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<dc:title>117 S2595 IS: Drug Shortages Prevention and Quality Improvement Act</dc:title>
<dc:publisher>U.S. Senate</dc:publisher>
<dc:date>2021-08-04</dc:date>
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<dc:language>EN</dc:language>
<dc:rights>Pursuant to Title 17 Section 105 of the United States Code, this file is not subject to copyright protection and is in the public domain.</dc:rights>
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<distribution-code display="yes">II</distribution-code><congress>117th CONGRESS</congress><session>1st Session</session><legis-num>S. 2595</legis-num><current-chamber>IN THE SENATE OF THE UNITED STATES</current-chamber><action><action-date date="20210804">August 4, 2021</action-date><action-desc><sponsor name-id="S308">Mr. Cardin</sponsor> (for himself and <cosponsor name-id="S394">Ms. Smith</cosponsor>) introduced the following bill; which was read twice and referred to the <committee-name committee-id="SSHR00">Committee on Health, Education, Labor, and Pensions</committee-name></action-desc></action><legis-type>A BILL</legis-type><official-title>To address prescription drug shortages and improve the quality of prescription drugs, and for other purposes.</official-title></form><legis-body><section id="idEFE4BFA67C1C48B09FA0DF5B11D99361" section-type="section-one" commented="no"><enum>1.</enum><header>Short title</header><text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>Drug Shortages Prevention and Quality Improvement Act</short-title></quote>.</text></section><section section-type="subsequent-section" id="idB741C264356A4DFFBEF5C4A270E14E1A"><enum>2.</enum><header>Lengthen expiration dates to mitigate critical drug shortages</header><subsection id="id9f2fd50a63f44420aff14cf74d9712f7"><enum>(a)</enum><header>In general</header><text>The Federal Food, Drug, and Cosmetic Act is amended by inserting after section 506C–1 (<external-xref legal-doc="usc" parsable-cite="usc/21/356c-1">21 U.S.C. 356c–1</external-xref>) the following:</text><quoted-block style="OLC" display-inline="no-display-inline" id="id64b08d3017fc42d0b40ad078e120e85f"><section id="idea582dfd98ff4dee9ebbe967d9002d81"><enum>506C–2.</enum><header>Extended shelf life dates for essential drugs</header><subsection id="idb35f092cfed44abeb3d86650ee8dc6b4"><enum>(a)</enum><header>In general</header><text>A manufacturer of a drug subject to notification requirements under section 506C(a) (referred to in this section as an <quote>essential drug</quote>) shall—</text><paragraph id="id3e6b65e60d7a4d01bd30df5c113ce5bf"><enum>(1)</enum><text>submit to the Secretary data and information as required by subsection (b)(1);</text></paragraph><paragraph id="ida03b38ee6b18467aa837aa9d34791eec"><enum>(2)</enum><text>conduct and submit the results of any studies required under subsection (b)(2); and</text></paragraph><paragraph id="idde7b3ecce8f8483f855b811a1d2d4d98"><enum>(3)</enum><text>make any labeling change described in subsection (c) by the date specified by the Secretary pursuant to such subsection.</text></paragraph></subsection><subsection id="id142684ff92f145939e83d6dc18f5481d"><enum>(b)</enum><header>Notification</header><paragraph id="id24e1091c37a94810bb638c3f53e96d89"><enum>(1)</enum><header>In general</header><text>The Secretary may issue an order requiring the manufacturer of any essential drug to submit, in such manner as the Secretary may prescribe, data and information from any stage of development of the drug that are adequate to assess the shelf life stability of the drug to determine the longest supported expiration date.</text></paragraph><paragraph id="idd2a60915d1144aefb0bd07d1bfbfd3d3"><enum>(2)</enum><header>Unavailable or insufficient data and information</header><text>If the data and information required pursuant to an order issued under paragraph (1) are not available or are insufficient, the Secretary may require the manufacturer of the drug to—</text><subparagraph id="idacc9985b9fd449dca2a38242e7baac57"><enum>(A)</enum><text>conduct studies adequate to provide the data and information in accordance with section 211.166 of title 21, Code of Federal Regulations (or any successor regulations); and</text></subparagraph><subparagraph id="ide95394d0a7d2475cb8c7a023ce9ddd47"><enum>(B)</enum><text>submit to the Secretary the results, data, and information generated by such studies when available.