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<dc:title>118 S4905 IS: Innovation in Pediatric Drugs Act of 2024</dc:title>
<dc:publisher>U.S. Senate</dc:publisher>
<dc:date>2024-07-31</dc:date>
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<dc:language>EN</dc:language>
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<distribution-code display="yes">II</distribution-code><congress>118th CONGRESS</congress><session>2d Session</session><legis-num>S. 4905</legis-num><current-chamber>IN THE SENATE OF THE UNITED STATES</current-chamber><action><action-date date="20240731">July 31, 2024</action-date><action-desc><sponsor name-id="S259">Mr. Reed</sponsor> (for himself and <cosponsor name-id="S372">Mrs. Capito</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 amend the Federal Food, Drug, and Cosmetic Act with respect to molecularly targeted pediatric cancer investigations, and for other purposes.</official-title></form><legis-body><section id="HF1F441F4E96B4621AFCA50A6CD2AF2F3" section-type="section-one"><enum>1.</enum><header>Short title</header><text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>Innovation in Pediatric Drugs Act of 2024</short-title></quote>. </text></section><section id="H487E9F91EF0A460C9E0133A22A384D82"><enum>2.</enum><header>Ensuring completion of pediatric study requirements</header><subsection id="H889CF126B7D24F149AC58C422D08D61C"><enum>(a)</enum><header>Equal accountability for pediatric study requirements</header><text>Section 505B(d) of the Federal Food, Drug, and Cosmetic Act (<external-xref legal-doc="usc" parsable-cite="usc/21/355c">21 U.S.C. 355c(d)</external-xref>) is amended—</text><paragraph id="H1A30158DED61464288865E41BE2A5F9E"><enum>(1)</enum><text>in paragraph (1), by striking <quote>Beginning 270</quote> and inserting <quote><header-in-text level="paragraph" style="OLC">Noncompliance letter.—</header-in-text>Beginning 270</quote>; </text></paragraph><paragraph id="H0EB38B4374A148F3A0558BD2E3ACBC69"><enum>(2)</enum><text>in paragraph (2)—</text><subparagraph id="H19CA2CA7A3DB4C268C20ECDA279B7A99"><enum>(A)</enum><text>by striking <quote>The drug or</quote> and inserting <quote><header-in-text level="paragraph" style="OLC">Effect of noncompliance.—</header-in-text>The drug or</quote>; and </text></subparagraph><subparagraph id="H9BB611903FD845D0908DA1C0C6E52D87"><enum>(B)</enum><text>by striking <quote>(except that the drug or biological product shall not be subject to action under section 303)</quote> and inserting <quote>(except that the drug or biological product shall be subject to action under section 303 only if such person demonstrated a lack of due diligence in satisfying the applicable requirement)</quote>; and</text></subparagraph></paragraph><paragraph id="HB663ABAAAF124C8CA8AF168AF40370A3"><enum>(3)</enum><text>by adding at the end the following:</text><quoted-block style="OLC" id="H9ABA1E84E7DA460D97A6C53334E01DA7" display-inline="no-display-inline"><paragraph id="H9718C8624A6F4D8FBB5814B85E5422A7"><enum>(3)</enum><header>Limitation</header><text>The Secretary shall not issue enforcement actions under section 303 for failures under this subsection in the case of a drug or biological product that is no longer marketed.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></subsection><subsection id="H0AF93093331B45C391E4284461DC9B4A"><enum>(b)</enum><header>Due diligence</header><text>Section 505B(d) of the Federal Food, Drug, and Cosmetic Act (<external-xref legal-doc="usc" parsable-cite="usc/21/355c">21 U.S.C. 355c(d)</external-xref>), as amended by subsection (a), is further amended by adding at the end the following:</text><quoted-block id="H33EBA9CCA0FD445BAC6AC1647B0F6FB6" style="OLC"><paragraph id="H695145A66BB2499EBB1E49DEEFC8E140"><enum>(4)</enum><header>Due diligence</header><text>Before the Secretary may conclude that a person failed to submit or otherwise meet a requirement as described in the matter preceding paragraph (1), the Secretary shall—</text><subparagraph id="H99E1D2FEB01B4FAAB02FA0E5367DF231"><enum>(A)</enum><text>issue a noncompliance letter pursuant to paragraph (1);</text></subparagraph><subparagraph id="HDEAFBE66475F425BBCB7D330D0242427"><enum>(B)</enum><text>provide such person with a 45-day period beginning on the date of receipt of such noncompliance letter to respond in writing as set forth in such paragraph; and</text></subparagraph><subparagraph id="HABB6D31F424B4C82B1D05DEE7D8C3C3C"><enum>(C)</enum><text>after reviewing such written response, determine whether the person demonstrated a lack of due diligence in satisfying such requirement.