Petitioner sells drug products containing citrus bioflavonoid,
an extract from fruit skins, as a principal active ingredient. In
the 1950's new drug applications (NDA's) were filed and became
effective for seven products, and two were sold without any NDA.
After the enactment of the 1962 amendments to the Federal Food,
Drug, and Cosmetic Act, these products, together with a large
number of other bioflavonoid products were examined by the Food and
Drug Administration (FDA) for effectiveness. Based upon National
Academy of Sciences-National Research Council (NAS-NRC) reports and
its own evaluation, FDA gave notice of opportunity for hearing on
its proposal to withdraw approvals of NDA's for all drugs
containing these compounds, alone or in combination with other
drugs. Petitioner then brought suit in the District Court, seeking
a declaratory judgment that its drugs are exempt from the efficacy
requirements under § 107(c)(4), the so-called "grandfather" clause.
FDA refused a stay pending the judicial proceedings and went
forward with its administrative action. Petitioner submitted no
evidence of "adequate and well controlled investigations," as
required by § 505(d) to support its claims of effectiveness, and
FDA withdrew petitioner's NDA's. Section 107(c)(4) exempts from the
effectiveness requirements any drug which, on the day preceding the
1962 enactment, (1) was commercially used or sold in the United
States, (2) was not a "new drug" as defined in the 1938 Act, and
(3) "was not covered by an effective application" for a new drug
under the 1938 Act. The District Court found that two of the
products had never been covered by effective NDA's and that, while
seven had been covered, their applications had later been withdrawn
by petitioner. It concluded that petitioner's drugs were not
covered by effective applications, and hence were exempt from the
effectiveness criterion. The Court of Appeals reversed on the
merits. It held that petitioner's drugs were not entitled to an
exemption, that an applicant could not withdraw an NDA once
Page 412 U. S. 656
it became effective, that the drugs were "covered by an
effective application," and that, although "me-too" drugs (similar
drugs) of other manufacturers would be exempt, petitioner's
"me-too's" were not exempt.
Held:
1. "Any drug" is used in § 107(c)(4) in the generic sense, which
means that the "me-too's," whether the products of the same or of
different manufacturers "covered" by an "effective" NDA, are not
exempt from the efficacy requirement of § 201(p). Pp.
412 U. S.
663-665.
2. Prescription drugs on the market are subject to the 1962
efficacy requirements, for if the 1962 amendments are to be
comprehensively meaningful, § 107(c)(4) cannot be read so as to
provide a loophole to permit the marketing of drugs previously
subject to new drug regulation without demonstrating by the new
statutory standards that they have the claimed efficacy. Pp.
412 U. S.
665-666.
3. The congressional purpose was to exempt only those drugs that
never had been subject to the new drug regulation, and therefore
any drug for which an NDA had once been effective does not fall
within the exempt category. Pp.
412 U. S.
666-668.
461 F.2d 223, affirmed.
DOUGLAS, J., delivered the opinion of the Court, in which all
Members joined, except BRENNAN, J., who took no part in the
consideration or decision of the case, and STEWART, J., who took no
part in the decision of the case.
Page 412 U. S. 657
MR. JUSTICE DOUGLAS delivered the opinion of the Court.
Petitioner sells a line of drugs containing, as a principal
active ingredient, citrus bioflavonoid, which is an extract from
fruit skins. The drugs are sold in capsules, syrup, and tablets. In
the 1950's, new drug applications (NDA's) were filed and became
effective for seven of them; two, however, were sold without any
NDA. In 1961, the Food and Drug Administration (FDA) advised
petitioner that two of the products, when distributed under the
existing labels, were not new drugs. These drugs were recommended
for a wide variety of ailments, from bleeding, to hypertension, to
ulcerative colitis. After the 1962 amendments to the Federal Food,
Drug, and Cosmetic Act of 1938, 52 Stat. 1040, as amended, 76 Stat.
780 these products, together with a large number of other
bioflavonoid products, were examined by FDA for drug effectiveness.
The National Academy of Sciences-National Research Council
(NAS-NRC) panels reviewed them. One panel on metabolic disorders
concluded that the "use of these materials as hemostatic agents for
capillary fragility is felt to be unjustifiable, and not proved." A
panel on hematologic disorders found there was no proof that these
products were efficacious for any medical use.