</text></subparagraph></paragraph></subsection><subsection id="idb2f9cd24d9e14c7c976f1f3320594637"><enum>(c)</enum><header>Labeling</header><text>The Secretary may issue an order requiring the manufacturer of an essential drug to, by a specified date, make any labeling change regarding the expiration period that the Secretary determines to be appropriate based on the data and information required to be submitted under this section or any other data and information available to the Secretary in accordance with labeling requirements under subpart G of part 211 of title 21, Code of Federal Regulations (or any successor regulations).</text></subsection><subsection id="id3eaf4b6df1be48dfb02fae6fd3c28fe9"><enum>(d)</enum><header>Confidentiality</header><text>Nothing in this section shall be construed as authorizing the Secretary to disclose any information that is a trade secret or confidential information subject to section 552(b)(4) of title 5, United States Code, or section 1905 of title 18, United States Code.</text></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></subsection><subsection id="id0f10b76610044b419f45a15d0ec6c777"><enum>(b)</enum><header>Civil monetary penalty</header><text>Section 303(b) of the Federal Food, Drug, and Cosmetic Act (<external-xref legal-doc="usc" parsable-cite="usc/21/333">21 U.S.C. 333(b)</external-xref>) is amended by adding at the end the following:</text><quoted-block style="OLC" display-inline="no-display-inline" id="idA3739C27610047368859EE54386FCF96"><paragraph id="id4234F7F7C298463E9D8D7D2B919DEC97" indent="up1"><enum>(9)</enum><text>If a drug manufacturer fails to submit data and information as required under section 506C–2(b)(1), fails to conduct or submit the results of studies as required under section 506C–2(b)(3), or fails to make a labeling change as required under section 506C–2(c), such manufacturer shall be liable to the United States for a civil penalty in an amount not to exceed $10,000 for each such violation.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subsection><subsection id="idee00b2e7d63e4f0abd0886d9270e0c34"><enum>(c)</enum><header>GAO Study of shelf life data</header><text>Not later than 2 years after the date of enactment of this Act, the Comptroller General of the United States shall conduct a study examining the process by which prescription drug manufacturers submit data on shelf life to the Food and Drug Administration. In carrying out this study, the Comptroller General shall consider whether manufacturers adequately test the shelf life stability of their drug products subject to section 211.166 of title 21, Code of Federal Regulations (or any successor regulations).</text></subsection><subsection id="idf364b5a02c484a91a57cc0a0261282c9"><enum>(d)</enum><header>Shelf life stability guidance</header><text>Not later than 6 months after the date of enactment of this Act, the Secretary shall publish for notice and comment in the Federal Register updates to stability testing under section 211.166 of title 21, Code of Federal Regulations (or any successor regulations).</text></subsection></section><section id="idb1230a770f4c4e548673b110315f604a"><enum>3.</enum><header>Quality Management Maturity Sterile Injectable Drug Pilot Program</header><subsection id="idf0728ac725ae414f8a6990944c5bd154"><enum>(a)</enum><header>Quality Management Maturity Sterile Injectable Drug Pilot Program</header><paragraph id="ide8817ba17c594cbaa4da82a2439ea38f"><enum>(1)</enum><header>In general</header><text>Not later than 6 months after the date of enactment of this Act, the Secretary of Health and Human Services (referred to in this section as the <quote>Secretary</quote>), acting through the Commissioner of Food and Drugs, shall commence the Quality Management Maturity (QMM) Sterile Injectable Drug Pilot Program (referred to in this section as the <quote>pilot program</quote>) under this section. Under such program, the Secretary shall—</text><subparagraph id="idd5eb2256b5ba49058b9fb6287b5f8044"><enum>(A)</enum><text>select eligible drug manufacturers to participate in the program in accordance with paragraph (2); and</text></subparagraph><subparagraph id="id7a65ab43b1984ba79a88ce85faf8bb31"><enum>(B)</enum><text>contract with a third-party contractor to develop a QMM assessment tool and conduct assessments, in cooperation with staff of the Food and Drug Administration, of each participant’s quality management system.