</text></subparagraph></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></subsection><subsection id="HD18A36A6EDF2450BA36813E8E90AB06A"><enum>(c)</enum><header>Conforming amendments</header><text>Section 303(f)(4)(A) of the Federal Food, Drug, and Cosmetic Act (<external-xref legal-doc="usc" parsable-cite="usc/21/333">21 U.S.C. 333(f)(4)(A)</external-xref>) is amended by striking <quote>or 505–1</quote> and inserting <quote>505–1, or 505B</quote>.</text></subsection><subsection id="H18CC4094DACD42B2BB5D114A0C3E03C2"><enum>(d)</enum><header>Transition rule</header><text>The Secretary of Health and Human Services may take enforcement action under section 303 of the Federal Food, Drug, and Cosmetic Act (<external-xref legal-doc="usc" parsable-cite="usc/21/333">21 U.S.C. 333</external-xref>) for failures described in section 505B(d) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/21/355c">21 U.S.C. 355c(d)</external-xref>) only if such failures occur on or after the date that is 180 days after the date of enactment of this Act.</text></subsection></section><section id="HCF796171A93240AEBDBFA4CFA9F635C6"><enum>3.</enum><header>FDA report on PREA enforcement</header><text display-inline="no-display-inline">Section 508(b) of the Food and Drug Administration Safety and Innovation Act (<external-xref legal-doc="usc" parsable-cite="usc/21/355c-1">21 U.S.C. 355c–1(b)</external-xref>) is amended—</text><paragraph id="H2D3FEDFF42D3472C80F11BBEB7B01EE4"><enum>(1)</enum><text>in paragraph (11), by striking the semicolon at the end and inserting <quote>, including an evaluation of compliance with deadlines provided for in deferrals and deferral extensions;</quote>;</text></paragraph><paragraph id="HD9FD5C80E38F4D7E886B63D62D0FBB2B"><enum>(2)</enum><text>in paragraph (15), by striking <quote>and</quote> at the end;</text></paragraph><paragraph id="H1C401C10B73946F3A527B0AAA3155681"><enum>(3)</enum><text>in paragraph (16), by striking the period at the end and inserting <quote>; and</quote>; and</text></paragraph><paragraph id="H97638C93B5C841F4929A286946AFC14E"><enum>(4)</enum><text>by adding at the end the following:</text><quoted-block id="HC78CEF36D10341F19F12EA0EA07084B7" style="OLC"><paragraph id="H827ADB879F9D49C496D9B229C673781F"><enum>(17)</enum><text>a listing of penalties, settlements, or payments under section 303 of the Federal Food, Drug, and Cosmetic Act (<external-xref legal-doc="usc" parsable-cite="usc/21/353">21 U.S.C. 353</external-xref>) for failure to comply with requirements under such section 505B, including, for each penalty, settlement, or payment, the name of the drug, the sponsor thereof, and the amount of the penalty, settlement, or payment imposed.</text></paragraph><after-quoted-block>.</after-quoted-block></quoted-block></paragraph></section><section id="HDE0098BC2C084EE2A75668D7652A6CE1" section-type="subsequent-section"><enum>4.</enum><header>Program for pediatric studies of drugs</header><text display-inline="no-display-inline">Section 409I(d) of the Public Health Service Act (<external-xref legal-doc="usc" parsable-cite="usc/42/284m">42 U.S.C. 284m(d)</external-xref>) is amended to read as follows:</text><quoted-block style="OLC" id="HD016FCDC086D431DA9CD544BF6D4D300" display-inline="no-display-inline"><subsection id="HB55C772D3C9B457D9DAFBD7137CABB97"><enum>(d)</enum><header>Funding</header><text display-inline="yes-display-inline">Of the amount made available for pediatric research to each national research institute and national center under this title for each of fiscal years 2025, 2026, and 2027, the Director of NIH is authorized to make available up to one percent of such amount for pediatric research under this section.</text></subsection><after-quoted-block>.</after-quoted-block></quoted-block></section><section id="H9B4075FA0FA34A629AEE01BD7AF704F9"><enum>5.