Based upon the NAS-NRC reports and its own evaluation, FDA gave
notice of opportunity for hearing on its proposal to withdraw
approvals of NDA's for all drugs containing these compounds, alone
or in combination with other drugs. Petitioner thereupon brought
suit in the District Court, asking for a declaratory judgment that
its drugs are exempt from the efficacy requirements under
Page 412 U. S. 658
§ 107(c)(4). The administrative proceedings went forward, FDA
refusing a stay pending the judicial proceedings. Petitioner
submitted no evidence of "adequate and well controlled
investigations" as required by § 505(d) of the Act, 21 U.S.C. §
355(d), to support its claims of effectiveness. The Commissioner
made findings and withdrew petitioner's NDA's.
In the District Court, petitioner contended that the drugs were
exempt from regulation by reason of § 107(c)(4) of the 1962
amendments, which provides:
"In the case of any drug which, on the day immediately preceding
the enactment date, (A) was commercially used or sold in the United
States, (B) was not a new drug as defined by section 201(p) of the
basic Act as then in force, and (C) was not covered by an effective
application under section 505 of that Act, the amendments to
section 201(p) made by this Act shall not apply to such drug when
intended solely for use under conditions prescribed, recommended,
or suggested in labeling with respect to such drug on that
day."
The District Court found that two of the products had never been
covered by effective NDA's and that, while seven had been covered,
their applications had later been withdrawn by petitioner. It found
that the products were "safe" for use in treating abnormal
capillary permeability and fragility. It therefore concluded that,
as of the day the 1962 amendments became effective, petitioner's
products were not new drugs, were not covered by effective
applications within the meaning of § 107(c)(4), and hence were
exempt from the effectiveness criterion added to the regulatory
provisions of §§ 505 and 201(p), 21 U.S.C. §§ 355 and 321(p). In so
ruling,
Page 412 U. S. 659
the Court the District Court necessarily determined that it, and
not FDA, had jurisdiction to decide exemption questions. The Court
of Appeals agreed that the District Court alone had jurisdiction,
but reversed on the merits. [
Footnote 1] 461 F.2d 223. It held that none of
petitioner's bioflavonoid drugs was entitled to exemption under §
107(c)(4). As to the seven for which NDA's had been filed, it held
that an applicant could not withdraw an NDA once it became
effective. It concluded that, even if the drugs were generally
recognized as safe on the day preceding the effective date of the
1962 Act, they were "covered by an effective application" within
the meaning of § 107(c)(4)(C), and thus were not exempt from the
1962 amendments. As to the "me-too" drugs, those specific drugs for
which petitioner had not filed an NDA, the Court of Appeals held
that, although the "me-too's" of other manufacturers competing with
petitioner's bioflavonoids would be exempt, petitioner's "me-too's"
were not exempt, because the NDA's covering the pioneer drugs
prepared by petitioner covered all of its products similar in
formula and labeling. While the Government agrees that
petitioner's
Page 412 U. S. 660
"me-too" products should be accorded the same treatment as the
"me-too's" of other manufacturers who had never filed NDA's, the
parties are at odds on other issues. [
Footnote 2]
The resolution of the questions presented turns essentially on
the meaning of § 107(c)(4), quoted above. But as background for the
problem of construction, references should be made to other 1962
amendments. Section 201(p) [
Footnote 3] was amended to redefine a "new drug" as one
not generally recognized by experts as both safe and effective for
use under the conditions prescribed or one that has not been used
to a material extent and for a material time. Section 505(a) was
amended to require affirmative approval of FDA, where previously
it
Page 412 U. S. 661
had provided that an NDA would automatically become effective
unless a contrary order were issued. [
Footnote 4] Section 505(d) [
Footnote 5] was amended to require disapproval of an
application
Page 412 U. S. 662
if there is "a lack of substantial evidence that the drug will
have the effect it purports or is represented to have." Section
505(e) was amended to require that any previous approval of an
application be withdrawn whenever it appears from new information
or otherwise that there is a lack of substantial evidence of the
drug's effectiveness.
There remained the problem of the application of the new drug
efficacy provisions to drugs already on the market. Without
transitional protection, all drugs -- except those marketed prior
to the 1938 Act whose labeling had not been changed and which were
exempt from the "new drug" provision of § 201(p) -- would have been
in violation of the amended Act unless generally recognized as
effective. Even NDA's which were outstanding would have become
ineffective because FDA had not approved them under the new
criteria. Section 107(c)(2) of the amendments therefore provides
that applications which were effective on the day before the
enactment date of the 1962 amendments should be deemed "approved."
Section 107(c)(2) thus eliminated the
Page 412 U. S. 663
necessity to review and approve every application already on
file.
