1

 

                DEPARTMENT OF HEALTH AND HUMAN SERVICES

 

                         PUBLIC HEALTH SERVICE

 

                      FOOD AND DRUG ADMINISTRATION

 

              CENTER FOR FOOD SAFETY AND APPLIED NUTRITION

 

 

 

 

 

 

 

 

 

 

 

                   DIETARY SUPPLEMENTS PUBLIC MEETING

 

                  PRE-MARKET NOTIFICATION PROGRAM FOR

 

                        NEW DIETARY INGREDIENTS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

                       Monday, November 15, 2004

 

                               9:04 a.m.

 

 

 

 

                        Harvey W. Wiley Building

                       5100 Paint Branch Parkway

                     College Park, Maryland  20740
                                                                 2

 

                            C O N T E N T S

 

      AGENDA ITEM                                             PAGE

 

      Welcome - Barbara Schneeman, Ph.D., Director,

      Office of Nutritional Products, Labeling and

      Dietary Supplements                                        3

 

      Opening Remarks - Michael Landa, Deputy Director of

      Regulatory Affairs, CFSAN                                  4

 

      Meeting Introduction - Susan Walker, M.D.,

      Director, Division of Dietary Supplement Programs          7

 

      Moderator - Vasilios Frankos, Ph.D., Special

      Assistant to Division Director, Division of Dietary

      Supplement Programs                                       15

 

      Facilitator - Kelly Williams-Randolph, D.V.M.,,

      M.P.M., Consumer Safety Officer, Division of

      Dietary Supplement Programs                               17

 

      Speaker Group 1

      Michael McGuffin, President, American Herbal

      Products Association                                      19

      Annette Dickinson, Ph.D., President, Council for

      Responsible Nutrition                                     39

      David Seckman, Executive Director and CEO, National

      Nutritional Foods Association                             56

 

      Speaker Group 2

      Alan Feldstein, Counsel, and Richard Collins,

      Principal, Collins, McDonald & Gann, P.C.                 69

      George A. Burdock, Ph.D., President, Burdock Group        81

      A. Wes Siegner, Jr., Director, Hyman, Phelps &

      McNamara, P.C.                                            96

 

      Speaker Group 3

      John L. Zenk, M.D., Chief Medical Officer,

      Humanetics Corporation                                   116

      Paul Bolar, Vice President, Regulatory and Legal

      Affairs, Pharmavite                                      121

      Willi Hunziker, D.V.M., MBA, CEO, Hunziker

      Consulting                                               132

 

      Closing Remarks - Vasilios Frankos, Ph.D.                143

 

                                                                 3

 

                         P R O C E E D I N G S

 

                DR. SCHNEEMAN:  Good morning.  If I could

 

      get everyone to please take their seats, I think

 

      we'd like to get started.  We know we have a full

 

      program, and we want to give as much time as

 

      possible for our presenters and commenters so that

 

      FDA has an opportunity to hear what it is you have

 

      to say.

 

                My name is Barbara Schneeman.  I'm the

 

      Director of the Office of Nutritional Products,

 

      Labeling and Dietary Supplements.  That is one of

 

      the offices in the Center for Food Safety and

 

      Applied Nutrition, and we are definitely pleased to

 

      welcome you out here to College Park for this

 

      meeting on new dietary ingredients.

 

                As the meeting has been set up, FDA is

 

      here to listen.  We'll be gathering comments and

 

      analyzing those over the next few weeks, and we

 

      know that many of you also plan to submit written

 

      comments, and we're looking forward to those

 

      written comments as well.

 

                Without further, I want to introduce

 

                                                                 4

 

      someone from the Center Director's office, who is

 

      also relatively new to our office, Mike Landa, who

 

      has been with FDA for quite a number of years but

 

      has just recently taken the position of Deputy

 

      Director for Regulatory Affairs in the Center for

 

      Food Safety and Applied Nutrition.  And so I'd like

 

      to ask Mike to make a few opening comments.

 

                Thank you.

 

                MR. LANDA:  Thank you.  Thanks, Barbara.

 

                First, let me welcome everyone.  Thank you

 

      for coming today to share your views with us.  We

 

      hope and expect this meeting will be instructive

 

      for us, but let me add we don't anticipate that it

 

      will be interactive; that is, what we expect it to

 

      be is in what's called listening mode.  The "we,"

 

      as you will learn later this morning, will consist

 

      of sort of a listening panel, including myself, Dr.

 

      Schneeman, and several others.

 

                With respect to the NDI notice itself, let

 

      me just say we know there have been requests for an

 

      extension of the comment period.  We know it's a

 

      long-ish notice, at least in terms of the number of

 

                                                                 5

 

      questions we've asked and areas we've asked for

 

      comment on.  We will be making a decision shortly

 

      on the request for extension, and we'll let you

 

      know once the decision has been made.

 

                The purpose of the meeting today, as

 

      Barbara mentioned, is for us to hear presentations

 

      on the Pre-Market Notification Program for NDIs.

 

      We're soliciting comments from all interested

 

      persons, from consumers, from industry, from

 

      others, concerning the content and requirements,

 

      format requirements for notifications made under

 

      the statute and in the agency's regulations.  The

 

      Federal Register notice announcing this meeting

 

      sets out the questions we're most interested in

 

      hearing your comments on in great detail.  Copies

 

      of the notice, by the way, are on the registration

 

      table outside the auditorium.

 

                We'll consider the presentations we hear

 

      today and any comments we get to the docket in

 

      deciding what our next step or steps will be.  That

 

      makes it, of course, extremely important that you

 

      make sure to get your comments to the

 

                                                                 6

 

      docket--closer?  Okay.  Is that better?  Is that

 

      worse?

 

                [Laughter.]

 

                MR. LANDA:  To briefly recap what I was

 

      saying, but apparently no one heard, a couple of

 

      points.  One, we're going to be--"we" meaning the

 

      agency folks here--we'll be in listening mode

 

      today.  We may ask clarifying questions of the

 

      speakers, but we are here primarily to listen.  In

 

      that sense, we don't expect the meeting to be

 

      interactive.

 

                The second point I made was that we know

 

      we have requests for extension of the comment

 

      period in-house.  The agency has not yet decided

 

      whether to grant that request.  We'll let you know

 

      as soon as a decision is made.

 

                The third point was that there are copies

 

      of the notice available at the registration desk.

 

      For those of you who don't have a copy with you,

 

      perhaps during a break you can grab one out there.

 

      We will, of course, take into accounts presentations we hear

 

      today and any comments we received

 

                                                                 7

 

      on the docket in deciding what the next step or

 

      steps will be in relation to new dietary ingredient

 

      notifications.  It makes it all the more important

 

      that people make sure to get comments to the

 

      docket.  If they are sent elsewhere in the agency,

 

      they may or may not work themselves to the docket,

 

      so please send them there.

 

                In just a minute, I'll turn the program

 

      over to Dr. Susan Walker, who is in what we call

 

      ONPLDS, with affection.  Susan is Director of the

 

      Division of Dietary Supplement Programs in ONPLDS.

 

      But just before I turn the meeting over to her, I'd

 

      like to publicly acknowledge the work of the

 

      division in making this meeting happen.  I think

 

      ONPLDS certainly in general but the division in

 

      particular really drove this meeting.  I'd also

 

      like to acknowledge the work of a couple of lawyers

 

      in the Office of Chief Counsel who do foods work

 

      for us:  Irene Chen and Louisa Nickerson.

 

                I think with that I'll just turn the

 

      meeting over to Susan.

 

                DR. WALKER:  Thank you, Mike, and thank

 

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      you all very much for coming.  We're truly glad

 

      that you're all here today, and we've been looking

 

      forward to this meeting.  Let me see if I can

 

      actually remember how to do this audiovisual piece.

 

                Well, maybe we need an AV person.  Oh,

 

      there we go.

 

                What I'm going to do is very briefly just

 

      introduce the members of our panel today, and then

 

      I'll give a very short background about how we got

 

      to where we are today and why we're having this

 

      meeting.  And I'd actually like these folks to

 

      stand up because they've done so much work in

 

      getting us to this point.  As Mike said, the

 

      division is within the Office of Nutritional

 

      Products, Labeling and Dietary Supplements.  Our

 

      Office Director, Dr. Barbara Schneeman, has been

 

      extremely supportive and completely behind our

 

      efforts, and we really thank her for that.

 

                There are three branches in the division,

 

      and we've got Dr. Bob Moore, Compliance.  I think

 

      you're all pretty familiar with Bob.  And then Dr.

 

      Linda Pellicore, Regulations and Review, and Linda

 

                                                                 9

 

      is really the person you have to get through if

 

      you're going to get through the NDI program.  So

 

      I'd like to introduce Linda especially.  And then

 

      Dr. Jason Woo, who's our Clinical Team Leader.

 

      Also we have Dr. Bill Frankos, Special Assistant

 

      for Science Review, and Bill has recently come to

 

      the agency, about a year ago, and he will be

 

      moderating our session.  And we'll talk more about

 

      that in a bit.

 

                Now, I'd like to acknowledge Dr. Kelly

 

      Williams-Randolph, who was very instrumental in

 

      setting up our meeting and making sure this

 

      happened today.

 

                Other members of our panel I'd like to

 

      introduce:  Mike Landa, who you just met; Barbara

 

      Schneeman; and then Dr. Jeanne Rader, who is

 

      Division Director for the Research and Applied

 

      Technology Division; and then Dr. Alan Rulis, who

 

      I'm sure you all know, who is currently the Senior

 

      Advisor for Special Projects.

 

                Now, in our new dietary ingredient

 

      program, basically we have a variety of ingredients

 

                                                                10

 

      that are notified to us, but this is our recent

 

      history, which is predominantly botanicals and

 

      botanically derived substances.  So as we move

 

      forward, it's important to remember this is a very

 

      large part of what we're receiving in our

 

      notification process, and this probably reflects

 

      the fact that the complexity of this area really

 

      drives some of the complexity of this entire

 

      process.  And we really have to be aware of these

 

      substances as we move forward.

 

                Now, in looking at our notification

 

      program over the past few years, we've noticed that

 

      there have been many more notifications and that

 

      FDA has been objecting to a larger percentage of

 

      these notifications.  And looking at these, we

 

      wanted to determine why is this happening, and

 

      we've identified several factors.  These are not

 

      all the factors, but basically they're issues about

 

      describing the new dietary ingredient.  We need to

 

      know what it is, and that actually sounds like a

 

      very simple question, but it's a very complex

 

      issue, particularly with botanicals.

 

                                                                11

 

                We need to understand how and why it's

 

      eligible to be a new dietary ingredient.  We need

 

      to understand what's an adequate amount of safety

 

      information for the statutory bar in the law which

 

      is establishing reasonable expectation of safety.

 

      And then we've noticed there's other necessary

 

      information that's frequently not there, just

 

      general identifying information.

 

                All of these are in dockets and they're

 

      publicly available.  Anybody can go in there, can

 

      see all the notifications and see all the responses

 

      from FDA.

 

                So this is the history in the past ten

 

      years.  The notifications, obviously we're getting

 

      more and more, and there's a higher and higher

 

      objection rate.  Some folks have pointed out that

 

      it's likely that there are notifications in here

 

      that may not be new dietary ingredients.

 

                So what's really the key to the issue

 

      today?  It can be summarized in two slides that I'm

 

      going to put up here.  And this is the discussion

 

      we really need to have over the next few weeks and

 

                                                                12

 

      months.

 

                The first piece is when is a substance an

 

      eligible dietary ingredient under the statute,

 

      under 201(ff), which has three sections, so it's

 

      going to be very important to look at the basic

 

      eligibility of a substance to be a dietary

 

      ingredient.

 

                So once this gate has been opened and gone

 

      through, the next question is:  Was the dietary

 

      ingredient marketed in the U.S. prior to October

 

      15, 1994?  Because this is the actual statutory

 

      definition of a new dietary ingredient in DSHEA,

 

      and there are really only two answers.  It's yes or

 

      no.  If it was not, then that substance is a new

 

      dietary ingredient.  If it was, then it's not a new

 

      dietary ingredient.

 

                The ramifications of this are large

 

      because if you're a new dietary ingredient, not all

 

      new dietary ingredients have to notify.  A subset

 

      of new dietary ingredients has to notify.  So the

 

      next question that's going to be very important is:

 

      What is the group of substances that does not have

 

                                                                13

 

      to notify?  The third important question is:  For

 

      those that do have to notify, how do we fulfill

 

      both parts of the notification requirement such

 

      that we don't reach a status where that product is

 

      adulterated?  Because if there exists a history of

 

      use or other evidence of safety, basically

 

      establishing this reasonable expectation of safety

 

      and FDA has been notified, then that's a lawfully

 

      marketed product.  If either of these is not met,

 

      that product on its face is adulterated.

 

                So the scope of this meeting clearly is to

 

      discuss and receive comments on the status of

 

      substances as new dietary ingredients; questions

 

      about the chemical identity of a new dietary

 

      ingredient; when and under what circumstances does

 

      an ingredient that may have been available prior to

 

      1994, is there a point at which it becomes new

 

      because it's been transformed, there's been a

 

      chemical alteration, there's been a different

 

      extraction process?  We've really got to develop an

 

      understanding of what "marketed prior to 1994"

 

      really means in terms of safety because we really

 

                                                                14

 

      have to bring this all back to safety.  The intent

 

      of that section of DSHEA I would imagine--this is

 

      me speaking personally, but it's the safety

 

      gatekeeper.  And if we look at 201(ff), the

 

      identity section, and we look at 413, the new

 

      dietary ingredients section, those two pieces taken

 

      together are a very powerful safety tool.

 

                So we need to look at the standard for

 

      establishing a reasonable expectation of safety,

 

      what type of information should be provided.  We

 

      need to look at some of the definitions for new

 

      dietary ingredients.  And when we look at all this,

 

      as we said in the notice, we'll determine if

 

      there's a need for guidance or amending the

 

      regulations.

 

                So in order to proceed with this actually

 

      complicated task, we're having this public meeting

 

      today to get started.  We'll receive the comments

 

      to the docket.  We'll look at those and then

 

      determine next steps.  And for today's meeting, I'd

 

      like to actually introduce Dr. Bill Frankos, who's

 

      going to serve as our moderator.  Bill is a Special

 

                                                                15

 

      Assistant for Science Review within the division,

 

      and he received his Ph.D. in pharmacology and

 

      toxicology from the University of Maryland Pharmacy

 

      School.  He has over 30 years' experience in the

 

      toxicological and pharmacological evaluation of

 

      data used to assess the safety of nutritional

 

      supplements, foods and food additives, drugs,

 

      medical devices, cosmetics, pesticides, and

 

      environmental and occupational exposures.  And

 

      prior to joining FDA, Bill was a principal in

 

      Environ Corporation and Associate Director, Life

 

      Sciences Division, at Clement Associates.

 

                Previous to joining the private sector, he

 

      was with us in FDA in the Office of the Commissioner as a

 

      senior toxicologist, and previous to

 

      that at the Office of Food Additive Safety, I

 

      believe.  So Bill obviously has a lot of

 

      experience.  He's going to be very helpful in

 

      moving this process along, and I'd like to

 

      introduce him today as moderator for our session.

 

      Thank you.

 

                DR. FRANKOS:  Thank you.  I'm quite

 

                                                                16

 

      excited at the prospect of starting to deal with

 

      some of the issues that have been presented in the

 

      Federal Register notice.  The list of questions

 

      that you've all seen is a list that was developed

 

      after the whole division went back and carefully

 

      looked at the process of NDI review and the

 

      problems that occurred.  We felt that there were so

 

      many issues that we needed to deal with that we

 

      needed to open this up to the public, get input,

 

      and start a process that is certainly going to take

 

      several months, and we feel that it needs to be a

 

      public process.  This meeting is the first of what

 

      I think will be other meetings that may have to

 

      occur in order to bring this together.

 

                The panel that Susan introduced is here to

 

      really listen, but if clarification is needed, they

 

      certainly will ask questions.  The ground rules for

 

      the questioning is that we will only be asking

 

      questions that are clarifying questions.

 

                Now, if any members of the audience have a

 

      specific question, a clarifying question they would

 

      like to ask, if you come to one of these mikes here

 

                                                                17

 

      and introduce yourselves, we can recognize you.

 

      But I would like those questions to be clarifying

 

      questions, not going into areas that have not been

 

      addressed by the speakers.

 

                I'd like to introduce Kelly

 

      Williams-Randolph.  She's been doing a great job

 

      coordinating this notice, and she wants to go

 

      through a little bit of the housekeeping, and then

 

      after that we'll start with the speakers.  Thank

 

      you.

 

                DR. WILLIAMS-RANDOLPH:  Thanks, Bill.

 

      Good morning.  I'd like to start off with a welcome

 

      to the members of the FDA panel, the folks from

 

      industry, consumers, health professionals, and

 

      everybody that's here in the audience.  I'd like to

 

      go over some meeting logistics with you, starting

 

      with today's agenda.

 

                This morning we will spend with

 

      introductory remarks and one speaker group session.

 

      There will be a morning break at 10:30 a.m. for 15

 

      minutes, and then another speaker group session.

 

      After the second speaker group session, we will

 

                                                                18

 

      have another 15-minute break, scheduled for 11:45

 

      a.m., and then have our final speaker group

 

      session.  Bill Frankos will then give closing

 

      remarks.