</text></subparagraph></paragraph><paragraph id="idcacc255a536340f59b6dcc9f97a6ae26"><enum>(2)</enum><header>Eligibility</header><text>To be eligible to participate in the pilot program under this section, a manufacturer shall—</text><subparagraph id="idaa8148866b614db7924e7de6994d32f3"><enum>(A)</enum><text>be a for-profit or nonprofit entity;</text></subparagraph><subparagraph id="id8B70ABB1405549F79914B460FD075264"><enum>(B)</enum><text>manufacture a prescription drug that is a sterile injectable drug;</text></subparagraph><subparagraph id="idd4702fd0b33f44db9396fc79f62a225a"><enum>(C)</enum><text>manufacture a drug that is deemed an essential medicine under Executive Order 13944 (85 Fed. Reg. 49929); </text></subparagraph><subparagraph id="id6d8c4942022d4c9bbc28368426d28906"><enum>(D)</enum><text>have received a final classification of <quote>No Action Indicated</quote> or <quote>Voluntary Action Indicated</quote> with respect to all inspections of all manufacturing facilities of the entity conducted by the Food and Drug Administration within the 5-year period immediately preceding the date of enactment of this Act;</text></subparagraph><subparagraph id="idf100e9e9064841e98c16128eea1b921b"><enum>(E)</enum><text>be a person who has registered one or more establishments under subsection (b)(1) or (i)(1) of section 510 of the Federal Food, Drug, and Cosmetic Act (<external-xref legal-doc="usc" parsable-cite="usc/21/360">21 U.S.C. 360</external-xref>), with respect to the manufacture of a prescription drug described in subparagraph (B); and</text></subparagraph><subparagraph id="id33c4924d090a49ff9b41ce97f19cf7f6"><enum>(F)</enum><text>agree to—</text><clause id="id82f49b9151d64fe69589864597a0c5bf"><enum>(i)</enum><text>permit a third-party contractor to conduct regular assessments under the QMM pilot program, as described in paragraph (3), either on-site or remotely;</text></clause><clause id="id8702602419c943be85ca1d4c391fae6a"><enum>(ii)</enum><text>collect and submit metrics data to the Food and Drug Administration and the contractor by an agreed upon date, prior to each assessment described in clause (i); and</text></clause><clause id="id8e5105cbcc5f44ee970561e3f3cbe029"><enum>(iii)</enum><text>be available for consultations with the third-party contractor and the Food and Drug Administration prior to and after each assessment described in clause (i), including discussions regarding the participant’s established QMM-related activities and the contractor’s post-assessment recommendations regarding these activities.</text></clause></subparagraph></paragraph><paragraph id="id4906b5b07e3046578bbafe5e35dc9843"><enum>(3)</enum><header>Assessments</header><text>Assessments that are conducted jointly by a third-party contractor, in cooperation with staff of the Food and Drug Administration, will regularly conduct manufacturer facility assessments to determine the manufacturer’s quality management maturity progress or status. Pilot program assessments will cover multiple topics and shall include—</text><subparagraph id="id7d9323185681459ebc64a7836b118395"><enum>(A)</enum><text>supply chain management;</text></subparagraph><subparagraph id="id45a497c4f78647a59c51c35758f7b9bf"><enum>(B)</enum><text>manufacturing strategy and operations;</text></subparagraph><subparagraph id="idda1c2747079d400aa0d76c3cf535c450"><enum>(C)</enum><text>safety, environmental, and regulatory compliance;</text></subparagraph><subparagraph id="iddc4b4b9cb3d6469bb32e9221ce23d88d"><enum>(D)</enum><text>inventory management;</text></subparagraph><subparagraph id="id78bc2ba907514588b80b730bd9b40a17"><enum>(E)</enum><text>performance management and continual improvement;</text></subparagraph><subparagraph id="idb4a0a60621204a548f9f4a954024984e"><enum>(F)</enum><text>risk management;</text></subparagraph><subparagraph id="idb1e7fd575eee47b993ca8ea66937e6a5"><enum>(G)</enum><text>management review and responsibility;</text></subparagraph><subparagraph id="id413543bc5a9647198cea8e689279afa8"><enum>(H)</enum><text>planning;</text></subparagraph><subparagraph id="id368419a24f494a52bf62f1ba7b1cc267"><enum>(I)</enum><text>workforce management;</text></subparagraph><subparagraph id="ideebbae2103be47de9e84f71f1c6956e8"><enum>(J)</enum><text>quality culture; and</text></subparagraph><subparagraph id="id29444a781c36486d90beaa275e9d6b98"><enum>(K)</enum><text>customer experience.</text></subparagraph></paragraph><paragraph id="idda7b090ab19846f2b3e1c8da427a167f"><enum>(4)</enum><header>Program duration</header><text>Not later than 6 months after the date of enactment of this Act, the Secretary shall publish instructions for applicants in the Federal Register. Such instructions shall include a timeline for the application period for such program, and a 1-year timeline for the pilot program following such application period.