REGGIE B. WALTON, District Judge.
The plaintiff filed its Complaint in this case on July 8, 2010, alleging that certain actions taken by the United States Food and Drug Administration (the "FDA") violated both the Administrative Procedure Act ("APA"), 5 U.S.C. § 702 (2006), and the Food, Drug, and Cosmetic Act ("FDCA"), 21 U.S.C. § 355(a) (2006). This case is now before the Court on the parties' cross-motions for summary judgment. See Plaintiff's Motion for Summary Judgment ("Pl.'s Mot."); Federal Defendants' Motion for Summary Judgment ("Defs.' Mot.").
The FDCA provides that "[n]o person shall introduce or deliver for introduction into interstate commerce any new drug, unless an approval of an application filed pursuant to ... this section is effective with respect to such drug." 21 U.S.C. § 355(a). In other words, the FDCA "requires all new prescription drugs to obtain FDA approval under a new drug application ('NDA') before they can enter the marketplace." Pl.'s Mem. at 4. An NDA submitted by a drug manufacturer seeking FDA approval of a brand name drug, also known as a pioneer drug,
"A drug shall be considered to be bioequivalent to a listed drug if the rate and extent of absorption of the drug do not show a significant difference from the rate and extent of absorption of the listed drug." 21 U.S.C. § 355(j)(8)(B)(i). Additionally, for locally acting, topical drugs, "the Secretary may establish alternative, scientifically valid methods to show bioequivalence if the alternative methods are expected to detect a significant difference between the [proposed generic] drug and the listed drug in safety and therapeutic effect." Id. § 355(j)(8)(C).
The plaintiff manufactures Aldara, a topical, locally acting cream that was first approved as a pioneer drug by the FDA on February 27, 1997. Pl.'s Stmnt. ¶ 1. Aldara's active ingredient is imiquimod. Id. Aldara is currently approved by the FDA for the treatment of three conditions (also known as "indications"). Id. ¶ 2; see Defs.' Stmnt. ¶ 1. First, in 1997, the FDA approved Aldara for the treatment of external genital and perianal warts ("genital warts" or "EGW"), a form of sexually transmitted disease caused by infection with certain strains of the human papillomavirus. Pl.'s Stmnt. ¶ 2. Then in 2004, the FDA approved Aldara for the treatment of clinically typical, nonhyperkeratotic, nonhypertrophic actinic keratoses ("actinic keratoses") on the face or scalp. Id. ¶ 3. Actinic keratoses are flat, scaly growths on the skin that usually form on parts of the body that are exposed to
On June 23, 2004, defendant-intervenor Nycomed submitted to the FDA a draft protocol for conducting a clinical bioequivalence study involving patients with EGW as part of its effort to obtain FDA approval for a generic version of Aldara. Id. ¶ 8. On March 11, 2005, the FDA's Office of Generic Drugs, the division of the FDA charged with reviewing Nycomed's ANDA, provided written comments on Nycomed's proposed protocol in which it instructed the applicant to perform a single clinical bioequivalence study involving patients with actinic keratoses, rather than EGW. Id. ¶ 9; Pl.'s Mem. at 8. On that same date, the Office of Generic Drugs provided the same instructions regarding clinical bioequivalence studies involving patients with actinic keratoses to a number of other applicants seeking approval for generic versions of Aldara. Pl.'s Stmnt. ¶ 10. Four years later, in March of 2009, the Office of Generic Drugs prepared a draft guidance for imiquimod and sent it to the FDA Dermatology Division for review. Id. ¶¶ 12-13. In its June 15, 2009 response, the Dermatology Division rejected the Office of Generic Drugs' view that a single study concerning actinic keratoses was appropriate. Id. ¶ 14. Rather, the Dermatology Division recommended that if the FDA were going to allow generic applicants for Aldara to conduct a single clinical trial for purposes of demonstrating bioequivalence, that the study should involve patients with sBCC, not actinic keratoses. Id. The Dermatology Division later went a step further and recommended that applicants for generic versions of Aldara conduct clinical studies involving patients with EGW as well. Id. ¶ 15.
