtains, tablecloths, pillows, pet beds, athletic bandages, and outdoor cushions
10 Notices
Perfluorooctanoic Acid (PFOA)
Hobby Items: Notices include artist paste paints, art panels, lens mounts, pickleball paddles, jump rope, molding cream, and golf storage boot
8 Notices
Di(2-ethylhexyl)phthalate (DEHP), Di-n-butyl phthalate (DBP), Lead, Diethanolamine, and Perfluorooctanoic Acid (PFOA)
Coal Tar Epoxy
1 Notice
Bisphenol A (BPA), Epichlorohydrin, Ethylbenzene, soots, tar and mineral oils (coal tar)
There are numerous defenses to Prop. 65 claims, and proactive measures that industry can take prior to receiving a Prop. 65 Notice in the first place. Keller and Heckman attorneys have extensive experience in defense of Prop. 65 claims and in all aspects of Prop. 65 compliance and risk management. We provide tailored Proposition 65 services to a wide range of industries, including food and beverage, personal care, consumer products, chemical products, e-vapor and tobacco products, household products, plastics and rubber, and retail distribution.
AI Drug Development: FDA Releases Draft Guidance
On January 6, 2025, the U.S. Food and Drug Administration (FDA) released draft guidance titled Considerations for the Use of Artificial Intelligence To Support Regulatory Decision-Making for Drug and Biological Products (“guidance”) explaining the types of information that the agency may seek during drug evaluation. In particular, the guidance outlines a risk framework based on a “context of use” of Artificial Intelligence (AI) technology and details the information that might be requested (or required) relating to AI technologies, the data used to train the technologies, and governance around the technologies, in order to approve their use. At a high level, the guidance underscores the FDA’s goals for establishing AI model credibility within the context of use.
This article provides an overview of the guidance, including example contexts of use and detailing the risk framework, while explaining how these relate to establishing AI model credibility through the suggested data and model-related disclosures. It further details legal strategy considerations, along with opportunities for innovation, that arise from the guidance. These considerations will be valuable to sponsors (i.e., of clinical investigations, such as Investigational New Drug Exemption applications), along with AI model developers and other firms in the drug development landscape.
Defining the Question of Interest
The first step in the guidance’s framework is defining the “question of interest:” the specific question, decision, or concern being addressed by the AI model. For example, questions of interest could involve the use of AI technology in human clinical trials, such as inclusion and exclusion criteria for the selection of participants, risk classification of participants, or determining procedures relating to clinical outcome measures of interest. Questions of interest could also relate to the use of AI technology in drug manufacturing processes, such as for quality control.
Contexts of Use
The guidance next establishes contexts of use – the specific scope and role of an AI model for addressing the question of interest – as a starting point for understanding any risks associated with the AI model, and in turn how credibility might be established.
The guidance emphasizes that it is limited to AI models (including for drug discovery) that impact patient safety, drug quality, or reliability of results from nonclinical or clinical studies. As such, firms that use AI models for discovering drugs but rely on more traditional processes to address factors that the FDA considers for approving a drug such as safety, quality, and stability, should be aware of the underlying principles of the guidance but might not need to modify their current AI governance. An important factor in defining the contexts of use is how much of a role the AI model plays relative to other automated or human-supervised processes; for example, processes in which a person is provided AI outputs for verification will be different from those that are designed to be fully automated.
Several types of contexts of use are introduced in the guidance, including:
Clinical trial design and management
Evaluating patients
Adjudicating endpoints
Analyzing clinical trial data
Digital health technologies for drug development
Pharmacovigilance
Pharmaceutical manufacturingGenerating real-world evidence (RWE)
Life cycle maintenance
Risk Framework for Determining Information Disclosure Degree
The guidance proposes that the risk level posed by the AI model dictates the extent and depth of information that must be disclosed about the AI model. The risk is determined based on two factors: 1) how much the AI model will influence decision-making (model influence risk), and 2) the consequences of the decision, such as patient safety risks (decision consequence risk).
For high-risk AI models—where outputs could impact patient safety or drug quality—comprehensive details regarding the AI model’s architecture, data sources, training methodologies, validation processes, and performance metrics may have to be submitted for FDA evaluation. Conversely, the required disclosure may be less detailed for AI models posing low risk. This tiered approach promotes credibility and avoids unnecessary disclosure burdens for lower-risk scenarios.
However, most AI models within the scope of this guidance will likely be considered high risk because they are being used for clinical trial management or drug manufacturing, so stakeholders should be prepared to disclose extensive information about an AI model used to support decision-making. Sponsors that use traditional (non-AI) methods to develop their drug products are required to submit complete nonclinical, clinical, and chemistry manufacturing and controls to support FDA review and ultimate approval of a New Drug Application. Those sponsors using AI models are required to submit the identical information, but in addition, are required to provide information on the AI model as outlined below.
High-Level Overview of Guidelines for Compliance Depending on Context of Use
The guidance further provides a detailed outline of steps to pursue in order to establish credibility of an AI model, given its context of use. The steps include describing: (1) the model, (2) the data used to develop the model, (3) model training, (4) and model evaluation, including test data, performance metrics, and reliability concerns such as bias, quality assurance, and code error management. Sponsors may be expected to be more detailed in disclosures as the risks associated with these steps increase, particularly where the impact on trial participants and/or patients increase.
In addition, the FDA specifically emphasizes special consideration for life cycle maintenance of the credibility of AI model outputs. For example, as the inputs to or deployment of a given AI model changes, there may be a need to reevaluate the model’s performance (and thus provide corresponding disclosures to support continued credibility).
Intellectual Property Considerations
Patent vs. Trade Secret
Stakeholders should carefully consider patenting the innovations underlying AI models used for decision-making. The FDA’s extensive requirements for transparency and submitting information about AI model architectures, training data, evaluation processes, and life cycle maintenance plans would pose a significant challenge for maintaining these innovations as trade secrets.
That said, trade secret protection of at least some aspects of AI models is an option when the AI model does not have to be disclosed. If the AI model is used for drug discovery or operations that do not impact patient safety or drug quality, it may be possible to keep the AI model or its training data secret. However, AI models used for decision-making will be subject to the FDA’s need for transparency and information disclosure that will likely jeopardize trade secret protection. By securing patent protection on the AI models, stakeholders can safeguard their intellectual property while satisfying FDA’s transparency requirements.
