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Emergency Use Authorization

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595: 277:– all in response to the COVID-19 pandemic. On April 16, 2021, the FDA revoked the emergency use authorization (EUA) that allowed for the investigational monoclonal antibody therapy bamlanivimab, when administered alone, to be used for the treatment of mild-to-moderate COVID-19 in adults and certain pediatric patients. 119:
The "may be effective" standard for EUAs provides for a lower level of evidence than the "effectiveness" standard that the FDA uses for product approvals, using a risk-benefit analysis based on "the totality of the scientific evidence available", it is "reasonable to believe" that the product may be
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EUAs have historically been infrequent. A review article by Rizk et al. provides a summary of the US experience in 2020 with pharmacological EUA approvals during the COVID-19 pandemic. It also provides a description of, and clinical rationale for, the EUA-approved drugs during the pandemic and
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EUAs may be applied to drugs, devices or biological product. EUAs may permit the emergency use of an unapproved drug, device or biologic product, or permit an unapproved use of an approved drug, device or biologic product. Furthermore, drugs, devices or biologic products may or may not have
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Consideration of a drug for an EUA requires a finding that it is "reasonable to believe" that the drug "may be effective" "to prevent, diagnose, or treat serious or life-threatening diseases or conditions that can be caused by a agent(s)" or to mitigate a disease or condition caused by an
198:. Under certain conditions, an EUA may authorize the emergency use in humans, of drugs, devices or biologic products approved under the animal efficacy rule. EUAs may also only be implemented during the period of a public health emergency as defined by a declaration of the Secretary of 104:. Subsequent legislative authorities expanded the class of drugs eligible for consideration, and the range of testing to which the drug or therapy has been subjected. The scope and applicability of EUAs is also affected by 676: 127:
determines that the precipitating emergency has ended (in consultation with the issuer of the appropriate state of emergency as necessary), or once the product or unapproved use is approved through normal channels.
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of 2004 (S. 15, Public Law 108–276) for funding of the development and procurement of medical countermeasures against CBRN threats, the Pandemic and All-Hazards Preparedness Reauthorization Act of 2013 (H.R. 307,
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of the drug in the full statutory meaning of the term, but instead authorizes the FDA to facilitate availability of an unapproved product, or an unapproved use of an approved product, during a declared
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undergone human efficacy trials, due to risk, feasibility or ethical considerations. Drugs, devices or biologic products which have only been tested or approved under the
112:), which may affect the definition of the situations considered to be public health emergencies, and under which the authority of the FDA to issue EUAs may be exercised. 374:
Webb, Jamie; Shah, Lesha D.; Lynch, Holly Fernandez (September 1, 2020). "Ethically Allocating COVID-19 Drugs Via Pre-approval Access and Emergency Use Authorization".
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Rizk, John G.; Forthal, Donald N.; Kalantar-Zadeh, Kamyar; Mehra, Mandeep R.; Lavie, Carl J.; Rizk, Youssef; Pfeiffer, JoAnn P.; Lewin, John C. (November 2020).
697: 199: 636: 124: 222:(CDC), on April 27, 2009, the FDA issued Emergency Use Authorizations to make available diagnostic and therapeutic tools to identify and respond to the 514: 612: 253:, for deployment of the FDA EUA for certain medical devices involved in the diagnosis of COVID-19. In February 2020, The FDA issued an EUA for 281: 219: 93: 651: 713: 285: 32: 554: 137: 44: 319: 466:
FDA Authorizes Emergency Use of Influenza Medicines, Diagnostic Test in Response to Swine Flu Outbreak in Humans.
416:"Expanded Access Programs, compassionate drug Use, and Emergency Use Authorizations during the COVID-19 pandemic" 288:. The vaccine had received emergency authorization in the United Kingdom earlier in the month, but according to 116:
FDA-regulated product ... used to diagnose, treat, or prevent a disease or condition caused by" such an agent.
65: 573:"Coronavirus (COVID-19) Update: FDA Revokes Emergency Use Authorization for Monoclonal Antibody Bamlanivimab" 578: 472: 28: 292:
officials, this was only for certain batches of the vaccine. In the U.S., the VRBPAC supported an EUA for
203: 178: 109: 158: 284:'s Vaccines and Related Biological Products Advisory Committee (VRBPAC) voted to recommend EUA for the 166: 146: 314: 309: 202:. Conditions determining the applicability of such declarations may be specified by federal statute. 223: 175: 155: 630: 162: 89: 141: 235: 191: 226:
under certain circumstances. The agency issued these EUAs for the use of certain powerful
8: 540:"Emergency Use Authorization (EUA) of Remdesivir for Coronavirus Disease 2019 (COVID-19)" 463: 262: 440: 415: 391: 270: 81: 61: 488:"Coronavirus Disease 2019 (COVID-19) Emergency Use Authorizations for Medical Devices" 48: 677:"2020 Meeting Materials, Vaccines and Related Biological Products Advisory Committee" 445: 395: 242: 435: 427: 383: 254: 231: 85: 387: 431: 207: 105: 36: 614:
Vaccines and Related Biological Products Advisory Committee - 12/10/2020 meeting
289: 227: 707: 599: 52: 539: 140:(FDCA) of 1938 (Public Law 75-717) as added and subsequently amended by the 449: 274: 101: 97: 245:, the Secretary of HHS declared the public health emergency for the novel 349:"Emergency Use Authorization of Medical Products and Related Authorities" 273:(revoked, although its license for established indications remains), and 77:
concluding reflections on the EUA program and its potential future uses.