 

                In addition, I would also like to go over

 

      the speaker group session presentation time limits

 

      and time limits for clarification questions from

 

      FDA panel and audience members.  Each speaker will

 

      have 15 minutes to present, with a five-minute

 

      follow-up period for clarification questions

 

      regarding the presentation.  We will be using a

 

      color card timing formula for keeping speaker

 

      presentations on schedule.  A green card will

 

      signal the speaker that they have five remaining

 

      minutes.  A yellow card will indicate the speaker

 

      has one remaining minute.  And the red card will

 

      indicate that the speaker should finish his or her

 

      sentence.

 

                In closing, you can find bathrooms located

 

      midway between the front entrance of the building

 

      and the registration tables.  Signs are also posted

 

      indicating the location of the restrooms, and on

 

                                                                19

 

      the back of your agendas you'll find a floor plan.

 

                Thank you, and I hope you will find today

 

      useful.  Now I'll give the floor back to Bill.

 

                DR. FRANKOS:  Thank you.

 

                Our first speaker will be Michael

 

      McGuffin, who is president of the American Herbal

 

      Products Association.  Michael, can you come up?

 

                MR. McGUFFIN:  Thanks, Bill.  How do I get

 

      to my presentation here?

 

                [Pause.]

 

                MR. McGUFFIN:  Good morning.  It's a

 

      pleasure to be here, and I appreciate the

 

      opportunity to address you all.  I really

 

      appreciate the people from FDA inviting me.

 

                I already tried to negotiate an extra five

 

      minutes from Bill, so I hope we can tolerate.  I've

 

      got a pretty packed presentation here.

 

                AHPA represents about 200 companies that

 

      sell herbal products, almost exclusively as dietary

 

      supplements, and my primary comments are going to

 

      be the impact of this rule on herbal products.

 

      AHPA will submit substantive comments to the

 

                                                                20

 

      docket, and just for the record, we would really

 

      appreciate those extra 60 days.  This is a knotty

 

      issue, as you all know, and anything you can do to

 

      give us the time extension will be appreciated.

 

                I'm going to just move into this in the

 

      interest of trying to get through this in 15 or

 

      maybe 18 minutes, and I want to start with the

 

      definition if a dietary ingredient, specifically as

 

      that applies to botanicals, and I'm emphasizing

 

      here with these bold lines that there are really

 

      two different classes of botanical ingredients:

 

      the 321(ff)(1)(C), which is an herb or other

 

      botanical, it's an unprocessed herbal ingredient;

 

      and then (F) can be a concentrate, a metabolite, a

 

      constituent, an extract, or a combination of any of

 

      the above.  And I think it's important to think of

 

      these separately.  Although much of the information

 

      that's required for a new raw material herb or a

 

      new constituent or concentrate or extract are the

 

      same, there are some differences that I'm going to

 

      point out that I think are important to keep in

 

      mind.

 

                                                                21

 

                I'll get back to this a little later, but

 

      I want to look, too, at just an overview of what's

 

      required in a new dietary ingredient notification.

 

      If you go to 21 CFR 190.6, that's where the reg is

 

      written, and I class five different pieces of

 

      information that are required there if you break

 

      down the various subparagraphs.  And I don't need

 

      to say much about the first or the last.  Almost

 

      everybody knows their name and address and

 

      remembers to sign it.  But each of these other

 

      things needs some attention:  the name of the

 

      ingredient, which with an herb must include the

 

      Latin name; a description of the supplement that

 

      contains the ingredient, including, of course, the

 

      level of use and conditions of use; and the big

 

      deal, the thing that we're really after, the

 

      evidence on which a reasonable expectation of

 

      safety is based.

 

                I want to point out something that's not

 

      here.  It does not specifically state in 190.6 that

 

      you need to identify the dietary ingredient.

 

      There's a requirement for a description of the

 

                                                                22

 

      supplement.  There is not a specified requirement

 

      for a description of the ingredient.  I'm going to

 

      again come back to that later because it's

 

      something that we need to pay attention to.

 

                A quick review.  As of last week, there

 

      are 249 notices on the docket.  Fifteen of these

 

      are for dietary supplements.  They don't belong

 

      here.  There should not be submissions for new

 

      dietary supplements.  It's not required.  It

 

      confuses the system.  But where we end up was 194

 

      unique dietary ingredient submissions.  There are

 

      also a number of duplicates, a few withdrawn, but

 

      this 249 comes down to 194.  And of those 194, I

 

      get slightly different numbers than Susan did, I

 

      think.  I count 83 non-herbal dietary ingredients

 

      and 111 herbal.  And then the herbal breakdown into

 

      that subparagraph (C), the unprocessed herbs, there

 

      are 33 of those; herbal constituents, which is one

 

      of the words used in subparagraph (F), there are 26

 

      of those, and then there are 52 herbal extracts, or

 

      concentrates or oils or things that aren't just the

 

      herb but neither are they constituents.

 

                                                                23

 

                I don't do as good a job of drawing these

 

      pretty pictures as Susan also, but here's just a

 

      pie graph of--again, you can see over half of these

 

      are botanicals, and they're kind of split between

 

      these three subclasses of botanicals.

 

                Then here's the outcome, here's what

 

      happens if you look at these different subclasses

 

      with regard to the number of notifications, the

 

      number that are filed.  And "filed" is as close as

 

      FDA gets to "accepted."  It means they didn't

 

      object to.  It means they didn't send you back a

 

      letter with the word "adulterated" in the letter.

 

      So of the non-herbal ingredients, you can see 63

 

      percent of those are being filed; 65 percent of the

 

      herbal constituents; but the unprocessed herbs,

 

      only one out of five is making it through the

 

      process.  And the extracts, it's a little greater

 

      than one out of three.  So there's clearly the

 

      herbal constituents, things like sesamin from

 

      sesame seed, vinpocetine, those are getting

 

      through; whereas, the herbs themselves tend not to.

 

                Now, my interest is herbs, so I'm, of

 

                                                                24

 

      course, concerned about what is it that's making it

 

      so that the herbs don't get through, and so I've

 

      looked at why FDA refuses to file so many of these.

 

                Some of the issues are very specific to

 

      herbs:  plant part not named.  Again, though, 190.6

 

      does not specify tell us the part of the plant.

 

      One of the suggestions that AHPA will make, 190.6

 

      should specify name the part of the plant if your

 

      ingredient is a botanical.  It's obvious.  You

 

      don't have an ingredient that's a botanical without

 

      also naming the part.  But it's not stated.  Some

 

      companies miss that, and we'd like to help them

 

      address that.  This No. 247, that's a mushroom, and

 

      FDA said we don't know what part of the mushroom.

 

      So those were both objected to or rejected.

 

      There's confused nomenclature in the last one

 

      filed, this plum extract, where the filing company

 

      said we're not sure if it's Terminalia ferdinandiana or

 

      lapides.  FDA said, well, if you don't

 

      know, then we don't know.  It turns out those are

 

      two different names for the same plant.  They

 

      should have called me and I could have helped them

 

                                                                25

 

      with that.  But, nonetheless, that kind of

 

      confusion gets an objection notice.  Or in the case

 

      of freeze-dried kimchi--I love it.  Somebody wants

 

      to sell us freeze-dried kimchi, but they didn't

 

      tell us that it was Brassica, so FDA said we don't

 

      know what to do with that.

 

                Many of the other reasons that FDA objects

 

      to herbal filings, though, are the same that they

 

      object to the non-herbal filings, and Susan pointed

 

      out some of these.  I've quoted from some specific

 

      notices.  "It is unclear...whether the test

 

      substances used in the referenced studies are

 

      qualitatively or quantitatively similar to" to your

 

      new dietary ingredient.  So somebody says I want my

 

      ganiderma product to come to market, and here's a

 

      whole lot of information about ganiderma extract,

 

      but they don't clarify that it's, in fact, their

 

      ganiderma extract.  FDA says we don't have any

 

      information that's a basis for knowing that your

 

      ingredient is safe.  I've seen that one over and

 

      over and over.  And then as Susan also mentioned,

 

      inadequate information to clearly identify the

 

                                                                26

 

      ingredient.

 

                There have been other issues.  Things have

 

      been rejected just because they're frank toxins,

 

      things like extract of oleander--thank you for

 

      rejecting that one--pokeweed lectins, illegal

 

      substances like GBL, and then sometimes because the

 

      described dietary supplement is in a form that

 

      doesn't fit the definition.  My favorite one is an

 

      herbal eyepatch which FDA wisely chose to reject.

 

                With regard to this second point here,

 

      though, the inadequate information presented to

 

      identify the ingredient, I want to repeat, 190.6

 

      does not specifically state identify the

 

      ingredient.  Again, it's an obvious recommendation

 

      that AHPA will make that 190.6 should, in fact,

 

      state that the identification of the ingredient

 

      must be included.

 

                The next two slides are looking at the

 

      requirements set in 190.6 and breaking it down into

 

      the identity, the description of the supplement in

 

      which the product goes, and the evidence of safety.

 

      And I have two slides here.  This one is for

 

                                                                27

 

      subparagraph (C), which is herb or other botanical.

 

      And my position is that all you need to identify an

 

      herb is the name of the herb and the part.  You

 

      don't need chemistry.  You don't need anything that

 

      goes further than that because peppermint leaf is

 

      peppermint leaf if that's what I'm selling.  Now,

 

      that's an old ingredient, but just to make the

 

      impression.  Whereas, if it's anything in (F), if

 

      it's an extract, if it's a concentrate, clearly you

 

      need a lot more information, and all of these

 

      points are actually from a document that AHPA

 

      produced a couple of years ago, a guidance on

 

      manufacturing of extracts that I will leave a copy

 

      into the record here.

 

                You have to disclose the solvents, the

 

      ratios, all other ingredients.  You need to

 

      describe the process.  Is it a liquid product or a

 

      solid product?  And then these bracketed items--the

 

      markers, characterization, and purity--are often

 

      but not always relevant.  It's a much more dense

 

      process once it moves from an unprocessed herb.

 

      Whereas the dietary supplement description, it's

 

                                                                28

 

      not any different for the subclass (F), which are

 

      the extracts and concentrates, than it is for the

 

      raw herbs.  And the only difference that I have on

 

      evidence is that the evidence of the herb would be

 

      history of use and other evidence, whereas the

 

      extract you can argue that the history of use of

 

      similar dietary ingredients, like the raw herb, has

 

      relevance.

 

                I also want to point out that in the

 

      description I've made a pointed statement that

 

      there is not a requirement to identify the other

 

      dietary ingredients.  Most companies want to say,

 

      "My new dietary ingredient is this ingredient, and

 

      the use is 50 milligrams in a dietary supplement."

 

      Most of those submissions have gone through.  Most

 

      recently, FDA in one letter said, well, we don't

 

      know what the other ingredients are, so how would

 

      we know that the supplement is safe?  We want to

 

      argue against FDA taking that any further.

 

                Old versus new, again, the class (C) and

 

      the class (F) are different.  With regard to just

 

      herbs--roots and leaves and seeds and things that

 

                                                                29

 

      are just parts of plants--AHPA in 1995 sent out a

 

      call to industry to identify old herbal dietary

 

      ingredients.  The next year we submitted a list of

 

      over 1,600 herbs to FDA, identified those as

 

      believed to be in commerce prior to the date, and

 

      in 2000 we published "Herbs of Commerce," 2nd

 

      edition.  We added about 400 other plants in the

 

      meantime, numerous Chinese plants, numerous

 

      Ayurvedic plants, fungi, algaes.  It's a very

 

      thorough document.

 

                We also disclaimed it in two different

 

      ways.  The first disclaimer says just because it's

 

      here doesn't mean it was marketed prior to the

 

      date.  And the second one says just because it's

 

      not doesn't mean it wasn't.

 

                Our thinking here was we accepted

 

      submissions honorably.  We believed that they were

 

      submitted honorably.  But we didn't go out and

 

      double-check or prove that chamomile had, in fact,

 

      been marketed prior to the date.  Nonetheless, it

 

      is AHPA's position that even though "Herbs of

 

      Commerce" may not be authoritative, this disclaimer

 

                                                                30

 

      should not be read as a reason to abandon our text.

 

      It should not be seen as assuming that there is no

 

      relationship whatsoever between the listing of an

 

      herb in "Herbs of Commerce" and its marketing prior

 

      to the date.  That is what we asked people to tell

 

      us.  We think it has relevance.  We think it does

 

      create a presumption of presence in the

 

      marketplace.

 

                If the agency wants to take it further and

 

      get to something like an authoritative reference,

 

      AHPA is uniquely positioned.  We would be happy to

 

      discuss being actively involved in a process or

 

      being contracted for a process to do an old dietary

 

      ingredient substantiation for botanicals.  We know

 

      a lot about this issue.

 

                Then with regard to old herb extracts--and

 

      by extracts I mean everything in (F)--we didn't go

 

      out and say tell us all of the extracts.  We didn't

 

      ask that kind of thing a decade ago.  But there are

 

      standard accepted extract forms:  decoctions,

 

      liquid extracts, dry extracts, tinctures.  There

 

      are long accepted food-grade solvents, and I've

 

                                                                31

 

      listed numerous of those here; established

 

      extraction processes.  And there is a reason to

 

      think that all of the common herbs were

 

      manufactured by all of these common processes with

 

      all of these common solvents.  And if I've got a

 

      32-percent ethanol chamomile, I shouldn't have to

 

      prove that a 32-percent ethanolic extract of

 

      chamomile was marketed because it's in the range of

 

      reasonableness that it was marketed.

 

                I also want to point out there are other

 

      solvents that I didn't list here and other

 

      extraction processes that had come into the

 

      marketplace, not as extensively, things like hexane

 

      and acetone, super-critical gases and

 

      super-critical extraction.

 

                Let me move then to suggestions, and the

 

      first few here I'm just repeating, modifications to

 

      190.6, and an assumption that "Herbs of Commerce"

 

      herbs are "old," as are extracts by common

 

      processes.  I'm repeating, we'd really like to see

 

      the agency just not accept filings for new dietary

 

      supplements.  Those are wrong.  They create a

 

                                                                32

 

      bizarre record where now there's a document that

 

      says that licorice root and ginseng aren't allowed

 

      to be sold because somebody submitted--actually,

 

      they don't say that.  They say your product may be

 

      adulterated which contains this ingredient.  There

 

      are these lawyers in California that will make lots

 

      out of that.  We'd really like to see that stop.

 

                We'd also like to see the agency refuse

 

      filings for obvious old dietary ingredients, and

 

      I've listed a number of them here.

 

                With regard to enforcement, I think it's

 

      obvious that enforcement needs to be prioritized

 

      based on safety concerns, and one point in passing,

 

      Susan mentioned the food exemption if it's present

 

      in the food supply and not chemically altered, and

 

      we want to make sure that the agency thinks what we

 

      think, that international food supply counts

 

      against that clause.

 

                We'd like to see restraint from overly

 

      broad or maybe I mean overly narrow interpretations, but

 

      I've given some examples.  For an

 

      herb, for the agency to say you didn't give us

 

                                                                33

 

      specifications on purity, that's a GMP issue, not a

 

      new dietary ingredient issue.  Compositional

 

      analysis, I've made my pitch that I don't believe

 

      compositional analysis of chamomile flowers is

 

      warranted; whereas, chamomile extract in a new

 

      solvent and a new extraction method may be.  And,

 

      also, this issue about I really strongly argue

 

      against any requirement that the only way I can get

 

      my new dietary ingredient approved is to disclose

 

      every other ingredient that it may ever be marketed

 

      with.  That puts an unfair burden on every product

 

      that has a single new dietary ingredient versus the

 

      whole world of products that have only old dietary

 

      ingredients.  And we would oppose that.

 

                There's a tendency for companies to

 

      resubmit when they change the dose and that I think

 

      is wise, but we'd like some guidance on that.

 

      There ought to be minimum criteria for FDA to

 

      review a submission.  I'm not sure what those are,

 

      but I'm sure that they do include all of the

 

      administrative parts of 190.6, if it's not in

 

      triplicate, if it's not signed, if it didn't

 

                                                                34

 

      disclose the plant part, those kinds of what I

 

      called here administrative or technical issues.

 

      And then, of course, the identity of the new

 

      dietary ingredient, if it's not identified I don't

 

      think the agency should go through that whole

 

      process of sending it back saying your ingredient

 

      is adulterated.  I think the agency ought to not

 

      accept it, and I know that the record shows the

 

      agency does go back and ask for more information.

 

      We encourage that.  We'd love to see more timely

 

      access at FDA's docket.  I notice today it's really

 

      up to date.  We appreciate that.  But I also know

 

      that you pushed a bunch of stuff through in the

 

      last few weeks.  We appreciate that.

 

                In closing, AHPA and another organization,

 

      NPI, we're in the middle of creating a searchable

 

      database.  We're going to make it so that you can

 

      go in and search for astaxanthin or licorice or

 

      whatever and find every submission that mentioned

 

      that.  We'll also search--we'll provide a summary

 

      outcome statement of what happened, was it filed or

 

      was it objected to.

 

                                                                35

 

                A couple things that I didn't get on here,

 

      we'd love to see an opportunity to withdraw that's

 

      very similar to what happens in a GRAS notice.

 

      There have been three or four withdrawals, one of

 

      which the agency refused to allow.  We think that

 

      it ought to have rules that are a very similar to

 

      the GRAS withdrawal process.

 

                We need to see consistency.  I know that

 

      FDA intends to be consistent, but I can find

 

      examples.  Astaxanthin, there have been five

 

      submissions--the three that were submitted prior to

 

      2002, those were accepted; the two that were

 

      submitted this summer were not.  I don't know that

 

      they were markedly different, those ingredients.

 

      If they were not, we'd need to understand did

 

      something change in the policy, because it needs to

 

      be very consistent, and I think you understand

 

      that.

