Drug safety is an utmost important consideration during drug development. Pharmaceutical drug use in the USA dates back more than a century, and the use of these drugs led to creation of new acts or changes to the existing ones. A glaring example of the need for drug safety occurred in October 1937, when the use of the antibiotic sulfanilamide caused upwards of 100 deaths. Mortality was not due to the active ingredient itself, but by the addition of diethylene glycol (DEG): a solvent for the API. DEG was thought to be inert, lacking any therapeutic benefits. However, it was the toxicity of the substance that led to the fatal side effects. The manufacturer claimed they did not foresee these side effects, due to the lack of animal studies prior to the drug being released to market. Due to this incident, the U.S. Food and Drug Administration (FDA) approved an act to ensure the safety of any drug by mandating non-clinical and clinical studies before drugs are marketed for public use. (1)
Since the early days of FDA regulation regarding drug safety, the method most utilized to remove potentially hazardous materials from the market is through the use of recalls. These are by far the most effective way to deal with public health hazards while also allowing the manufacturer to maintain their reputation to the global market. This is because the majority of recalls seen in modern days are voluntary.
Types of Recalls/Withdrawals
In most cases, drug companies should remove any products that are beyond their control and that are determined to be in violation of FDA regulations from the market. How the violative product is removed from the market will depend on the nature and extent of the violation, with the two primary mechanisms being recall and market withdrawal.
A recall involves the removal and/or correction of a marketed product that violates FDA regulations and laws; for example, if it is adulterated or misbranded. If the FDA decides the necessity, it could take enforcement action due to its statutory powers, thus mandating a recall. However, more often, companies decide to perform voluntary recalls. A recall could be ordered for something as simple as a specification deviation result during expiration testing which occurs prior to the labeled expiration date. When a company decides to voluntarily recall a product must notify FDA and provide the following information as outlined in the regulations:
· The product involved and the rationale for the recall
· The company's risk evaluation of the problem
· The total amount of product in distribution
· The proposed recall strategy
· A copy of the proposed or distributed recall communication.
Along with the FDA, companies typically consider the class of the recalled product (I, II, or III). (2) The FDA has three classes of recall: those products that merely violate the FDA’s labeling or manufacturing laws; those that might cause a temporary health problem or pose a slightly serious threat; and those dangerous or defective products that could cause serious health problems or death. (3)
If a company does not voluntarily conduct a recall that the FDA finds warranted, the FDA then has the authority to mandate the recall. When this occurs, the FDA conducts a health hazard evaluation, determining the recall class, and then informs the company of its decision.
A market withdrawal, in contrast to a recall, is the removal or correct...
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