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USE OF ADVISORY COMMITTEES BY THE FOOD AND DRUG ADMINISTRATION

HEARINGS

BEFORE A

SUBCOMMITTEE OF THE

COMMITTEE ON

GOVERNMENT OPERATIONS
HOUSE OF REPRESENTATIVES

NINETY-THIRD CONGRESS

SECOND SESSION

MARCH 6, 7, 8, 12, 13; APRIL 30; AND MAY 21, 1974

Printed for the use of the Committee on Government Operations

34-974 O

U.S. GOVERNMENT PRINTING OFFICE

WASHINGTON: 1974

For sale by the Superintendent of Documents, U.S. Government Printing Office
Washington, D.C. 20402 - Price $4.65

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COMMITTEE ON GOVERNMENT OPERATIONS

JACK BROOKS, Texas

CHET HOLIFIELD, California, Chairman

L. H. FOUNTAIN, North Carolina
ROBERT E. JONES, Alabama

JOHN E. MOSS, California
DANTE B. FASCELL, Florida
HENRY S. REUSS, Wisconsin

TORBERT H. MACDONALD, Massachusetts
WILLIAM S. MOORHEAD, Pennsylvania
WM. J. RANDALL, Missouri

BENJAMIN S. ROSENTHAL, New York
JIM WRIGHT, Texas

FERNAND J. ST GERMAIN, Rhode Island
JOHN C. CULVER, Iowa

FLOYD V. HICKS, Washington
DON FUQUA, Florida

JOHN CONYERS, JR., Michigan
BILL ALEXANDER, Arkansas
BELLA S. ABZUG, New York

HAROLD D. DONOHUE, Massachusetts
JAMES V. STANTON, Ohio
LEO J. RYAN, California
CARDISS COLLINS, Illinois

FRANK HORTON, New York
JOHN N. ERLENBORN, Illinois
JOHN W. WYDLER, New York
CLARENCE J. BROWN, Ohio
GUY VANDER JAGT, Michigan
GILBERT GUDE, Maryland

PAUL N. MCCLOSKEY, JR., California
JOHN H. BUCHANAN, JR., Alabama
SAM STEIGER, Arizona
GARRY BROWN, Michigan
CHARLES THONE, Nebraska
RICHARD W. MALLARY, Vermont
STANFORD E. PARRIS, Virginia
RALPH S. REGULA, Ohio
ANDREW J. HINSHAW, California
ALAN STEELMAN, Texas

JOEL PRITCHARD, Washington
ROBERT P. HANRAHAN, Illinois

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CONTENTS

330-331

April 26, 1966, and May 16, 1966, the Upjohn Co. memorandums
regarding Promone injections_

August 15, 1972, excerpt from the Federal Register regarding legal

status of approved labeling for prescription drugs; prescribing

for uses unapproved by the FDA...

Correspondence sent to the Cardiovascular and Renal Committee
members prior to their April 13, 1973, meeting-
FDA documents filed in the Supreme Court_-
FDA Public Advisory Committees as of December 31, 1973- 440-441
FDA statement on Ob/Gyn advisory committee meeting April 27,
1973, re followup on Depo Provera users.

231-232

414-431

383-384

June 3, 1974, letter to Chairman Fountain regarding subcommittee
staff documents on propranolol and advisory committees.. 332-334

Letters regarding carcinogenicity studies on propranolol..

March 7, 1974, report of the Bureau of Drugs meeting with OSE

and advisory committee chairmen__.

Letters, statements, etc. submitted for the record by-Continued
Crout, J. Richard, M.D.-Continued

Page

355-356

Statement by Charles Anello, Sc. D., Director, Division of Sta-
tistics, Bureau of Drugs, FDA, re Depo-Provera
Statement of Edwin M. Ortiz, M.D., and Marion J. Finkel, M.D.,
regarding efficacy for the drug diethylstilbestrol.

Statement by Marion J. Finkel, M.D., re DES in livestock feed
and as "morning after" contraceptive---

Statement by Victor Berliner, Ph. D., Supervisory Pharma-
cologist, Division of Metabolic and Endocrine Drug Products,
Bureau of Drugs, FDA, re Depo-Provera

Fountain, Hon. L. H., a Representative in Congress from the State
of North Carolina, and chairman, Intergovernmental Relations
Subcommittee:

Accounting of costs-Advisory committee chairmen attending
the December 14, 1973 meeting, table_-_-

410

442

376

105

April 23, 1973, letter to members, Cardiovascular and Renal
Advisory Committee, regarding rationale for using propranolol
in angina pectoris_-

April 19, 1974, FDA memorandum regarding Depo-Provera,
clarification of recall status.

277-278

447-448

338-339

112-114

450-452

Article from the January 1974 issue of Family Planning Digest
entitled "FDA OK's Limited Depo-Provera Use".
Chronology of NDA 16–762 for propranolol ("Inderal”) for angina
pectoris prepared by subcommittee staff__
Correspondence regarding the recall of Depo-Provera
Correspondence with HEW Secretary and the Commissioner of
Food and Drug Administration concerning the need to
strengthen FDA's procedures to prevent the appointment of
special employees who may have conflicts of interest....
Costs involved for operating certain advisory committees for
1972 and 1973, etc...

