Articles Posted in Orphan Drugs

Thumbnail image for Thumbnail image for orphan drug.bmpOn June 12, 2013, FDA issued a Final Rule amending the 1992 Orphan Drug Regulations to implement the Orphan Drug Act. The Final Rule largely reflects the 2011 Proposed Rule (see our previous blog on the draft rule here) to amend the Orphan Drug Regulations with several changes for clarity and accuracy. FDA explicitly stated that the Final Rule has no effect on the scope of, or eligibility for, orphan-drug-exclusive approval, because it merely clarifies existing and longstanding FDA practices. The Final Rule will take effect on August 12, 2013.

The two most important amendments and clarifications in the final rule are the new definition of “orphan subset” and the various clinical superiority requirements for designation requests and exclusive approvals for a subsequent drug for the same use or indication.

To qualify as an “orphan subset” drug (21 CFR §316.3(b)(13)), the drug sponsor must show that while the drug is safe and effective in the orphan subset population, the drug is not suitable for use in those persons outside of the orphan subset (i.e., those persons who have the same non-rare disease or condition). Such non-suitability must be based on either a pharmacokinetic property (such as toxicity and mechanism of action), or previous clinical experience with the drug.
Continue reading

eurosdollars.jpgOn April 7, Simeon Bennett from Bloomberg reported that individual members of the European Union are attempting to control the cost of medical care by containing the reimbursement of drugs intended for smaller patient populations, generally called orphan drugs. In Europe, orphan drugs are defined as a medicine to treat no more than 5 in 10,000 inhabitants. Many of these drugs undergo a centralized approval process via the European Medicines Agency (see related blog resource page here.) In practice, however, these drugs may only reach the market when each member state decides that its national health system will reimburse for the drug. For example, 35 orphan drugs reached the market in Belgium, 44 in the Netherlands, and 28 in Sweden in 2008. 35 such drugs reached the market in France and 23 in Italy in 2007.

According to Yann Le Cam, CEO of Eurodis, a French patient advocacy group for patients with rare diseases, “The price of orphan medicinal products is under much more debate. We have seen countries which were providing good access to orphan medicinal products now questioning the continuation of reimbursement.”

Some examples provided in the Bloomberg report included the Netherlands demanding price reductions for certain therapies such as Sanofi’s Myozyme® (alglucosidase alfa), an enzyme replacement therapy for patients with Pompe disease, which costs 700,000 euros ($909,000). As we previously reported from MassBio’s Annual Meeting, Myozyme® was the largest research and development effort in the history of Genzyme, which was later acquired by Sanofi, and the result of a concerned father of two children with Pompe’s disease pushing the promising therapy along to help it reach the public. Another example mentioned in the report included Ireland recommending against the government paying for Vertex Pharmaceuticals, Inc.’s Kalydeco® (ivacaftor) for cystic fibrosis until the company significantly reduced the price for the drug product. Yet another example was the rejection by the United Kingdom (“UK”) to expand use of Alexion Pharmaceuticals, Inc.’s drug Soliris® (eculizumab) for two blood disorders, despite the recommendation for this use by an advisory panel. Instead, the government referred the matter to its National Institute for Health and Care Excellence, which we recently blogged on here, as an instrument to encourage value-based medicine in the UK.
Continue reading

monoclonal antibodies.pngOn March 14-15, the Massachusetts Biotechnology Council (“MassBio”) held its Annual Meeting in Cambridge, Massachusetts. The Meeting also featured a Keynote from FDA Commissioner Margaret A. Hamburg, M.D. (see related blog here). Key themes at the Meeting were the importance of the Cambridge/Boston biotechnology community for advancing new therapies and the unique resources available in the area that have made it an industry leader. Some of the Cambridge/Boston advantages discussed were the intellectual research capital (local universities such as Harvard and Massachusetts Institute of Technology), venture capital, and local biotechnology businesses, such as Biogen Idec and Genzyme, as well as other biotechnology companies that now have offices in the Cambridge/Boston area and are seeking partnerships to develop new products, such as AstraZeneca, Pfizer, Merck, Novo Nordisk, and Sanofi.

On the second day, Hamburg described here “special affection” for the Cambridge/Boston region dating back to her days at Harvard, saying that she hopes D.C. “would be as efficient and congenial as here.” Hamburg said that the Cambridge/Boston region is a life sciences enterprise fueled by top notch research and medical care with the top five NIH-funded hospitals and a “biotech supercluster second to none” with “a remarkable 500 biotech and pharma companies here, and some thirty venture capital firms.”