</text></paragraph></subsection><subsection id="ide5ccdbc3b260466f85cee2aea4cde79e"><enum>(b)</enum><header>Report to Congress</header><text>Not later than 6 months after the completion of the pilot program, the Secretary shall submit a report to Congress on such pilot program. Such report shall include—</text><paragraph id="id0A618F5EDB78400CB22FDEC88D86D12E"><enum>(1)</enum><text>a summary of third-party assessments of each participating manufacturer’s quality management system;</text></paragraph><paragraph id="idABC1DC8766C446559D88A6C6819DC816"><enum>(2)</enum><text>recommendations on next steps towards developing a publicly available Food and Drug Administration rating system for quality management maturity systems of sterile injectable drug manufacturing facilities, including specific drugs manufactured at each facility; </text></paragraph><paragraph id="id3118806D46CB461A90DF336EF3ACA6C2"><enum>(3)</enum><text>considerations the Food and Drug Administration may take in updating guidance of current good manufacturing practice of sterile injectable drug products; and</text></paragraph><paragraph id="id8c1510059fa94cbbb2dd6605ab5e9253"><enum>(4)</enum><text>recommendations on incorporating pilot programs (or related work) described in the guidances entitled, <quote>Quality Management Maturity for Finished Dosage Forms Pilot Program for Domestic Drug Product Manufacturers; Program Announcement</quote>, issued by the Food and Drug Administration on October 16, 2020 (85 Fed. Reg. 65824), and <quote>Quality Management Maturity for Active Pharmaceutical Ingredients Pilot Program for Foreign Facilities; Program Announcement</quote>, issued by the Food and Drug Administration on October 16, 2020 (85 Fed. Reg. 65828), into publicly available Food and Drug Administration rating systems for overall quality management maturity systems. </text></paragraph></subsection><subsection id="id33f6497dd9444392896e0513043a727f"><enum>(c)</enum><header>Definition</header><text>In this section, the term <term>sterile injectable drug</term> means a drug approved under section 505 of the Federal Food, Drug, and Cosmetic Act (<external-xref legal-doc="usc" parsable-cite="usc/21/355">21 U.S.C. 355</external-xref>), a biological product licensed under section 351 of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/262">42 U.S.C. 262</external-xref>), or a combination product (as described in section 503(g) of the Federal Food, Drug, and Cosmetic Act (<external-xref legal-doc="usc" parsable-cite="usc/21/353">21 U.S.C. 353(g)</external-xref>) whose primary mode of action is that of a drug or biological product, whose manufacturing, distribution, and administration processes require sterile conditions.</text></subsection></section><section id="id40918c9548f343d993d2396c9827ae77"><enum>4.</enum><header>Improved data sharing: ensuring timely and informative notification</header><subsection id="idf6a4f27138dc4991bfc77aad31eb226a"><enum>(a)</enum><header>In general</header><text>Section 301 of the Federal Food, Drug, and Cosmetic Act (<external-xref legal-doc="usc" parsable-cite="usc/21/331">21 U.S.C. 331</external-xref>) is amended by adding at the end the following:</text><quoted-block style="OLC" display-inline="no-display-inline" id="idab8e0fbdca1341d6ace4f39bd76cbe23"><subsection id="idb69061f0b2394c8bb5a60e605ee6b4cb"><enum>(fff)</enum><header>Failure To provide timely and informative notification</header><text>Any manufacturer who violates a requirement of this Act that relates to critical drugs by failing to provide timely, adequate information related to drug shortages pursuant to section 506C(a) shall be subject to a civil penalty in an amount not to exceed $50,000 per violation.</text></subsection><after-quoted-block>.</after-quoted-block></quoted-block></subsection><subsection id="id0c3e9a95fd654635b6260e3140301774"><enum>(b)</enum><header>Regulations</header><text>Not later than 1 year after the date of the enactment of this Act, the Secretary shall promulgate final regulations to carry out section 301(fff) of the Federal Food, Drug, and Cosmetic Act, as added by subsection (a).</text></subsection></section><section id="id4e0bc3423120403a81533342be1609e8"><enum>5.</enum><header>Supporting continuous manufacturing to prevent shortages for susceptible drugs</header><text display-inline="no-display-inline">Subtitle B of title III of the 21st Century Cures Act is amended by inserting after section 3016 (<external-xref legal-doc="usc" parsable-cite="usc/21/399h">21 U.S.C. 399h</external-xref>) the following:</text><quoted-block style="OLC" display-inline="no-display-inline" id="idC4A9EFC2920B4ABE8C1EEF3576D12589"><section id="idac9425c095cb49de87aa68b91e866b0c"><enum>3017.