[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3537 Reported in House (RH)]
<DOC>
Union Calendar No. 148
117th CONGRESS
1st Session
H. R. 3537
[Report No. 117-207]
To direct the Secretary of Health and Human Services to support
research on, and expanded access to, investigational drugs for
amyotrophic lateral sclerosis, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
May 25, 2021
Mr. Quigley (for himself, Mr. Fortenberry, Mr. Brendan F. Boyle of
Pennsylvania, Mr. Moulton, Mr. Garcia of California, Mr. Carbajal, Mr.
Larson of Connecticut, Ms. Jackson Lee, Ms. Dean, Mr. Suozzi, Ms.
Velazquez, Mr. Levin of California, Mr. Deutch, Ms. Norton, Mr.
Timmons, Mr. Brady, Mr. McKinley, Mr. Van Drew, Mr. Calvert, Mr.
Keating, Mr. Diaz-Balart, Mr. Carter of Georgia, Mrs. McBath, Mr. Smith
of Missouri, Mr. Turner, Mr. Duncan, Mr. Hice of Georgia, Mr. Young,
Mr. Smith of Nebraska, Mr. Grothman, Mr. Ruppersberger, Mr. Rutherford,
Mr. Schweikert, Mr. Ryan, Mr. Crow, Mr. Guthrie, Mr. Fitzpatrick, Ms.
McCollum, Mr. Austin Scott of Georgia, Mr. Baird, Mr. Rodney Davis of
Illinois, Mr. Valadao, Mr. Moolenaar, Mr. Malinowski, Ms. Roybal-
Allard, Mr. Payne, Mr. Lynch, Ms. Herrera Beutler, Mr. Buck, Mr.
Mullin, Mr. Grijalva, Mr. Cooper, Mr. Panetta, Mr. Kim of New Jersey,
Mr. Sires, Ms. Lee of California, Ms. Moore of Wisconsin, Ms.
Schakowsky, Mr. Thompson of California, Mr. Gallego, Mrs. Axne, Mrs.
Napolitano, Mr. Espaillat, Ms. Pressley, Mr. Fleischmann, Mr.
Reschenthaler, Mr. Cicilline, Ms. DeGette, Mr. Burchett, Mr. LaMalfa,
Ms. Meng, Ms. Brownley, Mr. Trone, Ms. Kuster, Mr. Connolly, Mr. Meeks,
Mrs. Kirkpatrick, Mrs. Demings, Mr. O'Halleran, Mr. Lieu, Mr.
DeSaulnier, Mr. Garamendi, Mr. Kilmer, Mr. Rush, Mr. McCaul, Mr.
McClintock, Mr. Mfume, Mr. Lamb, Mr. Green of Texas, Mr. Swalwell, Mr.
Gottheimer, Ms. Pingree, Ms. Kaptur, Mr. Ferguson, Ms. Scanlon, Mr.
Bacon, Mr. Wittman, Mr. Morelle, Mr. Amodei, and Mr. Waltz) introduced
the following bill; which was referred to the Committee on Energy and
Commerce
December 8, 2021
Additional sponsors: Ms. Sewell, Ms. Sherrill, Mr. Posey, Mr. Cole, Mr.
Curtis, Mr. Carson, Mr. Gonzalez of Ohio, Ms. Clark of Massachusetts,
Ms. Houlahan, Ms. Newman, Mr. Smith of New Jersey, Mr. LaHood, Mr.
Costa, Mr. Sherman, Mr. Chabot, Mr. Aguilar, Mrs. Beatty, Ms. Wasserman
Schultz, Ms. Davids of Kansas, Mr. Hill, Mrs. Carolyn B. Maloney of New
York, Mr. Vicente Gonzalez of Texas, Ms. Wexton, Mr. Huffman, Mr.
Tonko, Mrs. Luria, Mr. Bishop of Georgia, Mr. Correa, Mr. Katko, Mr.
Foster, Ms. Wild, Mr. Womack, Ms. Ross, Ms. Lois Frankel of Florida,
Mr. Keller, Mr. Stewart, Mr. Brooks, Mr. Auchincloss, Mr. Welch, Mr.
Wilson of South Carolina, Ms. Salazar, Mrs. Trahan, Ms. Stefanik, Ms.
Matsui, Mr. Cartwright, Mr. Yarmuth, Mr. Schneider, Mr. Delgado, Mr.
Westerman, Mr. Garcia of Illinois, Ms. Manning, Ms. Porter, Mr.