Opportunities for Innovation
The guidance requires rigorous risk assessments, data fitness standards, and model validation processes, which will set the stage for the creation of tools and systems to meet these demands. As noted above, innovative approaches for managing and validating AI models used for decision-making are not good candidates for trade secret protection, and stakeholders should ensure early identification and patenting of these inventions.
We have identified specific opportunities for AI innovation that are likely to be driven by FDA demands reflected in the guidance:
Requirements for transparency
Designing AI models with explainable AI capabilities that demonstrate how decisions or predictions are made
Bias and fitness of data
Systems for detecting bias in training data
Systems for correcting bias in training data
Systems for monitoring life cycle maintenance
Systems to detect data drift or changes in the AI model during life cycle of the drug
Systems to retrain or revalidate the AI model as needed because of data drift
Automated systems for tracking model performance
Testing methods
Developing models that can be tested against independent data sets and conditions to demonstrate generalizability
Integration of AI models in a practical workflow
Good Manufacturing Practices
Clinical decision support systems
Documentation systems
Automatic systems to generate reports of model development, evaluation, updates, and credibility assessments that can be submitted to FDA to meet regulatory requirements
The guidance provides numerous opportunities for innovations to enhance AI credibility, transparency, and regulatory compliance across the drug product life cycle. As demonstrated above, the challenges that the FDA seeks to address in order to validate AI use in drug development clearly map to potential innovations. Such innovations are likely valuable since they are needed to comply with FDA guidelines and offer significant opportunities for developing a competitive patent portfolio.
Conclusion
With this guidance, the FDA has proposed guidelines for establishing credibility in AI models that have risks for and impacts on clinical trial participants and patients. This guidance, while in draft, non-binding form, follows a step-by-step framework from defining the question of interest and establishing the context of use of the AI model to evaluating risks and in turn establishing the scope of disclosure that may be relevant. The guidance sets out the FDA’s most current thinking about the use of AI in drug development. Given such a framework and the corresponding level of disclosure that can be expected, sponsors may consider a shift in strategy towards using more patent protection for their innovations. Similarly, there may be more opportunities for identifying and protecting innovations associated with building governance around these models.
In addition to using IP protection as a backstop to greater disclosure, firms can also consider introducing more operational controls to mitigate the risks associated with AI model use and thus reduce their disclosure burden. For example, firms may consider supporting AI model credibility with other evidence sources, as well as integrating greater human engagement and oversight into their processes.
In meantime, sponsors that are uncertain about how their AI model usage might interact with future FDA requirements should consider the engagement options that the FDA has outlined for their specific context of use.
Comments on the draft guidance can be submitted online or mailed before April 7, 2025, and our team is available to assist interested stakeholders with drafting.
FDA Announces Red No. 3 Authorizations to be Revoked as Matter of Law, not Safety
Today FDA announced that it is revoking the color additive authorizations for Red No. 3 in food (including dietary supplements) and ingested drugs based on evidence showing that Red No. 3 is carcinogenic to male rats (not humans, or even female rats) and the so-called “Delaney Clause” of the Federal Food, Drug, and Cosmetic Act (FD&C Act) which prevents the agency from authorizing an additive that has been found to cause cancer in humans or animals. The Delaney Clause as it pertains to color additives can be found in section 721(b)(5)(B) of the FD&C Act (21 USC 379e(b)(5)(B)) and a similar provision pertaining to food additives can be found in section 409(c)(3)(A) (21 USC 348(c)(3)(A)).
FDA’s announcement makes clear that the currently available scientific information does not support safety concerns regarding the use of Red No. 3 and that its decision was one it feels it was required to make based on the extremely broad scope of the Delaney Clause, which was added to the FD&C Act over 60 years ago and has not been updated since to keep up with new scientific understandings of cancer.
More specifically, consistent with its prior statements on Red No. 3, FDA concluded that Red No. 3 causes cancer in male rats at high doses by increasing the levels of a thyroid hormone (TSH). However, this mechanism of action is not relevant to humans; rats are much more sensitive to changes in TSH levels and studies in humans have not demonstrated that Red No. 3 changes thyroid hormone levels, including TSH. Finally, carcinogenicity of Red No. 3 has not been observed when female rats were tested, or when either sex of mice, gerbils, or dogs were tested.
The decision will be published in the federal register tomorrow (01/16/2025), but a pre-publication version of the federal register notice is available here. Manufacturers using Red No. 3 in food will have until January 15, 2027 to reformulate their products while manufacturers using Red No. 3 in ingested drugs will have until January 18, 2028 to reformulate.
This follows California’s ban of Red No. 3 with the signing of the California Food Safety Act in 2023 by Gov. Gavin Newsom which will go into effect in 2027 as well.
FDA Sets Action Levels For Lead
A year ago, the FDA issued draft guidance for lead levels in baby foods. In the year since the FDA issued its draft guidance for lead levels in baby food, two states, California and Maryland, have adopted laws which require baby food manufacturers to test and publish heavy metal levels in their products. Litigation alleging that babies have developed autistic spectrum disorder (ASD) and / or attention deficit hyperactivity disorder (ADHD) has been continuing while the FDA finalized its guidance. In fact, last year the litigation was centralized in an MDL in the Northern District of California. Currently there are 88 cases in the MDL, and a pending motion to dismiss in which defendants have stated, among other things, that plaintiffs cannot prove a direct link between heavy metals in baby food and plaintiff’s alleged injuries. However, discovery is proceeding.
Last week the FDA set its action level for lead in baby food at the same levels proposed in the draft guidance:
10 parts per billion (ppb) for fruits, vegetables (excluding single-ingredient root vegetables), mixtures (including grain and meat-based mixtures), yogurts, custards/puddings, and single-ingredient meats;
20 ppb for root vegetables (single ingredient); and
20 ppb for dry infant cereals.
Lead is just one of the heavy metals under scrutiny from the FDA as part of its “Closer to Zero” program. The FDA is also considering cadmium, arsenic, and mercury with a target date to issue draft guidance this year for cadmium and arsenic. Mercury is found predominantly in seafood. The FDA has already issued Advice About Eating Fish for pregnant and lactating women and young children.
So – does the new FDA action level for lead impact the ongoing litigation? Doubtless both sides will cite the new action levels, but its impact remains to be seen. Basic product liability law requires plaintiffs to prove that heavy metals in the defendants’ baby foods were a substantial contributing factor to a plaintiff’s ASD or ADHD. Does the new lead action level advance that effort?
