BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                      



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          |SENATE RULES COMMITTEE            |                  AB 1277|
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                                    CONSENT


          Bill No:  AB 1277
          Author:   Hill (D) and Perea (D), et al.
          Amended:  8/13/12 in Senate
          Vote:     21

           
           SENATE HEALTH COMMITTEE :  7-0, 6/27/12
          AYES:  Hernandez, Harman, Alquist, Anderson, Blakeslee, 
            DeSaulnier, Rubio
          NO VOTE RECORDED:  De León, Wolk

           SENATE APPROPRIATIONS COMMITTEE  :  Senate Rule 28.8

           ASSEMBLY FLOOR  :  78-0, 5/19/11 (Consent) - See last page 
            for vote


           SUBJECT  :    Sherman Food, Drug, and Cosmetic Law

           SOURCE :     Author


           DIGEST  :    This bill eliminates licensing inspections by 
          the Department of Public Health (DPH) for drug and medical 
          device manufacturers, as specified. Limits DPHs authority 
          to make investigations or inspections of manufacturers to 
          situations where DPH has determined the health and safety 
          of the public is at risk, or when the U.S. Food and Drug 
          Administration (FDA) has requested assistance for 
          enforcement activities.

           Senate Floor Amendments  of 8/13/12 make technical changes 
          to ensure the federal citations refer to the appropriate 
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          sections of federal law, and limit inspection authority to 
          that authorized by the laws pertaining to drugs and 
          devices.  Specifically, the amendments (1) clarify that the 
          provisions of this bill pertaining to DPH's authority to 
          make investigations or inspections is limited to 
          inspections for compliance with the provisions of law 
          governing drugs and devices, and (2) make technical, 
          clarifying changes.

           ANALYSIS  :    Existing law:

          1.Establishes the federal Food, Drug, and Cosmetic Act, 
            which grants authority to the FDA to oversee the safety 
            of food, drugs, and cosmetics.

          2.Establishes the Sherman Law, administered by DPH, which, 
            among other things, regulates the packaging, labeling, 
            and advertising of drugs and medical devices in 
            California.

          3.Prohibits, in the Sherman Law, the sale, delivery, or 
            giving away of any new drug or new device unless it is 
            either: 

             A.   A new drug, and a new drug application has been 
               approved for it by the FDA, pursuant to federal law, 
               or it is a new device for which a premarket approval 
               application has been approved, and that approval has 
               not been withdrawn, terminated, or suspended under the 
               FDA; or

             B.   A new drug or new device for which DPH has approved 
               a new drug or device application, and has not 
               withdrawn, terminated, or suspended that approval.

          1.Requires DPH to adopt regulations to establish the 
            application form and set the fee for licensure and 
            renewal of a drug or device license. 

          2.Requires DPH to inspect the place of business of each 
            licensed manufacturer of a drug or medical device prior 
            to issuing a license, to determine ownership, adequacy of 
            facilities, personnel qualifications, and compliance with 
            current law.

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          3.Requires DPH to perform subsequent inspections once every 
            two years, unless the FDA has inspected the place of 
            business within the previous two years. Requires DPH to 
            use the information in the FDA inspection's written 
            documents, rather than conducting its own inspection.  

          4.Allows DPH, if necessary, to conduct an inspection to 
            obtain information not included or not sufficiently clear 
            in the FDA written documentation, as specified.

          5.Permits a DPH-authorized agent to enter and inspect 
            specified locations, as specified, to enforce the Sherman 
            Law.

          This bill:

          1.Clarifies that biologic products are included in 
            provisions of existing law prohibiting anyone from 
            selling, delivering, or giving away any new drug or new 
            device unless it has been approved under specified 
            provisions of federal law.

          2.Repeals the requirement that DPH inspect each place of 
            business prior to issuing a new license to a drug or 
            device manufacturer, and instead requires DPH to receive 
            from the place of business documentation that evidences 
            any of the following:

             A.   The place of business is operating pursuant to a 
               valid biologics license issued by the FDA, as 
               specified, requiring the documentation to include an 
               attestation from the place of business that a federal 
               inspection was completed within the past two years 
               from the date of the attestation;

             B.   The place of business is operating with a valid 
               federal establishment registration, as specified;

             C.   The place of business is operating in compliance 
               with audits conducted pursuant to the International 
               Standards Organization standards, as specified; or

             D.   The place of business is operating pursuant to an 

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               approved investigational new drug issued by the FDA, 
               or pursuant to an approved investigational device 
               exemption issued by the FDA, as specified.

          1.Prohibits DPH from inspecting the place of business prior 
            to issuing a license if DPH receives documentation that 
            satisfies the requirements in #2 above; if this 
            documentation is not received, DPH is required to inspect 
            the place of business prior to issuing a license.

          2.Requires DPH to provide an official copy of the valid 
            license upon request of the place of business.

          3.Repeals the requirement that DPH inspect a licensed drug 
            or device manufacturer once every two years following 
            initial licensure to determine ownership, adequacy of 
            facilities, and personnel qualifications.

          4.Limits the ability of DPH to make investigations or 
            inspections of licensed drug or device manufacturers to 
            only when any of the following occur:

             A.   DPH makes a determination that the health and 
               safety of the public is at risk;

             B.   DPH becomes aware of an issue and makes a 
               determination that the health and safety of the public 
               is at risk.

             C.   A complaint has been registered with DPH, and DPH 
               makes a determination that the health and safety of 
               the public is at risk.