 

                I know that there's a new emphasis now on

 

      the agency saying exactly which subparagraph of a

 

      dietary ingredient is it in.  I think that's a good

 

      question.  But I also don't think that when

 

                                                                36

 

      the--that's not a reason to object to a filing just

 

      because somebody didn't tell you that they believe

 

      that deer antler is in subparagraph (E) or that

 

      carnitine is also in subparagraph (E).

 

                Maybe my last statement.  The industry

 

      needs to see the whole process of the new dietary

 

      ingredient notification as a gate through which new

 

      ingredients can come, not as a barrier that refuses

 

      to allow new ingredients into the marketplace.  And

 

      we really look forward to working with the agency.

 

      Guidance is definitely needed.

 

                One point I forgot to make, some of these

 

      submissions are just a mess, and that needs to be

 

      acknowledged.  Some of them don't deserve to be

 

      filed.  They're embarrassingly narrow in the

 

      information that's submitted, and I think I can

 

      close it there.

 

                DR. FRANKOS:  Thank you, Mike.

 

                Any questions?  Linda.

 

                PARTICIPANT:  Mike, I wonder if you could

 

      tell us what NPI stands for on that last slide.

 

                MR. McGUFFIN:  You know, on the Metro on

 

                                                                37

 

      the way in, I thought--I'm fairly certain it's the

 

      Natural Products Institute.  I think that's what it

 

      is.  They're a publication company in our trade who

 

      does a lot of work in communication, and we're

 

      partnering with them to put this thing together.

 

                DR. FRANKOS:  Mike?

 

                PARTICIPANT:  When you compiled "Herbs for

 

      Commerce," did you ask for documentation?

 

                MR. McGUFFIN:  We did not.  We just asked

 

      for people to tell us, some companies provided--oh,

 

      sorry.  Yes, the question was, when we compiled the

 

      information for "Herbs of Commerce," did we ask for

 

      documentation?  No, we did not.  We simply asked

 

      for people to inform us what they were selling.

 

      Some companies provided us with notarized

 

      statements.  Some companies provided us with copies

 

      of their catalogues or advertising.  And, also, I'm

 

      kind of a pack rat.  I've got a whole box of

 

      catalogues from '93 and prior.

 

                DR. FRANKOS:  I have one question.  When

 

      you said that whole herbs history of use is

 

      relevant for evaluating the safety of extracts, I

 

                                                                38

 

      was curious how you would use that data when there

 

      are so many forms of extracts.

 

                MR. McGUFFIN:  I'll tell you what.  The

 

      question is:  How would I use information about

 

      whole herbs to evaluate the safety of an extract of

 

      that whole herb?  What I have done, Bill, is I've

 

      looked at all 249 of these.  What I haven't done is

 

      file one.  So I'm not sure.  I think some of the

 

      toxicologists that are going to talk to us might

 

      have more relevant responses to that because I

 

      think the way that you would use it, though, is the

 

      more that you could show that your extract had a

 

      chemical characteristic that was similar to the raw

 

      botanical, then I think you're going to be able to

 

      use that as information that suggests that we've

 

      been using that for some number of years or

 

      generations.

 

                DR. FRANKOS:  Thank you.

 

                Yes, Jason?

 

                PARTICIPANT:  [inaudible, off microphone]

 

      you're specifying international use as a food, not

 

      as a medicine or--

 

                                                                39

 

                MR. McGUFFIN:  Correct.  Yes, the question

 

      is with regard to my call for international use,

 

      there's that one--I forget.  What is it?  I forget.

 

      The one that says that you're not required to

 

      submit a new dietary ingredient that is present in

 

      the food supply in a form that's not chemically

 

      altered.  That's exactly the part I'm saying.  If

 

      it's present in the food supply in South Africa,

 

      that's okay; it doesn't have to have been present

 

      in the food supply in South Dakota.

 

                DR. FRANKOS:  Okay.  Thank you.

 

                MR. McGUFFIN:  Thank you.

 

                Our next speaker is Annette Dickinson.

 

      She's president of the Council for Responsible

 

      Nutrition.  Annette?

 

                DR. DICKINSON:  Good morning, and thanks

 

      to FDA for the opportunity to be here and for

 

      beginning this initiative.

 

                The Council for Responsible Nutrition is

 

      one of the leading trade associations for the

 

      dietary supplement industry.  Our members include

 

      mainstream manufacturers of dietary ingredients

 

                                                                40

 

      themselves, as well as manufacturers of both

 

      national brand names and private label dietary

 

      supplements.  And we also have a number of members

 

      whose interest is international in scope.

 

                We want to congratulate FDA for the three

 

      documents that were issued in the last few months,

 

      all of which are intended to move the agency and

 

      the industry toward full implementation of DSHEA.

 

      We don't believe anything is more important to

 

      solidifying the confidence in dietary supplements

 

      and the confidence both on the part of the

 

      regulators and on the part of Congress as well as

 

      consumers than moving to full implementation, and

 

      we congratulate the agency over the past couple of

 

      years for a number of initiatives toward full

 

      implementation and enforcement, which we believe is

 

      necessary.

 

                At the same time, we are concerned that

 

      that enforcement and implementation be consistent

 

      with the intent of DSHEA, and I know that the staff

 

      at FDA is determined to make that happen.  The

 

      purpose of DSHEA was to ensure consumer access to a

 

                                                                41

 

      wide variety of products and also to provide

 

      consumers with more information about the uses of

 

      those products.  The intent of DSHEA was to affirm

 

      the safety of a broad array, a very broad array of

 

      existing dietary ingredients and establish a

 

      notification process for new ingredients that was

 

      distinct from, deliberately distinct from and

 

      intended to be less burdensome than the food

 

      additive approach that the agency was using at the

 

      time.

 

                We have also submitted in conjunction with

 

      this meeting a statement prepared by our legal

 

      counsel, Peter Barton Hutt, which was prepared at

 

      the request of both CRN and one of our sister

 

      associations, CHPA, the Consumer Healthcare

 

      Products Association, which presents his legal view

 

      of the status of dietary ingredients and new

 

      dietary ingredients.

 

                The definition of dietary ingredients in

 

      the act is extremely broad and was meant to be

 

      broad, and any discussion of new dietary

 

      ingredients we believe must begin with a discussion

 

                                                                42

 

      of what fits within the rubric of dietary

 

      ingredients in the first place.

 

                While we agree that safety is an important

 

      factor in determining whether an ingredient may be

 

      marketed and also an important factor in

 

      determining whether an NDI notification is adequate

 

      for its purpose, safety is not necessarily a factor

 

      in defining the category per se, that is, the

 

      category of dietary ingredients.  And I'll offer a

 

      couple of examples of why that must be the case.

 

                One of the categories of dietary

 

      ingredients is minerals.  Minerals is an extremely

 

      broad category.  Minerals typically occur

 

      naturally, not as elements but as various

 

      compounds.  Calcium, for example, is an essential

 

      nutrient, an essential mineral which occurs

 

      naturally as calcium carbonate and some other

 

      forms.  However, it has been used for many years in

 

      dietary supplements and is grandfathered in other

 

      forms that actually do not occur naturally, such as

 

      calcium citrate.  This illustrates a point, which

 

      is that we do not believe the inclusion of a

 

                                                                43

 

      mineral in this category depends on it being in a

 

      naturally occurring form.  In addition, we do not

 

      believe that inclusion in the mineral category is

 

      limited to nutrients that are essential.  Calcium

 

      is certainly an essential mineral.  But there are

 

      many others, such as tin, vanadium, silicon, and

 

      boron, that have for many years been present in

 

      very popular national and private brands of

 

      multivitamin/multimineral formulations, and we

 

      consider all of these to be grandfathered

 

      ingredients.

 

                Likewise, the area of botanicals is an

 

      extremely broad category.  It includes common and

 

      generally safe ingredients such as ginseng, garlic,

 

      and ginkgo.  It also includes ingredients about

 

      which some safety concerns have been raised, such

 

      as comfrey, chapparal, and kava.  The fact that

 

      there may be safety concerns that need to be

 

      addressed does not mean that the ingredient doesn't

 

      fall definitionally into the category.  It is an

 

      issue that needs to be dealt with separately, and

 

      we urge FDA in its proceedings to keep these two

 

                                                                44

 

      sides of the issue separate, that is, what falls

 

      within the category of the definition and where

 

      safety issues may arise.

 

                Another category of ingredients in DSHEA

 

      is dietary substances.  We believe dietary

 

      substances is an extraordinarily broad category and

 

      must be accepted as broad.  There is a colloquy

 

      that we refer FDA to in our written comments that

 

      occurred during the passage of NLEA, not DSHEA,

 

      back in 1990 and that focuses on what might qualify

 

      as a nutritional substance.  We believe that all of

 

      the substances mentioned in that colloquy, which

 

      include enzymes, coenzyme Q-10, evening primrose

 

      oil, and various other substances, certainly fall

 

      within this category of dietary substances.

 

                The next question has to do with if

 

      something is an ingredient, is it a grandfathered

 

      ingredient?  In order to be grandfathered, there

 

      are three criteria that must be met:  the

 

      ingredient must have been on the market in a

 

      dietary supplement; it must have been on the market

 

      in the U.S.; and it must have been on the market

 

                                                                45

 

      prior to October 15, 1994.

 

                The vast majority of dietary supplements

 

      on the market currently contain grandfathered

 

      ingredients, and there is no suggestion in the law

 

      itself that there are any circumstances under which

 

      an old ingredient would become a new ingredient.

 

      This is something that is going to require

 

      considerable discussion within FDA, within our

 

      various associations, and among us all during this

 

      period of comment that we have available to us.  We

 

      have discovered in our various conference calls

 

      leading up to this meeting that we don't

 

      necessarily have agreement within our association

 

      about the breadth of what might be grandfathered

 

      and whether there are conditions under which an old

 

      ingredient might become a new ingredient.  So this

 

      will be, I am sure, a fertile field for further

 

      discussion as we move forward here, and it's

 

      another reason why we did join with AHPA and NNFA

 

      and other associations in requesting an extension

 

      of the comment period.

 

                Another issue I'd like to raise is that in

 

                                                                46

 

      some of FDA's recent enforcement actions, warning

 

      letters, FDA has taken the position that certain

 

      ingredients were not grandfathered because they

 

      were not legally marketed before 1994.  The term

 

      "legally marketed" does not appear in DSHEA, and we

 

      do not believe that necessarily legal marketing is

 

      a criteria for what is grandfathered, and I want to

 

      give you three examples of why that might be the

 

      case.

 

                The first two involve the essential trace

 

      minerals selenium and chromium.  On several

 

      occasions during the decades prior to the passage

 

      of DSHEA, FDA took the position that selenium and

 

      chromium were not formally recognized as food

 

      additives and were not formally approved as GRAS

 

      substances and, therefore, were not, technically

 

      speaking, legally marketed as dietary supplement

 

      ingredients.  Nevertheless, as we know, these

 

      ingredients were commonly marketed in dietary

 

      supplements prior to DSHEA and are still commonly

 

      marketed in dietary supplements.  And, in fact, FDA

 

      has now established an RDI for both of these

 

                                                                47

 

      minerals.  Therefore, it cannot be a criterion

 

      chromium and selenium being legitimate ingredients

 

      of dietary supplements and being grandfathered that

 

      FDA should have viewed them to be legally marketed

 

      prior to DSHEA.

 

                Another example is amino acids.  Under FDA

 

      food additive regulations, there were very limited

 

      conditions under which amino acids could be added

 

      to conventional foods, and technically FDA viewed

 

      them as not being legal ingredients in dietary

 

      supplements.  Nevertheless, they were widely

 

      markets as dietary supplements and still are and,

 

      in fact, now have their own subcategory in the

 

      definition of dietary supplements.  Therefore, we

 

      believe this is another illustration that

 

      grandfathering cannot be denied based on a narrow

 

      interpretation of whether an ingredient was legally

 

      marketed prior to DSHEA.

 

                In these comments today, CRN is going to

 

      focus really on some very broad issues and not

 

      delve into most of the detailed questions that FDA

 

      presented in the Federal Register notice, although

 

                                                                48

 

      we will certainly do that before the end of this

 

      process.

 

                In describing the information that should

 

      be provided in a new ingredient notification, we're

 

      going to skip over most of those questions, but we

 

      are going to indicate that one of the concerns that

 

      has come through loud and clear from our members is

 

      that FDA should be aware that much of the information they

 

      have requested, particularly regarding

 

      processing, may be proprietary information.  And as

 

      we move forward, there will be a need to assure

 

      that proprietary information can be protected.

 

                In addition to requesting information

 

      about the dietary ingredient, FDA requests certain

 

      information regarding the dietary supplement, and

 

      we believe this is entirely appropriate.  DSHEA

 

      refers to the new ingredient notification needing

 

      to provide information on the basis of which the

 

      dietary supplement itself can be expected to be

 

      safe.  However, as one small part of this section,

 

      FDA asks the question whether a label should be

 

      required to be submitted at this point.  We would

 

                                                                49

 

      simply note that in many cases the dietary

 

      ingredient notification is filed by the ingredient

 

      supplier or by a manufacturer during a pre-launch

 

      phase of development of the product, and a label

 

      simply may not be available at that point, so we do

 

      not believe submission of a label should be a

 

      critical part of that process.

 

                Really the core question facing all of us

 

      here and the core question that will need to be

 

      resolved before the end of this process is:  What

 

      type of information should be included in an NDI

 

      notification in order to establish a reasonable

 

      expectation of safety?  FDA has outlined a number

 

      of questions that are very good questions that

 

      should be considered by every company submitting an

 

      NDI notification.  However, we do not believe that

 

      the questions posed should be viewed as an absolute

 

      requirement or an outline for the information that

 

      must be submitted in a notification.  We believe it

 

      really goes beyond what we see as the intent of

 

      DSHEA in establishing this notification process.

 

                In particular, members of our association

 

                                                                50

 

      who are very familiar with food additive petitions

 

      look at this list of questions and they see

 

      something very similar to a "Red Book" list of what

 

      must be submitted for a food additive.  Members of

 

      our association who are on the pharmaceutical side

 

      look at this list and they see great similarity to

 

      what might be required for an NDA filing.  And we

 

      do not believe either the food additive model or

 

      the NDA model was intended to be the basis for

 

      describing what needs to be included in a new

 

      ingredient notification.

 

                We would request, as we move forward with

 

      defining what does need to be included, that FDA

 

      express its openness to consultation with companies

 

      who are considering an NDI notification in order to

 

      help them direct their information in such a way

 

      that the NDI notification will include the

 

      information FDA expects to see and that the company

 

      can improve its chances of having the NDI

 

      notification accepted.

 

                Some FDA personnel in the last little

 

      while here, the last month or so, have made

 

                                                                51

 

      presentations in which they have indicated that

 

      they really see no difference in the standard of

 

      safety that is described in DSHEA and the standard

 

      of safety that is expressed for food additives.  We

 

      cannot agree with this assumption because we

 

      believe that when Congress wrote DSHEA, it

 

      certainly was aware of the standards of safety that

 

      are set for food additives, and it chose to

 

      establish a different statement.  It indicated that

 

      new ingredients should be reasonably expected to be

 

      safe.  Furthermore, in terms of the process, it did

 

      not permit or require FDA to actually approve an

 

      NDI; that is, there is no formal approval of the

 

      NDI from FDA once the document is submitted.

 

                What is required is that the manufacturer

 

      or distributor should have in its holdings and

 

      should submit to FDA sufficient information to

 

      support the manufacturer's determination that the

 

      ingredient and the product are reasonably expected

 

      to be safe.  We believe those are significant

 

      differences from the food additive model and that

 

      FDA should clearly incorporate those aspects into

 

                                                                52

 

      their consideration.

 

                There are other models than the classic

 

      food additive model that we believe bear

 

      consideration here as FDA looks for a model on

 

      which to base the new ingredient notifications.  In

 

      particular, the GRAS self-determination process we

 

      believe is an extremely effective and flexible

 

      process.  I don't know what's happening to my--it

 

      looks fine right here on this screen.  I don't know

 

      what's happening up there.  We believe the GRAS

 

      self-determination process is an example of a

 

      highly effective and flexible process which allows

 

      manufacturers to make a determination of safety,

 

      relying heavily on the input of experts or

 

      committees of experts to help them make that

 

      determination and to help respond to any questions

 

      FDA may have.

 

                There are other programs that might be

 

      considered.  For example, the EPA has a program

 

      that it puts new chemicals through when it approves

 

      new chemicals for introduction into the

 

      environment, which involves a functional analysis,

 

                                                                53

 

      a functional safety analysis--a structure activity

 

      analysis, is what I'm trying to say, of the

 

      compound as it relates to other compounds in the

 

      same class.  And we think this might have some

 

      relevance to FDA's review as it pertains to new

 

      ingredients that are single chemicals.

 

                Likewise, Canada's Natural Health Products

 

      Directorate has recently--is just this year

 

      implementing a whole new program of review,

 

      including protocols for safety evaluation of

 

      natural health products, and we believe there may

 

      be some elements of this that would be relevant to

 

      this program.

 

                FDA itself has adopted on occasion other

 

      methods than the food additive method for looking

 

      at safety of various ingredients in evaluating

 

      health claims for psyllium and stanol and sterol

 

      esters.  FDA found that those ingredients did not

 

      have official regulatory status at the time the

 

      health claim was evaluated and required the

 

      companies to submit certain additional information

 

      on the safety of those ingredients, and we think

 

                                                                54

 

      the nature of those submissions may be relevant to

 

      this process.