</enum><header>Pediatric studies of orphan drugs</header><subsection id="H63BA3F7E1D854552B5C11C7A9ED19E79"><enum>(a)</enum><header>Application of pediatric research requirements to orphan drugs</header><paragraph id="H44CD62BC84164B5AB9B929849661D692"><enum>(1)</enum><header>In general</header><text>Section 505B(k) of the Federal Food, Drug, and Cosmetic Act (<external-xref legal-doc="usc" parsable-cite="usc/21/355c">21 U.S.C. 355c(k)</external-xref>) is amended to read as follows:</text><quoted-block style="OLC" id="H137F7D91F04A4294A2592362F7C98786" display-inline="no-display-inline"><subsection id="H631EE55653EE474298BA8DE53C1FBE42"><enum>(k)</enum><header>Relation to orphan drugs</header><paragraph id="H68F80F2799164BAA91EC7ECC3A769619"><enum>(1)</enum><header>In general</header><text>This section does not apply to a drug or biological product for an indication for which orphan designation has been granted under section 526 unless the Secretary determines that pediatric assessments of such drug or biological product required under this section could represent a meaningful therapeutic benefit as described in subsection (c).</text></paragraph><paragraph id="H6B62FD0B7E8A441591D1C84A64A55E3B"><enum>(2)</enum><header>Deferrals and waivers</header><text>Deferrals and waivers under subsections (a)(4) and (a)(5) shall apply to assessments described in this subsection to the same extent and in the same manner as such deferrals and waivers apply with respect to the assessments under subsection (a)(1), and waivers under subsection (b)(2) shall apply to assessments described in this subsection to the same extent and in the same manner as such waivers apply with respect to the assessments required pursuant to subsection (b)(1).</text></paragraph></subsection><after-quoted-block>.</after-quoted-block></quoted-block></paragraph><paragraph id="H38E8F04CA4DC4632BAAFF6DBAE8D2CC4"><enum>(2)</enum><header>Applicability</header><text display-inline="yes-display-inline">The amendment made by paragraph (1) applies only to applications described in subparagraph (A) or (B) of section 505B(a)(1) of the Federal Food, Drug, and Cosmetic Act (<external-xref legal-doc="usc" parsable-cite="usc/21/355c">21 U.S.C. 355c(a)(1)</external-xref>) that are submitted on or after the later of—</text><subparagraph id="HA4AA22A12B8E4646B8007BF4521A4818"><enum>(A)</enum><text>the date that is 18 months after the date of issuance of the final guidance under subsection (b); and</text></subparagraph><subparagraph id="HF9CC9B7A5E65496887B890E4BECAFB91"><enum>(B)</enum><text display-inline="yes-display-inline">such later date as may be specified by the Secretary of Health and Human Services (referred to in this section as the <quote>Secretary</quote>) by regulation.</text></subparagraph></paragraph></subsection><subsection id="H97B3E6D25EF84D05BA678A3A3A2B6030"><enum>(b)</enum><header>Guidance</header><paragraph id="H70EE4022C86A49D88559FBEFD5E040DE"><enum>(1)</enum><header>Issuance</header><text>The Secretary shall—</text><subparagraph id="HE6980C9C671D47C38DF9AFA9A396ABBA"><enum>(A)</enum><text display-inline="yes-display-inline">not later than 1 year after the date of enactment of this Act, issue draft guidance describing how, upon the applicability of the amendment made by subsection (a)(1), the requirements of section 505B of the Federal Food, Drug, and Cosmetic Act (<external-xref legal-doc="usc" parsable-cite="usc/21/355c">21 U.S.C. 355c</external-xref>) will apply with respect to any drug or biological product for an indication within a disease or condition for which orphan designation has been granted under section 526 of such Act (<external-xref legal-doc="usc" parsable-cite="usc/21/360bb">21 U.S.C. 360bb</external-xref>); and</text></subparagraph><subparagraph id="H84C5BD00C770478D8EFEA04103E7FC43"><enum>(B)</enum><text>not later than 18 months after the date of the public meeting required by subsection (c)(1), finalize such draft guidance.</text></subparagraph></paragraph><paragraph id="H1ABF5171121F48098278A2A461A592A2"><enum>(2)</enum><header>Contents</header><text>The guidance under subsection (b) shall address the following:</text><subparagraph id="HECA1D1F4D2F149DCBDA381E471DFBBC7"><enum>(A)</enum><text display-inline="yes-display-inline">Information regarding how full and partial waivers under subsections (a)(5)(A), (a)(5)(B), and (b)(2) of section 505B of the Federal Food, Drug, and Cosmetic Act (<external-xref legal-doc="usc" parsable-cite="usc/21/355c">21 U.S.C. 355c</external-xref>) for any drug or biological product for an indication within a disease or condition for which orphan designation has been granted under section 526 of such Act (<external-xref legal-doc="usc" parsable-cite="usc/21/360bb">21 U.S.C. 360bb</external-xref>) will be granted.