             D.   A notification has been sent by the FDA to DPH that 
               requests assistance regarding any Class I or II recall 
               action memorandum.

             E.   The FDA has requested assistance for enforcement 
               activities, including, but not limited to, embargoes, 
               seizures, or injunctions.

           Background
           
           DPH licensure of drug and device manufacturers.    DPH's 

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          Food and Drug Branch (FDB) is responsible for licensing and 
          inspecting all manufacturers of pharmaceutical drug 
          products and medical devices in California, unless the 
          manufacturer is specifically exempted.  DPH currently 
          licenses and inspects 1,673 drug and medical device 
          manufacturing firms in California.  FDB is required to 
          inspect the place of manufacture before issuing or denying 
          a license; firms cannot legally manufacture in California 
          without a valid license.  In addition to issuing a license, 
          DPH has the authority to revoke or suspend a license for 
          any violation of the Sherman Law.  Existing law also 
          requires FDB to conduct license renewal inspections of 
          these companies once every two years, and permits 
          additional follow-up inspections to be conducted "for 
          cause" (e.g., to investigate injuries and deaths or 
          following product recalls).  

          According to DPH, its inspections are aimed at preventing 
          the sale and distribution of drugs and medical devices that 
          have been improperly manufactured; are adulterated, 
          misbranded or falsely advertised; have not been shown to be 
          safe or effective; or in the case of medical devices, fail 
          to meet design verification requirements.  As these 
          products are being used to treat life-threatening diseases 
          or are necessary for life support, early regulation by DPH 
          prevents product contamination, misbranding, and a variety 
          of formulation, fabrication, and labeling problems.  

           FDA regulation of drug and device manufacturers.   Before a 
          new drug even gets to the manufacturing stage, it must 
          undergo preclinical testing, followed by clinical testing.  
          The FDA is involved in each stage of testing, ensuring the 
          tests conform to FDA's Good Laboratory Practices.  After 
          three phases of clinical trials, and if the FDA does not 
          require additional information about the drug's efficacy, 
          safety and side effects, the sponsor of the new drug may 
          submit a New Drug Application, which contains all relevant 
          and necessary information about how the drug will be 
          manufactured. According to the FDA, "Manufacturing issues 
          are also among the reasons that approval Ýof a New Drug 
          Application] may be delayed or denied.  Drugs must be 
          manufactured in accordance with standards called good 
          manufacturing practices, and the FDA inspects manufacturing 
          facilities before a drug can be approved.  If a facility 

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          isn't ready for inspection, approval can be delayed. Any 
          manufacturing deficiencies found would need to be corrected 
          before approval. 

          In addition to approval of each individual drug, federal 
          law requires every establishment in any state engaged in 
          the manufacture, preparation, propagation, compounding, or 
          processing of a drug to register the name of the business 
          with the FDA.  Federal law goes on to require that every 
          such registered establishment be inspected by the FDA at 
          least once in the two-year period beginning with the date 
          of registration and at least once in every successive 
          two-year period thereafter.

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes   
          Local:  No

           SUPPORT  :   (Verified  8/14/12)

          Advanced Medical Technology Association
          BayBio
          BIOCOM
          California Healthcare Institute
          Pharmaceutical Research and Manufacturers of America
          Silicon Valley Leadership Group


           ARGUMENTS IN SUPPORT  :    This bill is supported by the 
          California Healthcare Institute (CHI), which states that 
          the duplicative regulation of drug and medical device 
          manufacturers is a perfect example of onerous state 
          regulations.  According to CHI, California is the only 
          state that has duplicate regulations requiring state-level 
          permitting and inspection of drug and medical device 
          facilities.  According to CHI, the FDA performs stringent 
          oversight of drug and device manufacturers, with approvals 
          required and inspections taking place throughout the 
          development process and on a regular basis thereafter.  CHI 
          states that duplicative state oversight and inspection 
          place an increased financial burden on manufacturers in 
          California.  CHI stated that in one example, a company 
          spent more than $200,000 and had more than 40 staff members 
          involved in a FDB inspection that took 8 days to complete.  
          CHI states that this was a routine inspection and did not 

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          find any health or safety problems, and was conducted less 
          than six months after a comprehensive FDA inspection.


           ASSEMBLY FLOOR  :  78-0, 5/19/11
          AYES:  Achadjian, Allen, Ammiano, Atkins, Beall, Bill 
            Berryhill, Block, Blumenfield, Bonilla, Bradford, 
            Brownley, Buchanan, Butler, Charles Calderon, Campos, 
            Carter, Cedillo, Chesbro, Conway, Cook, Davis, Dickinson, 
            Donnelly, Eng, Feuer, Fletcher, Fong, Fuentes, Furutani, 
            Beth Gaines, Galgiani, Garrick, Gatto, Gordon, Grove, 
            Hagman, Halderman, Hall, Harkey, Hayashi, Roger 
            Hernández, Hill, Huber, Hueso, Huffman, Jeffries, Jones, 
            Knight, Lara, Logue, Bonnie Lowenthal, Ma, Mansoor, 
            Mendoza, Miller, Mitchell, Monning, Morrell, Nestande, 
            Nielsen, Norby, Olsen, Pan, Perea, V. Manuel Pérez, 
            Portantino, Silva, Skinner, Smyth, Solorio, Swanson, 
            Torres, Valadao, Wagner, Wieckowski, Williams, Yamada, 
            John A. Pérez
          NO VOTE RECORDED:  Alejo, Gorell


          CTW:n  8/17/12   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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