In adopting its action level for lead, the FDA acknowledged:
Even low lead exposure can harm children’s health and development, specifically the brain and nervous system. Neurological effects of lead exposure during early childhood include learning disabilities, behavioral difficulties, and lowered IQ. Lead exposures also may be associated with immunological, cardiovascular, renal, and reproductive and/or developmental effects. Because lead can accumulate in the body, even low-level chronic exposure can be hazardous over time.
However, in setting lead levels, the FDA analyzed lead levels in various baby foods going as far back as 2014. The FDA data showed that:
All food categories had mean lead concentrations well below 10 ppb, with the exception of root vegetables, which had a mean concentration of 11.6 ppb.
Consequently, the vast majority of all baby foods for at least the past ten years have had lead concentrations below the new FDA action levels. While the FDA has not defined any level of lead exposure as “safe,” if the FDA actions levels are accepted by the courts as “safe” levels, that would seem to be a barrier to plaintiffs’ efforts to recover. Plaintiffs’ likely retort is that single exposures are not the issue, but the cumulative exposures are. Such an argument by plaintiffs leads to potential defenses. How are plaintiffs going to link the cumulative exposure in infants to particular manufacturers? Heavy metals are ubiquitous in the environment. Babies can acquire heavy metals in utero, from breast milk, from soil, from water, from air pollution, from lead paint in homes, and the list goes on. Further, plaintiffs’ experts will face Daubert (or similar challenges) as to whether heavy metal exposure in baby food is even capable of causing the injuries at issue.
While the new FDA action levels for lead do provide guidance to manufacturers as to how to avoid FDA enforcement actions, their impact on litigation remains to be seen. How the MDL court rules on pending motions to dismiss and the results of upcoming discovery and expert motion practice will be instructive. Thus far, plaintiffs have failed at the motion to dismiss and Daubert stages. This blog will continue to follow developments.
2024 Hatch-Waxman Year in Review
Introduction
In 2024, the Hatch-Waxman Act continued to play a critical role in the U.S. pharmaceutical landscape, driving the dynamics between brand-name drugmakers and generics. This landmark legislation, enacted to encourage innovation while ensuring access to affordable medications, remained a focal point for numerous legal battles and regulatory shifts. Key decisions throughout the year have refined interpretations of its provisions, influencing patent challenges, market exclusivities, and the pathway for generics. As the pharmaceutical sector navigates evolving market pressures, agency action, and possible legislation, the legal contours of the Hatch-Waxman Act continued to impact both the business and legal strategies of pharmaceutical companies in 2024.
The Year By Numbers
In the year 2024, 312 complaints were filed initiating Hatch-Waxman litigation (compared to 259 in 2023)1:
As evident above, the overwhelming majority of ANDA complaints were filed in the District of Delaware and the District of New Jersey. This common trend remains consistent for the same reasons these district courts have always been hubs for ANDA litigation: most pharmaceutical companies are incorporated in Delaware and are commonly headquartered in New Jersey. Furthermore, because these two jurisdictions handle the majority of ANDA litigation, the local patent rules and proclivities of judges within these districts generally account for the unique procedural complexities that large-scale Hatch-Waxman litigation can impose on these dockets.
Given that Hatch-Waxman litigation is statutorily decided at the bench if it goes to trial, it behooves all litigants to have matters handled by judges experienced in the technical subject matter. As shown above, almost 50% of all ANDA complaints filed were assigned to one of five judges, ensuring that those judges have familiarity with common Hatch-Waxman substantive and procedural issues, and usually leading to a rapport between those judges and the attorneys that frequently litigate in front of them.
In 2024, 283 on-going Hatch-Waxman litigations were either resolved or terminated.2 There was a slight decrease in settlements in 2024: 39% of terminated matters in 2024 compared to 50% in 2023.3 Innovator companies (i.e., NDA & patent holders) were considered to have prevailed on issues 20% of the time, whereas generic companies were considered to have prevailed on issues only 2% of the time (i.e., those decisions excluding settlements and procedural resolutions). While these statistics may suggest that innovator companies find favorable resolutions more frequently than generic manufacturers, generics generally may be more inclined to seek settlement when perceiving a likely favorable outcome, rather than continue litigation. This trend existed in 2023 and remained in 2024.
Looking at patent findings from 2024 (below4), evidently very few ANDA cases were decided at summary judgment in 2024, a frequency from which few conclusions can be drawn. When cases went to trial, however, we saw a finding of infringement more frequently than noninfringement, and validity was upheld more frequently than not. Of those that were held invalid at trial, most were decided on obviousness grounds. Granted, however, these numbers don’t consider invalidity positions that were dropped due to case narrowing prior to trial, rather than on the merits.
This contrasts slightly to the results from 2023 (below5):
Namely, judges were seemingly more reticent to find patents invalid at summary judgment in 2024, while they did so three times in 2023 – again, however, a small sample size. In good news for innovator companies, district courts not only held patents invalid at trial far less frequently in 2024 compared to the year prior: 4 of 17 (24%) and 9 of 15 (60%), respectively. District courts also found infringement of valid patents at trial slightly more in 2024 compared to the year prior: 9 of 13 (69%) versus 6 of 10 (60%), respectively.
Federal Circuit Decisions and the Greater Context In Which They Fit
We saw a slight uptick in Hatch-Waxman decisions from the Federal Circuit last year (7 in 2024 compared to 5 in both 2023 and 2022), some of which significantly affect going forward how practitioners and in-house counsel manage and plan their IP strategies, expand their portfolios through prosecution, and preserve existing exclusivities in the federal courts and in front of the Patent Trial and Appeal Board. Some of the decisions we’ve seen from the Federal Circuit in 2024 were also germane to broader agency and legislative proposals that could come to fruition in 2025, as discussed below.
Edwards Lifesciences v. Meril Life Sciences6& the Safe Harbor Provision
Holding: The Hatch-Waxman safe harbor applied to the importation of two demonstration samples to a medical conference for the purpose of recruiting clinical investigators to support FDA approval.