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This article incorporates text from this source, which is in the
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Pandemic and All-Hazards Preparedness Reauthorization Act of 2013
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In the United States, EUAs are authorized by Section 564 of the
652:"U.K. Approves Pfizer coronavirus vaccine, a first in the West" 413: 64:
from one of several agencies or of a "material threat" by the
515:"U.S. Approves Abbott Labs Coronavirus Test For Hospital Use" 257:
CDC test kits for COVID-19. In 2020, the FDA issued EUAs for
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chemical, biological, radiological and nuclear (CBRN) threats
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After initial authorizations for serious diseases such as
27:) in the United States is an authorization granted to the 131: 16:
Granted by the Food and Drug Administration in the US
167: 147: 617:. Archived from the original on December 10, 2020 552: 542:. U.S. Food and Drug Administration. May 1, 2020. 409: 407: 405: 343: 341: 339: 337: 335: 705: 649: 635:: CS1 maint: bot: original URL status unknown ( 565: 402: 332: 210:(Title 3 of the Code of Federal Regulations). 555:"FDA Authorizes Remdesivir Drug for COVID-19" 373: 282:Center for Biologics Evaluation and Research 553:Holland S, Mason J, Maler S (May 1, 2020). 220:Centers for Disease Control and Prevention 185:Applicability and the animal efficacy rule 165:of 2016 (H.R. 34, Public Law 114–255) and 494:. FDA U.S. Food & Drug Administration 439: 512: 241:On February 4, 2020, in response to the 643: 320:Pan American Health Organization (PAHO) 213: 706: 218:In response to requests from the U.S. 125:Secretary of Health and Human Services 51:, to allow the use of a drug prior to 650:Benjamin Mueller (December 2, 2020). 33:Federal Food, Drug, and Cosmetic Act 132:History of legal authority for EUAs 35:as added to and amended by various 13: 265:, Fresenius Propoven 2% emulsion ( 172:Tooltip Public Law (United States) 152:Tooltip Public Law (United States) 138:Federal Food Drug and Cosmetic Act 14: 725: 691: 376:The American Journal of Bioethics 120:effective for the specified use. 593: 286:Pfizer–BioNTech COVID-19 vaccine 249:virus, which causes the disease 88:, EUAs were also authorized for 669: 605: 583:(Press release). April 16, 2021 353:US Food and Drug Administration 315:European Medicines Agency (EMA) 310:World Health Organization (WHO) 200:Health and Human Services (HHS) 546: 532: 506: 480: 456: 367: 66:Secretary of Homeland Security 1: 388:10.1080/15265161.2020.1795529 325: 106:presidential executive orders 714:Food and Drug Administration 579:Food and Drug Administration 473:Food and Drug Administration 432:10.1016/j.drudis.2020.11.025 208:presidential executive order 31:(FDA) under sections of the 29:Food and Drug Administration 7: 698:Emergency Use Authorization 303: 204:Code of Federal Regulations 110:Code of Federal Regulations 92:principally in response to 21:Emergency Use Authorization 10: 730: 181:of 2017 (no short title). 468:FDA News, April 27, 2009" 94:public health emergencies 55:. It does not constitute 43:(PAHPRA), as codified by 224:2009 swine flu pandemic 90:medical countermeasures 280:In December 2020, the 163:21st Century Cures Act 71: 194:are loosely known as 142:Project BioShield Act 420:Drug Discovery Today 214:Use during pandemics 192:animal efficacy rule 683:. December 3, 2020. 