Crawford, Mr. DeFazio, Mr. Langevin, Miss Rice of New York, Mr. Golden,
Mr. Sessions, Mr. Harder of California, Mr. Lowenthal, Mr. Soto, Mr.
Raskin, Mr. Joyce of Ohio, Mr. Lamborn, Mr. Johnson of Georgia, Ms.
Barragan, Mr. Dunn, Mr. Courtney, Mr. Carter of Louisiana, Mr. Lucas,
Mr. Emmer, Mr. Graves of Missouri, Ms. Omar, Mr. Peters, Ms. Craig, Mr.
Danny K. Davis of Illinois, Mr. Bera, Mr. Bilirakis, Ms. Strickland,
Mr. Gibbs, Mr. Meuser, Mr. Higgins of New York, Mr. Gallagher, Mr.
Lawson of Florida, Mr. Owens, Mrs. Miller-Meeks, Mr. Cardenas, Mr.
Wenstrup, Ms. Jacobs of California, Mr. Perlmutter, Mrs. Hartzler, Mr.
Stauber, Mr. Krishnamoorthi, Mr. Kildee, Ms. Slotkin, Mr. Sarbanes, Mr.
Griffith, Ms. Spanberger, Mr. McGovern, Mr. Khanna, Mr. Mann, Mr.
Biggs, Mr. Sean Patrick Maloney of New York, Mr. Thompson of
Pennsylvania, Ms. DelBene, Mr. Nadler, Ms. Sanchez, Mr. McNerney, Mrs.
Watson Coleman, Mrs. Fletcher, Mr. Mast, Mr. Stanton, Mr. Smith of
Washington, Mr. Weber of Texas, Ms. Kelly of Illinois, Mr. Jones, Mr.
Neguse, Mr. Kahele, Mr. Himes, Mr. Huizenga, Mr. Higgins of Louisiana,
Mr. Bergman, Mr. Balderson, Mr. David Scott of Georgia, Mr. Aderholt,
Mr. Armstrong, Mr. DesJarlais, Mr. Moore of Alabama, Mr. Schiff, Mr.
Thompson of Mississippi, Mrs. Kim of California, Mr. Feenstra, Ms.
Adams, Mr. Kelly of Mississippi, Mr. Allred, Mr. Cohen, Mr. Brown of
Maryland, Mr. Johnson of Ohio, Mrs. Murphy of Florida, Mr. Luetkemeyer,
Ms. Williams of Georgia, Mr. Gosar, Mr. Tiffany, Mr. Casten, Ms.
Cheney, Mrs. Hayes, Mr. Jeffries, Mr. Smucker, Ms. Lofgren, Mr. Hern,
Ms. Tenney, Ms. Bonamici, Mrs. Steel, Mr. Garbarino, Mr. Norcross, Ms.
Escobar, Mrs. Cammack, Mr. Gomez, Mr. Torres of New York, Mr. Bowman,
Ms. Tlaib, Ms. Bass, Ms. Wilson of Florida, Ms. Clarke of New York, Mr.
Levin of Michigan, Ms. Stevens, Ms. Leger Fernandez, Ms. Waters, Mr.
Kind, Mr. Cuellar, Mr. Phillips, Mr. Hagedorn, Mr. Palazzo, Ms. Blunt
Rochester, Mr. Moore of Utah, Mr. Blumenauer, Ms. Granger, Ms. Jayapal,
Mr. Horsford, Mr. Cline, Ms. Speier, Mr. Carl, Mr. Cawthorn, Mr. Murphy
of North Carolina, Mr. Obernolte, Mr. Kelly of Pennsylvania, Mr.
Scalise, Ms. Malliotakis, Mr. Evans, Mr. Zeldin, Mr. Simpson, Mr.
Steube, Mr. Johnson of Louisiana, Mr. Loudermilk, Mrs. Hinson, Mr.
LaTurner, Ms. Bourdeaux, Ms. Johnson of Texas, Mr. Case, Mr. Jacobs of
New York, Mrs. Bice of Oklahoma, Mrs. Wagner, Mr. Gooden of Texas, Mr.
