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Principles of Premarket Pathways for Combination Products: Guidance for Industry and FDA Staff

FinalCenter for Biologics Evaluation and Research Center for Devices and Radiological Health Center for Drug Evaluation and Research Office of the Commissioner,Office of Clinical Policy and Programs,Office of Combination Products01/26/2022

Description

Section 3038 of the 21st Century Cures Act, enacted in December 2016 (P.L. 114-255) (“Cures Act”), substantially amended section 503(g) of the Federal Food, Drug, and Cosmetic Act (FD&C Act) (21 USC 353(g)), the principal section of the FD&C Act expressly addressing combination products. General themes of these amendments include enhancing clarity, predictability, efficiency, and consistency of premarket regulatory expectations for combination products, including by ensuring that Agency components and staff coordinate appropriately on premarket review of these products, and that Agency thinking is aligned in conducting these reviews. FDA is publishing this guidance as part of its efforts to implement Cures Act section 3038 and in keeping with the Agency’s long-standing commitment to transparency, efficiency, and regulatory consistency, to facilitate development of safe and effective combination products.

Scope & Applicability

Product Classes

9
Combination Product

Products combining drug, device, or biological constituents; Generally recommended for Enhanced Documentation; Requires 14971-based framework incorporating ICH Q9; A drug-device combination where the device constituent part detects ingestion.

gene therapy

Example of a biologic-led combination product

interchangeable biological product

Biological product that may be substituted for the reference product

biosimilar

Biological product highly similar to a reference product

Biologic-led combination products

Products licensed through BLA pathways under the PHS Act

drug-led combination products

Combination products where the drug is the primary constituent

RLD

Reference Listed Drug used as the basis for an ANDA submission.

Class III Device

Generally recommended for Enhanced Documentation; Regulatory classification mentioned for implantable sensors and HPV tests; Mentioned in the context of an in vitro nucleic acid test for CMV DNA.

Biological Product

Regulated under section 351(i) of the PHS Act; Virus, therapeutic serum, toxin, vaccine, or protein applicable to prevention or treatment; Alternative regulation category for products meeting device definition

Stakeholders

2
Sponsor

Entity responsible for submitting applications under section 524B

Medical Devices Advisory Committee

Procedures for meetings of the committee

Regulatory Context

Attributes

5
PMOA

Primary Mode of Action determining the lead center

Substantial equivalence

Regulatory standard for 510(k) clearance; demonstration required for 510(k) submission; regulatory standard for 510(k) clearance; Comparison of subject device parameters to predicate 510(k) submission numbers.

Shelf life

Determined by the sponsor for the investigational product.; investigational product(s) are stable over the period of use and only used within the current shelf life

therapeutic equivalence

assessing the therapeutic equivalence of a proposed generic drug-device combination product

bioequivalent

proposed product must be bioequivalent to the RLD

Identified Hazards

Hazards

1
Toxicity

Assessment of toxicity required in a 351(k) BLA

Related CFR Sections (4)

Related Warning Letters (4)

  • CGMP/Finished Pharmaceutical/Adulterated

    Advanced Pharmaceutical Technology

    2025-03-18
  • CGMP/Drugs/Adulterated

    EyePoint Pharmaceuticals, Inc.

    2024-08-27
  • CGMP/Finished Pharmaceuticals/Adulterated/Unapproved New Drug

    Omega Tech Labs LLC

    2024-08-06
  • Investigational Device Exemptions (IDE)/Premarket Approval Application (PMA)

    Aquavit Pharmaceuticals, Inc

    2021-06-29

See Also (8)

Principles of Premarket Pathways for Combination Products: Guidance for Industry and FDA Staff | Guideline Explorer | BioRegHub