Hamburg described FDA as striving for true collaboration and regulatory flexibility with industry, including MassBio, and has been hearing that industry wants more clarity, certainty, transparency with decisions. Hamburg said that FDA is trying to have creative approaches–not a one size-fits-all approach. To this end, Hamburg described approaches that FDA has taken with four new products from the Massachusetts area: 1) Inclusig® for two rare forms of leukemia, 2) Juxtapid® (an orphan drug), 3) Linzess® for irritable bowl syndrome, and 4) Kalydeco® for cystic fibrosis. In addition, Hamburg highlighted new provisions in the Food and Drug Administration Safety and Innovation Act (“FDASIA”) for expedited approvals, citing 31 breakthrough therapy designation requests, of which 9 have been granted, 10 denied, 11 pending, and 1 withdrawn. To help with more companies taking advantage of this new process, FDA will be publishing a new guidance shortly, Hamburg announced.
Continue reading

humanonachip.jpgOn March 14-15, the Massachusetts Biotechnology Council (“MassBio”) held its Annual Meeting in Cambridge, Massachusetts. The Meeting featured key topics such as biosimilars and a Keynote from John Crowley, Chairman and CEO of Amicus Therapeutics.

On the first day of the conference, Crowley exemplified many of the speakers’ entry in biotechnology, which originated with a family member or friend with a disease requiring development of a biotechnology product. For Crowley, it was his two children Megan and Patrick, were diagnosed with a severe neuromuscular disorder, Glycogen storage disease type II, known as Pompe’s disease. Rather that sitting still to wait for a cure, Crowley became involved in the process, first moving to Princeton, New Jersey, to be close to doctors specializing in the disease and leaving his job with Bristol-Myers Squibb. He later took a position as CEO of Novazyme Pharmaceuticals, a biotechnology research company located in Oklahoma City founded by Dr. William Canfield, which was conducting research on a new experimental treatment for the disease. Novazyme was acquired by Genzyme Corporation, which was then the world’s third largest biotechnology company. Crowley was put in charge of Genzyme’s global Pompe program, becoming the largest research and development effort in the company’s history.

Through these efforts, an experimental enzyme replacement therapy was developed, and Megan and Patrick Crowley received the therapy, which Crowley credits with saving his children’s lives. Crowley went on to become President and CEO of Orexigen Therapeutics and was named the President and CEO of Amicus Therapeutics, based in Cranbury, New Jersey, which he helped take public in 2007. Crowley’s efforts were documented in a Wall Street Journal article and other publications, which ultimately resulted in Harrison Ford working to bring the story to life in a major motion picture, Extraordinary Measures.
Continue reading

Thumbnail image for Thumbnail image for Thumbnail image for Thumbnail image for Thumbnail image for Thumbnail image for aci_header_banner.gifOn November 28-29, 2012, the American Conference Institute (“ACI”) held in Boston, Massachusetts, its inaugural conference: “Orphan Drugs and Rare Diseases: Maximizing Opportunities and Overcoming Stumbling Blocks in the Designation and Development Process“. The Conference was well attended and featured a pre-conference boot camp on the Orphan Drug Act as well as a post-conference master class on overcoming clinical trial challenges and proving the safety and efficacy for orphan drugs.

One highlight of the conference was Timothy R. Cote, M.D., M.P.H., Principal, Cote Orphan Consulting (Director of FDA’s Office of Orphan Drug Products Development (2007-2011)). Cote provided a back drop for how the Orphan Drug Act came about, emphasizing that while for each individual disease the afflicted patient population is small, when all of the orphan diseases are pooled together, actually the population is sizable and a rapidly-growing area. Dr. Cote described orphan drug development as a “high touch” field where the need for new therapies are often driven by families with afflicted members and typical “big pharma” strategies are less effective. Calling it “scrappy not crappy” science, Cote explained that unlike big pharma projects that involve thousands of patients and hundreds of millions of dollars to develop new therapies, orphan drugs often can be developed for under $10 million–in part because there are so few patients who are candidates for clinical studies and treatment. Cote said while approximately 60% of orphan drug designation requests are approved, the success stories are the products that obtain new drug application approval and win the highly-coveted seven-year exclusivity for the first orphan indication (“a horse race”). More importantly, the basic research required to find cures for orphan drugs often provides valuable medical knowledge in how our bodies work, which he called “pharma karma.”

