[Code of Federal Regulations]
[Title 21, Volume 1]
[Revised as of April 1, 2007]
From the U.S. Government Printing Office via GPO Access
[CITE: 21CFR99.3]
[Page 446-447]
TITLE 21--FOOD AND DRUGS
CHAPTER I--FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN
SERVICES
PART 99 DISSEMINATION OF INFORMATION ON UNAPPROVED/NEW USES FOR MARKETED
Subpart A General Information
Sec. 99.3 Definitions.
(a) Agency or FDA means the Food and Drug Administration.
(b) For purposes of this part, a clinical investigation is an
investigation in humans that tests a specific clinical hypothesis.
(c) Group health plan means an employee welfare benefit plan (as
defined in section 3(1) of the Employee Retirement Income Security Act
of 1974 (29 U.S.C. 1002(1))) to the extent that the plan provides
medical care (as defined in paragraphs (c)(1) through (c)(3) of this
section and including items and services paid for as medical care) to
employees or their dependents (as defined under the terms of the plan)
directly or through insurance, reimbursement, or otherwise. For purposes
of this part, the term medical care means:
(1) Amounts paid for the diagnosis, cure, mitigation, treatment, or
prevention of disease, or amounts paid for the purpose of affecting any
structure or function of the body;
(2) Amounts paid for transportation primarily for and essential to
medical care referred to in paragraph (c)(1) of this section; and
(3) Amounts paid for insurance covering medical care referred to in
paragraphs (c)(1) and (c)(2) of this section.
(d) Health care practitioner means a physician or other individual
who is a health care provider and licensed under State law to prescribe
drugs or devices.
(e) Health insurance issuer means an insurance company, insurance
service, or insurance organization (including a health maintenance
organization, as defined in paragraph (e)(2) of this section) which is
licensed to engage in the business of insurance in a State and which is
subject to State law which regulates insurance (within the meaning of
section 514(b)(2) of the Employee Retirement Income Security Act of 1974
(29 U.S.C. 1144(b)(2))).
(1) Such term does not include a group health plan.
(2) For purposes of this part, the term health maintenance
organization means:
(i) A Federally qualified health maintenance organization (as
defined in section 1301(a) of the Public Health Service Act (42 U.S.C.
300e(a)));
(ii) An organization recognized under State law as a health
maintenance organization; or
(iii) A similar organization regulated under State law for solvency
in the same manner and to the same extent as such a health maintenance
organization.
(f) Manufacturer means a person who manufactures a drug or device or
who is licensed by such person to distribute or market the drug or
device. For purposes of this part, the term may also include the sponsor
of the approved, licensed, or cleared drug or device.
(g) New use means a use that is not included in the approved
labeling of an approved drug or device, or a use that is not included in
the statement of intended use for a cleared device.
[[Page 447]]
(h) Pharmacy benefit manager means a person or entity that has, as
its principal focus, the implementation of one or more device and/or
prescription drug benefit programs.
(i) A reference publication is a publication that:
(1) Has not been written, edited, excerpted, or published
specifically for, or at the request of, a drug or device manufacturer;
(2) Has not been edited or significantly influenced by such a
manufacturer;
(3) Is not solely distributed through such a manufacturer, but is
generally available in bookstores or other distribution channels where
medical textbooks are sold;
(4) Does not focus on any particular drug or device of a
manufacturer that disseminates information under this part and does not
have a primary focus on new uses of drugs or devices that are marketed
or are under investigation by a manufacturer supporting the
dissemination of information; and
(5) Does not present materials that are false or misleading.
(j) Scientific or medical journal means a scientific or medical
publication:
(1) That is published by an organization that has an editorial
board, that uses experts who have demonstrated expertise in the subject
of an article under review by the organization and who are independent
of the organization, to review and objectively select, reject, or
provide comments about proposed articles, and that has a publicly stated
policy, to which the organization adheres, of full disclosure of any
conflict of interest or biases for all authors or contributors involved
with the journal or organization;
(2) Whose articles are peer-reviewed and published in accordance
with the regular peer-review procedures of the organization;
(3) That is generally recognized to be of national scope and
reputation;
(4) That is indexed in the Index Medicus of the National Library of
Medicine of the National Institutes of Health; and
(5) That is not in the form of a special supplement that has been
funded in whole or in part by one or more manufacturers.
(k) Supplemental application means:
(1) For drugs, a supplement to support a new use to an approved new
drug application;
(2) For biologics, a supplement to an approved license application;
(3) For devices that are the subject of a cleared 510(k) submission
and devices that are exempt from the 510(k) process, a new 510(k)
submission to support a new use or, for devices that are the subject of
an approved premarket approval application, a supplement to support a
new use to an approved premarket approval application.
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