The FDA and hCG: Approved NDAs for Biological Products That Were Deemed to be BLAs on March 23, 2020

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madman

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On March 23, 2020, an approved application for a biological product under section 505 of the Federal Food, Drug, and Cosmetic Act (FD&C Act) was deemed to be a license for the biological product under section 351 of the Public Health Service Act (PHS Act) (see section 7002(e)(4)(A) of the Biologics Price Competition and Innovation Act of 2009).

To enhance transparency and facilitate planning for March 23, 2020, transition date, FDA compiled a preliminary list of approved applications for biological products under the FD&C Act that were listed in FDA’s Approved Drug Products with Therapeutic Equivalence Evaluations (the Orange Book) and that would be affected by this transition provision. FDA posted this list on the FDA website in December 2018, and periodically updated this list before the March 23, 2020, transition date. The September 2019 update to this preliminary list added certain administratively closed applications related to approved applications for biological products that were on the December 2018 version of this list. The January 2020 update to the preliminary list reflected a change to the definition of “biological product” made by the Further Consolidated Appropriations Act, 2020, which was enacted on December 20, 2019. Section 605 of this Act further amended the definition of a “biological product” in section 351(i) of the PHS Act to remove the parenthetical “(except any chemically synthesized polypeptide)” from the statutory category of “protein.”

FDA has provided below a list of each approved application for a biological product under the FD&C Act that was deemed to be a license (i.e., an approved biologics license application (BLA)) for the biological product on March 23, 2020. These former NDAs have been removed from FDA’s Orange Book and were added to FDA’s “Purple Book: Lists of Licensed Biological Products with Reference Product Exclusivity and Biosimilarity or Interchangeability Evaluations” on March 23, 2020. On April 2, 2020, FDA updated this list to correct an error in the listing of the names of two application holders.
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Updated July 30, 2020

Bulk Drug Substances Nominated for Use in Compounding Under Section 503B of the Federal Food, Drug, and Cosmetic Act



Three categories of bulk drug substances:


Category 1: Bulk Drug Substances Under Evaluation
Category 2: Bulk Drug Substances that Raise Significant Safety Risks
Category 3: Bulk Drug Substances Nominated Without Adequate Support



.
503B Category 1: Bulk Drug Substances Under Evaluation

Testosterone
Testosterone Cypionate
Testosterone Propionate
 

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No. Only hCG. I hate the fact that it is an old product and now they are making compounding pharmacies spend millions if they want to sell it.

Hey Nelson,
Where can I find HCG now? I see it on GoodRX and it says it's sold at Safeway, Walgreens etc for around 110 but when I call these places they say they cannot get it. Are we out of luck now?
 
Hey Nelson,
Where can I find HCG now? I see it on GoodRX and it says it's sold at Safeway, Walgreens etc for around 110 but when I call these places they say they cannot get it. Are we out of luck now?
If you have a prescription, why not just keep ordering it from Empower? I've used Empower and the online pharmacies. I'll take Empower any day.
 
If you have a prescription, why not just keep ordering it from Empower? I've used Empower and the online pharmacies. I'll take Empower any day.
Well,
That's not a problem for me but last time I told my Doctor I needed it he said that they stopped carrying it and his other source had also stopped carrying it. But reading here, it appears they are still carrying it. My Doc said that they didn't have it listed any longer for sale. He emailed me my script, can I order it direct from Empower or does my Doc have to order it? I would rather continue to give empower the business if possible.
 
Empower still has it but I don't know for how long. Your doctor has to fax a script to them. You can’t. Have your doctor’s front desk call Empower to ask how to set up an account with them.
The brand name product may be available at regular pharmacies but I hear there may be a shortage. Prices will increase for sure now that over 23 compounding pharmacies were made to stop selling it by the FDA.

I repeat this every week but it seems no one is reading.


From Empower Pharmacy:

Empower is still engaging with the FDA and pursuing legislative options to update the Biologics Price Competition and Innovation Act to allow compounders to continue making HCG and other biologics like we have always been able to. Just as there has never been a risk to a prescriber for prescribing a compounded biologic there will be none to further do so.

The Biologics Price Competition and Innovation Act was designed to improve access to important biologic medications including insulin. The effect on compounding pharmacies was unintentional, and to stop compounding pharmacies from producing certain transitional biologics that have been compounded for years goes against the intention of this policy.


In addition, the off-label use of HCG includes infertility and TRT protocols in men. Urologists and men’s health providers have used compounding pharmacies for years, and compounded prescription data is not reported to the government the same way commercial drugs are reported through insurances, therefore the very large patient population who uses HCG off label has not been accounted for. There isn’t enough commercial supply to meet all patients needs at this time. Until there is enough supply to meet patients needs and the discrepancy in policy has been properly addressed, several FDA registered outsourcing facilities are continuing to supply HCG until further notice.
 
Empower still has it but not for too long. Your doctor has to fax a script to them. You can’t. Have your doctor’s front desk call Empower to ask how to set up an account with them.
The brand name product may be available at regular pharmacies but I hear there may be a shortage. Prices will increase for sure now that over 23 compounding pharmacies were made to stop selling it by the FDA.

I repeat this every week but it seems no one is reading.

Thanks Nelson,
He already has an account with them. That's where he has been ordering from for me for the past 2 years.

I read about the HCG regulations last year and thought it might be an issue in the future. The future appears to be hear now.
 
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So far it seems readily available in Canada... does anyone know if Canada is going in the same direction?
I'm sure the increased cost will find its way here!
 
Great thanks Nelson!
Is it not possible for US citizens to order through Canadian Pharmacies?
I used to hear about that a lot.
 
Beyond Testosterone Book by Nelson Vergel
I have read that HCG is derived from the urine of pregnant women. This regulation effects compounding pharmacies. Is the HCG they provide made differently?
 
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