Section 107(c)(3) provides that drugs covered by NDA's already
on file whose labeling remains unchanged are not affected by the
amended provisions of § 505(b) or by approvals or refusals under §
505(d) insofar as the effectiveness of the drugs is concerned, so
long as the application is not withdrawn or suspended under §
505(e). It also provides that the new effectiveness requirement in
the withdrawal provision would not apply until two years after the
amendments were adopted, or until the NDA approval were withdrawn
for reasons other than lack of the drug's effectiveness, whichever
came first. It seems apparent that, by reason of § 107(c)(3), the
industry was assured it could continue to market previously
approved NDA's unless and until the NDA was withdrawn, and that,
before such withdrawal, they would be given a minimum of two years
within which to submit "substantial evidence" to support the claims
for their products.
Section 107(c)(4) exempted drugs from the new effectiveness
requirements so long as their composition and labeling remained
unchanged. This exemption, however, applies only to a product that,
on the day before the 1962 amendments became effective, (A) was
used or sold commercially in the United States, (B) was generally
recognized by the experts as safe; and (C) was not "covered" by an
"effective" application.
The first question is which "me-too" copies of an NDA drug are
subject to the efficacy requirements to the same extent as the NDA
product itself? Are only the "me-too's" of the same manufacturer
"covered" by an effective application within the meaning of §
107(c)(4)(C), and thus not exempt from § 201(p), or are no
"me-too's" exempt whoever manufactures them? It seems clear that §
107(c) was designed in general to make the new
Page 412 U. S. 664
1962 requirements applicable to drugs then on the market after a
two-year grace period. Section 107(c)(4) created an exception from
this general policy. Senator Eastland explained these "transitional
provisions," stating:
"Established drugs which have never been required to go through
new drug procedures will not be affected by the new effectiveness
test insofar as their existing clauses are concerned. [
Footnote 6]"
It is true that an NDA covers a particular product or products
that it names and that § 505 when applied to an NDA is personal to
the manufacturer who files it. Section 505, in other words,
addresses itself to drugs as individual products. But we agree with
the Government that "any drug," when used in § 107(c)(4), is used
in the generic sense, which means that the "me-too's," whether
products of the same or of different manufacturers "covered" by an
"effective" NDA, are not exempt from the efficacy requirements of §
201(p). If that were not true, then, as the Court of Appeals said,
the "me-too's" of one manufacturer covered by an NDA of another
manufacturer would be exempt from regulation, while the "me-too's"
of the manufacturer holding the NDA could be regulated. That seems
to be a reading of § 107(c)(4) that is discriminatory, and
needlessly so. For it is avoided by taking "any drug" in that
subsection as a generic term. The transitional nature of § 107(c)
works in that direction. A reading to exclude all "me-too" drugs
from the word "covered," as used in § 107(c)(4), would create a
hiatus in the regulatory scheme for which there seems to be no
cogent reason. We find no persuasive reason to resolve the
ambiguities in favor of the manufacturers so that preexisting
pioneer drugs would be subject to the new efficacy requirements,
but the "me-too's," which often do equal service for them, would
escape
Page 412 U. S. 665
the thrust of the 1962 amendments. That resolution of the
ambiguities would largely leave pre-1962 drugs of unproved
effectiveness untouched by the 1962 amendments, and perpetuate a
competitive contest in the marketing of ineffective pre-1962 drugs.
FDA would, of course, have authority to pursue that category of
drugs under the misbranding provisions of the Act. But that slow,
cumbersome method is utterly unsuited to the need. We decline to
attribute such a self-defeating purpose to the Congress. After all,
the 1962 regulatory scheme proposes administrative control through
an expert agency in lieu of the more cumbersome 1938 devices, as a
result of which, "good medical practice is hampered, and the
consumer is misled until, perhaps years later, the Government has
gathered the necessary evidence to sustain its burden of proving
the violation in court." [
Footnote
7]
Petitioner, focusing on prescription drugs, [
Footnote 8] contends that the construction of §
107(c)(4) urged by the Government would make the exemption
meaningless. Prescription drugs, as FDA points out, are not likely
to have come on the market subsequent to 1938 without being a "new
drug" for some time. But the over-the-counter (OTC) drugs, known as
the proprietaries, are often made up of old, established
ingredients. Such products, coming on the market for the first time
between 1938 and 1962, might never have been subject to new drug
regulation. If so, they would be entitled to the exemption provided
by § 107(c)(4). Senator Kefauver, the main
Page 412 U. S. 666
sponsor of the 1962 Act, deplored the absence in an earlier bill
of the failure to submit proprietaries on the market to tests of
efficacy. He said:
"Effectiveness, as well as safety, should apply to new
proprietary drugs, but proprietaries now on the market are not to
be subject under the present bill to the provisions requiring them,
upon notice by the FOA [
sic], to support their claims for
effectiveness. I think they should be so required. That is a matter
which can be remedied in conference or by other legislation.