Although not a decision surrounding the filing of an ANDA, the Federal Circuit began their 2024 Hatch-Waxman jurisprudence addressing the safe harbor provision, 35 U.S.C. § 271(e)(1): a valuable mechanism for fostering innovation in the pharmaceutical space. Federal Circuit precedent has interpreted the provision as broad, applying “as long as there is a reasonable basis for believing that the use of the patented invention will produce the types of information that are relevant to an FDA submission,”7 and even extending to activities which may be promotional rather than regulatory, but “where those activities are consistent with the collection of data necessary for filing an application with the FDA.”8 Here, Judges Stoll, Cunningham, and Lourie (dissenting) addressed whether the importation of two demonstration-only transcatheter heart valves for a conference during the process of pre-market approval was protected by the safe harbor, and ultimately affirmed precedent.9 As Judge Stoll put it, the question is not why or how the devices were imported or used, but whether the importation was for a use reasonably related to submitting information to the FDA.10 It was here. On appeal from a grant of summary judgment of no infringement, the Federal Circuit affirmed that there was no genuine dispute of material fact that Meril imported the devices for purposes reasonably related to recruiting investigators during pre-market approval processes and thus was covered by the safe harbor provision.11 For innovator companies, especially those in crowded commercial spaces where the risk of “brand-to-brand” litigation is higher, the safe harbor’s broad applicability to a variety of pre-approval activities under the ”reasonably related” standard offers peace of mind throughout early stages of product development; however, practitioners should advise their clients that the safe harbor is less helpful post-FDA approval, where routine submissions aren’t generally afforded the same protection.12
While courts may view the Hatch-Waxman safe harbor as offering a “wide berth,”13 U.S. patent law generally has a particularly narrow experimental use defense to patent infringement.14 The Edwards decision was followed months later by a request for public commentary by the United States Patent and Trademark Office (USPTO) on the potential legislative codification of the experimental use exception.15 To date, statutory experimental use defenses are confined in the U.S. to the Hatch-Waxman Act16 and the Plant Variety Protection Act,17 but are codified in a much broader fashion in other leading IP countries, such as Germany, China, and India. Feedback to the USPTO’s request was mixed; proponents of further codification suggested the exception was overly narrow, vague, or detrimental to US innovation on the global scale, whereas those with opposing viewpoints generally suggested the status quo was sufficient. At this time, the USPTO has not taken any further public action on the topic, but don’t be surprised if we see legislation promoting American innovation in 2025, such as an expanded codification of the experimental use defense.
Salix Pharmaceuticals v. Norwich Pharmaceuticals,18Post-trial Section VIII Carve-outs, and the Obviousness of Polymorph Patents
Holding: The district court did not err in denying the generic’s motion to modify judgment after amending its ANDA to remove an infringing indication after trial; the district court also did not err in finding that a person of ordinary skill in the art would have a reasonable expectation of success obtaining certain polymorph forms of rifaximin.
One month later, the first ANDA decision came from the Federal Circuit from Judges Lourie, Chen, and Cunningham (dissenting in part), who issued a surprising decision in light of (but not contradictory to) previous rulings on polymorph patents, while also addressing a unique post-trial tactic by the ANDA filer to gain earlier entry into the market. With respect to the former, Federal Circuit precedent has made it clear that finding polymorph claims obvious is a tall task given the unpredictability of chemical polymorphism and therefore the lack of reasonable expectation of success, as discussed in Grunenthal GMBH v. Alkem19 (2019) and Pharmacyclics v. Alvogen20 (2022). However, unique to this case were the “distinct factual predicates” that justified the district court’s obviousness finding.21 The prior art here contained examples which disclosed in detail the process that would produce the claimed polymorph, turn demonstrating a reasonable expectation of success in doing so.22 Therefore, unlike in previous § 103 decision on polymorphs, those at issue here was appropriately found to be obvious. Separately, Norwich’s ANDA sought to market generic Xifaxan for three indications: travelers’ disease, hepatic encephalopathy (HE) and irritable-bowel syndrome with diarrhea (IBS-D).23 However, when the district court ordered that the ANDA would not be approved until the expiry of the HE patents (which were found infringed), Norwich amended its ANDA post-trial to remove the infringing HE indication and sought to modify the judgment and gain earlier market entry.24 Both the district court and Federal Circuit rejected this attempt.25 The latter held that “it [was] not the potential use that of the drug for HE that is the relevant infringement,” but instead “the submission of the ANDA that included an infringing use,” and therefore “[t]hat the ANDA further recited a non-patent-protected indication does not negate the infringement resulting from the ANDA’s submission.”26 Further, allowing amendment of an ANDA at the Rule 60 stage is in the discretion of the district court, and the Federal Circuit’s affirmation of the district court’s decision created strong precedent that determining “whether an ANDA applicant has successfully carved out language from a label to turn infringement into non-infringement” “would essentially be a second litigation,” and is “inequitable and inappropriate.”27
This decision offers two key takeaways for counsel for both innovators and generics: for the former, the nonobviousness of polymorph patents is not a guaranteed, despite the unique, unpredictable nature of the science and the general position of related jurisprudence. While finding polymorph patents obvious is still a significant challenge given their general nature, it is possible for the right facts to line up correctly in a § 103 analysis. For generic companies, future tactical attempts to carve out infringing indications post-trial now must overcome cut-and-dry precedent suggesting the futility of the practice to gain earlier market entry.
Amarin Pharma v. Hikma Pharmaceuticals28 & Skinny Labels
Holding: The complaint plausibly pleaded induced infringement based on the label and public statements made by the generic manufacturer.
The next panel from the Federal Circuit (Moore, Lourie, Albright) next dealt with what seemed like a section viii carve out ANDA case, but was rather a “run-of-the-mill induced infringement case.”29 The generic product, an icosapent ethyl already on the market, was approved for only one of the two indications (treatment of severe hypertriglyceridemia) that the NDA product (Vascepa) had been approved for, but included no limitation of use as to the second indication, and the generic manufacturer had made repeated public statements referring to itself as the “generic Vascepa,” despite being approved for only half the indications.30 Unique to this case was that it was appealed from the motion to dismiss stage, and thus discovery had not occurred.31 Not in dispute however was that the complaint sufficiently alleged direct infringement, knowledge, and intent, and thus the Federal Circuit’s decision focused on whether an “inducing act” was sufficiently alleged – it was.32 Reversing the district court’s dismissal, the Federal Circuit managed to walk along the “careful balance struck by the Hatch-Waxman Act regarding section viii carve-outs,” emphasizing that this decision did not “effectively eviscerate section viii-carveouts,” as argued by Hikma, and was instead “limited to the allegations” and “guided by the standard of review appropriate for this stage of the proceedings.”33 Given those explicitly limiting statements, this decision does little to affect true section viii jurisprudence under the Hatch-Waxman Act, and thus for practitioners, reliance on cases such as GlaxoSmithKline v. Teva (2021)34 is still appropriate for skinny label analyses.