On July 30, 2009, the plaintiff filed a Citizen Petition in which it asked the "FDA to require any ANDA for a generic imiquimod cream product relying on Aldara as the [pioneer drug, or] referenced product[,] to include [among other things,] comparative clinical data showing bioequivalence in patients with genital warts."
On January 26, 2010, the FDA issued a Citizen Petition Response (the "Response") in which it concluded that a single comparative clinical study involving patients with actinic keratoses is sufficient to demonstrate bioequivalence in all three conditions for which Aldara has FDA approval — genital warts, actinic keratoses, and sBCC.
On February 25, 2010, the FDA approved Nycomed's ANDA for an imiquimod topical cream. Pl.'s Stmnt. ¶ 24. The demonstration of bioequivalence in Nycomed's ANDA was supported by clinical trials conducted by Nycomed involving patients with actinic keratoses. Id. ¶ 26.
Courts will grant a motion for summary judgment under Rule 56(a) of the Federal Rules of Civil Procedure only if the moving party has shown "that there is no genuine dispute as to any material fact and [it] is entitled to judgment as a matter of law." Fed.R.Civ.P. 56(a). Moreover, "in ruling on cross-motions for summary judgment, the Court shall grant summary judgment only if one of the moving parties is entitled to judgment as a matter of law upon material facts that are not genuinely disputed." Muwekma Ohlone Tribe v. Kempthorne, 452 F.Supp.2d 105, 113 (D.D.C.2006) (Walton, J.) (citation omitted). Summary judgment "is an appropriate procedure when a court reviews an agency's administrative record," Shays v. FEC, 424 F.Supp.2d 100, 109-10 (D.D.C.2006), and, because this case "involves a challenge to a final administrative action, the Court's review is limited to the administrative record." Fund for Animals v. Babbitt, 903 F.Supp. 96, 105 (D.D.C.1995) (citing Camp v. Pitts, 411 U.S. 138, 142, 93 S.Ct. 1241, 36 L.Ed.2d 106 (1973)).
The APA entitles a person suffering legal wrong because of agency action, or adversely affected or aggrieved by agency action to judicial review. 5 U.S.C. § 702; Hill Dermaceuticals, Inc. v. FDA, 524 F.Supp.2d 5, 9 (D.D.C.2007). The APA requires the reviewing court to set aside an agency action that is "arbitrary, capricious, an abuse of discretion, or otherwise not in accordance with law." 5 U.S.C. § 706(2)(A). In conducting this review, considerable deference must be accorded to the agency. See Citizens to Pres. Overton Park, Inc. v. Volpe, 401 U.S. 402, 416, 91 S.Ct. 814, 28 L.Ed.2d 136 (1971). Specifically, in the context of this case, the
Despite the presumption of validity and the deference that must be afforded to an agency's actions, a reviewing court "must consider whether the [agency's] decision was based on a consideration of the relevant factors and whether there has been a clear error of judgment." Marsh v. Or. Natural Res. Council, 490 U.S. 360, 378, 109 S.Ct. 1851, 104 L.Ed.2d 377 (1989) (internal quotation marks omitted). At a minimum, the agency must have considered relevant data and articulated an explanation establishing a "rational connection between the facts found and the choice made." Bowen v. Am. Hosp. Ass'n, 476 U.S. 610, 626, 106 S.Ct. 2101, 90 L.Ed.2d 584 (1986) (citation omitted). An agency action usually is arbitrary or capricious if
Motor Veh. Mfrs. Ass'n v. State Farm Mut. Auto. Ins. Co., 463 U.S. 29, 43, 103 S.Ct. 2856, 77 L.Ed.2d 443 (1983); see also County of L.A. v. Shalala, 192 F.3d 1005, 1021 (D.C.Cir.1999) ("Where the agency has failed to provide a reasoned explanation, or where the record belies the agency's conclusion, [the court] must undo its action."). As noted, the "requirement that agency action not be arbitrary or capricious includes a requirement that the agency adequately explain its result." Pub. Citizen, Inc. v. FAA, 988 F.2d 186, 197 (D.C.Cir.1993). This requirement is not particularly demanding, however. Id. Nothing more than a "brief statement" is necessary, so long as the agency explains "why it chose to do what it did." Tourus Records, Inc. v. DEA, 259 F.3d 731, 737 (D.C.Cir.2001). If the court can "reasonably... discern[ ]" the agency's path, it will uphold the agency's decision. Pub. Citizen, 988 F.2d at 197 (citing Bowman Transp., Inc. v. Arkansas-Best Freight Sys., Inc., 419 U.S. 281, 286, 95 S.Ct. 438, 42 L.Ed.2d 447 (1974)).
