FDA Issues New Guidance for REMS Testing During COVID-19 Pandemic

The FDA has issued a new guidance to sponsors and health care providers regarding certain Risk Evaluation and Mitigation Strategy (REMS)-required testing during the coronavirus disease 2019 (COVID-19) pandemic.

“The FDA recognizes that during the COVID-19 public health emergency, the completion of some REMS-required laboratory testing or imaging studies may be difficult because patients suspected of having COVID-19 may be self-isolating and/or subject to quarantine,” said Amy Abernethy, MD, PhD, principal deputy commissioner of the FDA, in a press release. “Under these circumstances, undergoing testing or imaging studies in order to obtain a drug that is subject to a REMS can put patients and others at risk for transmission of the coronavirus. We will continue to work with sponsors to ensure that patients have appropriate access to the medications they need.”

According to the letter, health care providers prescribing and/or dispensing drugs who are subject to REMS with laboratory testing or imagining requirements should consider whether there are compelling reasons not to complete these tests or studies during this public health emergency and use their best medical judgement in weighing the benefits and risks of continuing treatment in the absence of laboratory testing and imaging studies.

The FDA does not intend to take action against sponsors and others for the duration of the public health emergency for failing to adhere to REMS requirements for certain laboratory testing or imaging studies.

Additionally, the FDA may require REMS for certain drugs if the agency determines that it is necessary to ensure that the benefits of the drug outweigh its risks. Generally, REMS may include a medication guide, a patient package insert, a communication plan, and certain packaging and safe disposal technologies for drugs that pose a serious risk of abuse or overdose.

The agency may also require certain elements to assure safe use (ETASU) as part of REMS for a drug. ETASU are medical interventions or other actions health care professionals need to execute prior to prescribing or dispensing the drug to the patient, such as a requirement to undergo monthly laboratory testing. Some actions may also be required in order for the patient to continue on treatment.

The policy outlined in the guidance will be in effect for the duration of the public health emergency.

Reference

• Coronavirus (COVID-19) Update: FDA provides update on patient access to certain REMS drugs during COVID-19 public health emergency [news release]. FDA website. Published March 22, 2020. https://www.fda.gov/news-events/press-announcements/coronavirus-covid-19-update-fda-provides-update-patient-access-certain-rems-drugs-during-covid-19. Accessed March 23, 2020.