Following the Salix and Amarin decisions in 2024 we saw new related agency action from the FDA and year-end legislation. In July 2024, the FDA rejected a citizen’s petition from Novartis requesting the FDA reject ANDAs for generic Entresto, instead allowing generic manufacturers to add new language to their label, not included in the currently approved indication, that would effectively narrow the subset of patients for which use of the generic product is appropriate.35 In this case, inclusion of the language “patients with…reduced ejection fraction” was permissible as it therefore excluded “patients with…preserved ejection fraction,” which is patent protected.36 This decision was affirmed by the District Court for the District of Columbia.37 To wrap up 2024, we also saw the introduction of a bill titled the “Skinny Labels, Big Savings Act” on December 17, which seeks to provide safe harbor protection to generics and biosimilars using skinny labels in certain contexts.38
Allergan USA v. MSN Laboratories39 & Obviousness-type Double Patenting
Holding: First-filed, first-issued, later-expiring patent claims were not invalid for obviousness-type double patenting over later-filed, later-issued, earlier-expiring reference claims.
In August, the Federal Circuit clarified its 2023 In re Cellect decision40 which, at the time, served to massively upheave the doctrine of obviousness-type double patenting (ODP), patent term adjustments (PTA), and terminal disclaimers. However, Judges Lourie, Dyk, and Reyna reeled the impacts of that decision back in. Although the district court considered itself “bound” by the In re Cellect holding, the Federal Circuit distinguished the two as addressing different questions.41 Here, the question was “can a first-filed, first-issued, later-expiring claim be invalidated by a later-filed, later-issued, earlier-expiring reference claim having a common priority date,” to which the Court decided “no.”42 The Cellect decision, however, was boiled down to establishing the rule that “when it comes to evaluating ODP on a patent that has received PTA, the relevant expiration date is the expiration date including PTA—not the original expiration date measured twenty years from the priority date.”43 Practitioners now know that Cellect does not require a patent to be invalidated by reference patents simply because it expires later. The doctrine of obviousness-type double patent serves to prohibit the extension of a first patent by subsequently filed patently indistinct patents; it does not serve to cut short first-filed patents with duly received PTA, simply because later-filed patents expire first.
This decision also follows a May proposal from the USPTO to implement a new rule on terminal disclaimers, such that a terminal disclaimer would include a provision aiming to reduce the costs associated with challenging patent families under ODP.44 The rule proposed that when filing a terminal disclaimer, a patentee must agree that a patent subject to a terminal disclaimer would only be enforceable if it was not tied through such a disclaimer to a patent which had otherwise been held unpatentable or invalid.45 The rule avoids the issue of having to invalidate multiple related patents separately, and if implemented, may significantly impact how practitioners approach continuation patents and handle large patent families within a portfolio. We may see a decrease in continuation applications, and instead see applications claiming much broader scopes and an increase in divisional applications.
Astellas Pharma v. Sandoz46 & Patent Eligibility
Holding: Courts may not sua sponte consider patent eligibility as grounds for patent invalidity.
In September, the Federal Circuit made clear that issues of patent eligibility under Section 101 cannot be decided sua sponte by district courts. Known as the principle of party presentation, there are circumstances in which a court may take “a modest initiating role” in shaping litigation,47 but addressing patent eligibility when not raised by a party is not one such circumstance. Here, patent eligibility was never raised during the course of the litigation, but the court considered it anyway in its final decision.48 While the district court phrased its decision in such a manner that parties may not “consent around the bounds of patent eligibility,” the Federal Circuit Judges Lourie, Prost, and Reyna made clear that patent eligibility is not a threshold issue akin to subject-matter jurisdiction, but instead is entitled to the presumption of validity, as is the case with other grounds of validity.49 While perhaps this decision offers greater direction to courts than counsel, it serves as a polite reminder to practitioners that any invalidity defense not raised is waived.
The topic of patent eligibility was particularly ripe in 2024, and continuing into 2025, especially with the growth of artificial intelligence (AI). Although not a topic that is overly adjacent to Hatch-Waxman litigation, counsel for both innovator and generic companies should remain cognizant of updated guidance from the USPTO, such as that which issued in July.50 A full summary of the guidance can be found here. Generic companies do appear to be raising § 101 invalidity grounds less frequently in recent years; however, counsel should nonetheless stay informed on both procedural and substantive developments in patent eligibility jurisprudence.
Galderma Laboratories v. Lupin51 & Bioequivalence Data and In Vitro Testing
Holding: The district court did not err in holding that the plaintiff had not proven infringement by relying on its in vitro testing and bioequivalence.
As one of two December ANDA decisions in 2024, the Federal Circuit analyzed whether in vitro testing and bioequivalence were sufficient to establish literal infringement or infringement under the doctrine of equivalence. The result? They aren’t. Although likely not a hard-and-fast rule that in vivo and in vitro results are not comparable, the Federal Circuit found no clear error in the district court’s conclusion as such in this particular case, finding that Galderma improperly drew conclusions about in vivo behavior from in vitro testing.52 Evidently, the issue was a failure of proof, rather than scientific incomparability.53 Further, unique to the facts of this case, although with a slightly broader applicability generally, under a doctrine of equivalents analysis, a showing of bioequivalence, at most, shows substantially the same result, but fails to show substantially the same function or substantially the same way, as is required under the “function, way, result” test.54 This decision highlights the importance of accurate and reliable testing to prove infringement, as well as fulsome expert testimony relaying as such.
Teva v. Amneal Pharmaceuticals55 & Orange-Book Listings
Holding: Patents directed towards inhaler devices were improperly listed in the Orange Book.