Harris, Mr. Jackson, Mr. Mooney, Mr. Burgess, Ms. Letlow, Mr. Upton,
Ms. Schrier, Mr. Butterfield, Mr. Bentz, Mrs. Fischbach, Mr. Graves of
Louisiana, Mr. Walberg, Mr. Good of Virginia, Mrs. Torres of
California, Mr. Pappas, Mrs. McClain, Mr. Guest, Mr. C. Scott Franklin
of Florida, Mr. Gohmert, Mr. Rouzer, Mr. Bost, Mr. Williams of Texas,
Mr. Banks, Mrs. Lawrence, Mr. Crist, Ms. Castor of Florida, Ms. Eshoo,
Mr. Crenshaw, and Mr. Newhouse
December 8, 2021
Reported with an amendment, committed to the Committee of the Whole
House on the State of the Union, and ordered to be printed
[Strike out all after the enacting clause and insert the part printed
in italic]
[For text of introduced bill, see copy of bill as introduced on May 25,
2021]
_______________________________________________________________________
A BILL
To direct the Secretary of Health and Human Services to support
research on, and expanded access to, investigational drugs for
amyotrophic lateral sclerosis, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Accelerating Access to Critical
Therapies for ALS Act''.
SEC. 2. GRANTS FOR RESEARCH ON THERAPIES FOR ALS.
(a) In General.--The Secretary of Health and Human Services
(referred to in this section as the ``Secretary'') shall award grants
to participating entities for purposes of scientific research utilizing
data from expanded access to investigational drugs for individuals who
are not otherwise eligible for clinical trials for the prevention,
diagnosis, mitigation, treatment, or cure of amyotrophic lateral
sclerosis. In the case of a participating entity seeking such a grant,
an expanded access request must be submitted, and allowed to proceed by
the Secretary, under section 561 of the Federal Food, Drug, and
Cosmetic Act (21 U.S.C. 360bbb) and part 312 of title 21, Code of
Federal Regulations (or any successor regulations), before the
application for such grant is submitted.
(b) Application.--
(1) In general.--A participating entity seeking a grant
under this section shall submit to the Secretary an application
at such time, in such manner, and containing such information
as the Secretary shall specify.
(2) Use of data.--An application submitted under paragraph
(1) shall include a description of how data generated through
an expanded access request under section 561 of the Federal
Food, Drug, and Cosmetic Act (21 U.S.C. 360bbb) with respect to
the investigational drug involved will be used to support
research or development related to the prevention, diagnosis,
mitigation, treatment, or cure of amyotrophic lateral
sclerosis.
(3) Noninterference with clinical trials.--An application
submitted under paragraph (1) shall include a description of
how the proposed expanded access program will be designed so as
not to interfere with patient enrollment in ongoing clinical
trials for investigational therapies for the prevention,
diagnosis, mitigation, treatment, or cure of amyotrophic
lateral sclerosis.
(c) Selection.--Consistent with sections 406 and 492 of the Public
Health Service Act (42 U.S.C. 284a, 289a), the Secretary shall, in
determining whether to award a grant under this section, confirm that--
(1) such grant will be used to support a scientific
research objective relating to the prevention, diagnosis,
mitigation, treatment, or cure of amyotrophic lateral sclerosis
(as described in subsection (a));
(2) such grant shall not have the effect of diminishing
eligibility for, or impeding enrollment of, ongoing clinical
trials for the prevention, diagnosis, mitigation, treatment, or
cure of amyotrophic lateral sclerosis by determining that
individuals who receive expanded access to investigational
drugs through such a grant are not eligible for enrollment in--
(A) ongoing clinical trials that are registered on
ClinicalTrials.gov (or successor website), with respect
to a drug for the prevention, diagnosis, mitigation,
treatment, or cure of amyotrophic lateral sclerosis; or
(B) clinical trials for the prevention, diagnosis,
mitigation, treatment, or cure of amyotrophic lateral
sclerosis for which an exemption under section 505(i)
of the Federal Food, Drug, and Cosmetic Act (21 U.S.C.
355(i)) has been granted by the Food and Drug
Administration and which are expected to begin
enrollment within one year; and
(3) the resulting project funded by such grant will allow
for equitable access to investigational drugs by minority and
underserved populations.
(d) Use of Funds.--A participating entity shall use funds received
through the grant--
(1) to pay the manufacturer or sponsor for the direct costs
of the investigational drug, as authorized under section
312.8(d) of title 21, Code of Federal Regulations (or successor
regulations), to prevent, diagnose, mitigate, treat, or cure
amyotrophic lateral sclerosis that is the subject of an
expanded access request described in subsection (a), if such
costs are justified as part of peer review of the grant;
(2) for the entity's direct costs incurred in providing
such drug consistent with the research mission of the grant; or
(3) for the direct and indirect costs of the entity in
conducting research with respect to such drug.
(e) Definitions.--In this section:
(1) The term ``participating entity'' means a participating
clinical trial site or sites sponsored by a small business
concern (as defined in section 3(a) of the Small Business Act
(15 U.S.C. 632(a))) that is the sponsor of a drug that is the
subject of an investigational new drug application under
section 505(i) of the Federal Food, Drug, and Cosmetic Act (21
U.S.C. 355(i)) to prevent, diagnose, mitigate, treat, or cure
amyotrophic lateral sclerosis.