 

                Finally, FDA's guidance on new plant

 

      varieties produced through biotechnology also

 

      relies heavily on manufacturer determination of

 

      safety and on comparability to existing plant

 

      varieties with a minimal or no reliance on actual

 

      clinical testing to go along with that.

 

                FDA addresses the need for definition of

 

      certain other terms that appear in DSHEA, and we

 

      will reiterate here the same point that we made

 

      with regard to dietary ingredients.  All of the

 

      terms should be understood broadly and literally,

 

      terms such as extract, constituent, metabolite, and

 

      the issues having to do with safety or other

 

      considerations that arise because of the breadth of

 

      some of those definitions we believe should be

 

      dealt with directly and separately and not used as

 

      reasons for restricting the definition itself.

 

                We do endorse the seven recommendations

 

      FDA made in the Federal Register notice for

 

      improving the format and content of notifications,

 

                                                                55

 

      and we will be addressing those in more detail in

 

      further iterations of our comments on this issue.

 

                Finally, we congratulate FDA for

 

      undertaking this initiative and also for fully

 

      involving all stakeholders, which we believe is

 

      critical to the successful outcome of this

 

      discussion.  And we look forward to future

 

      opportunities to work with FDA to improve the

 

      confidence with which consumers, regulators, and

 

      legislators can view this product category.

 

                Thank you very much for this opportunity.

 

                [Applause.]

 

                DR. FRANKOS:  Any questions?

 

                [No response.]

 

                DR. FRANKOS:  Annette, I have one

 

      question.  With respect to using a GRAS

 

      self-determination process, how would you see that

 

      fitting into the NDI notification process?

 

                DR. DICKINSON:  I would see that fitting

 

      in in a way similar to the current GRAS

 

      self-determination process where a company may

 

      submit their determination to FDA and request

 

                                                                56

 

      listing of that GRAS notification.  In that process

 

      also, FDA does not formally approve the GRAS

 

      ingredient, but simply arrives at a point where it

 

      has no further questions.  But the company would

 

      ahead of time do its analysis of the safety,

 

      including relevant involvement of experts.

 

                DR. FRANKOS:  Thank you.

 

                Okay.  Our next speaker is David Seckman,

 

      and he is Executive Director and CEO of the

 

      National Nutritional Foods Association.

 

                MR. SECKMAN:  I'm David Seckman, Executive

 

      Director and CEO of the National Nutritional Foods

 

      Association.  NNFA was founded in 1936 and is the

 

      oldest and largest trade association in the natural

 

      products industry.  We represent the interests of

 

      more than 8,000 retailers, manufacturers,

 

      suppliers, and distributors of health foods,

 

      dietary supplements, and related items.  I

 

      appreciate being able to submit this testimony in

 

      response to the FDA's request for input on

 

      pre-market notification for new dietary

 

      ingredients.  And I think I'm glad I didn't have

 

                                                                57

 

      slides today.

 

                [Laughter.]

 

                MR. SECKMAN:  Just kidding.

 

                NNFA has consistently supported FDA's

 

      ability and efforts to enforce the Dietary

 

      Supplement Health and Education Act of 1994 and to

 

      ensure that dietary supplements continue to be

 

      safe.  In fact, in May of 2002, we submitted

 

      comments to FDA suggesting ways for FDA to enhance

 

      the quality, utility, and clarity of the pre-market

 

      notification requirements for a new dietary

 

      ingredient under Section 413.  We continue to

 

      believe that FDA could use public comments on

 

      Section 413 to provide the industry with much

 

      needed guidance on NDI submissions.  Of course, any

 

      guidance will apply to any company putting dietary

 

      ingredients on the market, whether they be the

 

      manufacturers of finished products or raw

 

      ingredient suppliers who need to guarantee safety

 

      to their customers.

 

                What everyone in the industry needs is

 

      clear guidance.  Specifically, NNFA believes that,

 

                                                                58

 

      as written, Section 413 is unclear both as to when

 

      a new dietary ingredient notification is required

 

      and the type of information to be included if a

 

      pre-market notification is filed.  In light of

 

      FDA's November 4th publication of its major

 

      initiatives for dietary supplements, NNFA

 

      specifically urges FDA to use caution in enforcing

 

      on NDI issues before it offers clarification to

 

      industry as to when a pre-market submission is

 

      required.  Although NNFA will be commenting in more

 

      detail later, the following are a couple of key

 

      issues and comments that we think that need to be

 

      addressed in the guidance.

 

                Our first issue concerns the not

 

      chemically altered exemption.  According to Section

 

      413, a dietary supplement containing an NDI is not

 

      adulterated if the dietary supplement contains only

 

      dietary ingredients which have been presented in

 

      the food supply as an article used for food in the

 

      form in which the food has not been chemically

 

      altered.  Thus, the chemically unaltered

 

      ingredients from the food supply does not require

 

                                                                59

 

      NDI filings to be made before being used in a

 

      dietary supplement.

 

                The legislative history of DSHEA offers a

 

      small bit of clarification of what is meant by

 

      chemically altered, and I quote:  "The term

 

      `chemically altered' does not include the following

 

      physical modifications:  minor loss of volatile

 

      components, dehydration, lyophilization, milling,

 

      tincture or solution in water, slurry powder, or

 

      solid in suspension."  Clearly, many forms of

 

      processing have been left off this list, and FDA

 

      has not offered industry guidance of how to

 

      determine whether a process would or would not be

 

      considered chemically altered.

 

                NNFA takes the position that a dietary

 

      ingredient should fall within its not chemically

 

      altered exemption as long as the resulting dietary

 

      ingredient is found in nature.  Supplements are a

 

      subset of food.  They need to be regulated

 

      accordingly.  If it can be shown that an ingredient

 

      either is a single entity or complex, can be found

 

      in our diets, and there is no evidence of ill

 

                                                                60

 

      effects, that ingredient should be allowed for

 

      sale.  Moreover, FDA should not assume that changes

 

      in the processing or formulation always result in a

 

      change in the chemical structure that would require

 

      an NDA filing.  Such an interpretation is

 

      consistent with the intent of Section 413 in that

 

      it would require exempt entities which known safety

 

      records based on food usage from the NDA pre-market

 

      submission requirement.

 

                Our next concern in regard to Section 413

 

      is the lack of clarification as to whether

 

      components of food, such as the lycopene found in

 

      tomatoes are subject to the pre-market notification

 

      requirement.  NNFA takes the position that

 

      components would also be subject to the not

 

      chemically altered exemption in Section 413(a)(1);

 

      thus, if the extraction method used to isolate

 

      components does not results in the chemical

 

      alteration of the component, the component should

 

      be exempt from the NDA filing requirement.

 

      Moreover, the 413 exemption should extend to the

 

      components to the components that are chemically

 

                                                                61

 

      altered during the extraction process but are in a

 

      form that is found in nature.  Such components,

 

      again, have been proven safe within the food

 

      supply.

 

                NNFA's next concern is in regard to how

 

      the NDI substance should be chemically identified,

 

      an issue FDA raised in numerous questions about it

 

      in the Federal Register notice.  NNFA takes the

 

      position that chemical identifications of a

 

      substance must reflect the level of variation of

 

      the substance that is found in nature.  For

 

      example, botanical ingredients vary in composition

 

      depending on where in the world they are grown.

 

      Certainly the agency would not require an NDI

 

      notification for each region unless there are

 

      significant differences that result in a safety

 

      issue.  In addition, other ingredients may vary as

 

      percentage of certain confirmations.  Again,

 

      however, this level of differences should not

 

      trigger the new NDI requirements as long as the

 

      variation reflects that which is found in nature.

 

                Next I would like to comment on the type

 

                                                                62

 

      of information about a dietary supplement product

 

      that should be included in the NDI notification.

 

      NNFA has some specific concerns about conditions of

 

      use and labeling as put forth by the FDA in its

 

      notice.  NNFA would like to point out that when the

 

      agency raises such questions, it blurs the line

 

      between an NDI and a dietary supplement product as

 

      a whole.  FDA should not be concerned with how an

 

      ingredient was used unless it was previously used

 

      as a drug, which raises other sections of DSHEA or

 

      how it was labeled.  This information does not go

 

      to the safety of the dietary ingredient and should

 

      not alter the review process as to whether a

 

      specific dietary ingredient is safe for use.

 

                My final comments have to do with

 

      establishing a reasonable expectation of safety.

 

      FDA raises the question of what quality and

 

      quantity of data and information are needed to

 

      establish a reasonable expectation of safety based

 

      upon the history of use.  NNFA takes the position

 

      that FDA should establish clear parameters

 

      regarding what kinds of evidence would sufficiently

 

                                                                63

 

      demonstrate reasonable evidence of safety.

 

      However, NNFA cautions that FDA's guidelines should

 

      not be so rigid so as to establish inflexible

 

      requirements.  The kinds of data available for

 

      dietary ingredients vary widely, from very long

 

      documented history of use to clinical studies to

 

      observational reviews.  The kinds of data available

 

      may also change over time.  NNFA is concerned that

 

      the NDA process, along with the FDA's recently

 

      issued initiatives, does not become a mechanism to

 

      stifle or halt NDI submissions by presenting an

 

      almost insurmountable barrier for acceptance.  To

 

      adequately reflect this reality, FDA should

 

      continuously exercise flexibility in the types of

 

      evidence required, for example, where an NDI does

 

      not have a long history of consumption by human,

 

      such as novel extractions of grandfathered

 

      botanicals.  Moreover, an NDI that is an extract

 

      from an old dietary ingredient and is significantly

 

      similar to the old dietary ingredient might require

 

      less safety data than a new one.  To respond

 

      otherwise would result in the stifling of research

 

                                                                64

 

      and development for the use ingredients.

 

                FDA also raises questions about what

 

      quality and quantity of data and information are

 

      needed and to establish a reasonable expectation of

 

      safety based upon information other than a history

 

      of use.  Here, NNFA would simply like to point out

 

      that while a certain amount of scientific evidence

 

      is certainly necessary to establish safety, the

 

      burden should not be so high as to mirror a drug

 

      safety review. NNFA submits that information to

 

      establish a reasonable expectation of safety should

 

      suffice.  This may include animal and in vitro

 

      studies conducted in an appropriate model or other

 

      test.

 

                Finally, the FDA specifically questioned

 

      what types of documentations are necessary to

 

      establish that an ingredient was marketed in the

 

      U.S. before October 15, 1994, and thus

 

      grandfathered.  NNFA and other industry groups in

 

      1994 took the lead in developing lists that

 

      reflected products marketed prior to that year.

 

      Those lists have been relied on by industry, by

 

                                                                65

 

      industry lawyers, consultants, and presumably even

 

      the FDA.  NNFA submits that they have achieved

 

      authoritative status and should continue to be

 

      available to be relied upon for confirming

 

      grandfather status.  I'd also like to point out

 

      that if an ingredient does not appear on one of

 

      these lists, it may also be grandfathered if there

 

      is evidence of marketability prior to October 1994.

 

      Examples of such evidence may include human

 

      studies, product advertisement, product catalogues,

 

      order forms, and invoices.

 

                Again, in closing, I'd like to thank the

 

      FDA for the opportunity to comment on the NDI

 

      process.

 

                DR. FRANKOS:  Thank you.

 

                Any questions?  Jason?

 

                PARTICIPANT:  [inaudible, off microphone]

 

      variation in nature.  Does that mean just in one

 

      species or parts or portions of the plant or

 

      [inaudible]?

 

                DR. FRANKOS:  Can you repeat the question,

 

      please?  Or go to a mike, yes.

 

                                                                66

 

                MR. SECKMAN:  You want clarification of

 

      what--

 

                PARTICIPANT:  Clarification to variation

 

      in nature, extending to just the different growing

 

      conditions you might find in botanicals, or

 

      different portions of the plants being used?

 

                MR. SECKMAN:  Both.

 

                DR. FRANKOS:  Any other questions?

 

                PARTICIPANT:  How did you postulate human

 

      studies that may have been done on an ingredient

 

      prior to October of '94 would constitute reason for

 

      those ingredients to be grandfathered in?

 

      [inaudible] on ingredients never led to or related

 

      to those ingredients being sold in the marketplace?

 

                MR. SECKMAN:  Did everybody hear the

 

      question?

 

                DR. FRANKOS:  No.  I think paraphrase it.

 

                MR. SECKMAN:  Studies done on humans

 

      before 1994, is what your question really was, how

 

      does it relate to the new dietary ingredients for

 

      the new dietary ingredient requirements?

 

                PARTICIPANT:  Right.  I asked [inaudible].

 

                                                                67

 

                DR. FRANKOS:  Mike, please.

 

                PARTICIPANT:  Okay.  I asked you how is it

 

      that you could postulate that human studies or

 

      studies--you know, clinical trials perhaps, done

 

      prior to October of '94 on certain dietary

 

      supplements or ingredients should be equivalent to

 

      those ingredients being grandfathered in if those

 

      ingredients were never sold on the marketplace?

 

                MR. SECKMAN:  I mean, there are valid

 

      studies that were done prior to.  They just haven't

 

      been used in the filing of the new dietary

 

      ingredient.  I think you can make a fair argument

 

      to that sense and be able to file it based on that

 

      information.  I think that should be able to be

 

      used.

 

                PARTICIPANT:  Will the person who just

 

      asked the question identify himself, please?

 

                MR. KALMAN:  The person that asked the

 

      question was Douglas Kalman from Miami Research

 

      Associates.

 

                DR. FRANKOS:  Any other questions?

 

                [No response.]

 

                                                                68

 

                DR. FRANKOS:  Okay.  We're on time,

 

      actually a little early.  I think we could just go

 

      right into a 15-minute break and then start again.

 

      I would like to point out that the next speakers

 

      can go to a breakout room during the break and

 

      prepare their slides.  There's a room set up.  I

 

      don't know what room it is, but it's next door to

 

      the auditorium.

 

                PARTICIPANT:  1A-001.

 

                DR. FRANKOS:  1A-001.

 

                [Recess.]

 

                DR. FRANKOS:  We're having some

 

      audiovisual problems, so I'd like it if everybody

 

      could come back together, we'll have Alan Feldstein

 

      give an oral presentation, so he is the slides, and

 

      so we can start, and hopefully they'll get the

 

      audiovisual stuff together shortly.

 

                And one other thing:  There is overflow in

 

      Room 1A-001, if there are not enough seats or if

 

      anybody is feeling hot, there is a room that has

 

      been set up, and there is an audiovisual connection

 

      in that room as well.  So there are also chairs

 

                                                                69

 

      that are open down here at the bottom, up front.

 

                I think we will start then with Alan

 

      Feldstein.  He is counsel with Collins, McDonald &

 

      Gann.  Alan, I think they're working there.  Maybe

 

      you could sit here.

 

                MR. FELDSTEIN:  Sure, that would be fine.

 

                Good morning.  Can everybody hear me okay?

 

      Great.  Collins, McDonald & Gann is a law firm

 

      located in the State of New York that represents

 

      manufacturers, distributors, marketers, and

 

      individuals in the sports and fitness supplement

 

      industry.  Again, my name is Alan Feldstein, and I

 

      am your slides today.  And with me is my colleague

 

      Richard Collins, principal of the firm; I'm of

 

      counsel of the firm.

 

                Again, as everyone has said, we appreciate

 

      the opportunity to share our thoughts, and we

 

      welcome the opportunity to present our comments on

 

      this matter, which is of great importance not only

 

      to our clients but to the segment of the industry

 

      we represent as a whole.

 

                We have reviewed the Federal Register

 

                                                                70

 

      notice of this meeting, and we have also read with

 

      great interest the recent Guidance for Industry on

 

      Substantiation for Dietary Supplement Claims, as

 

      well as Dr. Crawford's recent statements before the

 

      Council for Responsible Nutrition.  And while

 

      today's meeting is on the topic of new dietary

 

      ingredients and the 75-day pre-market notification

 

      process rather than substantiation of label claims,

 

      our comments address a fundamental issue that is

 

      relevant to both topics.  And that issue is the

 

      perception--and I underline that, the

 

      perception--that both FDA and the sports and

 

      fitness supplement industry have of each other and

 

      how that perception impacts the actions,

 

      philosophies, and attitudes of both sides.

 

                One of the threshold questions that

 

      remains a mystery is, Under what circumstances must

 

      a pre-market notification be filed?  According to

 

      the Overview of Dietary Supplements posted on

 

      January 3, 2001, on FDA's website, DSHEA "requires

 

      that a manufacturer or distributor notify FDA if it

 

      intends to market a new dietary supplement in the

 

                                                                71

 

      United States that contains a `new dietary

 

      ingredient.'"  However, the law appears to say

 

      something a bit differently.

 

                DSHEA actually says that a District which

 

      contains a new dietary ingredient shall be deemed

 

      adulterated unless it meets one of two criteria.

 

      One of those criteria is the submission of a proper

 

      pre-market NDI notification 75 days before

 

      marketing the product.  The other, however, is that

 

      the dietary supplement "contains only dietary

 

      ingredients which have been present in the food

 

      supply as an article used for food in a form in

 

      which the food has not been chemically altered."

 

                Industry has widely interpreted this

 

      language to require pre-market notice only if the

 

      product's new dietary ingredients are not present,

 

      unaltered, in the food supply.  In fact, many

 

      manufacturers have chosen to decline to submit

 

      pre-market notice based upon their belief that

 

      their products comply with this provision under

 

      DSHEA, and it appears that in ten years, FDA has

 

      never taken an action under this provision with

 

                                                                72

 

      respect to a single product other than the recent

 

      action involving androstenedione.  If FDA has an

 

      alternative interpretation of the statute, it has

 

      never explained that to industry, and that is an

 

      example of the problem--a classic failure of

 

      communication which escalates distrust on both

 

      sides.

