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Time Line: Chronology of Drug Regulation in the United States

1820 Eleven physicians meet in Washington, D.C., to establish the U.S. Pharmacopeia, the first compendium of standard drugs for the United States.
1846 Publication of Lewis Caleb Beck's Adulteration of Various Substances Used in Medicine and the Arts, helps document problems in the drug supply.
1848 Drug Importation Act passed by Congress requires U.S. Customs Service inspection to stop entry of adulterated drugs from overseas.
1903 Lyman F. Kebler, M. D., Ph. C., assumes duties as Director of the Drug Laboratory, Bureau of Chemistry.
1905 Samuel Hopkins Adams' ten-part exposé of the patent medicine industry, "The Great American Fraud," begins in Collier's.

The American Medical Association, through its Council on Pharmacy and Chemistry, initiates a voluntary program of drug approval that would last until 1955. To earn the right to advertise in AMA and related journals, companies submitted evidence, for review by the Council and outside experts, to support their therapeutic claims for drugs.
1906 The original Food and Drugs Act is passed by Congress on June 30 and signed by President Theodore Roosevelt. It prohibits interstate commerce in misbranded and adulterated foods and drugs. The Meat Inspection Act is passed the same day. Shocking disclosures of insanitary conditions in meat-packing plants, the use of poisonous preservatives and dyes in foods, and cure-all claims for worthless and dangerous patent medicines were the major problems leading to the enactment of these laws.
1911 In U.S. v. Johnson, the Supreme Court rules that the 1906 Food and Drugs Act does not prohibit false therapeutic claims but only false and misleading statements about the ingredients or identity of a drug.
1912 Congress enacts the Sherley Amendment to overcome the ruling in U.S. v. Johnson. It prohibits labeling medicines with false therapeutic claims intended to defraud the purchaser, a standard difficult to prove.
1914 The Harrison Narcotic Act imposes upper limits on the amount of opium, opium-derived products, and cocaine allowed in products available to the public; requires prescriptions for products exceeding the allowable limit of narcotics; and mandates increased record-keeping for physicians and pharmacists that dispense narcotics. A separate law dealing with marihuana would be enacted in 1937.
1933 FDA recommends a complete revision of the obsolete 1906 Food and Drugs Act. The first bill is introduced into the Senate, launching a five-year legislative

FDA assembles a graphic display of shortcomings in pharmaceutical and other regulation under the 1906 act, dubbed by one reporter as the Chamber of Horrors, exhibited nationwide to help draw support for a new law.

1937 Elixir Sulfanilamide, containing the poisonous solvent diethylene glycol, kills 107 persons, many of whom are children, dramatizing the need to establish drug safety before marketing and to enact the pending food and drug law.
1938 The Federal Food, Drug, and Cosmetic Act of 1938 is passed by Congress, containing new provisions:

bead2.gif (276 bytes)   Requiring new drugs to be shown safe before marketing-starting a new system of drug regulation.
bead2.gif (276 bytes)   Eliminating the Sherley Amendment requirement to prove intent to defraud in drug misbranding cases.
bead2.gif (276 bytes)   Extending control to cosmetics and therapeutic devices.
bead2.gif (276 bytes)   Providing that safe tolerances be set for unavoidable poisonous substances.
bead2.gif (276 bytes)   Authorizing standards of identity, quality, and fill-of-container for foods.
bead2.gif (276 bytes)   Authorizing factory inspections.
bead2.gif (276 bytes)   Adding the remedy of court injunctions to the previous penalties of seizures and prosecutions.

Under the Wheeler-Lea Act, the Federal Trade Commission is charged to oversee advertising associated with products, including pharmaceuticals, otherwise regulated by FDA.

FDA promulgates the policy in August that sulfanilamide and selected other dangerous drugs must be administered under the direction of a qualified expert, thus launching the requirement for prescription only (non-narcotic) drugs.
1941 Insulin Amendment requires FDA to test and certify purity and potency of this life-saving drug for diabetes.

Nearly 300 deaths and injuries result from distribution of sulfathiazole tablets tainted with the sedative, phenobarbital. The incident prompts FDA to revise manufacturing and quality controls drastically, the beginning of what would later be called good manufacturing practices (GMPs).
1945 Penicillin Amendment requires FDA testing and certification of safety and effectiveness of all penicillin products. Later amendments would extend this requirement to all antibiotics. In 1983 such control would be found no longer needed and abolished
1948 Supreme Court rules in U. S. v. Sullivan that FDA's jurisdiction extends to the retail distribution, thereby permitting FDA to interdict in pharmacies illegal sales of drugs--the most problematical being barbiturates and amphetamines.
1951 Durham-Humphrey Amendment defines the kinds of drugs that cannot be used safely without medical supervision and restricts their sale to prescription by a licensed practitioner.
1952 In U.S. v. Cardiff, the Supreme Court rules that the factory inspection provision of the 1938 FDC Act is too vague to be enforced as criminal law.