</text></subparagraph><subparagraph id="H1601BB67E9834C4495D7CF06EC0CDC25"><enum>(B)</enum><text display-inline="yes-display-inline">Application of the requirements of section 505B(e) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/21/355c">21 U.S.C. 355c(e)</external-xref>) to drugs or biological products for an indication within a disease or condition for which orphan designation has been granted under section 526 of such Act (<external-xref legal-doc="usc" parsable-cite="usc/21/360bb">21 U.S.C. 360bb</external-xref>), including submission and timing of planned requests for full or partial waivers and responses by the Food and Drug Administration to those requests.</text></subparagraph><subparagraph id="HC60E381895644D9AA316AD0D8A2D3B9A"><enum>(C)</enum><text display-inline="yes-display-inline">Rare diseases and conditions (as defined in section 526(a)(2) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/21/360bb">21 U.S.C. 360bb(a)(2)</external-xref>) that should be added to the lists under section 505B(a)(5)(E) and 505B(b)(2)(E) of such Act, as added by subsection (f), and a process for regularly updating such lists.</text></subparagraph><subparagraph id="HC1E736C2F0CC45C6AB4400006339CAE3"><enum>(D)</enum><text display-inline="yes-display-inline">Situations where the initial pediatric study plan under section 505B(e) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/21/355c">21 U.S.C. 355c(e)</external-xref>) includes a plan to fulfill the requirements of section 505B(a) of such Act (<external-xref legal-doc="usc" parsable-cite="usc/21/355c">21 U.S.C. 355c(a)</external-xref>) without requesting waivers in any age group.</text></subparagraph><subparagraph id="HAA821A213C2C4A3984B260E3B2F54C5D"><enum>(E)</enum><text display-inline="yes-display-inline">Consideration of how the Secretary will balance the unique scientific challenges of rare disease drug development with the need for improved pediatric labeling of drugs and biological products for indications within diseases or conditions for which orphan designation has been granted under section 526 of such Act (<external-xref legal-doc="usc" parsable-cite="usc/21/360bb">21 U.S.C. 360bb</external-xref>).</text></subparagraph><subparagraph id="HC0AB55A19A264E9D9E0AF1B374EEA4E7"><enum>(F)</enum><text display-inline="yes-display-inline">Considerations of the strengths, weaknesses, appropriateness, and limitations of different types of real-world evidence specific to the fulfillment of requirements under section 505B of such Act (<external-xref legal-doc="usc" parsable-cite="usc/21/355c">21 U.S.C. 355c</external-xref>).</text></subparagraph><subparagraph id="HE0A88A3A25EC4A7EAA3BF7554E20BCBB"><enum>(G)</enum><text>Consideration of input received from the public meeting set forth in subsection (c).</text></subparagraph></paragraph></subsection><subsection id="HC82D930D3CD14748AC1E4383B01141C9"><enum>(c)</enum><header>Public meeting</header><text>The Secretary shall—</text><paragraph id="HCA58C4E2C6E947009F1D30E0B2F6D372"><enum>(1)</enum><text display-inline="yes-display-inline">not later than 6 months after the date of issuance of the draft guidance under subsection (b)(1)(A), hold a public meeting to inform the final guidance to be issued under subsection (b)(1)(B); and</text></paragraph><paragraph id="H567D1D811A4F41ABBEBA62DCB5BE0557"><enum>(2)</enum><text>publish prior notice of such meeting in the Federal Register.</text></paragraph></subsection><subsection id="H4BD5F1BEC1494ECB949DDC0743CAA25C"><enum>(d)</enum><header>GAO study</header><text display-inline="yes-display-inline">Not later than 4 years after the applicability date described in subsection (a)(2), the Comptroller General of the United States shall submit to the Committee on Energy and Commerce and the Committee on Ways and Means of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate a report that—</text><paragraph id="HAB48AC9998DB4C4B84B0BDE0E5364163"><enum>(1)</enum><text>addresses the impacts of this Act on—</text><subparagraph id="H9991931A3399418CB7895F8A49DDEEAB"><enum>(A)</enum><text>rare disease drug development in the United States; and</text></subparagraph><subparagraph id="H5C9E556822DB4A6FBC8773242D72B5F4"><enum>(B)</enum><text display-inline="yes-display-inline">the availability of pediatric information on drugs and