Wrapping up 2024, the Federal Circuit addressed a key issue pressing innovator pharmaceutical companies: the propriety of Orange Book listings. In this case, Teva had listed patents directed to inhaler devices in the Orange Book in order to delay the entry of generic products to the market.56 Because such patents “contain no claim for the active ingredient at issue,” Judges Prost, Taranto, and Hughes affirmed the district court’s delisting order.57 In what ultimately came down to issues of statutory interpretation, the Federal Circuit rejected arguments that a patent is properly listed if it “reads on” the approved drug or claims any component of a drug.58 Practitioners now know this is not the case. First, “the fact that an NDA could infringe a patent does not mean that the patent ‘claims’ the underlying drug within the meaning of the listing provision.”59 And second, “[t]o list a patent in the Orange Book, that patent must, among other things, claim the drug for which the applicant submitted the application and for which the application was approved,” i.e., the active ingredient.60 While NDA holders are keen to protect their products from generic entry into the market, this decision from the Federal Circuit affirms that there is a limit to the Orange Book, and NDA holders would be wise to ensure any such listings do in fact claim the active ingredient at issue.
This decision comes in the wake of threats by the Federal Trade Commission and new de-listing policies. For example, in September 2023, the FTC issued a new policy61 stating that improper Orange Book listings may constitute a violation of Section 5 of the FTC Act, and in November 2023, the FTC announced a plan62 to challenge over 100 Orange Book Listings and a further 300 listings in April 202463. Many companies have received warning letters from the FTC, only some of whom have voluntarily delisted at-risk Orange Book patents however. The financial detriment of doing so is clear, and other companies have therefore pushed back, arguing compliance with the listing provisions. The FTC appears to be predominantly targeting medical device patents, such as those in Teva v. Amneal, but for the most part, action by the FTC remains limited to issuing policies and sending letters to NDA holders. Further, it has yet to be determined whether this is an appropriate exercise of agency power, especially in the wake of the Supreme Court’s goodbye to Chevron deference.64
To conclude, many of the Federal Circuit’s Hatch-Waxman decisions in 2024 reshaped how pharmaceutical companies and their counsel address patent prosecution, litigation, and portfolio management, especially in view of the broader regulatory, legislative, agency-based changes that may occur in 2025 and beyond. As patent law continues to evolve, these cases will serve as critical touchstones in understanding the future of pharmaceutical patents and the broader implications for drug pricing and accessibility in the years to come.
1 LexMachina stats showing 312 federal district court cases with “Patent:ANDA” case tag, filed between ”2024-01-01 and 2024-12-31″) (Compare with LexMachina stats showing 259 federal district court cases with ”Patent:ANDA” case tag, filed between ”2023-01-01 and 2023-12-31″.2 LexMachina stats showing 283 federal district court cases with “Patent:ANDA” case tag, terminated between ”2024-01-01 and 2024-12-31″.3 Compare supra with LexMachina stats showing 284 federal district court cases with “Patent:ANDA” case tag, terminated between ”2023-01-01 and 2023-12-31″.4 LexMachina stats showing 91 findings in cases with “Patent:ANDA” case tag, with ”Infringement, Invalidity, No Infringement, No Invalidity, No Unenforceability, or Unenforceability” as patent findings, with findings decided between ”2024-01-01 and 2024-12-31″.5 LexMachina stats showing 91 findings in cases with “Patent:ANDA” case tag, with ”Infringement, Invalidity, No Infringement, No Invalidity, No Unenforceability, or Unenforceability” as patent findings, with findings decided between ”2023-01-01 and 2023-12-31″.6 Edwards Lifesciences Corp. v. Meril Life Scis. Pvt. Ltd., 96 F.4th 1347 (Fed. Cir. 2024).7 Amgen Inc. v. Hospira, Inc., 944 F.3d 1327, 1338 (Fed. Cir. 2019).8 Momenta Pharm., Inc. v. Teva Pharm. USA Inc., 809 F.3d 610, 619 (Fed. Cir. 2015).9 Supra, note 6, at 1351.10 Id. at 135311 Id. at 1355.12 Classen Immunotherapies v. Biogen IDEC, 659 F.3d 1057, 1070 (Fed. Cir. 2011).13 Merck KGaA v. Integra Lifesciences I, Ltd., 545 U.S. 193, 202 (2005).14 See, e.g., Madey v. Duke Univ., 307 F.3d 1351 (Fed. Cir. 2002).15 89 Fed. Reg. 53963.16 35 U.S.C. § 271(e)(1).17 7 U.S.C. § 2544.18 Salix Pharms., Ltd. v. Norwich Pharms. Inc., 98 F.4th 1056 (Fed. Cir. 2024).19 Grunenthal GMBH v. Alkem Lab’ys Ltd., 919 F.3d 1333 (Fed. Cir. 2019).20 Pharmacyclics LLC v. Alvogen, Inc., No. 2021-2270, 2022 WL 16943006 (Fed. Cir. Nov. 15, 2022).21 Supra, note 18, at 1065.22 Id. at 1066-67.23 Id. at 1060.24 Id. at 1068-69.25 Id. at 1069.26 Id. at 1068.27 Id. at 1069.28 Amarin Pharma, Inc. v. Hikma Pharms. USA Inc., 104 F.4th 1370 (Fed. Cir. 2024).29 Id. at 1377.30 Id. at 1372-74.31 Id. at 1377.32 Id. at 1378.33 Id. at 1381.34 GlaxoSmithKline LLC v. Teva Pharms. USA, Inc., 7 F.4th 1320 (Fed. Cir. 2021).35 Final Response Letter from FDA CDER to Novartis Pharmaceuticals Corporation, Docket FDA-2022-P02228 (24 Jul. 2024), https://downloads.regulations.gov/FDA-2022-P-2228-0015/attachment_1.pdf. 36 See id.37 Novartis Pharms. Corp. v. Becerra, No. 24-CV-02234 (DLF), 2024 WL 4492072 (D.D.C. Oct. 15, 2024).38 Sens. Hickenlooper, Welch, Cotton, & Collins, Skinny Labels, Big Savings Act, https://www.hickenlooper.senate.gov/wp-content/uploads/2024/12/Skinny-Labels.pdf.39 Allergan USA, Inc. v. MSN Lab’ys Priv. Ltd., 111 F.4th 1358 (Fed. Cir. 2024).40 In re: Cellect, LLC, 81 F.4th 1216 (Fed. Cir. 2023).41 Supra, note 39, at 1368.42 Id. at 1366.43 Id. at 1369.44 89 Fed.Reg. 4043945 Id.46 Astellas Pharma, Inc. v. Sandoz Inc., 117 F.4th 1371 (Fed. Cir. 2024).47 United States v. Sineneng-Smith, 590 U.S. 371, 376 (2020).48 Supra, note 46, at 1376.49 Id. at 1378.50 89 Fed.Reg. 5812851 Galderma Lab’ys, L.P. v. Lupin Inc., 122 F.4th 902 (Fed. Cir. 2024).52 Id. at 908.53 Id. at 908.54 Id. at 910.55 Teva Branded Pharm. Prods. R&D, Inc. v. Amneal Pharms. of New York, LLC, No. 2024-1936, 2024 WL 5176737 (Fed. Cir. Dec. 20, 2024).56 Id. at *5-*6.57 Id. at *7, *17.58 Id. at *10-*11.59 Id. at *12.60 Id. at *15.61 Federal Trade Commission, “Federal Trade Commission Statement Concerning Brand Drug Manufacturers’ Improper Listing of Patents in the Orange Book,” (14 Sept. 2023), https://www.ftc.gov/system/files/ftc_gov/pdf/p239900orangebookpolicystatement092023.pdf.62 Federal Trade Commission, “FTC Challenges More Than 100 Patents as Improperly Listed in the FDA’s Orange Book,” (November 7, 2023), https://www.ftc.gov/news-events/news/press-releases/2023/11/ftc-challenges-more-100-patents-improperly-listed-fdas-orange-book.63 Federal Trade Commission, “FTC Expands Patent Listing Challenges, Targeting More Than 300 Junk Listings for Diabetes, Weight Loss, Asthma and COPD Drugs,” (April 30, 2024), https://www.ftc.gov/news-events/news/press-releases/2024/04/ftc-expands-patent-listing-challenges-targeting-more-300-junk-listings-diabetes-weight-loss-asthma.64 Loper Bright Enterprises v. Raimondo, 603 U.S. 369 (2024).
