BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 1277
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          Date of Hearing:   April 26, 2011

                            ASSEMBLY COMMITTEE ON HEALTH
                              William W. Monning, Chair
                AB 1277 (Hill and Perea) - As Amended:  April 13, 2011
           
          SUBJECT  :  Sherman Food, Drug, and Cosmetic Law.

           SUMMARY  :  Revises the frequency of licensing inspections by the 
          Department of Public Health (DPH) for drug and medical device 
          manufacturers from once every two years to once every four 
          years, as specified.  Specifically,  this bill  :  

          1)Clarifies that manufacturers of biologic products are included 
            in existing law allowing manufacturers of drugs and medical 
            devices to sell, deliver, or give away their products in 
            California if they meet existing licensing and approval 
            requirements prescribed by the federal Food and Drug 
            Administration (FDA).

          2)States legislative intent to preclude DPH from requiring drug 
            and medical device manufacturers to also obtain separate state 
            approval from DPH, except to the extent that DPH requires 
            documentation that the federal requirements are met.

          3)Changes the frequency of state licensing inspections for these 
            manufacturers from once every two years to once every four 
            years and permits DPH to, if necessary, perform follow up 
            inspections, as specified, to protect the health and safety of 
            the public. 

           EXISTING LAW  establishes the Sherman Food, Drug, and Cosmetic 
          Law, administered by DPH, to regulate drug and medical device 
          manufacturers in California.

           FISCAL EFFECT  :   This bill has not yet been analyzed by a fiscal 
          committee.

           COMMENTS  :   

          1)PURPOSE OF THIS BILL  .  According to the author, biotechnology 
            and medical device companies are subject to inspections from 
            both the FDA and DPH every two years, in addition to 
            inspections performed by DPH prior to initial clinical trials 
            of products and the potential follow-up inspections the state 








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            performs within weeks after FDA inspections.   The author 
            argues that, aside from the licensing and inspection fees, 
            these inspections can cost these companies thousands of 
            dollars in preparation, manpower, and facilitation.  The 
            author points out that a recent survey of biomedical companies 
            demonstrated the widespread perception that often times the 
            state licensing and inspection process is duplicative of FDA 
            inspection requirements in that there is little difference 
            between what is inspected and a frequent lack of coordination 
            in the state and federal inspection timelines.  The author 
            contends that duplicative and occasionally unnecessary 
            inspections place an increased financial burden on these 
            companies when they must already expend substantial financial 
            resources to prepare for them.  This bill is intended to 
            reduce redundant inspections between the state and federal 
            government by changing the state inspection frequency from 
            once every two years to once every four years to better 
            complement the federal inspection schedule. 

           2)BACKGROUND  .  DPH's Food and Drug Branch (FDB) is responsible 
            for licensing and inspecting all manufacturers of 
            pharmaceutical drug products, including biologics, 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 prior to issuing 
            a new drug or medical device manufacturing license; firms 
            cannot legally manufacture in California without a valid 
            license.  Current law 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 to 
            investigate product recalls).  DPH reports that its 
            inspections aim to prevent 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. 

          The FDA also plays a role in regulating drugs and medical 
            devices in California.  According to DPH, the FDA and state 
            FDB have partnered to provide more oversight of these 
            industries.  The FDA has taken the lead in regulating imported 
            drug and medical devices at the point of entry and has primary 
            responsibility for approving new drugs and devices.  The FDA 








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            also inspects approximately 10% of manufacturers in California 
            each year.  Since 2004, the FDA has adopted a risk-based 
            approach to selecting which drug and medical device 
            manufacturing facilities to inspect in an effort to more 
            effectively allocate its inspectional resources.  Generally, 
            the FDA determines its frequency of a facility's inspections 
            based on such risk factors as the facility's compliance 
            history and the type of products that it manufactures.  The 
            FDA reports that this model is designed to assist the agency 
            in predicting where its inspections are most likely to achieve 
            the greatest public health impact.   

          DPH indicates that, through partnership agreements, these 
            inspections are not duplicated by FDB and the results of both 
            FDA and FDB inspections are shared.  In addition, DPH notes 
            that the FDA generally does not inspect new manufacturers 
            until two to three years after they have initiated 
            manufacturing.  DPH states that, because these products are 
            used to treat life-threatening diseases or are necessary for 
            life-support, early regulation by FDB avoids product 
            contamination, misbranding, and a variety of formulation, 
            fabrication, and labeling problems.

           3)INSPECTIONS  .  FDB conducts four types of inspections: new 
            drug, renewal drug, new medical device, and renewal medical 
            device.  New license inspections of drug manufacturers require 
            an extensive examination of the facility, quality control, 
            employee qualifications, validation of processes, packaging, 
            labeling, and documentation.  These inspections require an 
            average 60 hours to complete because of their complexity.  
            Inspection time for renewals is generally less than a new 
            license inspection because less explanation of requirements 
            and inspection activities are needed since the facility should 
            already be familiar with the process.  The renewal inspection 
            consists of updating FDB's database and reviewing new elements 
            such as, examining corrective actions from the previous 
            inspection, following up on product problems, auditing 
            newly-established production process and result records, and 
            evaluating changes and new products.  On average, drug 
            manufacturing renewal inspections require 40 hours for 
            completion.

          New license inspections of medical device manufacturers are 
            similar to new license inspections of drug manufacturers 
            because they also require a comprehensive review of their 








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            manufacturing facilities, procedures, personnel, product 
            labeling, and advertising before a license is issued.  On 
            average, these inspections take approximately 40 hours to 
            complete while renewal inspections, on average, take 35 hours 
            to complete.  Similar to drug manufacturer renewal 
            inspections, the firm subject to the inspection is already 
            familiar with the requirements; therefore, the inspection 
            focuses on updating FDB files and reviewing new elements since 
            the last inspection.

          DPH acknowledges that there is a current backlog for conducting 
            new and renewal drug and medical device manufacturer license 
            inspections due to an unanticipated increase in the number of 
            new medical device manufacturer license applications received 
            in 2010.  According to DPH, the change in this bill to extend 
            the license renewal inspection frequency from two years to 
            four years will assist in reducing this backlog. 
                
           4)SUPPORT  .  BayBio and BIOCOM state that this bill seeks to 
            eliminate any overlap between state and federal inspections of 
            the life sciences industry while still allowing FDB to perform 
            follow up inspections in instances where the public's health 
            and safety may be at risk.   The California Healthcare 
            Institute writes in support that this bill provides an 
            opportunity for manufacturers to demonstrate compliance with 
            federal and state laws through a more streamlined process that 
            clearly identifies an appropriate timeframe for when state and 
            federal inspections should occur.  

           5)DOUBLE REFERRAL  .  This bill is double referred.  Should it 
            pass out of this committee, it will be referred to the 
            Assembly Committee on Business, Professions & Consumer 
            Protection.

           6)POLICY COMMENT  .  It is unclear whether or not duplication 
            exists between the inspections of these facilities conducted 
            by DPH and those done by the FDA.  Consequently, the extent to 
            which this bill is needed is unclear given that DPH indicates 
            that each agency executes its inspection responsibilities over 
            manufacturers with distinctly different operational and 
            inspectional strategies.     

           REGISTERED SUPPORT / OPPOSITION  :   

           Support 








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          BayBio
          BIOCOM
          California Healthcare Institute

           Opposition 
           
          None on file.

           
          Analysis Prepared by  :    Cassie Royce / HEALTH / (916) 319-2097