263:convalescent plasma 39:, including by the 656:The New York Times 559:The New York Times 271:hydroxychloroquine 123:EUAs end once the 82:pandemic influenza 62:state of emergency 296:'s mRNA vaccine, 243:COVID-19 pandemic 86:emerging diseases 721: 685: 684: 673: 667: 666: 664: 662: 647: 641: 640: 634: 626: 624: 622: 609: 603: 597: 596: 592: 590: 588: 569: 563: 562: 550: 544: 543: 536: 530: 529: 527: 525: 510: 504: 503: 501: 499: 484: 478: 477: 460: 454: 453: 443: 411: 400: 399: 371: 365: 364: 362: 360: 345: 255:COVID-19 testing 232:quantitative PCR 173: 169: 153: 149: 108:(Title 3 of the 37:Acts of Congress 729: 728: 724: 723: 722: 720: 719: 718: 704: 703: 694: 689: 688: 675: 674: 670: 660: 658: 648: 644: 628: 627: 620: 618: 611: 610: 606: 594: 586: 584: 571: 570: 566: 551: 547: 538: 537: 533: 523: 521: 511: 507: 497: 495: 486: 485: 481: 462: 461: 457: 412: 403: 372: 368: 358: 356: 347: 346: 333: 328: 306: 228:antiviral drugs 216: 196:animal products 187: 171: 151: 134: 74: 49:§ 360bbb-3 17: 12: 11: 5: 727: 717: 716: 702: 701: 693: 692:External links 690: 687: 686: 668: 642: 604: 564: 545: 531: 513:Bruce Japsen. 505: 479: 455: 426:(2): 593–603. 401: 366: 355:. January 2017 330: 329: 327: 324: 323: 322: 317: 312: 305: 302: 290:European Union 230:, and for the 215: 212: 186: 183: 133: 130: 73: 70: 45:21 U.S.C. 15: 9: 6: 4: 3: 2: 726: 715: 712: 711: 709: 699: 696: 695: 682: 678: 672: 657: 653: 646: 638: 632: 631:cite AV media 616: 615: 608: 601: 600:public domain 582: 580: 574: 568: 560: 556: 549: 541: 535: 520: 516: 509: 493: 489: 483: 475: 474: 469: 467: 459: 451: 447: 442: 437: 433: 429: 425: 421: 417: 410: 408: 406: 397: 393: 389: 385: 381: 377: 370: 354: 350: 344: 342: 340: 338: 336: 331: 321: 318: 316: 313: 311: 308: 307: 301: 299: 295: 291: 287: 283: 278: 276: 272: 268: 264: 260: 256: 252: 248: 244: 239: 237: 233: 229: 225: 221: 211: 209: 205: 201: 197: 193: 182: 180: 177: 176:115–92 (text) 170: 164: 160: 157: 150: 143: 139: 129: 126: 121: 117: 113: 111: 107: 103: 99: 95: 91: 87: 83: 78: 69: 67: 63: 58: 54: 50: 46: 42: 38: 34: 30: 26: 22: 680: 671: 659:. Retrieved 655: 645: 621:December 10, 619:. Retrieved 613: 607: 585:. Retrieved 576: 567: 558: 548: 534: 522:. Retrieved 518: 508: 496:. Retrieved 491: 482: 471: 465: 458: 423: 419: 379: 375: 369: 357:. Retrieved 352: 279: 275:bamlanivimab 240: 217: 195: 188: 156:113–5 (text) 135: 122: 118: 114: 100:, including 98:bioterrorism 79: 75: 56: 24: 20: 18: 661:December 2, 498:October 19, 382:(9): 4–17. 700:by the FDA 326:References 259:remdesivir 247:SARS-CoV-2 234:swine flu 587:April 16, 396:221324833 298:mRNA-1273 708:Category 524:April 7, 450:33253920 304:See also 267:propofol 251:COVID-19 96:such as 57:approval 53:approval 492:fda.gov 441:7694556 359:May 14, 294:Moderna 168:Pub. L. 161:), the 148:Pub. L. 519:Forbes 448:  438:  394:  206:or an 174:  154:  47:  581:(FDA) 577:U.S. 392:S2CID 179:(PDF) 159:(PDF) 663:2020 637:link 623:2020 589:2021 526:2020 500:2020 446:PMID 361:2020 236:test 84:and 681:FDA 436:PMC 428:doi 384:doi 269:), 72:Use 25:EUA 19:An 710:: 679:. 654:. 633:}} 629:{{ 575:. 557:. 517:. 490:. 470:. 444:. 434:. 424:26 422:. 418:. 404:^ 390:. 380:20 378:. 351:. 334:^ 300:. 261:, 238:. 68:. 665:. 639:) 625:. 602:. 591:. 561:. 528:. 502:. 476:. 464:" 452:. 430:: 398:. 386:: 363:. 23:(

Index

Food and Drug Administration
Federal Food, Drug, and Cosmetic Act
Acts of Congress
Pandemic and All-Hazards Preparedness Reauthorization Act of 2013
21 U.S.C.
§ 360bbb-3
approval
state of emergency
Secretary of Homeland Security
pandemic influenza
emerging diseases
medical countermeasures
public health emergencies
bioterrorism
chemical, biological, radiological and nuclear (CBRN) threats
presidential executive orders
Code of Federal Regulations
Secretary of Health and Human Services
Federal Food Drug and Cosmetic Act
Project BioShield Act
Pub. L.
113–5 (text)
(PDF)
21st Century Cures Act
Pub. L.
115–92 (text)
(PDF)
animal efficacy rule
Health and Human Services (HHS)
Code of Federal Regulations

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