FDA Proposes New Front-of-Pack Nutrition Label for Packaged Foods
The FDA has announced a proposal to require a new nutrition label on the front of packages for most packaged foods. The label design, shown below, would give consumers readily visible information about a food’s saturated fat, sodium, and added sugars content—three nutrients the FDA states are directly linked with chronic diseases when consumed in excess. The proposed “Nutrition Info box” rates packaged food as being “Low,” “Med,” or “High” in saturated fat, sodium, and added sugars. It was designed after the FDA conducted an experimental study in 2023 of nearly 10,000 U.S. adults to further explore consumer responses to three different types of front-of-pack labels. The new Nutrition Info box is intended to complement the FDA’s existing Nutrition Facts label.
If finalized, the proposed rule would require food manufacturers to add the Nutrition Info box to most packaged food products three years after the final rule’s effective date for businesses with $10 million or more in annual food sales and four years after the final rule’s effective date for businesses with less than $10 million in annual food sales. Comments on the proposed rule can be submitted electronically to http://www.regulations.gov by May 16, 2025.
FDA Furthers Efforts to Improve the Accelerated Approval Pathway through New Draft Guidance on Confirmatory Trials
On January 6, the U.S. Food and Drug Administration (“FDA” or the “Agency”) released a draft guidance titled “Accelerated Approval and Considerations for Determining Whether a Confirmatory Trial is Underway” (the “Draft Guidance”). The Draft Guidance responds to FDA’s new authorities and responsibilities in administering the accelerated approval program under the 2023 Consolidated Appropriations Act, which FDA addressed at a high level in an initial draft guidance about a month ago (see our article on this initial guidance here). The new Draft Guidance narrows in on heightened requirements for confirmatory trials and outlines the granular process for ensuring that confirmatory trials are “underway” to verify the clinical benefits of accelerated approval drugs. FDA is inviting comments to the Draft Guidance, with a deadline set for March 10, 2025.
Background
As explained in greater detail in our previous article, the accelerated approval program balances the urgent need for treatment of certain serious and/or rare conditions with the equally important need to ensure patient safety by allowing for the conditional approval of drugs for serious and/or rare conditions before the drug has been fully proven “safe and effective” under the traditional three-phase clinical study route, based on the identification of a “surrogate” or “intermediate” endpoint reasonably likely to predict the drug’s ultimate clinical benefit.[1] As a condition of accelerated approval, sponsors are required to perform post-market confirmatory trials to verify anticipated clinical benefits (i.e., support a complete finding of safety and efficacy that meets FDA’s standard for full market approval). Accordingly, the successful completion of these confirmatory studies converts a drug’s accelerated approval to a traditional approval.
New Confirmatory Trial Requirements – “Underway”
In this Draft Guidance, FDA provides a detailed explanation of the heightened requirement – established in last month’s draft guidance – that confirmatory trials be “underway” prior to accelerated approval. Under the heightened requirement, FDA mandates that confirmatory trials be “well underway, if not fully enrolled” before accelerated approval is granted, with full enrollment required for instances in which post-approval enrollment would be particularly challenging. The Agency explains that a trial is “underway” if it (1) has a target completion date “consistent with diligent and timely conduct of the trial; (2) “the sponsor’s progress and plans for post-approval conduct of the trial provide sufficient assurance to expect timely completion of the trial”; and (3) enrollment of the trial has been, at least, initiated. The Draft Guidance goes on to provide considerations for determining the target completion date for a confirmatory trial, which must be supported by “clear and sound justification,” as well as other measurable benchmarks that FDA intends to consider in reviewing confirmatory trial plans, such as recruitment and retention goals, site activation statistics, and accrual rates.
The Draft Guidance does establish that FDA may make exceptions to the heightened confirmatory trial requirement for scenarios like unexpected future events or rare diseases with “very small populations” and “high unmet need,” where non-randomized studies may be adequate and appropriate justification is made, but makes clear that such exceptions will likely be few and far between. Further, as it did in its initial draft guidance last month, FDA emphasizes the importance in ongoing collaboration with sponsors, and encourages sponsors to engage in early and frequent discussions with the Agency to align on clinical trial plans and timelines.
Takeaways
In our previous article, we suggested that the 2023 Consolidated Appropriations Act served as a clear signal to FDA to “tighten the reins” on the accelerated approval program in light of the significant lag time between accelerated approval and full approval of accelerated approval drugs being used to treat patients (data shows many drugs lingering on the market for years before confirmatory trials were initiated – if they were ever started at all). This Draft Guidance appears to be doing exactly that, but in a more prescriptive manner than last month’s high-level framework guidance. Here, FDA underscores that confirmatory trials are the key to ensuring that balance between urgent access to potentially life-saving drugs and patient safety, and, helpfully, sets out clearer operational expectations for sponsors’ execution of such trials.