496-501

87-89

356-363

Documents, medical officers' reviews of NDA No. 12-541/S-004
and IND 1086, concerning Depo-Provera - -
Excerpt from the Federal Register of February 11, 1974, regarding
medroxyprogesterone acetate for intramuscular administration
(withdrawal of approval of pertinent parts of new drug
application)

446-447

272-275

Excerpts of the April 14, 1972, meeting of the Cardiovascular
and Renal Advisory Committee__
February 14, 1973, covering letter and HEW memorandum of
January 3, 1973, re interim procedures to insure implementation
of the provisions of the Federal Advisory Committee Act,
Public Law 92-463_.

482-487

February 14, 1973, open and closed sessions, minutes of the
FDA Cardiovascular and Renal Advisory Committee and
costs entailed.

311-314

314-317

February 25, 1974, open session, eighth meeting of the FDA
Ophthalmic Drugs Advisory Committee..
Food and Drug Administration, Bureau of Drugs, minutes, 10th
meeting (closed session) FDA Cardiovascular and Renal
Advisory Committee, April 13, 1973____

FDA's compliance with requirements of Advisory Committee
Act, statement prepared by subcommittee staff.
FDA memorandum of December 1, 1972, regarding Commis-
sioner's staff meeting with Bureau of Drugs-November 30,
1972.

July 9, 1974, letter to Chairman Fountain from the American
Law Division of the Library of Congress, re Freedom of
Information Act...

141

77-78

460-461

June 22, 1973, pharmacology review of NDA 16-762, propra-
nolol.

480

267-268

Letter, dated February 28, 1974, to D. C. Goldberg, professional
staff member, Intergovernmental Relations Subcommittee,
from Eric O. Feigl, M.D., professor, University of Washing-
ton, re strengthening the FDA advisory committees...

191

Letters, statements, etc., submitted for the record by-Continued
Fountain, Hon. L. H.-Continued

Letter, dated July 15, 1974, to Hon. Roy Ash, Director, OMB,
and C. W. Weinberger, Secretary HEW, from L. H. Fountain,
and reply from Secretary Weinberger re: underestimation of
advisory committee costs--

Letter, dated May 8, 1973, from Ayerst Laboratories to FDA,
subject: NDA 16-762; Inderal (propranolol hydrochloride)
tablets..

Letters to the editor, JAMA, and drug commentary, JAMA,
regarding propranolol..

Page

90-93

127

258-265

288-290

March 29, 1974, excerpt from the Federal Register regarding
Subpart D-Records and Reports_---
Memorandum, dated December 11, 1972, to Acting Director,
Division of Cardiopulmonary-Renal Drug Products, from
Acting Director, Office of Scientific Evaluation, subject:
Propanolol and bethanidine..

Minutes of 7th Meeting-Panel on Review of Orthopaedic De-
vices, January 14, 1973_.

Notice of meetings which appeared in the Federal Register of
April 22, 1974.

150

516

489-491

November 13, 1973, letter to Chairman Holifield from Under
Secretary Frank C. Carlucci, HEW, re travel regulations
concerning selection of meeting sites..

513-514

October 3, 1972, memorandum from Dr. Crout regarding Inderal
in treatment of angina pectoris. -

248-249

October 10, 1973, excerpt from the Federal Register regarding medroxyprogesterone acetate injectable contraceptive__ 323-328 Position descriptions for GS-14 and GS-15 medical officers engaged in new drug review work..

Review of clinical data-NDA 12-541, Depo Provera__
Summary by Dr. Belton, of basis of approval of propranolol
Sundry documents regarding diethylstilbestrol postcoitally.

505-509 366-367

135

386-390

Tables 0006 and 0013 of the third national cancer survey. 370-373 United States Code, chapter 5, administrative procedure, title 5, section 552_

Verbatim transcript of April 13, 1973, closed meeting of Cardi-
ovascular-Renal Advisory Committee__

470

296-310

Working group on use of advisory committees in drug evaluation— avoiding conflict of interests in special Government employees_245-246 Hutt, Peter Barton, Assistant General Counsel, Food and Drug Division, HEW:

Court citations regarding public disclosure....
Definition of controlled study.

471

413-414

HEW policies covering records of advisory committee meetings. 465-466
Information regarding disposition of committee meeting tran-
scripts (statement by Ernest L. Brisson, FDA).
Policy regarding panel meeting transcripts.

462

458-459

469

Stenographic services utilized by the Bureau of Drugs.
Rodgers, William H., Jr., professor of law, Georgetown University Law
Center:

Biographical note_

Statement..

209

215-218

Schmidt, Alexander M., M.D., Commissioner, Food and Drug Administration:

Copies of letters which were sent to advisory committee chairmen
and replies thereto...

101-104

Curriculums vitae of Drs. Schmidt, Crout, Tepper, and Mr.
Hutt...

5-10

Estimated cost of six new committees to be established by Secre-
tary involving drug review process, and calendar year 1973 re-
port to OMB showing estimated cost and man-years expended
in support of FDA advisory committees __

85-86

Statement..

Submissions to additional subcommittee questions.
Wesson, Laurence G., M.D., Jefferson Medical College, Philadelphia
Pa.:

11-66

515-522

Curriculum vitae_

Statement...

175

178-181

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