Another highlight of the conference was Christopher-Paul Milne, D.V.M., M.P.H., J.D., Associate Director, Tufts Center for the Study of Drug Development, Tufts University. Milne said that while the initial orphan market was thought of as relatively small, there are often higher rates of return than more “mainstream” diseases, particularly for diseases with more options for treatment. One phenomena that he tracked was the “ultra orphans,” where the orphan population for treatment, which is restricted to less than 200,000 when applied for orphan drug designation in the United States, can get closer to the 200,000 number, and sometimes can expand to more mainstream numbers, if the therapy is later found to have non-orphan treatment options. While certain disease areas such as various cancers have good orphan drug representation, other therapeutic areas, such as neurology, have had less success stories, Milne reported. Milne added that amidst the tension of competition versus collaboration, it has often been important for unlikely partners to work together, with the help and motivation of patient groups, such as the National Organization for Rare Diseases (“NORD”).
Continue reading

Frommer Lawrence & Haug LLP Partner Brian J. Malkin will present on “Mastering the Intricacies of the Orphan Drug Designation Process: A Step-by-Step Guide to Navigating the Pathway” on November 29, 2012. Mr. Malkin’s presentation is part of ACI’s inaugural conference, “Orphan Drugs and Rare Diseases: Maximizing Opportunities and Overcoming Stumbling Blocks in the Designation and Development Process” in Boston, Massachusetts from November 28-29, 2012. Mr. Malkin’s presentation will include how to assess whether a compound/indication qualifies for orphan drug designation, what benefits may be achieved by obtaining an orphan drug designation prior to product/indication approval, and how to respond to a rejection for an orphan drug designation request, including demonstrating clinical superiority. For more information, see here.

Thumbnail image for Thumbnail image for Thumbnail image for Thumbnail image for Thumbnail image for aci_header_banner.gifAmerican Conference Institute (ACI) will be holding its inaugural Legal, Regulatory and Compliance Guide to Orphan Drugs and Rare Diseases in Boston at the Hyatt Regency on November 28-29, 2012. This unique program features a distinguished faculty of over two dozen leading legal and regulatory orphan drugs and rare diseases experts – including the former director of FDA’s Office of Orphan Products Development, senior in-house pharmaceutical counsel, leading patient advocates, and preeminent FDA and patent attorneys – who will address the intricacies of the FDA’s orphan drug designation process as well as the challenges affecting orphan drug development and commercialization and overall patent portfolio considerations.

The ACI conference provides a comprehensive forum for the industry to discuss the latest legal and regulatory developments affecting orphan products and therapies for rare diseases and to analyze the strategic considerations in drug development aimed at providing patients facing an unmet medical need with safe and effective life changing therapy. In light of recent cases concerning FDA enforcement of orphan exclusivity, the conference will also feature a spotlight session on “Protecting Orphan Drug Designation and Proactively Guarding Against Potential Liability.”

More information about this event, including a full agenda, faculty list, and brochure can be accessed at

FDA Lawyer’s Blog discount code: FDA 200

gavelgold.jpgK-V Pharmaceutical Company (“K-V”) has taken the fight over its preterm-birth prevention drug, Makena® (17-hydroxypreogesterone caproate solution) (“HPC”), to the International Trade Commission (“ITC”). In its complaint, K-V asks the ITC to: (1) issue a temporary general exclusion order prohibiting any unauthorized importation of HPC and (2) issue a temporary cease and desist order stopping owners, importers, and consignees from importing, selling, offering for sale, distributing, or soliciting any HPC unless authorized by K-V.

K-V states that its merits argument will focus on the importation of HPC for the purpose of making compounded versions of Makena®. K-V argues that importation of HPC for use in compounding copies of Makena® is a violation of Section 337 of the Tariff Act of 1930. According to Section 337, “[u]nfair methods of competition and unfair acts in the importation of articles . . . in the United States, or in the sale of such articles by the owner, importer, or consignee, the threat or effect of which is . . . to destroy or substantially injure an industry in the United States,” are “unlawful.” 19 U.S.C. § 1337(a)(1)(A). K-V argues that, because all HPC in the United States comes from abroad, and the only use for HPC is in the manufacture of Makena® or allegedly unlawful copies of Makena®, the importation of HPC undermines federal law and K-V’s statutory orphan drug exclusivity and “is clearly an unfair act and an unfair method of competition.”