(2) The term ``participating clinical trial'' means a phase
3 clinical trial conducted pursuant to an exemption under
section 505(i) of the Federal Food, Drug, and Cosmetic Act (21
U.S.C. 355(i)) or section 351(a) of the Public Health Service
Act (42 U.S.C. 262(a)) to investigate a drug intended to
prevent, diagnose, mitigate, treat, or cure amyotrophic lateral
sclerosis.
(3) The term ``participating clinical trial site'' means a
health care facility, or network of facilities, at which
patients participating in a participating clinical trial
receive an investigational drug through such trial.
(f) Sunset.--The Secretary may not award grants under this section
on or after September 30, 2026.
SEC. 3. HHS PUBLIC-PRIVATE PARTNERSHIP FOR RARE NEURODEGENERATIVE
DISEASES.
(a) Establishment.--Not later than one year after the date of
enactment of this Act, the Secretary of Health and Human Services
(referred to in this section as the ``Secretary'') shall establish and
implement a Public-Private Partnership for Neurodegenerative Diseases
between the National Institutes of Health, the Food and Drug
Administration, and one or more eligible entities (to be known and
referred to in this section as the ``Partnership'') through cooperative
agreements, contracts, or other appropriate mechanisms with such
eligible entities, for the purpose of advancing the understanding of
neurodegenerative diseases and fostering the development of treatments
for amytrophic lateral sclerosis and other rare neurodegenerative
diseases. The Partnership shall--
(1) establish partnerships and consortia with other public
and private entities and individuals with expertise in
amyotrophic lateral sclerosis and other rare neurodegenerative
diseases for the purposes described in this subsection;
(2) focus on advancing regulatory science and scientific
research that will support and accelerate the development and
review of drugs for patients with amyotrophic lateral sclerosis
and other rare neurodegenerative diseases; and
(3) foster the development of effective drugs that improve
the lives of people that suffer from amyotrophic lateral
sclerosis and other rare neurodegenerative diseases.
(b) Eligible Entity.--In this section, the term ``eligible entity''
means an entity that--
(1) is--
(A) an institution of higher education (as such
term is defined in section 1001 of the Higher Education
Act of 1965 (20 U.S.C. 1001)) or a consortium of such
institutions; or
(B) an organization described in section 501(c)(3)
of the Internal Revenue Code of 1986 and exempt from
tax under subsection (a) of such section;
(2) has experienced personnel with clinical and other
technical expertise in the field of biomedical sciences and
demonstrated connection to the patient population;
(3) demonstrates to the Secretary's satisfaction that the
entity is capable of identifying and establishing
collaborations between public and private entities and
individuals with expertise in neurodegenerative diseases,
including patients, in order to facilitate--
(A) development and critical evaluation of tools,
methods, and processes--
(i) to characterize neurodegenerative
diseases and their natural history;
(ii) to identify molecular targets for
neurodegenerative diseases; and
(iii) to increase efficiency,
predictability, and productivity of clinical
development of therapies, including advancement
of rational therapeutic development and
establishment of clinical trial networks; and
(B) securing funding for the Partnership from
Federal and non-Federal governmental sources,
foundations, and private individuals; and
(4) provides an assurance that the entity will not accept
funding for a Partnership project from any organization that
manufactures or distributes products regulated by the Food and
Drug Administration unless the entity provides assurances in
its agreement with the Secretary that the results of the
project will not be influenced by any source of funding.
(c) Gifts.--
(1) In general.--The Partnership may solicit and accept
gifts, grants, and other donations, establish accounts, and
invest and expend funds in support of basic research and
research associated with phase 3 clinical trials conducted with
respect to investigational drugs that are the subjects of
expanded access requests under section 561 of the Federal Food,
Drug, and Cosmetic Act (21 U.S.C. 360bbb).
(2) Use.--In addition to any amounts appropriated for
purposes of carrying out this section, the Partnership may use,
without further appropriation, any funds derived from a gift,
grant, or other donation accepted pursuant to paragraph (1).
SEC. 4. ALS AND OTHER RARE NEURODEGENERATIVE DISEASE ACTION PLAN.
