|2005N-0345|| Drug Approvals: Circumstances under which an active ingredient may be simultaneously marketed in both a prescription drug product and an over-the-counter drug product|
|FDA Comment Number :||EC1923|
|Submitter :||Ms. Reagan Middlebrook||Date & Time:||10/31/2005 04:10:50|
|Organization :||Ms. Reagan Middlebrook|
|Category :||Individual Consumer|
| A. Should FDA initiate a rulemaking to codify its interpretation of section 503(b) of the action regarding when an active ingredient can be simultaneously marketed in both prescription drug product and an OTC drug product?|
| The FSA should quit stalling and approve OTC sale of emergency contraception, with no prescriptions required for any age group. Your two advisory committees that exhaustively reviewed data in December 2003 found that emergency contraception was safe and effective and consequently recommended OTC approval.
More than 70 professional medical and public health associations including the American Medical Association, the American College of Obstetricians and Gynecologists and the Society for Adolescent Medicine have endorsed EC access for women of all ages. The American Academy of Pediatrics has urged its members to "help ensure that all adolescents have knowledge of and access to contraception, including barrier methods and EC supplies.
When the age restriction was suggested at the December Advisory Committee meetings, the FDA staff noted then that it has been the policy of the Division of Reproductive and Urologic Drug Products to make no distinction between post-pubescent adolescents and adult women insofar as contraceptive use is concerned. The Advisory Committee members then rejected the age restriction proposal.
The apparent move by the agency to restrict access to young women, 16 years of age and younger, therefore flies in the face of the recommendations of the majority of respected medical professional associations and the government's own stated policy. It is a bigotted rule that can only lead to teen pregnancies. What possible basis can you have for such a rule? If a girl under 16 is old enough to need emergency contraception then she is old enough to get it.
|B. Is there significant confusion regarding FDA's interpretation of section 503(b) of the act?|
| Your attempt to limit access based on age has muddled what should have been a clear-cut decision to approve OTC sale of this safe, effective, and necessary emergency contraception.|
|C. If so, would a rulemaking on this issue help dispet that confusion?|
| No. It is entirely unnecessary. It seems all that would do is provide a further stalling tactic on what is a decision that should have been made 2 years ago!|
| A. If FDA limited sale of an OTC product to a particular subpopulation, e.g., by making the product available to the subpopulation by prescription only, would FDA be able to enforce such a limitation as a matter of law?|
| Restricting the sale of emergency contraception to young women is in very poor taste. Last time I checked your job had to do with the safety of a product, not what your personal morals say about its use. If you have moral objections to the product, don't use it. But as it has been proven to be safe and effective, please don't keep it from the people who need it.|
|B. If it could, would it be able to do so as practical matter and, if so, how?|
| Such a move would be intrusive for all young women who would be required to show personal identification as a proof of age. The suggestion of federal enforcement brings to mind federal agents pursuing 16 year olds concerned about an unintended pregnancy who in the act of obtaining emergency contraception are breaking a federal law. The absurdity is hard to exaggerate. The government ought to have more important matters to attend to than encouraging pregnancy by refusing this product to those who need it.|
| A. Assuming it is legal to market the same active ingredient in both a prescription and OTC product, may the different products be legally sold in the same package?|
|Making emergency contraception universally available would remove the need for separate packaging.|
|B. If the two products may be lawfully sold in a single package, under what circumstances would it be inappropriate to do so?|
| Under no circumstances would it be inappropriate. What is inappropriate are the stalling tactics the FDA has used so far to keep from approving this drug for OTC sale.|
| Some 39 nations have made emergency contraception available without prescription and 8 states in the U.S. have now adopted a process to streamline access of emergency contraception. The FDA's delay and ill-advised intention to restrict access to women 16 and younger is unacceptable and intolerable. Please make the decision to allow emergency contraception available to all women, all ages, and no restrictions.
This latest tactic to further delay making the correct decision to approve universal, over-the-counter availability of emergency contraception is an insult to all women. It further discredits the Food and Drug Administration as a responsible, professional science-based organization. The proposal to restrict access of EC OTC to women 16 and under makes no rational or practical or medical scientific sense. Determination of the safety and effectiveness of emergency contraception, with the added public health value of preventing unintended pregnancies no matter the age of the woman - should be primary criteria for making this decision. What could possibly be the public health value in restricting access to adolescents ill- prepared emotionally and physically to carry a pregnancy to term? I agree and the data indicate that access to emergency contraception --will not- - encourage promiscuity or that EC would lessen the routine use of contraception.