21 USC 353b - Outsourcing facilities

U.S Code last checked for updates: May 05, 2024

§ 353b.

Outsourcing facilities

(a)

In general

Sections 352(f)(1), 355, and 360eee–1 of this title shall not apply to a drug compounded by or under the direct supervision of a licensed pharmacist in a facility that elects to register as an outsourcing facility if each of the following conditions is met:

(1)

Registration and reporting

(2)

Bulk drug substances

The drug is compounded in an outsourcing facility that does not compound using bulk drug substances (as defined in section 207.3(a)(4) of title 21, Code of Federal Regulations (or any successor regulation)), unless—

(A)

(i)

the bulk drug substance appears on a list established by the Secretary identifying bulk drug substances for which there is a clinical need, by—

(I)

publishing a notice in the Federal Register proposing bulk drug substances to be included on the list, including the rationale for such proposal;

(II)

providing a period of not less than 60 calendar days for comment on the notice; and

(III)

publishing a notice in the Federal Register designating bulk drug substances for inclusion on the list; or

(ii)

the drug compounded from such bulk drug substance appears on the drug shortage list in effect under section 356e of this title at the time of compounding, distribution, and dispensing;

(B)

if an applicable monograph exists under the United States Pharmacopeia, the National Formulary, or another compendium or pharmacopeia recognized by the Secretary for purposes of this paragraph, the bulk drug substances each comply with the monograph;

(C)

the bulk drug substances are each manufactured by an establishment that is registered under section 360 of this title (including a foreign establishment that is registered under section 360(i) of this title); and

(D)

the bulk drug substances are each accompanied by a valid certificate of analysis.

(3)

Ingredients (other than bulk drug substances)

(4)

Drugs withdrawn or removed because unsafe or not effective

(5)

Essentially a copy of an approved drug

(6)

Drugs presenting demonstrable difficulties for compounding

The drug—

(A)

is not identified (directly or as part of a category of drugs) on a list published by the Secretary, through the process described in subsection (c), of drugs or categories of drugs that present demonstrable difficulties for compounding that are reasonably likely to lead to an adverse effect on the safety or effectiveness of the drug or category of drugs, taking into account the risks and benefits to patients; or

(B)

is compounded in accordance with all applicable conditions identified on the list described in subparagraph (A) as conditions that are necessary to prevent the drug or category of drugs from presenting the demonstrable difficulties described in subparagraph (A).

(7)

Elements to assure safe use

(8)

Prohibition on wholesaling

(9)

Fees

(10)

Labeling of drugs

(A)

Label

The label of the drug includes—

(i)

the statement “This is a compounded drug.” or a reasonable comparable alternative statement (as specified by the Secretary) that prominently identifies the drug as a compounded drug;

(ii)

the name, address, and phone number of the applicable outsourcing facility; and

(iii)

with respect to the drug—

(I)

the lot or batch number;

(II)

the established name of the drug;

(III)

the dosage form and strength;

(IV)

the statement of quantity or volume, as appropriate;

(V)

the date that the drug was compounded;

(VI)

the expiration date;

(VII)

storage and handling instructions;

(VIII)

the National Drug Code number, if available;

(IX)

the statement “Not for resale”, and, if the drug is dispensed or distributed other than pursuant to a prescription for an individual identified patient, the statement “Office Use Only”; and

(X)

subject to subparagraph (B)(i), a list of active and inactive ingredients, identified by established name and the quantity or proportion of each ingredient.

(B)

Container

The container from which the individual units of the drug are removed for dispensing or for administration (such as a plastic bag containing individual product syringes) shall include—

(i)

the information described under subparagraph (A)(iii)(X), if there is not space on the label for such information;

(ii)

the following information to facilitate adverse event reporting: www.fda.gov/medwatch and 1–800–FDA–1088 (or any successor Internet Web site or phone number); and

(iii)

directions for use, including, as appropriate, dosage and administration.

(C)

Additional information

(11)

Outsourcing facility requirement

(b)

Registration of outsourcing facilities and reporting of drugs

(1)

Registration of outsourcing facilities

(A)

Annual registration

Upon electing and in order to become an outsourcing facility, and during the period beginning on October 1 and ending on December 31 of each year thereafter, a facility—

(i)

shall register with the Secretary its name, place of business, and unique facility identifier (which shall conform to the requirements for the unique facility identifier established under section 360 of this title), and a point of contact email address; and

(ii)

shall indicate whether the outsourcing facility intends to compound a drug that appears on the list in effect under section 356e of this title during the subsequent calendar year.

