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Pre-launch Promotional Materials for Accelerated Approvals

  • 1.  Pre-launch Promotional Materials for Accelerated Approvals

    This message was posted by a user wishing to remain anonymous
    Posted 27-Sep-2022 08:38
    This message was posted by a user wishing to remain anonymous

    Dear Colleagues,
    For an NDA based on accelerated approval, pre-approval submission of all promotional materials intended for launch is required per 21 CFR 314.550. The exact timing of the submission of these materials is vague per the regulations and the associated guidance, stating only that pre-submission should occur "during the preapproval review period". I assume that the submission would be most effective later in the NDA review cycle, once discussions with the FDA on the patient and PI labels has occurred. 
    Can anyone provide clear guidance on when the pre-launch materials should be submitted for a) priority review and b) regular review?
    Also, is the timing of the pre-launch material submission agreed upon with the Agency at the pre-NDA meeting?
    You insights are much appreciated!


  • 2.  RE: Pre-launch Promotional Materials for Accelerated Approvals

    This message was posted by a user wishing to remain anonymous
    Posted 27-Sep-2022 15:49
    This message was posted by a user wishing to remain anonymous

    First 6 months since accelerated approval date no promotions are allowed!


  • 3.  RE: Pre-launch Promotional Materials for Accelerated Approvals

    This message was posted by a user wishing to remain anonymous
    Posted 28-Sep-2022 08:52
    This message was posted by a user wishing to remain anonymous

    Thank you for your insights.
    Can you also provide your insights into the pre-approval timing of the submission of those promotional materials? The submission of launch promotional material is required "during the pre-approval period" per CFR, and I'm trying to learn from others' experience on the timing of this submission relative to key NDA review milestones (e.g., original submission, 120-day safety update, mid-cycle meeting, PDUFA date). Thank you!


  • 4.  RE: Pre-launch Promotional Materials for Accelerated Approvals

    Posted 29-Sep-2022 10:54
    Accelerated approvals can be complex animals but can be done with carefully executed plans that are very cross-functional in nature.   I'll provide some initial advice, but cannot cover all of it here.  Several things have to be considered:

    You must have good internal communications between the Regulatory team that is driving the NDA/BLA toward approval, the labeling team who will be negotiating with FDA on the draft labeling and FDA comments during finalization, marketing who is trying to craft all promotional content to align to the expected labeling, clinical development who knows the data and the studies supporting the approval, sales teams to understand their plans for launch and to partner with to educate them on the limitations that accelerated approvals place upon the commercial execution, as well as other functions depending upon your organizational structure.

    At a high level, you cannot submit your draft promotional materials prior to product approval until FDA is ready to accept them.  It is wise to initiate a dialogue with OPDP or APLB at FDA to ensure you have a good line of communication and working relationship.  They will almost always tell you that they will not want to see any draft materials until the label is in a near final state - reason being:  why should they expend limited resources reviewing content that is likely to change as the label evolves toward finalization.   What constitutes a "near final label"?  Often that is the point where 80-90% of of the FDA redlines have been resolved and things are progressing toward approval.

    As part of your planning efforts, a promotional regulatory person must be working closely with sales/marketing and importantly, your medical affairs team to plan out the timelines and sequencing of promotional and educational materials - not everything can be done first and not everything is needed on the day of approval.  Break out the proposed materials into buckets:  1) items needed to be used in the first 120 days post-approval, 2) items needed after the first 120 days post-approval.

    Those items in bucket 1 MUST be submitted to FDA prior to approval.  Those in bucket 2, must be submitted at least 30 days before date of intended use.  The later 30 day pre-submission timeline will need to be accounted for as an ongoing process or until the product converts from accelerated to full-approval.

    This separation of materials into these 2 buckets helps you narrow down the work needed to be accomplished in the pre-approval period.  

    There is so much more that you have to plan and account for in this setting.  I recommend finding a good ad/promo person to hire or an experienced consultant who has executed such launches.  They will have a wealth of knowledge that will help navigate this complex situation.  

    It is a challenging, but rewarding experience to accomplish an accelerated approval launch.  It is also fast-paced and loaded with pitfalls, so don't get discouraged.   Good Luck!