The Court's analysis begins with the District of Columbia Circuit's pronouncement that the FDA's "evaluations of scientific data within its area of expertise ... [are] entitled to a high level of deference." Serono, 158 F.3d at 1320 (internal quotation marks and citation omitted). This Circuit has also stated that the FDA's "judgment[] as to what is required to ascertain the safety and efficiency of drugs falls squarely within the ambit of the FDA's expertise and merit[s] deference" from the courts. A.L. Pharma, Inc. v. Shalala, 62 F.3d 1484, 1490 (D.C.Cir.1995) (citation omitted). Moreover, this "high degree of deference has been applied to the FDA's determinations regarding which methodologies it determines are needed to test the bioequivalency of a given generic." Astellas Pharma, 642 F.Supp.2d at 19 (citing Serono, 158 F.3d at 1325; Bristol-Myers Squibb, 923 F.Supp. at 217-18; Somerset Pharm., Inc. v. Shalala, 973 F.Supp. 443 at 453 (D.Del.1997)); see Schering Corp. v. FDA, 51 F.3d 390, 399 (3d Cir.1995) (holding that the FDA's approval of an ANDA was valid because, although a finding of bioequivalence is required
As noted above, the plaintiff makes two principal arguments why the FDA's actions in denying its Citizen Petition were arbitrary, capricious, and contrary to law. First, the plaintiff challenges the FDA's conclusion in its Response that external genital warts, actinic keratoses, and sBCC all share the same site of action. See Pl.'s Mem. at 15. Second, the plaintiff maintains that the FDA's conclusion in its Response that external genital warts are related to actinic keratoses and sBCC was based on an illogical conclusion and was contrary to the evidence before it. See Id. at 23. The FDA, on the other hand, maintains that both of these conclusions were based upon reasoned scientific analysis, and were therefore not arbitrary, capricious, or otherwise contrary to law. See Defs.' Mem. at 14-16. For the reasons that follow, the Court must side with the defendants.
The plaintiff contends that the FDA's conclusion that there is not a "sufficiently material difference in absorption properties between skin located in the genital area and skin located on the face and scalp" was a departure from its past agency positions and not supported by sufficient explanation. Pl.'s Mem. at 16. The plaintiff further maintains that the "FDA tries to sidestep this issue by asserting that the site of action for imiquimod is not where on the body the drug acts but rather in what layer of skin." Id. (internal emphases omitted). The plaintiff also strenuously asserts that the impropriety of the FDA's position is evidenced by the fact that the "FDA's own experts in the Dermatology Division" agreed with the plaintiff that "EGW occur at different anatomical locations with different types of skin." Id. at 15. Finally, the plaintiff argues that the FDA has improperly transferred the burden of proof concerning bioequivalency, or specifically the lack thereof, to the plaintiff rather than requiring the generic manufacturer seeking ANDA approval to show bioequivalence. Id. at 22. For these reasons, the plaintiff posits that it was a violation of the APA for the FDA to permit manufacturers seeking approval of generic imiquimod creams to submit bioequivalence studies based solely on actinic keratoses. See Pl.'s Mem. at 18 (discussing the site of action argument in connection to the labeling requirements imposed on Aldara).