 

                Further, in situations where all sides

 

      agree that pre-market notice is required, what sort

 

      of safety data does FDA require?  One only has to

 

      look at FDA's website on new dietary ingredients to

 

      understand the communication problem.  If you look

 

      at the FDA website to obtain guidance on

 

      information that the agency requires to approve or

 

      at least not object to a pre-market NDI

 

      notification, you will find this language:  "To

 

      date, we have not published guidance defining the

 

      specific information that the submission must

 

      contain.  Thus, you are responsible for determining

 

      what information provides the basis for your

 

      conclusion."

 

                And while I appreciate that the meeting

 

                                                                73

 

      today is the start, that is another example of the

 

      communication problem that I think persists today.

 

                The law states that new dietary

 

      ingredients which are not in the food supply can be

 

      introduced when there is a history of use or other

 

      evidence of safety establishing that the dietary

 

      ingredient, when used under conditions recommended

 

      or suggested in the labeling of the dietary

 

      supplement, will be reasonably expected to be safe.

 

      Despite pronouncements otherwise, the law does not

 

      state that there should be a risk/benefit analysis,

 

      as was done with ephedra.  It does not suggest a

 

      requirement of zero risk, as an FDA working group

 

      was asked to determine.  The process should not be

 

      a roundabout way of allowing the agency to say no,

 

      as is perceived by many of our clients.  If the NDI

 

      process is to work within the parameters of DSHEA,

 

      then we would submit that the following steps need

 

      to be taken:

 

                Any guidelines that are propounded by FDA,

 

      and actions undertaken by FDA, must adhere to a

 

      reasonableness standard, as was intended by

 

                                                                74

 

      Congress.

 

                And, equally important, the standards must

 

      be applied in a transparent and reasonable manner

 

      with specific guidelines.  In other words, we

 

      believe that if you submit the proper materials,

 

      your ingredient will be either approved or not

 

      objected to.

 

                In addition to these specific steps, it is

 

      our sincere hope that our comments today and this

 

      meeting today will also be the beginning of a

 

      dialogue to help change perceptions that exist

 

      about FDA's attitudes towards supplements.  The

 

      debate here today is not whether or not there is a

 

      negative bias by FDA but, rather, again, the

 

      perception that such a bias exists and the

 

      perception that there is no one within the agency

 

      that is an advocate or supporter of the industry.

 

      We believe many of the issues raised by FDA for

 

      this meeting and in recent draft guidance documents

 

      on substantiation can be resolved with improved

 

      cooperation and communication.

 

                In speaking with our clients and other

 

                                                                75

 

      members of the sports and fitness supplement

 

      industry, there is a sense of mistrust or that the

 

      process is stacked against anyone who wishes to

 

      file a pre-market notification.  That is not true,

 

      you might hear people within the agency say.  And

 

      you may be right.  But if you were to poll our

 

      clients and others in the industry, you would find

 

      that the perception exists.  Why does it?  For a

 

      moment I ask you to put yourself in the shoes of a

 

      company in the sports and fitness supplement

 

      industry.  Here are some of the things you have

 

      seen in the last ten years:

 

                You have witnessed the publicizing of a

 

      group of anecdotal adverse event reports in such a

 

      manner as to give the impression that they

 

      conclusively support a claim that dietary

 

      supplements containing ephedra are dangerous.  You

 

      then learn that the GAO in 1999 in its report

 

      concluded that FDA failed to establish that the

 

      proposed rule would have any public health benefit

 

      and that FDA did not establish that there was, or

 

      is, the need of any regulation.  Now, one may argue

 

                                                                76

 

      that this is old news and FDA was eventually right

 

      in banning the product, but since then the same

 

      issue arose with respect to Kava, and as recently

 

      as several months ago FDA was criticized by the

 

      American Herbal Products Association on AERs

 

      involving bitter orange.  AHPA was quoted as

 

      stating FDA is willing to regulate by anonymous

 

      press release and be cavalier in its approach to

 

      informing the public about the safety profile of

 

      bitter orange.  And while there have been

 

      announcements recently of a change in this policy,

 

      it is these cumulative actions that contribute to

 

      industry's perception.

 

                Number two, you are viewing FDA's newly

 

      heightened attention toward dietary supplements

 

      from a historical perspective dating back to a

 

      period before DSHEA, when legislators and federal

 

      judges were expressing concerns over FDA's

 

      activities against dietary supplements.  For

 

      example, a Senate committee found FDA was

 

      "distorting the law" to prevent safe supplements

 

      from being marketed, and a federal judge, in

 

                                                                77

 

      adjudicating a seizure action by FDA of

 

      encapsulated black currant oil, chided FDA for

 

      engaging in an "Alice in Wonderland approach" to

 

      make an end run around the statutory scheme.

 

                You have also seen androstenedione sold

 

      openly as a dietary supplement for many years, then

 

      suddenly removed from the market not only for

 

      safety reasons but for failure to file a pre-market

 

      NDI notification.  Industry is suspicious of FDA's

 

      claim of safety because of the long delay.  And

 

      even more puzzling is FDA's claim that it was not

 

      aware of evidence that the compound is present in

 

      the food supply.  Studies have confirmed its

 

      presence in meat.  The literature is there.

 

                And, finally, as an example that has just

 

      recently occurred with one of our clients, you are

 

      a company that obeys the laws and has ceased

 

      selling ephedra in the United States.  Further,

 

      you've complied with all the procedures necessary

 

      to permit you to sell your product overseas to a

 

      country that permits the sale of ephedra.  Yet

 

      despite this fact, you are visited no less than

 

                                                                78

 

      three times over a period of two weeks by FDA field

 

      inspectors who continually are looking for a way to

 

      prohibit you from selling your product overseas.

 

                Thus, from our client's perspective, they

 

      have seen FDA take actions that they believe were

 

      not based on science, and when they ask what are

 

      the rules that they have to play by, they are told

 

      there is no guidance for determining what

 

      information needs to be provided.  Or if they play

 

      by the rules, they still encounter resistance.

 

      This fosters a climate where many people believe

 

      that no matter what is submitted, you will not get

 

      a fair hearing.  Some industry representatives have

 

      told us that they believe that virtually all NDI

 

      notifications submitted in the past year have been

 

      rejected.  That perception creates an atmosphere

 

      fostering noncompliance with the law in which no

 

      one benefits.

 

                Recently, Dr. Crawford echoed these

 

      sentiments when he stated that the agency in the

 

      past had said "we are going to enforce the law, but

 

      you are going to have to guess what the standards

 

                                                                79

 

      are."  We admire Dr. Crawford's candor, and he

 

      zeros in on the exact kind of atmosphere fostering

 

      this perception.  Our industry members are

 

      concerned because of the perception that the

 

      rulemakers are biased against them.  The question

 

      being asked by them is:  "Are these guidelines and

 

      proposed rules being drafted in the spirit of DSHEA

 

      or in the spirit of pushing the industry to a

 

      pre-market approval drug model?"

 

                The latter would be detrimental to the

 

      American public.  The economic, technological, and

 

      innovative advances which have guided this country

 

      and made it a leader happen when the framework of

 

      the rules are clearly set, while at the same time

 

      there is cooperation between industry and the

 

      government agencies that regulate them, allowing

 

      ample room for innovation.  Given our growing

 

      health crisis, FDA should be encouraging, not

 

      discouraging, innovation within a framework of

 

      safety.

 

                Therefore, in addition to our specific

 

      proposals about NDIs, we would ask that FDA give

 

                                                                80

 

      serious considerations to three other proposals

 

      that we believe will go a long way in improving its

 

      relationship with the sports and fitness supplement

 

      industry in general:

 

                It must, in a meaningful way, create lines

 

      of communication with all segments of the industry

 

      to better understand the different segments of the

 

      industry and their needs and desires;

 

                It should take steps to communicate with

 

      and learn about the segment of the American

 

      population that uses sports and fitness nutritional

 

      supplement products so that it can create and

 

      implement its policies and procedures in a manner

 

      consistent with the public that is serves;

 

                And, finally, we'd also recommend strongly

 

      that FDA have an ombudsman within CFSAN, as it does

 

      with many other industries that it regulates.  This

 

      would be someone who will investigate complaints

 

      from outside FDA and facilitate the resolution of

 

      disputes between CFSAN and the industry it

 

      regulates.  Having someone who can help with

 

      communication between industry and CFSAN will go a

 

                                                                81

 

      long way toward achieving a balance between the

 

      need to keep Americans safe and the right of

 

      Americans to make their own health decisions about

 

      dietary supplements.

 

                Until there is better cooperation and

 

      communication between FDA and industry and until

 

      there are people within the agency who support the

 

      use of supplements, we believe this will continue

 

      to be a problem.  To begin to solve the problem,

 

      there needs to be an effort to change the

 

      perception that exists.  And in any relationship,

 

      there's always somebody who has to take the first

 

      step, and I would ask that FDA be the one that

 

      takes that first step.

 

                Thank you very much.

 

                DR. FRANKOS:  Any questions?

 

                [No response.]

 

                DR. FRANKOS:  Okay.  Now, our next speaker

 

      is George Burdock, President of the Burdock Group,

 

      and, George, you can sit here and then she can

 

      change your slides, or stand there and she can

 

      change your slides.

 

                                                                82

 

                DR. BURDOCK:  Good morning.  Thank you for

 

      the opportunity to allow me to speak to you on this

 

      very important subject.  My name is George Burdock.

 

      I am a toxicologist and consult in the food

 

      ingredients and dietary supplements business.  My

 

      company has offices in Florida and Washington, D.C.

 

      My contact information is available at my website

 

      appearing at the bottom of each slide or overhead

 

      here, and if you would like a copy of these slides

 

      in living color, please come to my website and

 

      request one, and we'll be glad to send you one.

 

      Because it is not in color, any refunds for

 

      admission will have to be coordinated through Mr.

 

      Frankos.

 

                I would like to address today the dietary

 

      supplement issue as a whole, to include review,

 

      safety, and claims; that is, the claim as to

 

      supplement or nutritional status and possible

 

      structure/function claims, which I refer to in this

 

      talk as efficacy claims.

 

                I am concerned that in response to what

 

      may seem to be a crisis, FDA may be persuaded to

 

                                                                83

 

      take an overly conservative path which may place

 

      safe and efficacious dietary supplements out of the

 

      reach of consumers.  This raising of the bar will

 

      almost certainly result in an underground/unregulated market

 

      populated by charlatans, with spurious

 

      claims of potentially unsafe products.  I believe

 

      an overly conservative path is supported by several

 

      diverse groups, many of which share our sincere

 

      belief that the public deserves a safe and

 

      efficacious product.  There are others, however,

 

      whose goal is not as sincere, and among these the

 

      most zealous supporters of an overly conservative

 

      pathway are those that will gain most financially,

 

      the charlatans of the underground market.

 

                The dietary supplement market is a

 

      strongly consumer-driven market, and the public has

 

      long demonstrated a profound willingness to obtain

 

      benefit from substances outside of mainstream drugs

 

      or food.  There are many driving forces behind this

 

      demand, and they included a demand for improvements

 

      in the quality of life, a lionizing of natural

 

      remedies, and a reaction to the high cost of drugs.

 

                                                                84

 

      A strong consumer market encourages enterprise,

 

      investment, and competition within the supplier

 

      community, as long as there is adequate return on

 

      investment.

 

                The wants and needs of the various players

 

      have created tension.  This tension begs for

 

      resolution.  In this graphic, consumers, industry,

 

      and the agency are depicted as the intersections of

 

      a triangle, each with examples of driving forces

 

      between the two.  In this graphic, the relationship

 

      between industry and the consumer is depicted by

 

      consumer demand on the one hand and the need by

 

      industry for a return on investment.  Between

 

      industry and the agency is a demand by industry to

 

      exercise its freedom of speech, and the response by

 

      the agency that only efficacious products may be

 

      marketed.  Between the consumer and the agency, I

 

      have shown a demand for greater access to fulfill

 

      the wants and needs described earlier by consumers,

 

      or of consumers, and the pushback from the agency

 

      that only safe products should be allowed in the

 

      marketplace.

 

                                                                85

 

                The tension demonstrated in the graphic

 

      sets the stage for a possible response by the

 

      consumer; that is, if an overly conservative

 

      pathway is taken by the agency, it will affirm the

 

      beliefs of many who preach there is a conspiracy to

 

      keep inexpensive natural substances off the market

 

      by "big pharma" and by regulators.  And it will

 

      also give affirmation to those who want to believe

 

      that we are all witless incompetents that ignore

 

      the lessons of our forebears about the natural

 

      remedies of "Mother Earth."  Setting the bar too

 

      high will ultimately result in the loss of our

 

      credibility and the faith of the consumer.

 

                The last time the bar was raised and

 

      threatened to cut off the source for consumer

 

      satisfaction resulted in the passage of DSHEA,

 

      which was meant as a safety valve to ease the

 

      tension between the public and what was seen as an

 

      overregulation by the agency.  Locking down this

 

      safety valve with an overly conservative response

 

      will cause consumers to lose faith in the very

 

      agency responsible for their protection, and with

 

                                                                86

 

      the aid of the Internet, give rise to an

 

      underground, uncontrolled, unsafe wild, wild West

 

      of a marketplace.

 

                Maintenance of the faith of the consumer

 

      is essential, but in order to achieve this goal,

 

      the agency, as the key player, needs the active

 

      involvement of industry.  Only FDA can elevate the

 

      role of industry from producer to participant, and

 

      in so doing, FDA becomes the engine for resolution.

 

      To do so, FDA must take three steps.

 

                First, the promotion and use of

 

      independent expert panels for the determination of

 

      safety and efficacy; second, initiate a

 

      notification program and post the results on the

 

      Internet so consumers will know what is safe and

 

      efficacious and debunk illegitimate or copycat

 

      products; third, provide a term of exclusivity for

 

      industry.  This period of exclusivity will allow

 

      industry an opportunity to return on investment

 

      without which there will be very little R&D and

 

      only the wild, wild West that I mentioned a few

 

      minutes ago.

 

                                                                87

 

                There is precedent for the use of

 

      independent experts, such as GRAS panels, generally

 

      recognized as safe for food ingredients; GRASE,

 

      that's generally recognized as safe and effective,

 

      for drugs; and any number of FDA advisory

 

      committees on FDA issues, including OTC drugs,

 

      dietary supplements, food ingredients, and others.

 

      The FDA fact sheet describing a strategy for

 

      dietary supplements includes a statement that

 

      third-party reviews will be permitted.  There are

 

      other examples of involvement by independent expert

 

      groups, and I implore the agency not to follow an

 

      overly conservative path as exemplified by

 

      significant scientific agreement where only

 

      institutions could approve claims.  If the

 

      precedent of SSA is followed, then something like

 

      the Health Independence Information Act will be

 

      passed, which essentially takes all authority out

 

      of the hands of the agency.

 

                The second of the three steps forward is a

 

      notification program.  There is precedent here with

 

      the GRAS notification program and the program for a

 

                                                                88

 

      new dietary ingredient.  The results are posted on

 

      the agency website, and the public would be

 

      informed about what was safe and efficacious, and

 

      retail merchants could self-police, knowing what is

 

      legitimate and what was not.  Simply put, a

 

      notification program rewards the legitimate players

 

      by letting the public know who plays by the rules

 

      and who does not.

 

                The third of the three steps forward is to

 

      allow a legitimate manufacturer a period of

 

      exclusive marketing rights.  That is the period

 

      when safety information on the product is made

 

      public, but information supporting efficacy remains

 

      embargoed by the agency.  Also, any other

 

      manufacturer wishing to sell an identical product

 

      using the same claim during the period when

 

      efficacy information is embargoed must present his

 

      own efficacy information to the agency.  While

 

      immediate release of safety information is

 

      essential, immediate release of the data supporting

 

      efficacy does not help the consumer.  It only

 

      eliminates the incentive for investment.

 

                                                                89

 

                There is precedent for embargoed

 

      information as seen with the food master files

 

      where safety information is released while

 

      manufacturing and other key information may not be.

 

      And we all know about drug master files where all

 

      information is held secret, and for the same

 

      reason:  to allow the manufacturer a reasonable

 

      period for return on investment.  Without return on

 

      investment, there is no incentive for performance

 

      of safety or efficacy studies and we are back again

 

      to the wild, wild West scenario.

 

                Without possibly jumping the gun or

 

      belaboring the issue, but to illustrate a point,

 

      consumer demand and the promise of reward motivates

 

      manufacturers to fund R&D, safety testing, and

 

      efficacy testing to support claims.

 

                The agency with the notification system

 

      can inform the manufacturer that it has no

 

      objection to the finding that the product is safe

 

      and the claim is adequately supported.

 

                Following this positive feedback from the

 

      agency, the manufacturer can crank up his

 

                                                                90

 

      marketing, manufacturing, and distribution arms to

 

      respond to consumer demand.

 

                If, however, as illustrated above where

 

      the no-objection notice has a lot of little arrows

 

      coming off of it, if this is where the no-objection

 

      notice is publicly broadcast and the information is

 

      not embargoed, then for lack of a better term,

 

      pirates can share the claims support information,

 

      and because the pirates' only expense is marketing,

 

      manufacturing, and distribution, the pirates can

 

      sell at a cheaper price and consumer dollars go to

 

      someone other than the manufacturer that paid for

 

      the R&D, safety, and efficacy testing.