(a) In General.--Not later than 6 months after the date of
enactment of this Act, the Commissioner of Food and Drugs shall publish
on the website of the Food and Drug Administration an action plan
describing actions the Food and Drug Administration intends to take
during the 5-year period following publication of the plan with respect
to program enhancements, policy development, regulatory science
initiatives, and other appropriate initiatives to--
(1) foster the development of safe and effective drugs that
improve or extend, or both, the lives of people living with
amyotrophic lateral sclerosis and other rare neurodegenerative
diseases; and
(2) facilitate access to investigational drugs for
amyotrophic lateral sclerosis and other rare neurodegenerative
diseases.
(b) Contents.--The initial action plan published under subsection
(a) shall--
(1) identify appropriate representation from within the
Food and Drug Administration to be responsible for
implementation of such action plan;
(2) include elements to facilitate--
(A) interactions and collaboration between the Food
and Drug Administration, including the review centers
thereof, and stakeholders including patients, sponsors,
and the external biomedical research community;
(B) consideration of cross-cutting clinical and
regulatory policy issues, including consistency of
regulatory advice and decisionmaking;
(C) identification of key regulatory science and
policy issues critical to advancing development of safe
and effective drugs; and
(D) enhancement of collaboration and engagement of
the relevant centers and offices of the Food and Drug
Administration with other operating divisions within
the Department of Health and Human Services, the
Partnership, and the broader neurodegenerative disease
community; and
(3) be subject to revision, as determined appropriate by
the Secretary of Health and Human Services.
SEC. 5. FDA RARE NEURODEGENERATIVE DISEASE GRANT PROGRAM.
The Secretary of Health and Human Services, acting through the
Commissioner of Food and Drugs, shall award grants and contracts to
public and private entities to cover the costs of research on, and
development of interventions intended to prevent, diagnose, mitigate,
treat, or cure, amyotrophic lateral sclerosis and other rare
neurodegenerative diseases in adults and children, including costs
incurred with respect to the development and critical evaluation of
tools, methods, and processes--
(1) to characterize such neurodegenerative diseases and
their natural history;
(2) to identify molecular targets for such
neurodegenerative diseases; and
(3) to increase efficiency and productivity of clinical
development of therapies, including through--
(A) the use of master protocols and adaptive and
add-on clinical trial designs; and
(B) efforts to establish new or leverage existing
clinical trial networks.
SEC. 6. GAO REPORT.
Not later than 4 years after the date of the enactment of this Act,
the Comptroller General of the United States shall submit to the
Committee on Energy and Commerce of the House of Representatives and
the Committee on Health, Education, Labor, and Pensions of the Senate a
report containing--
(1) with respect to grants awarded under the program
established under section 2--
(A) an analysis of what is known about the impact
of such grants on research or development related to
the prevention, diagnosis, mitigation, treatment, or
cure of amyotrophic lateral sclerosis; and
(B) data concerning such grants, including--
(i) the number of grants awarded;
(ii) the participating entities to whom
grants were awarded;
(iii) the value of each such grant;
(iv) a description of the research each
such grant was used to further;
(v) the number of patients who received
expanded access to an investigational drug to
prevent, diagnose, mitigate, treat, or cure
amyotrophic lateral sclerosis under each grant;
(vi) whether the investigational drug that
was the subject of such a grant was approved by
the Food and Drug Administration; and
(vii) the average number of days between
when a grant application is submitted and when
a grant is awarded; and
(2) with respect to grants awarded under the program
established under section 5--
(A) an analysis of what is known about the impact
of such grants on research or development related to
the prevention, diagnosis, mitigation, treatment, or
cure of amyotrophic lateral sclerosis;
(B) an analysis of what is known about how such
grants increased efficiency and productivity of the
clinical development of therapies, including through
the use of clinical trials that operated with common
master protocols, or had adaptive or add-on clinical
trial designs; and
(C) data concerning such grants, including--
(i) the number of grants awarded;
(ii) the participating entities to whom
grants were awarded;
(iii) the value of each such grant;
(iv) a description of the research each
such grant was used to further; and
(v) whether the investigational drug that
was the subject of such a grant received
approval by the Food and Drug Administration.
SEC. 7. AUTHORIZATION OF APPROPRIATIONS.
For purposes of carrying out this Act, there are authorized to be
appropriated $100,000,000 for each of fiscal years 2022 through 2026.
Union Calendar No. 148
117th CONGRESS
1st Session
H. R. 3537
[Report No. 117-207]
_______________________________________________________________________
A BILL
To direct the Secretary of Health and Human Services to support
research on, and expanded access to, investigational drugs for
amyotrophic lateral sclerosis, and for other purposes.
_______________________________________________________________________
December 8, 2021
Reported with an amendment, committed to the Committee of the Whole
House on the State of the Union, and ordered to be printed