</enum><header>Grants for continuous manufacturing to prevent drug shortages</header><subsection id="id9139ce3226df4ae0b6f059d41dd50d33"><enum>(a)</enum><header>In general</header><text>The Secretary of Health and Human Services, acting through the Commissioner of Food and Drugs, shall solicit and, beginning not later than one year after the date of enactment of the <short-title>Drug Shortages Prevention and Quality Improvement Act</short-title>, receive, requests from institutions of higher education and nonprofit entities engaged in the manufacture of sterile injectable drugs for the purpose of upgrading drug establishment to continuous manufacturing or other advanced manufacturing capabilities.</text></subsection><subsection id="idf4113b8597064f32b325410e1ab89b99"><enum>(b)</enum><header>Grant criteria</header><text>An institution of higher education or a nonprofit entity shall be eligible for a grant under this section if such institution or entity manufactures a drug that—</text><paragraph id="id9b3e38bef42949d593a07827bd83bdf8"><enum>(1)</enum><text>is categorized as an essential medicine under Executive Order 13944;</text></paragraph><paragraph id="idABFA7DB6880148D389786CA6FE3F9E9E"><enum>(2)</enum><text>is a sterile injectable drug; and</text></paragraph><paragraph id="id191E2D8A6E8B4371806A44E72279549A"><enum>(3)</enum><text>is vulnerable to shortage.</text></paragraph></subsection><subsection id="id72b429bb39b34be586ab2f298b4b73f2"><enum>(c)</enum><header>Grant selection</header><text>As a condition for accepting a grant under this section, an institution of higher education and nonprofit entity shall agree to participate in the Quality Management Maturity Sterile Injectable Drug Pilot Program established under section 3 of the <short-title>Drug Shortages Prevention and Quality Improvement Act</short-title>.</text></subsection><subsection id="ida1cb0244725c4b448995268476e5d17a"><enum>(d)</enum><header>Authorization of appropriations</header><text>To carry out this section, there is authorized to be appropriated $1,000,000,000 for the period of fiscal years 2022 through 2027.</text></subsection><subsection id="iddbae68d2094b4f01959cdf9ad00297e6"><enum>(e)</enum><header>Definitions</header><text>In this section:</text><paragraph id="idcebc1db63edb46de915532168ccba9d7"><enum>(1)</enum><header>Advanced manufacturing</header><text>The term <term>advanced manufacturing</term> means an approach for the manufacturing of drugs that incorporates novel technology, or uses an established technique or technology in a new or innovative way (such as continuous manufacturing where the input materials are continuously transformed within the process by 2 or more unit operations) that enhances drug quality or improves the manufacturing process.</text></paragraph><paragraph id="id47dc5256968b46a8a429043050321d27"><enum>(2)</enum><header>Continuous manufacturing</header><text>The term <term>continuous manufacturing</term>—</text><subparagraph id="id618e2c747662473a97ca13c0af840488"><enum>(A)</enum><text>means a process where the input materials are continuously fed into and transformed within the process, and the processed output materials are continuously removed from the system; and</text></subparagraph><subparagraph id="idde68a03908a144168a91d9eafc3f84ec"><enum>(B)</enum><text>consists of an integrated process that consists of a series of 2 or more unit operations.</text></subparagraph></paragraph><paragraph id="idaf24c1c4546345e890be12838dfc5c0d"><enum>(3)</enum><header>Sterile injectable drug</header><text>The term <term>sterile injectable drug</term> means a drug approved under section 505 of the Federal Food, Drug, and Cosmetic Act (<external-xref legal-doc="usc" parsable-cite="usc/21/355">21 U.S.C. 355</external-xref>), a biological product licensed under section 351 of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/262">42 U.S.C. 262</external-xref>), or a combination product (as described in section 503(g) of the Federal Food, Drug, and Cosmetic Act (<external-xref legal-doc="usc" parsable-cite="usc/21/353">21 U.S.C. 353(g)</external-xref>) whose primary mode of action is that of a drug or biological product, whose manufacturing, distribution, and administration processes require sterile conditions.</text></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></section></legis-body></bill> 