The FDA responds that the pertinent question regarding the plaintiff's site of action argument "is not whether the two sites are the same in all respects, but whether they would respond to treatment with the generic product to the same extent that they would to Aldara, and that [this] is a question that requires scientific expertise to answer." Defs.' Mem. at 19. The FDA further contends that "[the plaintiff's] argument that the `sites of action' are different, boils down to an assertion that the properties of [actinic keratoses] and EGW-affected skin must be different, and a belief that this must matter somehow." Id. (internal footnote omitted). The FDA maintains that its Response "considered and rejected all of these assertions and explained that it found `no direct support in the literature for [the plaintiff's] contention that the absorptive properties of EGW-affected skin are significantly different from [actinic keratoses] or sBCC-affected skin.'" Id. (quoting the Response at 10). The FDA thus asserts that the Response's rejection of the plaintiff's site of action argument
The plaintiff makes much of the Dermatology Division's assessment of the issues in question, namely, its opinion that a clinical trial based solely on patients with actinic keratoses would be insufficient to demonstrate bioequivalence between Aldara and generic imiquimod given the different sites of action. See Pl.'s Mem. at 15 ("But more telling still, in the matter at hand, [the] FDA's own experts in the Dermatology Division told the decisionmakers: `We further agree that EGW occur at different anatomical locations with different types of skin. Of the three indications, EGW is the only one that could potentially involve mucosal skin. If there is some difference in behavior of a generic product on mucosal skin as compared to Aldara, such a condition could only be identified in the study of EGW.'") (quoting November 18, 2009 letter from Dr. Brenda Carr to Dr. Beitz); Pl.'s Reply at 2 ("[A]s the FDA dermatologists aptly pointed out, [the] FDA simply can make no predictive statements about how the generic product will work in patients with EGW without running clinical tests in patients with that disease."). The fact remains, however, that within the FDA hierarchy, the Dermatology Division does not, and in this case did not, have the final word in responding to the plaintiff's Citizen Petition. Rather, that authority belongs to Dr. Janet Woodcock as the director of the CDER. Defs.' Stmnt. ¶ 41. As the District of Columbia Circuit observed in Serono,
158 F.3d at 1321 (internal citations omitted). Accordingly, the Court must examine the extent to which the Response, signed by Dr. Woodcock and issued pursuant to her authority as director of the CDER, contained well-reasoned explanations.
The internal disagreement between the different divisions of the FDA is certainly not irrelevant, but neither is it the dispositive proof of arbitrary and capricious action that the plaintiff seems to believe it is. Had the FDA entirely ignored the opinion offered by the Dermatology Division regarding the need for tests run in patients with EGW, then there would be some evidence that the FDA's actions were perhaps arbitrary or capricious. Here, however, after the internal disagreement arose, the FDA elevated the matter to Dr. Beitz, the "supervisor of the dermatologists," Defs.' Stmnt. ¶ 3 6, who conducted a new round of research and offered her own, independent findings, Id. ¶ 37. Examining the exact argument raised by the Dermatology Division, Dr. Beitz concluded that
Id. ¶¶ 38, 39 (quoting January 26, 2010 Memorandum from Dr. Beitz).