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    Glenn Byrd, MBA
    Chair, RAPS Board of Directors
    United States
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  • 5.  RE: Pre-launch Promotional Materials for Accelerated Approvals

    This message was posted by a user wishing to remain anonymous
    Posted 30-Sep-2022 08:52
    This message was posted by a user wishing to remain anonymous

    Thank you for answering my question about the recommended timing of the pre-approval submission beyond what the guidance/CFR say - when FDA redlines are ~80-90% resolved. And beyond that thank you for your insightful details on the complexities of executing the launch under accelerated approval conditions. The recommendation on bucketing the approval items is really useful and of course the consideration to get an expert consultant on board... Much appreciated!


  • 6.  RE: Pre-launch Promotional Materials for Accelerated Approvals

    Posted 29-Sep-2022 10:36
    This is not accurate.  Promotion is allowed if conducted according to the specific accelerated approval conditions.

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    Glenn Byrd, MBA
    Chair, RAPS Board of Directors
    United States
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  • 7.  RE: Pre-launch Promotional Materials for Accelerated Approvals

    This message was posted by a user wishing to remain anonymous
    Posted 30-Sep-2022 08:52
    This message was posted by a user wishing to remain anonymous

    Disagree! Your points provided above typically applies to regular approval not for accelerated approval! The OP will find out that very soon!


  • 8.  RE: Pre-launch Promotional Materials for Accelerated Approvals

    Posted 29-Sep-2022 12:34
    Here is link regarding promotional submissions for biologics accelerated approved products:
    Basically for the promotions intend to disseminate in the first 120 days after approval, submissions need to occur during pre-approval! 
    https://www.fda.gov/vaccines-blood-biologics/labeling-cber-regulated-products/submitting-biologics-advertising-promotional-labeling

    "Unless otherwise informed by the agency, all advertising and promotional materials that are intended for dissemination or publication within 120 days following marketing approval must be submitted to the agency for review during the pre-approval review period with Form FDA 2253 Transmittal of Advertisements and Promotional Labeling for Drugs for Human Use (check box #13 "Part I/Draft") .  Furthermore, after 120 days following marketing approval, all advertising and promotional materials must be submitted at least 30 days prior to the intended time of initial dissemination or publication with Form FDA 2253 Transmittal of Advertisements and Promotional Labeling for Drugs for Human Use.  [21 CFR 314.550 and 21 CFR 601.45]"

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    GRSAOnline
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  • 9.  RE: Pre-launch Promotional Materials for Accelerated Approvals

    This message was posted by a user wishing to remain anonymous
    Posted 30-Sep-2022 08:52
    This message was posted by a user wishing to remain anonymous

    Thank you, Narayan.
    I'd already read the guidance/regulations and am looking for real word experience and details on how to implement them. We are currently mapping out deliverables by quarter and my commercial team needs to know if their pre-approval promotional materials are due with NDA submission, half way through review, or near the end. We will get more granular and pull in expert consultants as we get closer. In the meantime, in your experience when during the NDA review period does this "pre-approval" submission typically take place? 

    Thanks!


  • 10.  RE: Pre-launch Promotional Materials for Accelerated Approvals

    Posted 30-Sep-2022 09:38
    For accelerated approval products, yes! My example would be for a product that was not referred to an Advisory Com meeting and was designated a priority review, and after the primary review is complete i.e. approx. 5 weeks before the action date, I'd raise the issue of promotional material submission with the FDA! PM would advise you the steps. Good luck!

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    GRSAOnline
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  • 11.  RE: Pre-launch Promotional Materials for Accelerated Approvals

    Posted 30-Sep-2022 15:58
      |   view attached
    I am not an expert in this area, but I recommend you review the excellent presentation (attached) on this topic that Dale Cooke (https://regulatoryrx.blogspot.com/p/phi.html) recently presented at a RAPS webinar on the topic you mention.

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    Roger Cepeda, JD, MBA, RAC
    MedTech Law LLC
    roger@medtech.law
    Mobile: 847-421-8361
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    Attachment(s)