[
Footnote 9]"
It can be inferred from this statement that prescription drugs
on the market were to be subjected to the efficacy requirements. If
the 1962 amendments are to be comprehensively meaningful, we
decline to read § 107(c)(4) so as to provide a loophole so that the
manufacturers can go on marketing drugs previously subject to new
drug regulation without demonstrating by the new statutory
standards that they are effective as claimed.
The second question presented by this case is whether an
applicant could have withdrawn or "deactivated" an NDA prior to the
1962 amendments so that its drug was no longer "covered by an
effective application," and thus is now exempt from efficacy
regulation by reason of § 107(c)(4). Petitioner, in 1961, had
stated in a letter to the Director of New Drug Branch of the Bureau
of Medicine in FDA that "[i]t is our recollection that the C. V. P.
class of products were no longer considered to be new drugs. . . ."
Petitioner in 1961 also stopped filing supplemental information as
required by regulation with regard to the products for which NDA's
had become effective. It claims that these acts were sufficient
to
Page 412 U. S. 667
withdraw the NDA's and to bring its products within the
exemption.
Initially, we repeat that the legislative history indicates that
it was Congress' purpose to exempt only those drugs that never had
been subject to the new drug regulation. [
Footnote 10] Quite obviously, any drug for which an
NDA once had been effective does not fall within that category.
Congress rejected an approach that would have exempted from the
efficacy requirements of the 1962 amendments all drugs then
marketed which had become generally recognized as safe. It now
would be irrational for us to construe § 107(c)(4) of the
amendments to exempt a drug merely because the manufacturer had
taken some formal steps totally unrelated to the drug's
effectiveness to indicate that the drug was no longer a "new drug"
under the pre-1962 standards. The result would be that some drugs
for which an NDA had been filed would be subject to the efficacy
requirements, and some would not, even though one could not
differentiate between the drugs on the grounds of effectiveness.
For example, 43 NDA's had been filed with respect to bioflavonoids
and related compounds. There is no reason to believe that any
product is more or less effective than another. According to the
Solicitor General, the "state of activity, inactivity, or
withdrawal" of the applications varied from one to the next when
the 1962 amendments became effective. It would be totally
inconsistent with the statutory scheme and the policy underlying
the 1962 amendments, as well as patently unjust, to conclude that
some manufacturers could continue to market their bioflavonoid
products, but others could not. We cannot attribute such
Page 412 U. S. 668
an intention to Congress and, accordingly, cannot agree with
petitioner that its NDA's had been withdrawn prior to 1962 so that
its bioflavonoid products were no longer "covered by an effective
application."
Affirmed.
MR. JUSTICE BRENNAN took no part in the consideration or
decision of this case. MR. JUSTICE STEWART took no part in the
decision of this case.
[
Footnote 1]
Unlike the situation in
CIBA Corp. v. Weinberger, ante,
p.
412 U. S. 640, the
order of the Commissioner withdrawing petitioner's NDA's had not
become final prior to the District Court's assuming jurisdiction.
In fact, the Court of Appeals for the District of Columbia Circuit
reversed the Commissioner's decision, 151 U.S.App.D.C. 284, 466
F.2d 455, and the proceedings on remand are now pending before the
Commission. Thus, petitioner was not barred from proceeding in the
District Court.
Cf. CIBA Corp. v. Weinberger, supra. Our
decision today is not meant to indicate that the District Court,
had it concluded that its jurisdiction was concurrent with that of
FDA, would not have abused its discretion in refusing to stay this
action pending the outcome of administrative proceedings.
Cf.
Weinberger v. Bentex Pharmaceuticals, Inc., ante, p.
412 U. S. 645. The
Court of Appeals below found it unnecessary to consider whether
petitioner had failed to exhaust its administrative remedies. 461
F.2d at 226.
[
Footnote 2]
There lurks in the case a question whether a drug could have
been unsafe prior to the 1962 amendments because it was ineffective
in treating the conditions for which its use was recommended by the
label. That question, however, was not presented in the petition
for certiorari.