 

                Therefore, there will be no return on

 

      investment.  Funding for R&D, safety testing, and

 

      efficacy testing will dry up.

 

                Now, if I haven't gotten too far ahead of

 

      myself on exclusivity, to get back to the three

 

      steps forward program, we need to examine the use

 

      of independent experts and the notification

 

      program, for both of which we are showing adequate

 

      precedent.

 

                                                                91

 

                First, in this regimen for independent

 

      expert review and FDA notification, a dossier is

 

      prepared and reviewed by a group of independent

 

      experts to determine if the information supply

 

      supports safety and a specific claim.

 

                Once approved by the experts, the dossier

 

      is then provided to the agency on a non-public

 

      basis and is reviewed by the agency within certain

 

      boundaries.  The object here is not to have the

 

      agency reinvent the wheel or take full ownership of

 

      the decision by an examination of all the data as

 

      it might do for a food additive petition, but

 

      maintain the spirit of the notification program by

 

      paying closest attention to three points:  first,

 

      the credentials of the experts.  Are these

 

      reviewers qualified by training and experience to

 

      make this sort of decision?  Secondly, is the

 

      rationale provided logical to support the claim?

 

      That is, if the evidence is narrow and specific and

 

      supports an equally narrow and specific claim,

 

      where is the claim is overly broad?  Lastly, is the

 

      supporting evidence credible?  Not all studies need

 

                                                                92

 

      to be double-blind, placebo-controlled studies, but

 

      does the information provided have adequate rigor

 

      to support the claim made?  The goal for the agency

 

      here is not to abdicate its authority but to

 

      provide oversight to ensure that legitimate experts

 

      are approving equally legitimate claims.

 

                The oversight function will also allow the

 

      agency to get along with its other work at hand and

 

      not become bogged down in the details, the very

 

      problem that plagued the GRAS affirmation process.

 

                Upon completion of its review, if the

 

      agency determines the notification is inadequate,

 

      the agency offers a description of the deficiencies

 

      and an opportunity for withdrawal of the

 

      notification.  If withdrawn, the information in the

 

      notification is not made public and the submitter

 

      has an opportunity to remedy the deficiencies

 

      without loss of the proprietary information

 

      therein.

 

                If the agency determines the opinion of

 

      the experts is sound, the agency responds to the

 

      submitter with a no-objection, followed by a public

 

                                                                93

 

      notice on the FDA website.

 

                The public notice would consist of the

 

      name of the manufacturer, the product identity, the

 

      truthful statement or claim, and the safety data.

 

      Not made public nor shared outside federal agencies

 

      for at least five years would be the efficacy data,

 

      the time and investment by the manufacturer to

 

      prove the claim, and should not be dissipated to

 

      the pirates.

 

                Again, the FDA should make public the

 

      safety information, the claim, the product name and

 

      the manufacturer.  The evidence for a claim should

 

      not be released for at least five years.  This is

 

      the same as with the food master file or a drug

 

      master file, and the option of releasing the data

 

      would be at the election of the submitter.

 

                Now, what benefit would be derived from

 

      independent expert review and FDA notification?

 

      First, the agency would be relieved of a possible

 

      logjam of petitions.  Second, the agency and public

 

      would benefit from the addition insight provided by

 

      experts outside the agency.  Third, consumers would

 

                                                                94

 

      know that the agency and industry were taking

 

      reasonable steps to respond to their demands for

 

      empowerment and access.

 

                How would ensuring return on investment to

 

      industry benefit anyone else in the triad of

 

      players I talked about earlier?  First, consumer

 

      demands for a variety of safe and effective

 

      products would be met.  Second, the agency and

 

      consumers would know that products were properly

 

      examined for safety and efficacy, that consumers

 

      would get not only value for their dollar but safe

 

      products as well.  Lastly, return on investment

 

      would ensure competition and new products in the

 

      marketplace.

 

                If FDA acts to take the three steps, all

 

      the players will benefit.  Consumers will be

 

      empowered with more and better products.  Industry

 

      will be assured of its right of free speech and a

 

      legitimate need for return on investment.  FDA will

 

      know that consumers are protected from unsafe or

 

      fraudulent products.  This is a win-win resolution.

 

                Thank you for your attention and allowing

 

                                                                95

 

      me to address you today.  I'd be delighted to

 

      answer any questions and, again, if you would like

 

      copies of any of these slides, in color as well,

 

      please contact me at my e-mail or website.

 

                Thank you.

 

                DR. FRANKOS:  Any questions?  Please come

 

      to the mike.

 

                PARTICIPANT:  George, you ushered in a

 

      topic that is outside the scope of this focus, but

 

      I'll address you on it, and that is efficacy.  What

 

      would you qualify as a sufficient amount of

 

      evidence to support an efficacy claim that would be

 

      overseen and reviewed or allowed by the FDA on a

 

      dietary supplement?

 

                DR. BURDOCK:  Something that meets the

 

      criteria of a structure/function claim.  I'm not

 

      trying to avoid your question, but I don't see what

 

      are the grounds on which I could answer.

 

                PARTICIPANT:  Structure/function claims do

 

      not have to be supported by a clinical trial for an

 

      actual finished good.

 

                DR. BURDOCK:  They don't have to be

 

                                                                96

 

      supported by a clinical trial, that's for sure.

 

      But there are other methods that support a

 

      structure/function claim.

 

                PARTICIPANT:  So I'm still asking for an

 

      exemplification of what you think would be

 

      sufficient for efficacy claims to be allowed or

 

      approved.

 

                DR. BURDOCK:  Adequate animal studies,

 

      proof of absorption, proof of mechanism.  There are

 

      a lot of ways to get to it.  It doesn't always have

 

      to be--in fact, I think for a structure/function

 

      claim, adequate human data may not be necessary at

 

      all.

 

                DR. FRANKOS:  Anyone else?

 

                [No response.]

 

                DR. FRANKOS:  Thank you.

 

                Good, we've got color.  Our next speaker

 

      is Wes Siegner, and he is with Hyman, Phelps &

 

      McNamara, and hopefully things are working now.

 

                MR. SIEGNER:  It must be my lucky day

 

      here.  I was actually looking forward to using the

 

      overhead because I used to be a teacher, and my

 

                                                                97

 

      first year one of my important lessons I learned

 

      was never turn your back on the audience, being the

 

      class.  So overheads were my favorite tools.  We

 

      didn't have computers back in those days.

 

                Well, thank you for this opportunity to

 

      speak, and welcome to this meeting.  Before I start

 

      here, I just want to note that there seems to be a

 

      lot of agreement in what we're seeing in this

 

      notice, and that makes me very happy.  I think

 

      industry recognizes what the stakes are here.

 

                I have a presentation which I typed out,

 

      which is a little different than my overheads.  I

 

      noticed that there's no copies left out on the

 

      table.  I have a few copies here for people who are

 

      desperate to read it before they go home tonight.

 

      But if you want to give me your card or give me a

 

      call, I can give you another copy if you're

 

      interested.

 

                Just starting out, the issues that are

 

      presented in this notice are very, very significant

 

      for the industry.  And as I said, I'm glad to see

 

      that trade associations and others recognize that

 

                                                                98

 

      because one of the things, I think, that we need to

 

      fix immediately is that not enough time has been

 

      given to allow people to consider what the issues

 

      are.  There won't be enough time to prepare

 

      comments by the 3rd of December, certainly, and I

 

      think actually my feeling is it ought to go well

 

      beyond February 3rd.  But whether that's on the FDA

 

      table at the moment or not is an issue, but we can

 

      fix that.

 

                The other thing I want people to

 

      understand is that it's not that FDA is doing

 

      anything wrong in what is going on here with NDIs.

 

      I have a very strong feeling that it's becoming a

 

      food additive approval process.  That will be the

 

      natural tendency of FDA if we leave them to their

 

      own devices, not because they're not doing their

 

      job but because they are doing their job.

 

                If you put safety in FDA's hands and say,

 

      look, we want you to go out there and enforce the

 

      law and protect consumers and make sure that the

 

      products are safe, you can't imagine that they're

 

      going to say, well, we're just going to kind of

 

                                                                99

 

      gloss over these safety reviews.  They're going to

 

      do a hard-nosed food additive type approval of

 

      those safety reviews.  And you as industry and I as

 

      a lawyer for industry need to find ways to give FDA

 

      an option to get out of that box.  I think we've

 

      seen some good ones today in terms of suggestions.

 

                My other point--oh, sorry.  I'm already on

 

      the next slide.  What do we do here?  There we go.

 

      Sorry.  No?  There were are.

 

                I'm the ten-year issue.  Basically what

 

      has been happening here with the development of NDI

 

      policy is that over a ten-year period, people have

 

      been submitting NDIs without the rules being known.

 

      FDA has been writing back, and the process has been

 

      evolving over this ten-year period, and there's a

 

      lot of important information in those NDI reviews

 

      and objections and filings.  I commend Michael

 

      McGuffin and Tony Young for trying to parse through

 

      all that--there's a huge volume of material--and

 

      pulling out some important lessons.  But I'm going

 

      to go through a few important things that I've seen

 

      in these notifications and correspondence.  I think

 

                                                               100

 

      industry deserves a fair break here in terms of

 

      being able to respond to all this.  We can't do it

 

      in 45 days.  My feeling is we need at least six

 

      months to really put this all together and get good

 

      comments in.

 

                I'm also encouraged by Bill Frankos'

 

      comment that this is maybe the beginning of a

 

      process, that there may be other meetings.  My

 

      concerns would be less strong on the comment period

 

      if the plan is going forward to say, okay, this is

 

      the initial review, we're going to consider these,

 

      give you some more chance to comment and to have

 

      public meetings.

 

                The other argument for more time here is,

 

      of course, all the other things that are coming

 

      down the pike.  We have the substantiation

 

      document, which has a 60-day comment period.  We

 

      have GMPs coming out.  We have new FDA directives

 

      in terms of their strategies for regulating

 

      supplements.  And I don't know how many people have

 

      read all that, let alone absorbed it.  I have read

 

      it; I'm not sure I've absorbed it.

 

                                                               101

 

                I've tried to boil this notice down into

 

      five issues.  They're not all the issues, of

 

      course, that are in this NDI notice, but to me

 

      these are really the most important issues for the

 

      industry looking forward and wanting to market as

 

      many safe dietary ingredients as the industry can

 

      market and that consumers deserve.

 

                The first issue here is that FDA is going

 

      to have a tendency to restrict the market by very

 

      narrowly defining "dietary ingredient," and I'm not

 

      going to go into all the shades of that, but I'll

 

      bring up one issue relating to that definitional

 

      issue.

 

                Annette Dickinson broached on this second

 

      point, which I think is critical.  There's this new

 

      standard creeping into the old dietary ingredient

 

      category where they're saying that the ingredient

 

      has to be lawfully marketed before 1994.  And if we

 

      go that route, there's some big problems for

 

      industry.

 

                Third, this issue with "present in the

 

      food supply," FDA wants to narrowly define that to

 

                                                               102

 

      mean just foods, not components of foods.  David

 

      Seckman picked up on this to some extent in his

 

      discussion.  That would be a very narrow

 

      interpretation of that.  I've got to be honest, the

 

      statutory language, as is typical of statutory

 

      language, is not entirely clear on this point.  But

 

      the goal here should be to assure safety but permit

 

      the broadest definition we can.

 

                The fourth issue is what does "reasonably

 

      expected to be safe" mean.  You know, I think

 

      industry would all agree that it means something

 

      less than a food additive safety standard.  But

 

      it's not defined, and, you know, there's no actual

 

      precedent in the act for this standard, and we can

 

      talk a little bit about that.  But the bottom line

 

      is people need to come to an agreement in the

 

      industry and at FDA what it all means.

 

                Then the last thing I'll touch on briefly

 

      is this issue of risk/benefit, which has come into

 

      play through the ephedra final rule and how it

 

      might apply to NDIs.

 

                The issue of narrowing the definition,

 

                                                               103

 

      we've already been through the dietary ingredient

 

      definition several times.  This is just a

 

      paraphrasing of it without all of the statutory

 

      sections.  I want to focus on the underlying

 

      language, which is "a dietary substance for use by

 

      man to supplement the diet by increasing the total

 

      dietary intake."

 

                Now, if you know exactly what that means,

 

      raise your hand.  It's a lot of words.  I'm not

 

      sure what it means myself.  The problem here is

 

      that FDA wants to define it in a way that's very

 

      narrow.  My view of this is that that was put in

 

      there as a phrase to kind of say, okay, we have

 

      amino acids, botanicals, herbs, vitamins, minerals;

 

      here's a phrase that's going to capture everything

 

      else that might be suitable for people to eat.  And

 

      "suitable" is kind of a nebulous word, but, you

 

      know, you don't want people eating unsafe things.

 

      That's captured in the safety review.

 

                Now, of course, the statutory definition

 

      also excludes ingredients that are being

 

      investigated as new drugs or were on the market as

 

                                                               104

 

      drugs before they were on the market as

 

      supplements.  But barring that, we should have a

 

      big, broad array of substances that we can market

 

      as dietary ingredients.  There will be new things

 

      discovered down the road, and we want to keep that

 

      door open.

 

                What FDA is saying in these letters back

 

      in the NDI process is that in order to qualify to

 

      be a dietary substance, it has to be part of man's

 

      usual food or drink.  Now, I'm not sure what that

 

      means either, but it doesn't signal to me that

 

      they're headed in the right direction.  I think

 

      that's a very narrow reading of the word "dietary

 

      substance."  We need to make sure FDA doesn't go

 

      down this path, that we keep that door open.

 

                And in the end, I can't estimate it.  You

 

      know, it could be several hundred ingredients.  It

 

      could be thousands of ingredients that the industry

 

      could lose if we don't get the right interpretation

 

      here.

 

                This is something that Annette hit on.  I

 

      won't go into it in great detail.  But, again, we

 

                                                               105

 

      have all assumed that there are a lot of

 

      ingredients out there that FDA and industry would

 

      view as old.  If we allow this lawfully marketed

 

      interpretation to creep into what FDA's thinking,

 

      what's going to happen is a lot of these old

 

      ingredients will suddenly become not legally

 

      marketed pre-'94 ingredients, and that means--not

 

      that they're necessarily going to come off the

 

      market, but they have to go through the NDI

 

      process.  And a lot of the old ingredients I don't

 

      think would make it, would have a tough time, and

 

      we'd end up losing a lot of ingredients.

 

                I have a list in the last point here of

 

      some of the ingredients that FDA, I believe, would

 

      view as illegal food additives, pre-'94, and if

 

      that's the case and the lawfully marketed standard

 

      is the one FDA is going to apply, all of these

 

      would need to come off or go through the NDI

 

      process.  And I think a lot of the herbs would

 

      suffer the same problem.

 

                Moving on to the next point, this

 

      narrowing of the "present in the food supply"

 

                                                               106

 

      definition, this is really a simple matter.  How

 

      are you going to interpret the statutory language?

 

      The statute says "dietary ingredients which have

 

      been present in the food supply as an article used

 

      for food in a form in which the food has not been

 

      chemically altered."  Well, we've had a lot of long

 

      discussions in our firm about what this means, and,

 

      again, it's not exactly clear.  You can subject it

 

      to several interpretations.  FDA wants to focus on

 

      the words "article used for food" meaning that if

 

      you have a potato, it's only the potato that is

 

      subject to this exemption from NDI notification.

 

      It's not any of the ingredients in the potato, the

 

      components, not the carbohydrates in there, not the

 

      proteins in there, not the vitamins or minerals in

 

      the potato.  It's just the potato.

 

                Again, the problem with this is that if we

 

      go down this route, we're going to lose a lot of

 

      dietary ingredients probably, but the real

 

      importance is that it forces a huge number of

 

      ingredients into the NDI review process.  And, you

 

      know, there ought to be some logical conclusion we

 

                                                               107

 

      could come to or interpretation with FDA that

 

      everybody could agree to.  And if it's a de minimis

 

      ingredient in a food that's been marketed forever,

 

      that doesn't give you any assurance that the

 

      ingredient might be safe.  But if it's a very

 

      substantial substance within a food that's been

 

      widely consumed, that really gives you an assurance

 

      of safety.  And why would we as industry need to

 

      spend the time to put together a panel of experts

 

      to review those?  And why should FDA have to review

 

      those types of substances?  My view is they

 

      shouldn't.

 

                This is the whole thing here:  What does

 

      "reasonably expected to be safe" mean?  Yes, it was

 

      great, we pointed out through DSHEA that FDA was

 

      not supposed to treat dietary supplements as food

 

      additives.  We have a different standard for NDIs.

 

      But Congress didn't really define it.  As a matter

 

      of fact, in this case, Congress decided that the

 

      legislative history wasn't going to be legislative

 

      history, so they in passing the law said, well,

 

      none of this that we've said about this law that

 

                                                               108

 

      you might use to interpret it really should count.

 

      You know, we still read it and put meaning into it,

 

      but, you know, this is a problem.  And I think that

 

      several people--Annette and others--have kind of

 

      hit the nail on the head that industry needs to do

 

      good self-reviews, either in the context of the

 

      GRAS self-affirmations, with panels of experts, or

 

      setting up their own panels of experts, like the

 

      cosmetics and flavors industries have done.

 

      Somehow industry has got to take this thing by the

 

      horns and do their own safety reviews, because if

 

      you don't, what's going to happen is, again--and

 

      it's not that FDA is doing anything wrong.  But if

 

      they have to protect the public and declare things

 

      safe or not safe, they're not going to say

 

      half-safe, they're going to do a full-blown safety

 

      review.  There's no other way around that.