A nationwide investigation by FDA reveals that chloramphenicol, a broad-spectrum antibiotic, has caused nearly 180 cases of often fatal blood diseases. Two years later FDA would engage the American Society of Hospital Pharmacists, the American Association of Medical Record Librarians, and later the American Medical Association in a voluntary program of drug reaction reporting.
1953 Factory Inspection Amendment clarifies previous law and requires FDA to give manufacturers written reports of conditions observed during inspections and analyses of factory samples.
1955 HEW Secretary Olveta Culp Hobby appoints a committee of 14 citizens to study the adequacy of FDA's facilities and programs. The committee recommends a substantial expansion of FDA staff and facilities, a new headquarters building, and more use of educational and informational programs.
1962 Thalidomide, a new sleeping pill, is found to have caused birth defects in thousands of babies born in western Europe. News reports on the role of Dr. Frances Kelsey, FDA medical officer, in keeping the drug off the U.S. market, arouse public support for stronger drug regulation.

Kefauver-Harris Drug Amendments are passed to ensure drug efficacy and greater drug safety. For the first time, drug manufacturers are required to prove to FDA the effectiveness of their products before marketing them. In addition, FDA is given closer control over investigational drug studies, FDA inspectors are granted access to additional company records, and manufacturers must demonstrate the efficacy of products approved prior to 1962.
1963 Advisory Committee on Investigational Drugs meets, the first meeting of a committee to advise FDA on product approval and policy on an ongoing basis.
1965 Drug Abuse Control Amendments are enacted to deal with problems caused by abuse of depressants, stimulants, and hallucinogens.
1966 FDA contracts with the National Academy of Sciences/National Research Council to evaluate the effectiveness of 4,000 drugs approved on the basis of safety alone between 1938 and 1962.
1968 FDA Bureau of Drug Abuse Control and the Treasury Department's Bureau of Narcotics are transferred to the Department of Justice to form the Bureau of Narcotics and Dangerous Drugs (BNDD), consolidating efforts to police traffic in abused drugs. A reorganization of BNDD in 1973 formed the Drug Enforcement Administration.

FDA forms the Drug Efficacy Study Implementation (DESI) to incorporate the recommendations of a National Academy of Sciences investigation of effectiveness of drugs marketed between 1938 and 1962.

Animal Drug Amendments place all regulation of new animal drugs under one section of the Food, Drug, and Cosmetic Act--Section 512--making approval of
animal drugs and medicated feeds more efficient.
1970 In Upjohn v. Finch, the Court of Appeals upholds enforcement of the 1962 drug effectiveness amendments by ruling that commercial success alone does not
constitute substantial evidence of drug safety and efficacy.

FDA requires the first patient package insert: oral contraceptives must contain information for the patient about specific risks and benefits.

The Comprehensive Drug Abuse Prevention and Control Act replaces previous laws and categorizes drugs based on abuse and addiction potential vis-à-vis therapeutic value.
1972 Over-the-Counter Drug Review initiated to enhance the safety, effectiveness and appropriate labeling of drugs sold without prescription.
1973 The U. S. Supreme Court upholds the 1962 drug effectiveness law and endorses FDA action to control entire classes of products by regulations rather than to rely only on time-consuming litigation.
1976 Vitamins and Minerals Amendments ("Proxmire Amendments") stop FDA from establishing standards limiting potency of vitamins and minerals in food supplements or regulating them as drugs based solely on potency.
1982 Tamper-resistant packaging regulations issued by FDA to prevent poisonings such as deaths from cyanide placed in Tylenol capsules. The Federal Anti-Tampering Act passed in 1983 makes it a crime to tamper with packaged consumer products.
1983 Orphan Drug Act passed, enabling FDA to promote research and marketing of drugs needed for treating rare diseases.
1984 Drug Price Competition and Patent Term Restoration expedites the availability of less costly generic drugs by permitting FDA to approve applications to market generic versions of brand-name drugs without repeating the research done to prove them safe and effective. At the same time, the brand-name companies can apply for up to five years additional patent protection for the new medicines they developed to make up for time lost while their products were going through FDA's approval process.
1987 FDA revises investigational drug regulations to expand access to experimental drugs for patients with serious diseases with no alternative therapies.
1988 The Prescription Drug Marketing Act bans the diversion of prescription drugs from legitimate commercial channels. Congress finds that the resale of such drugs leads to the distribution of mislabeled, adulterated, subpotent, and counterfeit drugs to the public. The new law requires drug wholesalers to be licensed by the states; restricts reimportation from other countries; and bans sale, trade or purchase of drug samples, and traffic or counterfeiting of redeemable drug coupons.
1991 FDA publishes regulations to accelerate reviews of drugs for life-threatening diseases.
1992 Generic Drug Enforcement Act imposes debarment and other penalties for illegal acts involving abbreviated drug applications.

Prescription Drug User Fee requires drug and biologics manufacturers to pay fees for product applications and supplements, and other services. The act also requires FDA to use these funds to hire more reviewers to assess applications.
1994 FDA announces it could consider regulating nicotine in cigarettes as a drug, in response to a citizen's petition by the Coalition on Smoking OR Health.

Uruguay Round Agreements Act extends the patent terms of U.S. drugs from 17 to 20 years.
1995 FDA declares cigarettes to be "drug delivery devices." Restrictions are proposed on marketing and sales to reduce smoking by young people.
1997 Food and Drug Administration Modernization Act reauthorizes the Prescription Drug User Fee Act of 1992 and mandates the most wide-ranging reforms in agency practices since 1938. Provisions include measures to accelerate review of devices, advertising unapproved uses of approved drugs and devices, health claims for foods in agreement with published data by a reputable public health source, and development of good guidance practices for agency decision-making.