[
Footnote 3]
"The term 'new drug' means --"
"(1) Any drug (except a new animal drug or an animal feed
bearing or containing a new animal drug) the composition of which
is such that such drug is not generally recognized, among experts
qualified by scientific training and experience to evaluate the
safety and effectiveness of drugs, as safe and effective for use
under the conditions prescribed, recommended, or suggested in the
labeling thereof, except that such a drug not so recognized shall
not be deemed to be a 'new drug' if at any time prior to the
enactment of this chapter it was subject to the Food and Drugs Act
of June 30, 1906, as amended, and if at such time its labeling
contained the same representations concerning the conditions of its
use; or"
"(2) Any drug (except a new animal drug or an animal feed
bearing or containing a new animal drug) the composition of which
is such that such drug, as a result of investigations to determine
its safety and effectiveness for use under such conditions, has
become so recognized, but which has not, otherwise than in such
investigations, been used to a material extent or for a material
time under such conditions."
21 U.S.C. § 321(p).
[
Footnote 4]
Section 505(c) provides:
"Within one hundred and eighty days after the filing of an
application under this subsection, or such additional period as may
be agreed upon by the Secretary and the applicant, the Secretary
shall either --"
"(1) approve the application if he then finds that none of the
grounds for denying approval specified in subsection (d) applies,
or"
"(2) give the applicant notice of an opportunity for a hearing
before the Secretary under subsection (d). . . on the question
whether such application is approvable. If the applicant elects to
accept the opportunity for hearing by written request within thirty
days after such notice, such hearing shall commence not more than
ninety days after the expiration of such thirty days unless the
Secretary and the applicant otherwise agree. Any such hearing shall
thereafter be conducted on an expedited basis and the Secretary's
order thereon shall be issued within ninety days after the date
fixed by the Secretary for filing final briefs."
21 U.S.C. § 355(c).
[
Footnote 5]
That section provides:
"If the Secretary finds, after due notice to the applicant in
accordance with subsection (c). . . and giving him an opportunity
for a hearing, in accordance with said subsection, that (1) the
investigations, reports of which are required to be submitted to
the Secretary pursuant to subsection (b) . . . do not include
adequate tests by all methods reasonably applicable to show whether
or not such drug is safe for use under the conditions prescribed,
recommended, or suggested in the proposed labeling thereof; (2) the
results of such tests show that such drug is unsafe for use under
such conditions or do not show that such drug is safe for use under
such conditions; (3) the methods used in, and the facilities and
controls used for, the manufacture, processing, and packing of such
drug are inadequate to preserve its identity, strength, quality,
and purity; (4) upon the basis of the information submitted to him
as part of the application, or upon the basis of any other
information before him with respect to such drug, he has
insufficient information to determine whether such drug is safe for
use under such conditions; or (5) evaluated on the basis of the
information submitted to him as part of the application and any
other information before him with respect to such drug, there is a
lack of substantial evidence that the drug will have the effect it
purports or is represented to have under the conditions of use
prescribed, recommended, or suggested in the proposed labeling
thereof; or (6) based on a fair evaluation of all material facts,
such labeling is false or misleading in any particular; he shall
issue an order refusing to approve the application. If, after such
notice and opportunity for hearing, the Secretary finds that
clauses (1) through (6) do not apply, he shall issue an order
approving the application. As used in this subsection and
subsection (e) . . . , the term 'substantial evidence' means
evidence consisting of adequate and well controlled investigations,
including clinical investigations, by experts qualified by
scientific training and experience to evaluate the effectiveness of
the drug involved, on the basis of which it could fairly and
responsibly be concluded by such experts that the drug will have
the effect it purports or is represented to have under the
conditions of use prescribed, recommended, or suggested in the
labeling or proposed labeling thereof."
21 U.S.C. § 355(d).
[
Footnote 6]
108 Cong.Rec. 17366.
[
Footnote 7]
H.R.Rep. No. 2464, 87th Cong., 2d Sess., p. 3.
[
Footnote 8]
Prescription drugs, as defined by § 503(b), 21 U.S.C. § 353(b),
include any drug for human use which (A) is habit-forming; (B)
"because of its toxicity or other potentiality for harmful
effect, or the method of its use, or the collateral measures
necessary to its use, is not safe for use except under the
supervision of a practitioner licensed by law to administer such
drug;"
or (C) is limited to prescription use in the application under §
505.
[
Footnote 9]
108 Cong.Rec. 17368.
[
Footnote 10]
See S.Rep. No. 1744, 87th Cong., 2d Sess., pt.. 2, p.
8; H.R.Rep. No. 2464, 87th Cong., 2d Sess., 12; H.R.Rep. No. 2526,
87th Cong., 2d Sess., 22-23; 108 Cong.Rec. 17366.