(B)

Availability of registration for inspection; list

(i)

Registrations

(ii)

List

(2)

Drug reporting by outsourcing facilities

(A)

In general

Upon initially registering as an outsourcing facility, once during the month of June of each year, and once during the month of December of each year, each outsourcing facility that registers with the Secretary under paragraph (1) shall submit to the Secretary a report—

(i)

identifying the drugs compounded by such outsourcing facility during the previous 6-month period; and

(ii)

with respect to each drug identified under clause (i), providing the active ingredient, the source of such active ingredient, the National Drug Code number of the source drug or bulk active ingredient, if available, the strength of the active ingredient per unit, the dosage form and route of administration, the package description, the number of individual units produced, and the National Drug Code number of the final product, if assigned.

(B)

Form

(C)

Confidentiality

(3)

Electronic registration and reporting

(4)

Risk-based inspection frequency

(A)

In general

Outsourcing facilities—

(i)

shall be subject to inspection pursuant to section 374 of this title; and

(ii)

shall not be eligible for the exemption under section 374(a)(2)(A) of this title.

(B)

Risk-based schedule

(C)

Risk factors

In establishing the risk-based schedule, the Secretary shall inspect outsourcing facilities according to the known safety risks of such outsourcing facilities, which shall be based on the following factors:

(i)

The compliance history of the outsourcing facility.

(ii)

The record, history, and nature of recalls linked to the outsourcing facility.

(iii)

The inherent risk of the drugs compounded at the outsourcing facility.

(iv)

The inspection frequency and history of the outsourcing facility, including whether the outsourcing facility has been inspected pursuant to section 374 of this title within the last 4 years.

(v)

Whether the outsourcing facility has registered under this paragraph as an entity that intends to compound a drug that appears on the list in effect under section 356e of this title.

(vi)

Any other criteria deemed necessary and appropriate by the Secretary for purposes of allocating inspection resources.

(5)

Adverse event reporting

(c)

Regulations

(1)

In general

(2)

Advisory committee on compounding

(3)

Interim list

(A)

In general

Before the effective date of the regulations finalized to implement subsection (a)(6), the Secretary may designate drugs, categories of drugs, or conditions as described such 1

 So in original.

subsection by—

(i)

publishing a notice of such substances, drugs, categories of drugs, or conditions proposed for designation, including the rationale for such designation, in the Federal Register;

(ii)

providing a period of not less than 60 calendar days for comment on the notice; and

(iii)

publishing a notice in the Federal Register designating such drugs, categories of drugs, or conditions.

(B)

Sunset of notice

Any notice provided under subparagraph (A) shall not be effective after the earlier of—

(i)

the date that is 5 years after November 27, 2013; or

(ii)

the effective date of the final regulations issued to implement subsection (a)(6).

(4)

Updates

(d)

 So in original. Two subsecs. (d) have been enacted.

Definitions

In this section:

(1)

The term “compounding” includes the combining, admixing, mixing, diluting, pooling, reconstituting, or otherwise altering of a drug or bulk drug substance to create a drug.

(2)

The term “essentially a copy of an approved drug” means—

(A)

a drug that is identical or nearly identical to an approved drug, or a marketed drug not subject to section 353(b) of this title and not subject to approval in an application submitted under section 355 of this title, unless, in the case of an approved drug, the drug appears on the drug shortage list in effect under section 356e of this title at the time of compounding, distribution, and dispensing; or

(B)

a drug, a component of which is a bulk drug substance that is a component of an approved drug or a marketed drug that is not subject to section 353(b) of this title and not subject to approval in an application submitted under section 355 of this title, unless there is a change that produces for an individual patient a clinical difference, as determined by the prescribing practitioner, between the compounded drug and the comparable approved drug.

(3)

The term “approved drug” means a drug that is approved under section 355 of this title and does not appear on the list described in subsection (a)(4) of drugs that have been withdrawn or removed from the market because such drugs or components of such drugs have been found to be unsafe or not effective.

(4)

(A)

The term “outsourcing facility” means a facility at one geographic location or address that—

(i)

is engaged in the compounding of sterile drugs;

(ii)

has elected to register as an outsourcing facility; and

(iii)

complies with all of the requirements of this section.

(B)

An outsourcing facility is not required to be a licensed pharmacy.

(C)

An outsourcing facility may or may not obtain prescriptions for identified individual patients.

(5)

The term “sterile drug” means a drug that is intended for parenteral administration, an ophthalmic or oral inhalation drug in aqueous format, or a drug that is required to be sterile under Federal or State law.

(d)

 ² Obligation to pay fees

(June 25, 1938, ch. 675, § 503B, as added Pub. L. 113–54, title I, § 102(a)(2), Nov. 27, 2013, 127 Stat. 588.)

cite as: 21 USC 353b