 

                Then the last thing here is risk/benefit.

 

      This is something that I think a lot of people

 

      haven't thought about, but there's a problem that

 

      comes into play as a result of the risk/benefit

 

      standard that FDA created through the ephedra rule.

 

                                                               109

 

      The problem is that if you look at 402(f) or

 

      342(f), as it's in 21 U.S.C., (A), the section of

 

      the law that applies to adulteration has a section

 

      in it that applies to the adulteration of NDIs.

 

      And that section applies the same unreasonable risk

 

      standard to NDIs as it does to any other dietary

 

      supplement.  And I'm not saying this is going to

 

      happen, but I can very well see down the road,

 

      again, if we leave FDA to kind of run this safety

 

      review, they're going to say, well, it doesn't make

 

      sense to put an NDI on the market under just a

 

      safety review.  When it's on the market, we have to

 

      judge it by safety and benefits.  So what we're

 

      going to do is require NDI notifications to prove

 

      benefits.  They're not doing this now.  I hope it

 

      never happens.  But this is just something

 

      that--another problem we need to keep an eye on.

 

                I just want to bring some notice to

 

      something here.  My first point, my conclusion, is

 

      that industry is at a crossroads.  Peter Hutt's

 

      conclusion is FDA is at a crossroads.  Well, so

 

      industry and FDA are meeting at the crossroads, and

 

                                                               110

 

      we need to through this notice get together and

 

      decide what the best path is.  And I'm confident

 

      that if we have enough time to parse through these

 

      issues and work them out with FDA, we can come to

 

      conclusions that are going to be benefiting

 

      industry and that are going to be benefiting FDA

 

      and not wasting a lot of your time, because I think

 

      that if you really get into this as a food additive

 

      review process, it's going to be very hard for you

 

      in terms of having to review things, and it's going

 

      to be terrible for industry, because in the end

 

      we'll be back where we were in the '80s and early

 

      '90s where the whole system kind of bogs down and

 

      we can't get anything on the market.

 

                Thank you.

 

                DR. FRANKOS:  Any questions?  Yes, can you

 

      come to the mike down here, please?  And please

 

      identify yourself.

 

                DR. BECHTEL:  I'm Dave Bechtel, senior

 

      toxicologist with Cantox.  Wes, interestingly, I

 

      totally agree with the issue of FDA's review of

 

      data for a new dietary ingredient.  I would ask you

 

                                                               111

 

      the following question:  Under DSHEA, it is my

 

      clear understanding that there are two options for

 

      new dietary ingredients:  one is a notification,

 

      the other is a new dietary ingredient submission.

 

      And that's in the regulations.

 

                Do you see any advantage or any

 

      opportunities in the existing regulations in the

 

      format to be able to deal with defining how FDA

 

      operates with the notification versus a submission?

 

                MR. SIEGNER:  Answering from where we

 

      stand right now and in terms of how I would advise

 

      a client to go forward, our view toward this is

 

      that we do treat them very much like GRAS

 

      self-affirmations and prepare the NDIs in a very

 

      thorough manner with a panel of experts or however

 

      many experts you need to address the safety issues

 

      that the ingredient raises.  And I don't really see

 

      the difference, unless FDA tells us otherwise, as

 

      to whether you do the notification or submission

 

      process.  It's all really the same thing.  You

 

      know, we can't really say what "reasonable

 

      expectation of safety" is, but if the industry or

 

                                                               112

 

      the company submitting the ingredient really takes

 

      it on its shoulders to get the experts lined up

 

      that FDA is going to say, okay, these are really

 

      qualified experts in the industry, they know their

 

      stuff, that's immediately going to set FDA at ease,

 

      more so than if they get a submission that's, you

 

      know, got some studies attached to it and says

 

      we're safe.

 

                So I think answering your question, I

 

      don't really see a difference between the two

 

      processes.  I think it's really more focused on

 

      right now how do we make FDA happy.

 

                DR. FRANKOS:  Wes, I'm a little confused.

 

      Once you determine you have a new dietary

 

      ingredient, I'm only aware of one process that you

 

      have to notify.  So you were talking about another

 

      process?

 

                MR. SIEGNER:  Well, actually I'm familiar

 

      with the notification process, and--

 

                [Inaudible comment.]

 

                DR. WALKER:  This is Susan Walker.  There

 

      is only one notification process.  Basically the

 

                                                               113

 

      75-day notification process is a process where you

 

      send in a submission.  So unless someone has

 

      clarification on something else, there's really

 

      just one process.

 

                MR. SIEGNER:  I think we're all talking

 

      about the same thing.

 

                DR. FRANKOS:  Okay.  I do have one

 

      question.  You brought up the issue of a de minimis

 

      level of a constituent of a food, let's say.  Could

 

      you define "de minimis"?  Is there a way to define

 

      that for us?  We would be very happy--

 

                [Laughter.]

 

                MR. SIEGNER:  Bill, I thought we were

 

      friends.

 

                [Laughter.]

 

                MR. SIEGNER:  I think my main point is

 

      that we ought not to be saying component or, you

 

      know, non-component.  And that, I recognize, does

 

      lead FDA into another, you know, part of the woods.

 

      I think we can get out of it.  But my point is I

 

      don't--let me be truthful.  I can't answer your

 

      question.

 

                                                               114

 

                [Laughter.]

 

                DR. FRANKOS:  Very good.

 

                MR. SIEGNER:  Very unlawyerly, but I'll be

 

      honest.  But the point is let's not review

 

      ingredients that we know people have been exposed

 

      to at significant levels for, you know, forever.  I

 

      think that's something that should not be in the

 

      NDI review process.  Things that, you know, don't

 

      warrant that kind of safety presumption, then we

 

      ought to figure out what they are.

 

                DR. FRANKOS:  Okay.  Any other questions?

 

      Yes?

 

                MR. SIEGNER:  Now I'm really in trouble.

 

                [Laughter.]

 

                DR. DICKINSON:  Annette Dickinson with

 

      CRN.  As a regulatory wonk, I can't resist looking

 

      up the answer to this question that you were just

 

      asked.  In DSHEA, under the new dietary ingredient

 

      section, after it talks about the notification

 

      part, there's a separate section on petitions,

 

      which says, which appears to say that apart from

 

      the requirement to submit a notification from an

 

                                                               115

 

      NDI, any person may file with the Secretary a

 

      petition proposing the issuance of an order

 

      prescribing the conditions under which a new

 

      dietary ingredient under its intended conditions of

 

      use will reasonably be expected to be safe.

 

                So I assume that's the separate thing that

 

      he was talking about.

 

                PARTICIPANT:  That would be like getting a

 

      regulation--

 

                DR. DICKINSON:  It would be like

 

      requesting a regulation right.

 

                DR. FRANKOS:  Okay.  That's what you're

 

      talking about.

 

                MR. SIEGNER:  Has anybody ever gone that

 

      route?

 

                DR. DICKINSON:  We've ignored that.

 

                DR. FRANKOS:  We're not aware of any.

 

                MR. SIEGNER:  Well, I guess I didn't

 

      answer that question very well either.

 

                [Laughter.]

 

                DR. FRANKOS:  Any other questions?

 

                [No response.]

 

                                                               116

 

                MR. SIEGNER:  Thanks.

 

                DR. FRANKOS:  Well, thank you.

 

                We're actually moving along pretty well,

 

      and we're on time.  So let's take a 15-minute break

 

      and come back and finish up.  Let's meet at 20 of.

 

                [Recess.]

 

                DR. FRANKOS:  Okay, we're into the home

 

      stretch here.  Our next speaker is John Zenk, and

 

      he is chief medical officer of Humanetics

 

      Corporation.

 

                DR. ZENK:  Thanks.  Five minutes left of

 

      the morning, so good morning.

 

                I'd like to begin by thanking the agency

 

      for allowing me to be here and have some input into

 

      this very important subject.  My name is John Zenk.

 

      I am a board-certified, licensed physician in

 

      Minnesota.  My specialty is internal medicine.  I

 

      also have a degree in pharmacy and actually was a

 

      practicing pharmacist before I started medical

 

      school.  I'm currently the chief medical and

 

      scientific officer for Humanetics Corporation in

 

      Eden Prairie, Minnesota.

 

                                                               117

 

                Humanetics is a privately held company

 

      that discovers, researches, develops, and

 

      commercializes new ingredients for the dietary

 

      supplement and drug industries.  We have made a

 

      substantial investment in the research of our new

 

      dietary ingredients, and our company has more than

 

      20 patents.  Our current ingredients include 7-Keto

 

      DHEA, which is a metabolite of DHEA; D-Pinitol,

 

      which is a naturally occurring methyl inositol

 

      which comes from legumes and the heartwood of pine

 

      trees.  We also have MicroLactin, which is a

 

      specially processed dairy protein, and I'd like to

 

      point out that the MicroLactin ingredient does not

 

      meet the definition of a new dietary ingredient.

 

                Our direct investment in research

 

      associated with our ingredients is in excess of $10

 

      million.  Much of the investment has gone toward

 

      well-designed human clinical trials to establish

 

      safety and efficacy of our products.  To date, more

 

      than 16 clinical trials have been performed on our

 

      ingredients.

 

                When Humanetics made a decision to enter

 

                                                               118

 

      the dietary supplement market, the company looked

 

      at the Dietary Supplement Health and Education Act

 

      and saw that our 7-Keto ingredient met the

 

      definition of a new dietary ingredient.  With our

 

      first customer, General Nutrition Corporation, we

 

      notified the agency, as required by law, in May of

 

      1997 prior to commercial sales of this ingredient.

 

      We appear to have been the 14th company to actually

 

      file a pre-market notification for a new dietary

 

      ingredient at that time.  Our company has now filed

 

      or supported the filing of six new dietary

 

      ingredient notifications.  Two of these were for

 

      our patented ingredient 7-Keto DHEA.  Another was

 

      for our D-Pinitol ingredient for which we presently

 

      have three U.S. patents.  Another was for D-ribose,

 

      and two were for a polyphenolic extract of the

 

      evening primrose plant.  Four of these NDIs were

 

      filed by the agency without objection, and the new

 

      dietary ingredients were introduced to the market

 

      by our company.

 

                As I mentioned, the company completed two

 

      NDI filings for the polyphenolic extract, and the

 

                                                               119

 

      agency concluded that the ingredient was not shown

 

      by the data submitted to be reasonably expected to

 

      be safe for use in dietary supplements.  Although

 

      we didn't agree with the assessment, out of respect

 

      for the agency and the provisions of DSHEA, neither

 

      Humanetics nor the New Zealand company that

 

      developed that ingredient introduced it for sale as

 

      a dietary ingredient in the United States.

 

                DSHEA established the shape and the

 

      contour of the playing field for new dietary

 

      ingredients.  The agency promulgated implementing

 

      regulations in September of 1997, and we have

 

      structured our business model for dietary

 

      ingredients around these regulations.  As

 

      competitors in the marketplace, however, we are at

 

      a disadvantage because others ignore this important

 

      part of the law, and the agency has only once (in

 

      the case of androstenedione) invoked this part of

 

      the law in its ten-year history.  Although we have

 

      followed the NDI provisions of DSHEA, we compete

 

      with many who do not.  I am sure many of us in the

 

      room today are aware of ingredients that would be

 

                                                               120

 

      considered new dietary ingredients for which no

 

      pre-market notification was filed.  We are also

 

      aware of ingredients for which pre-market

 

      notifications were filed, subsequently objected to

 

      by the FDA, and the ingredients are sole on the

 

      market in the United States.

 

                This public meeting appears to approach

 

      the new dietary ingredient provisions of the law as

 

      if they were just discovered and need to be

 

      explained.  These provisions have been in the law

 

      since 1994.  They became effective upon enactment.

 

      We are here today to express our opinion that the

 

      agency should focus its efforts on the enforcement

 

      of this most important aspect of DSHEA.  We believe

 

      that it is a good provision, we support it, and we

 

      feel that it is critical for many reasons,

 

      including the most important reason of, to protect

 

      the safety of consumers.

 

                Thank you again for allowing me to be here

 

      and provide this input.  I'd be happy to entertain

 

      any questions.

 

                DR. FRANKOS:  Thank you.

 

                                                               121

 

                DR. ZENK:  Thank you.

 

                DR. FRANKOS:  Our next speaker is Paul

 

      Bolar, Vice President of Regulatory and Legal

 

      Affairs with Pharmavite.

 

                MR. BOLAR:  Good morning, with about one

 

      minute to spare.  Someone mentioned to me earlier

 

      today that all these flashings of red and blue

 

      colors up on the screen are symptoms,

 

      after-symptoms of the election.  Being in the

 

      Washington area, we're still undergoing some of the

 

      convulsions, I guess, the aftermath.

 

                Pharmavite is a 33-year-old company based

 

      in Los Angeles, and we manufacture a broad line of

 

      vitamins, minerals, botanicals, and a wide range of

 

      other dietary ingredients.  Our products are sold

 

      in food, drug, mass merchandise, and chain stores

 

      throughout the United States.  I should mention

 

      that we have also submitted three NDI notices to

 

      the agency, so we're somewhat familiar with the

 

      process that we're discussing today.

 

                We're pleased that FDA is taking steps to

 

      clarify the regulatory requirements related to new

 

                                                               122

 

      dietary ingredients, and we support FDA's efforts

 

      to develop a more structured framework for the

 

      submission of NDI notifications.  As a result of

 

      these efforts, we believe consumers will benefit

 

      from a higher assurance of product safety and

 

      responsible companies will benefit from operating

 

      on a more level playing field resulting from a

 

      clearer understanding of the requirements.

 

                We will submit more detailed written

 

      comments to the docket on a variety of issues

 

      raised in the Federal Register notice, but for

 

      today I would like to specifically address three

 

      important issues related to this topic.  I'll first

 

      address the types of changes that should influence

 

      whether an old ingredient should be considered as a

 

      new ingredient; secondly, the type of information

 

      that should be required in NDI notifications; and,

 

      finally, some points about enforcement.

 

                With respect to the statute of new dietary

 

      ingredients, determining all of the variables that

 

      may impact whether a dietary ingredient is

 

      considered new is a difficult undertaken, and no

 

                                                               123

 

      single answer will satisfy all situations.

 

      Furthermore, DSHEA does not clearly define the

 

      types of changes to a so-called old dietary

 

      ingredient that would result in a new dietary

 

      ingredient.  Given the broad diversity of

 

      substances that potentially qualify as dietary

 

      ingredients and the wide range of possible effects

 

      that ingested substances may have on the human

 

      system, we believe it is better to err on the side

 

      of caution when determining whether an ingredient

 

      is a new ingredient and subject to the FDA

 

      notification requirements.

 

                Therefore, we believe that in many

 

      situations changes to the chemical composition or

 

      structure of an old ingredient should cause the

 

      altered substance to become a new dietary

 

      ingredient.  This would include modifications to

 

      existing ingredients that result in new salt forms,

 

      new esters, chelates, complexes, and other

 

      chemically modified or stabilized forms of old

 

      ingredients.

 

                For example, and ignoring for the moment

 

                                                               124

 

      whether or not an ingredient is old or new, zinc

 

      sulfate is markedly different from zinc chromate.

 

      Chromium chloride is significantly different from

 

      chromium picolinate.  We think there are any number

 

      of other examples that could be cited where

 

      different salts and complexes and so forth may have

 

      different safety profiles associated with them.

 

                This reasoning would also extend to old

 

      ingredients produced through new or unique

 

      manufacturing processes if the new processes result

 

      in significant alterations to the composition or

 

      chemical structure of the old ingredients.

 

      Additionally, botanical ingredients obtained from

 

      plants used in dietary supplements before 1994, but

 

      obtained from parts of the plant not previously

 

      used should be considered new dietary ingredients.

 

      In contrast, old ingredients that undergo changes

 

      in their manufacturing process that do not alter

 

      the chemical structure of the ingredients should

 

      not be considered new ingredients.  Such changes

 

      may include the use of different synthetic pathways

 

      to achieve the same ingredient or the use of

 

                                                               125

 

      different filtration or purification techniques,

 

      but may not necessarily alter the basic chemical

 

      structure of the dietary ingredient.

 

                While we support a broad interpretation of

 

      what constitutes a new dietary ingredient, we feel

 

      it is equally important that requirements for NDI

 

      notifications should be sufficiently comprehensive

 

      but not overbearing.  We believe that notifications

 

      should contain sufficient information to clearly

 

      characterize the substance in question.  As a

 

      general rule, more information is always preferred.

 

      There was a whole series of possible types of

 

      information suggested and asked to have comments

 

      submitted on.  We think as much information that

 

      can be provided certainly provides more certainty

 

      of what is being discussed.  But at a minimum,

 

      notices should include a clear description of the

 

      chemical structure of an ingredient containing a

 

      single compound and provide a reasonably complete

 

      characterization or profile of major constituents

 

      for more complex substances, such as fatty acid

 

      complexes and botanical extracts.

 

                                                               126

 

                Recommendations for conditions of use by

 

      the consumer and the amount of the new dietary

 

      ingredient contained in a proposed dietary

 

      supplement should be clearly stated in the notice.

 

      However, the formulation of the finished dietary

 

      supplement and copies of the actual labeling of the

 

      product should not be required because in many

 

      cases the formulations of labeling just simply have

 

      not been created at that point in time.  We also

 

      feel that there needs to be flexibility in the

 

      manner in which new dietary ingredients may be

 

      combined with other ingredients, and it should not

 

      be a process wherein the use of a new dietary

 

      ingredient is locked into just one particular

 

      combination of ingredients.