Thus, upon the Court's review of the administrative record it is clear that the "FDA produced a comprehensive response
The plaintiff is both correct in one respect and incorrect in another respect. The plaintiff is correct that the FDCA imposes upon the generic manufacturer the burden of demonstrating bioequivalence, and upon the FDA the burden of finding that the pioneer and the generic are bioequivalent before it approves the generic manufacturer's ANDA. The plaintiff is incorrect, however, in its understanding of how these burdens structure the regulatory process. For example, here, the generic manufacturer, Nycomed, submitted its ANDA, and, satisfied that the ANDA demonstrated bioequivalence, the FDA approved it. The FDA explained at length in its Response the reasons why it believed the studies conducted involving only patients with actinic keratoses were sufficient to demonstrate bioequivalence, and, in connection with this explanation, challenged the plaintiff to provide evidence disproving its conclusions. In other words, the FDA is not asking the plaintiff to prove lack of bioequivalence; rather, the FDA, after concluding that its proposed course of action would satisfy the duties imposed upon it by the FDCA and the FDA regulations, merely explained that one reason it denied the plaintiff's Citizen Petition was because it found no scientific evidence, nor did the plaintiff submit scientific findings, contrary to or disproving its conclusion. The FDA was satisfied with the studies' ability to demonstrate bioequivalence; it was the plaintiff who was not. See Astellas Pharma, 642 F.Supp.2d at 20 (concluding that the plaintiff "has identified no studies or other evidence demonstrating that the FDA's conclusion was irrational, implausible[,] or contrary to existing scientific consensus"). Accordingly, as did the Court in Astellas Pharma, this Court concludes that "although the plaintiff provides ample support for the uncontroversial position that supplemental testing could reveal additional information pertinent to bioequivalency, it has made no showing that the testing guidelines established by the FDA were insufficient to meet its statutory obligation to ensure the safety and efficiency of new drugs." Id.
The plaintiff next argues that the "FDA's [denial of its Citizen Petition] also is predicated upon the unsubstantiated assertion that genital warts are `related' to [actinic keratoses] and sBCC." Pl.'s Mem. at 23 (quoting the Response at 9 (FDA000374)). Again, the plaintiff seizes on the opinion of the Dermatology Division as support for its argument: "the [C]ourt need look no further than what [the]
The FDA responds that the plaintiff's argument is based on the "false premise[] that [the] FDA found the three indications to be related because they are treated by the same drug." Defs.' Mem. at 25 n. 22 (internal emphasis omitted). The FDA contends that its Response adequately explained its conclusions that: (1) a presumption can be made that it is not necessary for one of the indications in a multi-indication drug to be related to the others to conclude that a comparative clinical study based on one indication is sufficient to show bioequivalence; (2) even without that presumption, a single study could suffice if the FDA could reasonably conclude that the rate and extent of absorption of the generic does not show a significant different from the pioneer; and (3) genital warts, actinic keratoses, and sBCC were, in fact, related in light of their response to topical treatments that enhance local and cell-mediated immunity in immunocompetent individuals. Id. at 25-26. Thus, much like its arguments in response to the plaintiff's site of action argument, the FDA maintains that its denial of the Citizen Petition was well-reasoned, thoroughly explained, and based on scientific evidence.
The Court once again notes that it is not the Dermatology Division's opinion that is afforded deference under the precedent of this Circuit. The Court's task in evaluating the plaintiff's relatedness argument is therefore similar to that undertaken above in reference to the site of action argument: was the FDA's denial of the plaintiff's Citizen Petition well-reasoned, sufficiently explained, and in line with the scientific evidence before it? After a thorough review of the FDA's Response, and the entire administrative record, the Court concludes the answer to this question is yes.
In the portion of the Response addressing the relatedness of the three indications for which Aldara has FDA approval, the FDA explained that
Response at 8 (FDA 000373) (internal footnote omitted). The FDA, therefore, did not conclude that genital warts, actinic keratoses, and sBCC are related for all purposes or simply on the basis that they could all be treated by imiquimod. Rather, the FDA concluded that all three are
As explained above, because the FDA addressed each argument raised in the plaintiff's Citizen Petition, explained its conclusion with respect to each argument, and cited the scientific literature on which it relied, the FDA's Response denying the plaintiff's Citizen Petition was not arbitrary, capricious, or otherwise contrary to law, and therefore does not violate the APA. The plaintiff's motion for summary judgment is therefore