According to the Complaint, all the requisites for temporary relief are present. First, there will be immediate and irreparable harm to K-V because the pharmacies compounding copies of Makena® have diverted so much potential revenue from K-V that the drug company has had to file for Chapter 11 bankruptcy. Second, as mentioned above, there is a likelihood of success on the merits. K-V argues that the importation of HPC for the use in compounding violates the prohibition against mass-scale compounding and undermines K-V’s statutory orphan drug exclusivity. These unfair acts and unfair methods of competition are threatening to destroy K-V, i.e., the domestic industry. Third, K-V argues that the following public interest factors favors granting the desired relief: (1) prevention of preterm births; (2) ensuring safe and effective drugs; (3) preservation of a domestic industry; and (4) effectuating Congress’s intent to promote development of treatments for rare conditions. Finally, K-V states that it faces the balance of hardships. K-V argues that the compounding pharmacies have few, if any, protectable rights, whereas K-V has a “Congressionally-granted seven-year exclusive right to market Makena.” Additionally, K-V notes that its business’s survival depends on the success of Makena®, whereas the proposed respondents compound many other products and will survive if they are unable to compound Makena® during the exclusivity period.
Continue reading

Thumbnail image for Thumbnail image for Thumbnail image for aci_header_banner.gifOrphan Drugs and Rare Diseases Maximizing Opportunities and Overcoming Stumbling Blocks in the Designation and Development Process November 28-29, 2012 Hyatt Regency, Boston, MA

Developing drugs and investing in research and development can be risky business in general, and it can be even more so for small populations with unique disease states. Our faculty of leading experts from Pfizer, Shire, Medicis, GSK, Emergent BioSolutions and many more will give you strategies to offset potential risks inherent to orphan drug development including:

  • Understanding and factoring in the unique incentives, including favorable exclusivity, pricing, and tax benefits, for companies who decide to pursue designation
  • Replenishing product pipelines in the face of the patent cliff through novel therapies
  • Preparing for eventual pharmacovigilance and labeling issues downstream as designation takes off
  • Designing clinical trials end points and proving safety and efficacy in a smaller population
  • Protecting orphan drug status and keeping competitors at bay post-Makena

For more information, please visit our website:

FDA Lawyers blog readers are entitled to a discount when referencing the code: FDA 200

by Howard E. Rosenberg, Ph.D.

Disease.jpegToday, FDA held its first-ever Rare Disease Patient Advocacy Day, because of its recognition of the need for therapies for rare diseases. The day was designed to help patients and caregivers engage with the FDA on issues related to drug and medical device development for rare diseases and conditions. Debra Lewis, Deputy Director of FDA’s Office of Orphan Products Development (“OOPD”), said, “Today gives rare disease patient advocates the opportunity to meet with FDA staff and learn more about how FDA works. And, as we come together with colleagues, families, patients and advocacy groups, it gives FDA a moment to reflect on recent news in helping people with rare diseases.” She also highlighted a new study published in Pediatrics by Chandana Thorat et. al. which carried out a ten-year analysis of the effect of the Orphan Drug Act of 1983 (“ODA”). The study reports that from 2000 to 2009, 1138 “orphan” drugs were designated and 148 received FDA approval, of which 38 were for pediatric diseases. The proportion of approvals for pediatric products increased from 17.5% in the first half of the decade, to 30.8% in the second.

Stephen C. Groft, Pharm.D., Director, NIH Office of Rare Diseases Research, gave an overview of the available resources to researchers and patients alike in this area and highlighted that the considered best approach to carry out research and to look into solving the problems of these rare diseases is to engage in collaborative efforts. Thus the use of disease specific steering committees between academic research investigators and medical specialists, together with the patient advocacy groups and philanthropic foundations and working with offices such as the Office of Rare Diseases Research is the right way to achieve the goals, Groft explained.

The ODA has been viewed as the single biggest catalyst for encouraging research for orphan drug diseases with FDA approving more than 390 orphan products for the treatment of rare diseases since the legislation came into effect. EU legislation followed in 2000 and has also helped to incentivize research. Further, as we reported here, FDA has decided to expand OOPD’s staff to reflect the increasing proportion of orphan drug applications that the Agency has been receiving lately, reflecting over a third of new drug applications in 2011, as we reported here.
Continue reading