Although the 2023 Consolidated Appropriations Act gave FDA until June of this year to develop the Draft Guidance, the Agency put it out just a month after its initial draft guidance – no doubt because the two are meant to work in tandem.[2] The prior draft guidance introduced the heightened requirements for the accelerated approval program and the latter honed in on more granular confirmatory trial requirements, clearly defining when FDA considers a trial to be “underway” and putting sponsors on notice that FDA will be monitoring these trials far more scrupulously than in years past. Specifically, when reviewing accelerated approval applications, FDA will be monitoring to ensure that sponsors have established a full plan with measurable benchmarks and that the enrollment process has been, at least, initiated. These heightened requirements communicate that FDA wants accelerated approval drugs to be as close to traditional approval route as possible at the time of application – without swallowing the purpose of the accelerated approval program in the first place.
The new Draft Guidance provides actionable steps for sponsors to take in developing and initiating confirmatory trials to support accelerated approval applications, which furthers the overall goal to expedite the period of time that a drug has “accelerated approval” status, as opposed to traditional approval status. Moreover, Sponsors may also be motivated not only by these new requirements – as FDA will either reject initial accelerated approval or initiate a post-market withdrawal if its detailed new confirmatory trial requirements are not met – but by forces at play in the greater healthcare landscape. For example, a Pennsylvania-based insurer recently issued a policy excluding non-oncology accelerated approval drugs from most benefit plans.[3] If other payors adopt this approach, and accelerated approval drugs are widely excluded from insurance coverage, sponsors could be financially motivated to complete confirmatory trials to prove full safety and efficacy of their drugs, which may prove to be a much stronger driving force than the regulatory motivation established in the new Draft Guidance. Ultimately, whatever the impetus, it appears that the industry may be headed toward more expeditious completion of confirmatory trials for accelerated approval therapies – which, in any case, is probably a good thing for patients.
FOOTNOTES
[1] Section 506(c)(1)(A) of the Federal Food, Drug, and Cosmetic Act (FD&C Act)
[2] Not to mention, of course, that FDA may be trying to sure up regulation through guidances in light of uncertainties regarding its authority under the new administration.
[3] See Claim Payment Policy Bulletin – Drugs, Biologics, or Gene Therapies with an Accelerated Approval, Independence Blue Cross (Jan. 1, 2025).
Julian Klein also contributed to this article.
Cookware Association Files Federal Challenge to Minnesota’s Ban on PFAS in Cookware
The Cookware Sustainability Alliance (CSA) announced on January 9, 2025, that it has filed suit in the U.S. District Court for the District of Minnesota, seeking a preliminary injunction of Minnesota’s ban on the sale of cookware containing intentionally added per- and polyfluoroalkyl substances (PFAS). CSA v. Kessler (No. 0:25-cv-00041). According to CSA, the chemical coating on nonstick cookware contains fluoropolymers, which “are fundamentally different compounds from the chemicals that have motivated concerns about PFAS.” CSA claims that Minnesota’s ban violates the U.S. Constitution’s prohibition on individual states regulating interstate commerce and has raised other constitutional challenges to Minnesota’s statute. CSA states that it has offered to work cooperatively with Minnesota “to secure an exemption for fluoropolymer coated nonstick cookware because of their low-risk profile.”
EPA Releases Draft Risk Assessment of PFOA and PFOS in Biosolids, Will Hold Webinar on January 15, 2025
The U.S. Environmental Protection Agency (EPA) announced on January 14, 2025, a draft risk assessment of the potential human health risks associated with the presence of perfluorooctanoic acid (PFOA) and perfluorooctane sulfonic acid (PFOS) in biosolids, also known as sewage sludge. According to EPA, the findings show that there may be human health risks associated with exposure to PFOA or PFOS with all three methods of using or disposing of sewage sludge — land application of biosolids, surface disposal in landfills, or incineration. The draft risk assessment focuses on those living on or near impacted sites or those that rely primarily on those sites’ products (e.g., food crops, animal products, drinking water). EPA notes that the draft risk assessment does not model risks for the general public. EPA states that once prepared in final, the assessment will help EPA and its partners understand the public health impact of per- and polyfluoroalkyl substances (PFAS) in biosolids and inform any potential future actions to help reduce the risk of exposure. EPA has posted a pre-publication version of the Federal Register notice announcing the availability of the draft risk assessment. Publication of the notice in the Federal Register will begin a 60-day comment period. EPA will hold a webinar on January 15, 2025, at 12:00 p.m. (EST) to provide information on the draft risk assessment. The webinar will include an opportunity for questions and answers. EPA will post a recording of the webinar.
FDA Proposes Front-of-Pack Nutrition Label Rule
On January 14, 2025, FDA issued a pre-publication version of a proposed rule requiring a front-of-package (FOP) nutrition label on most packaged foods. The proposed FOP nutrition label would highlight the amount of saturated fat, sodium, and added sugars in a serving of food, as well as interpret the relative amounts of these nutrients, to help consumers quickly and easily identify how foods can be part of a healthy diet.
At a high level, the proposed rule would add 21 CFR 101.6, requiring the inclusion of a Nutrition Info box on the principal display panel of most foods that are required to display the Nutrition Facts label. In addition, the proposed rule would revise the requirements for the nutrient content claims “low sodium” and “low saturated fat.”
The proposed Nutrition Info box is intended to provide interpretive nutrition information in a convenient format. The Nutrition Info box format is similar in style to the Nutrition Facts Panel and would be required to be placed on the upper third of the principal display panel. The box would be required to include:
The title “Nutrition Info;”
A “Per serving” subheading and a statement of the serving size in household measure only;
A percent daily value subheading above the declaration of the quantitative percent daily value and the interpretive “Low,” “Med,” and “High” descriptions; and
Information on only saturated fat, sodium, and added sugars.
The interpretive descriptions are set at a proposed range of 5% daily value or less for “Low;” 6% to 19% daily value for “Med;” and 20% daily value or more for “High.” These ranges are based on longstanding consumer and nutrition education initiatives and existing regulatory definitions for nutrient content claims.
The proposed rule includes exemptions for foods exempt from nutrition labeling under 21 CFR 101.9(j). FDA also considered an exemption for products with insignificant amounts of saturated fat, sodium, and sugar, but ultimately declined to propose that exemption.
FDA is accepting comments on the proposed rule until May 16, 2025, at regulations.gov under docket number FDA-2024-N-2910.