Although both parties have urged a bipartisan response to the recent fungal meningitis outbreak, House Democrats pushed for legislation Wednesday that clarifies the Food and Drug Administration’s authority over compounding pharmacies, while Republicans expressed skepticism that a gap currently exists.
At a House Energy and Commerce Oversight Subcommittee hearing, Henry A. Waxman, the top Democrat on the full panel, said Congress should move “to correct the law” on a bipartisan basis before lawmakers head home at the end of the year. The often-heated hearing focused on whether the outbreak, which has been linked to a contaminated injectable steroid produced by a Massachusetts compounding pharmacy, could have been prevented.
“We’re going to be held responsible as members of Congress to make sure the law is clear and that the agency has the ability and resources to do the job that everybody expects you should have done,” Waxman, D.-Calif., told FDA Commissioner Margaret A. Hamburg. “And we want to make sure that you’re able to do it.”
Hamburg said her agency has “ambiguous, fragmented, unclear and contested authorities” over compounding pharmacies, noting that they are exempt from key parts of FDA law and that a “disconnect” exists between legal requirements across the country.
“I think there’s an enormous lack of clarity, and I think we should seize this opportunity to address it,” she said.
Hamburg said her agency would like to see a “risk-based framework” in which traditional compounding, or creating a customized medication for a particular patient, would be overseen at the state level. But she said there is a need for new legislation to provide FDA with broader authority over so-called non-traditional compounding, which “involve larger volume, more complex products, including sterile products, and broader distribution, potentially putting more patients at risk.”
The outbreak has been linked to 461 cases of illness across 19 states so far, including 32 deaths, according to the Centers for Disease Control and Prevention.
But Republicans said they believe FDA already had the necessary authority and repeatedly pressed Hamburg to state whether the agency had the power to shut down the New England Compounding Center.
“If there really is a lack of regulatory authority at some level, then that’s a legitimate policy recommendation,” said Texas Republican Joe L. Barton. “But if there’s not a lack of regulatory authority in existence in state and federal law right now, then it’s unnecessary.”
Full committee Chairman Fred Upton, R-Mich., also criticized the agency for not turning over documents related to the company that his panel has requested. He asked for a commitment that Hamburg would be fully responsive to questions from both parties so the committee can figure out what went wrong and patients can be assured of their safety going forward.
“This is not going to be the last hearing, because we don’t have the information that we need to proceed,” Upton said.
Speaking to reporters after the hearing, Subcommittee Chairman Cliff Stearns of Florida said Republicans are receptive to passing legislation on the issue this session. But he agreed that Congress still lacks the information it needs to legislate and maintained that GOP lawmakers cannot find any reason the FDA did not act after it issued a warning letter in 2006.
Terri Henderson, 6, center, whose mother is El Salvador, attends a rally with members of Congress at Union Station's Columbus Circle to announce the Restore Opportunity, Strengthen, and Improve the Economy (ROSIE) Act on July 29, 2014. The legislation provides incentives for government contractors to pay a living wage and other benefits that would help low-income workers.