 

                The level of evidence needed to establish

 

      a reasonable expectation of safety should remain

 

      reasonable and flexible.  For instance, the nature

 

      and amount of evidence sufficient to satisfy a

 

      reasonable expectation of safety may vary according

 

      to the degree of knowledge about the composition of

 

      the substance or whether the NDI is closely related

 

                                                               127

 

      to other known substances with known characteristics.  In

 

      cases where a modification to an old

 

      ingredient results in a new ingredient, required

 

      safety evidence should generally focus on the

 

      impact of the change in the new ingredient.  We

 

      believe that appropriate data comparing the new

 

      form of ingredient to the existing ingredient

 

      generally should be sufficient for acceptance by

 

      FDA rather than the kind of data package needed for

 

      a completely new substance.

 

                In order to reduce unnecessary burden on

 

      dietary supplement and dietary ingredient

 

      companies, we believe that FDA guidance should

 

      affirm that redundant NDI notices do not have to be

 

      submitted for ingredients for which another company

 

      has already submitted a satisfactory notice.  This

 

      assumes that the ingredient is essentially

 

      identical to and used for the same conditions of

 

      use specified in previous filings.  For example,

 

      while data submitted by the ingredient manufacturer

 

      covers those who use and distribute the substance

 

      in various dietary supplements, it should also be

 

                                                               128

 

      made clear that a submission by one distributor of

 

      a dietary supplement also covers the same use by

 

      other distributors of the same substance whether or

 

      not in the same chain of distribution.  However,

 

      this is not to say that one size fits all.

 

      Previous notice submissions should only be relied

 

      on if the levels of consumption and other

 

      conditions of use are consistent with the

 

      limitations specified in previous submissions.

 

      Where significant changes occur, new NDI

 

      notifications should be required for the new

 

      ingredient.

 

                Now I'd like to turn lastly to the issue

 

      of enforcement, and I'll probably echo some of the

 

      sentiments already presented by Dr. Zenk.

 

                We also believe that enforcement of the

 

      NDI notice provisions is an important issue for FDA

 

      to begin to address at this time.  Consistent and

 

      evenly applied enforcement of the NDI requirements

 

      will be a key factor in creating meaningful

 

      guidelines and a level playing field for

 

      manufacturers of dietary ingredients and dietary

 

                                                               129

 

      supplements.  A number of products exist on the

 

      market today that contain new dietary ingredients

 

      for which NDI notices have not been filed.  In some

 

      cases, the companies may either be ignorant of the

 

      notice requirements or they may have simply

 

      proceeded on the basis of liberal interpretations

 

      of the law.  Unfortunately, there are others who

 

      are blatantly cutting corners and exploiting the

 

      lenient enforcement environment that we have today.

 

      These situations have resulted in an unfair playing

 

      field for companies that attempt to uphold their

 

      end of the bargain.  As an example, Pharmavite

 

      recently considered an opportunity to market a

 

      supplement that included what we believe to be

 

      clearly a new dietary ingredient.  Upon diligent

 

      review, we declined to market this product because

 

      we did not feel that there was sufficient data at

 

      this time to submit a satisfactory NDI

 

      notification.  We are, therefore, pursuing

 

      additional studies to verify the safety of this

 

      ingredient.  However, others in this industry,

 

      including major competitors, have chosen to market

 

                                                               130

 

      this same product without filing an NDI

 

      notification.  This obviously is putting us at a

 

      significant competitive disadvantage.

 

                We urge FDA to establish reasonable

 

      guidelines for NDI notices and to institute

 

      enforcement measures as soon sa possible.

 

      Recognized that FDA has limited resources to police

 

      this situation, we suggest that FDA consider using

 

      an enforcement approach similar to the issuance of

 

      "Courtesy Letters" that are used for structure/function

 

      claims.  Such letters have been used

 

      effectively to advise companies about FDA's

 

      interpretation of appropriate dietary supplement

 

      claims, and we believe that a similar approach

 

      could be effectively implemented to notify

 

      companies who have failed to meet their obligation

 

      to file NDI notices, without a large investment in

 

      time and resource by the agency.

 

                Now, I recognize that there is a process

 

      by which FDA issues warning letters, but what I'm

 

      suggesting here is something a step back less--I

 

      guess less...

 

                                                               131

 

                PARTICIPANT:  Formal.

 

                MR. BOLAR:  Less formal, yes, than a

 

      warning letter.

 

                In conclusion, I'd like to say that we

 

      believe it is in the long-term best interest of

 

      consumers and of responsible businesses to

 

      carefully review the safety of all dietary

 

      ingredients.  We believe that a conservative

 

      approach is preferred when determining the status

 

      of new dietary ingredients.  However, this should

 

      be balanced with reasonable and focused NDI

 

      notification requirement.  Finally, efforts to

 

      enforce the NDI notice provisions will help assure

 

      broader compliance within the industry, promote a

 

      fairer markets environment, and ultimately assure

 

      the availability of safer products for consumers.

 

                Thank you.

 

                DR. FRANKOS:  Any questions?

 

                [No response.]

 

                DR. FRANKOS:  Thank you.

 

                Let me just reiterate that it's very

 

      important that any comments or ideas you have get

 

                                                               132

 

      submitted to the docket.  The docket is the only

 

      place we can officially look at information, so

 

      please get your submissions in.  Everything that is

 

      being discussed today will be documented, so part

 

      of the discussion here is also important to the

 

      deliberation.

 

                Our next speaker is Willi Hunziker, and he

 

      is CEO for Morpho (ph).

 

                DR. HUNZIKER:  Okay.  I guess I'm the

 

      first one in the afternoon, so good afternoon,

 

      everybody.  I put my talk under the name "the Swiss

 

      perspective," and that has actually two reasons:

 

      first of all, I am Swiss, so my perspective is the

 

      Swiss perspective; but not only that, I also used

 

      to work for a long time for one of the big Swiss

 

      pharmaceutical and nutraceutical producers, and now

 

      I also run my own consulting business consulting

 

      for people in that area.

 

                What I would like to present is a little

 

      bit an outside view and my personal view.  If you

 

      just look at nutrition and health, a large body of

 

      evidence, as I'm sure you're aware, substantiates a

 

                                                               133

 

      relation between nutrition and health.  And the

 

      health benefits are the result of a continued

 

      ingestion of specific substances or combination of

 

      substances contained in the food chain or in

 

      related areas.  And I'm mainly concentrating today

 

      on the food chain, and I'm mainly concentrating on

 

      pure substances derived from the food chain.  So

 

      it's a subset of the whole thing.

 

                The health benefits are mostly disease

 

      reduction, although there are others, but to a

 

      large extent, for example, cardiovascular risk,

 

      cancer risk, Alzheimer risk and so forth.  And the

 

      nutraceuticals, how we call them, are the active

 

      ingredients that kind of provide those health

 

      benefits.

 

                Now, looking from a public health point of

 

      view, the disease risk reduction at low cost is an

 

      attractive way to slow the continuous rise in

 

      health care costs of the aging population in the

 

      Western world, provided that these substances are

 

      safe and efficacious, I would say.  The safety,

 

      first, the food chain is a positive selection of

 

                                                               134

 

      substances having a low toxicity profile, either

 

      it's by selection or it's by co-evolution between

 

      the food chain and the human species.  There is,

 

      thus, the history of safe human use of these

 

      substances at the exposure levels obtained by the

 

      respective food, and I stress the exposure levels

 

      because I think that's an important kind of

 

      criteria.  And I think that's a good basis, this

 

      history of safe use is a good basis for assessing

 

      safety, but it might not be enough in all cases.

 

                The efficacy should be substantiated by a

 

      mechanism of rationale, and all clinical studies

 

      and mechanisms of rationale can be, of course,

 

      rather broad, can go from in vitro studies looking

 

      at mechanism, can be in animal studies, and so

 

      forth.  At the end, I think it would make sense to

 

      have authorized health claims that guide the

 

      consumer if we want to fulfill what I said about

 

      the public health of these products.

 

                Now, what package would one want to have?

 

      From a scientist's point of view, I would say

 

      substance source and available data, the presence

 

                                                               135

 

      in the human food chain, as I said, is a subset

 

      that I'm mainly dealing with, the documented

 

      evidence of safe human use, its documented evidence

 

      for efficacy, mechanistic plausibility and/or

 

      clinical data, and the safety profile of the

 

      substance.

 

                The conditions of use, those should be

 

      guided by the level of chronic exposure and, again,

 

      plasma concentration via the respective diet, so we

 

      want to be in a similar range as with the

 

      respective food.

 

                The target issue concentration reached by

 

      the respective diets, the safety profile of the

 

      substance, and the target organ concentration

 

      needed for efficacy, because if we want to have

 

      efficacy, of course, we need to have the

 

      concentrations required for efficacy at the target

 

      organs.

 

                Now, from the industry point of view, it

 

      looks a little bit different.  Establishing safety

 

      and efficacy data you might argue is fine, but how

 

      do we get investment back?  And that point has

 

                                                               136

 

      already been raised once before, because in the

 

      present situation, competitors can piggyback on

 

      established safety and efficacy data, and the tight

 

      patent protection is rarely possible for these

 

      kinds of products.  So that also kind of invites

 

      competitors to come in.  And that's why to a

 

      certain extent the industry shies away from making

 

      the necessary investment in safety and efficacy

 

      data.

 

                So a proposal would be, as already

 

      mentioned before by coincidence, a time-limited

 

      marketing exclusivity for the first mover in the

 

      field, similar to, for example, in the drug area.

 

      The orphan drug, somebody who develops a drug for

 

      an orphan indication has market exclusivity for a

 

      certain period of time.  Other possibilities would

 

      be prohibition of  (?)    piggybacking, altering

 

      brand-specific claims, and maybe other ideas, with

 

      the goal to kind of allow the first mover to get

 

      his investment back in the solid data that he has

 

      created.

 

                Now, nutraceutical, as I said before, we

 

                                                               137

 

      use for substances having a health benefit coming

 

      from the food chain.  Regarding the DSHEA

 

      regulation, they can fall in two categories, the

 

      dietary ingredients or the new dietary ingredients,

 

      as was discussed before.

 

                A question that came up is when does a

 

      dietary ingredient become a new dietary ingredient,

 

      and I would say by a significant change in the

 

      conditions of use leading to an increase in

 

      exposure.  So if the human body is exposed to a

 

      much higher degree by the new conditions of use

 

      than the old one, I think then that

 

      warrants--because of safety consideration warrants

 

      a new dietary ingredient status.  And, of course,

 

      also the safety profile, if it's a critical

 

      substance, then smaller increases in exposure might

 

      already trigger that.  Or by a significant chemical

 

      modification of the dietary ingredient, and there I

 

      see a little bit more from the liberal side that

 

      modifications, chemical modifications, for example,

 

      esters and so forth, which are readily cleaved on

 

      ingestion, they should not necessarily be

 

                                                               138

 

      considered as a new dietary ingredient; whereas

 

      other chemical modifications which are not readily

 

      cleaved or even lead to different metabolites in

 

      the body, of course, those should be looked at more

 

      carefully.

 

                What information on the chemical nature of

 

      the NDI should be provided?  Of course, origin,

 

      extract, raw, enriched, purified, fermented,

 

      chemically synthesized, chemical name of the

 

      efficacious molecule, as I said before.  My

 

      interest is mainly in the purified chemicals, so

 

      the impurity profile will only be a few percent in

 

      the normal case, at max.

 

                In the case of non-single compound NDI,

 

      one would have to look at the standardization

 

      question, the dose content of the efficacious

 

      molecule, provide evidence on the role of the other

 

      molecules in the mixture, what they contribute to

 

      the effect in the body, and the stability of the

 

      compound in the  (?)-enic form and the

 

      bioavailability in humans.

 

                Now, another question is:  What is an

 

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      acceptable ratio of the intended dose to the

 

      dietary intake?  If we assume that the safe human

 

      use of an NDI is documented by food-based exposure

 

      data on, again, plasma levels, because depending on

 

      the formulation with the same milligram amount of

 

      compound, you get highly different exposure levels,

 

      and additional pre-clinical tox and clinical safety

 

      data is available, like single ascending dose in

 

      humans or multiple ascending dose, then the dietary

 

      intake of the population with the highest safe

 

      beneficial intake should be used as a basis to

 

      define the intended dose so that kind of sets the

 

      bar.  And depending on the data situation, the bar

 

      can be raised, also the situation if you need

 

      higher levels for efficacy, the bars can be raised

 

      to even higher than three-fold if supported by

 

      additional safety data.  But the recommended dose

 

      at the end must be at least a small multiple below

 

      the safe upper limit of the dietary ingredient.

 

                So quite a few times it was discussed what

 

      is an adequate safety evidence, and I think that

 

      safety is a must for nutraceuticals, provided that

 

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      for food chain compounds there is evidence for a

 

      beneficial effect and it has a wide safety window.

 

      I think, on the other hand, it should be approvable

 

      a NDI.

 

                So what specific type of safety data would

 

      I suggest?  I think to know the fate of the

 

      molecule in the mammalian species, I would like to

 

      have an ADME started.  That means an absorption,

 

      distribution, metabolism, excretion study in rats,

 

      normally done with C14-labeled nutraceutical, a

 

      13-week oral tox in rats, then developmental tox,

 

      teratogenicity studies in rats, and tension of

 

      toxicity tests like the Ames test or a mouse

 

      lymphoma test.  That would be a first package to

 

      look at the safety to get some indication if there

 

      is a problem somewhere and at what dose.

 

                And then depending on the outcome of the

 

      first set of studies would be additional studies if

 

      required, and here it would help to have guidance

 

      from the agency kind of like a decision tree to

 

      say, okay, if you have a problem in that assay,

 

      then you might have to do this additional kind of

 

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      study.  For example, a 52-week toxicity study in

 

      rats, two-generation study in rats.  Standard

 

      carcinogenicity study, we kind of consider

 

      overkill.  We would rather see a SHE assay done.

 

      That's the Syrian hamster embryonic cell assay,

 

      which shows actually a good correlation in the data

 

      to the standard carcinogenicity assay.  And as I

 

      said before, we would like to have some guidance on

 

      what to do if one of the tests shows positive

 

      effects.

 

                Now, another thing is safety factors.  In

 

      the food additive, it's clearly stated that the

 

      safety factor of 100 is applied for estimation of

 

      an upper safe level in humans from the no observed

 

      adverse effect level found in rodent studies.  We

 

      think that this factor cannot be transformed into

 

      the nutraceutical area because the food additives

 

      are new to the human body, the human body was never

 

      exposed to them; whereas, the nutraceuticals you

 

      have a history of safe human use over centuries and

 

      centuries.  So I don't think that they should be

 

      treated the same way.

 

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                So the proposal is to have no standard

 

      safety factor.  I'm not saying no safety factor,

 

      but no standard safety factor.  The upper safe dose

 

      is derived from pharmacokinetic data in both humans

 

      and rodents, plus data from rodent tox studies,

 

      also considered the exposure needed to have the

 

      desired efficacy.  And from that data compiled

 

      should allow to determine an upper safe dose, which

 

      in humans leads to plasma levels not exceeding the

 

      no adverse effect level observed in the rodent tox

 

      studies.  The intended dose should then be a

 

      multiple below that level, for example, three times

 

      below the upper safe level, and it should also, of

 

      course, allow for the desired effect.

 

                I maybe will just skip that one in regard

 

      to the time.  So, in summary, nutraceuticals can

 

      provide the risk reduction for disease.  Thus, they

 

      may sense from a public health point of view.  They

 

      must be safe in the recommended dose as evidenced

 

      by appropriate safety data.  Efficacy should be

 

      evidenced by a mechanistic plausibility and/or

 

      clinical data serving as a basis for honest claims,

 

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      and I would kind of stress the term "honest

 

      claims."

 

                Legislation together with the industry has

 

      to find ways that allow the first mover to protect

 

      his investment in safety and efficacy.

 

                Thank you.

 

                DR. FRANKOS:  Thank you.

 

                Any questions?

 

                [No response.]

 

                DR. FRANKOS:  Well, thank you.  That

 

      brings us to the end of our meeting, and I just

 

      have a few comments.  I'm absolutely thrilled at

 

      the kind of dialogue we've started here, and I hope

 

      that we can continue more of this dialogue.  As a

 

      lot of you alluded to, there are quite a few

 

      questions that are in the Federal Register notice.

 

      Those questions were put together because there is

 

      a lot that's still to be done as far as coming up

 

      with more consistency in the NDI process.

 

                I encourage you each to address those

 

      questions individually.  Today we had a lot of

 

      general discussion, but I think it's important that

 

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      we get direct answers to the questions we've

 

      presented.

 

                As far as timeline goes, we'll wait to

 

      hear about extending the comment period, but we've

 

      heard quite a few suggestions here as to why we

 

      might want to extend it.  And I don't know about

 

      this last suggestion about going to six months, but

 

      we will--I don't think that's been officially

 

      submitted yet.

 

                The other thing that I'm very hopeful

 

      about is this whole idea of continued dialogue.

 

      I've heard quite a few commenters indicate that

 

      more dialogue is needed, and I would have to agree

 

      with that, and I'm looking forward to more

 

      meetings.  We may have to look at more specific

 

      questions based on the comments that we get.

 

                So I'd like to thank everyone.  It was

 

      really a very good meeting for me and for our

 

      panel.  I'm sure each of us has learned something

 

      today.

 

                So we're finished.  Have a great lunch.

 

                [Applause.]

 

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                [Whereupon, at 12:31 p.m., the meeting was

 

      adjourned.]

 

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