biological products within diseases or conditions for indications for which orphan designation has been granted under section 526 of the Federal Food, Drug, and Cosmetic Act (<external-xref legal-doc="usc" parsable-cite="usc/21/360bb">21 U.S.C. 360bb</external-xref>); and</text></subparagraph></paragraph><paragraph id="H67CEFA63C8E54653AD49D2226AF78899"><enum>(2)</enum><text>includes—</text><subparagraph id="HA182CC22E194441EA6BC26ECCBB4FDCA"><enum>(A)</enum><text display-inline="yes-display-inline">the findings of a survey of companies of varying sizes engaged in the development of orphan drugs, which shall include questions regarding the feasibility and other challenges of conducting pediatric studies for such indications; </text></subparagraph><subparagraph id="H3BA30A1B6E034F0DAAF4C634DA0210B3"><enum>(B)</enum><text>input from patient groups and medical provider associations; and</text></subparagraph><subparagraph id="H1A595CC83E0447D380B498D4CA8EA704"><enum>(C)</enum><text display-inline="yes-display-inline">an assessment of the impact changes to required pediatric studies had on drug development for rare diseases.</text></subparagraph></paragraph></subsection><subsection id="H4C41E134141540D19EC3FBEB8B3881AE"><enum>(e)</enum><header>Rule of construction</header><text display-inline="yes-display-inline">Nothing in this section shall be construed to limit requirements for investigations, as described in section 505B(a)(3) of the Federal Food, Drug, and Cosmetic Act (<external-xref legal-doc="usc" parsable-cite="usc/21/355c">21 U.S.C. 355c(a)(3)</external-xref>), of molecularly targeted pediatric cancer drugs for which orphan designation has been granted under section 526 of such Act (<external-xref legal-doc="usc" parsable-cite="usc/21/360bb">21 U.S.C. 360bb</external-xref>).</text></subsection><subsection id="H7F471EA07A694EF1B8945022027D8DB5"><enum>(f)</enum><header>Certainty regarding waivers</header><text display-inline="yes-display-inline">Section 505B of the Federal Food, Drug, and Cosmetic Act (<external-xref legal-doc="usc" parsable-cite="usc/21/355c">21 U.S.C. 355c</external-xref>) is amended—</text><paragraph id="H13229B7436664C48B8C02930D592F1EC"><enum>(1)</enum><text>in subsection (a)(5), by adding at the end the following:</text><quoted-block style="OLC" id="HCB6C431CB33B4613A2F550D197407FBE" display-inline="no-display-inline"><subparagraph id="H4BEB3FD043224145B57CB616536416C9"><enum>(E)</enum><header>Automatic full waiver list</header><text display-inline="yes-display-inline">The Secretary shall maintain a list, posted on the website of the Food and Drug Administration, of adult-related diseases and conditions—</text><clause id="H7F4C26CE9651461E94A4C1495D8B4D15"><enum>(i)</enum><text>with respect to which the necessary studies are impossible or highly impracticable, as described in subparagraph (A)(i); or</text></clause><clause id="H7E8E240333BB407698B551A1E334E91F"><enum>(ii)</enum><text>for which a drug or biological product for such disease or condition otherwise meets the criteria described in subparagraph (A).</text></clause></subparagraph><after-quoted-block>;</after-quoted-block></quoted-block></paragraph><paragraph id="H0F87604054094EA490547E4C9C0F99D1"><enum>(2)</enum><text>in subsection (b)(2), by adding at the end the following:</text><quoted-block style="OLC" id="H418C417B6AF3468DA708A69485B39C83" display-inline="no-display-inline"><subparagraph id="HC81FBF6766A849408B7882DB9B59D208"><enum>(E)</enum><header>Automatic full waiver list</header><text display-inline="yes-display-inline">The Secretary shall maintain a list, posted on the website of the Food and Drug Administration, of adult-related diseases and conditions with respect to which the necessary studies would meet the criteria for a full waiver under subparagraph (A).</text></subparagraph><after-quoted-block>; and</after-quoted-block></quoted-block></paragraph><paragraph id="H216DE6CC8FB34E7DB856805A4BFDCFD7"><enum>(3)</enum><text>in subsection (e)(4), by adding at the end the following: <quote>If, at the time of an applicant’s submission of the initial pediatric study plan, the disease or condition for which the drug is intended to treat appears on the list under subsection (a)(5)(E), then the assessments for such disease or condition shall be waived under subsection (a)(5).</quote>.</text></paragraph></subsection></section></legis-body></bill> 

