Kefauver–Harris Amendment
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The U.S. Kefauver–Harris Amendment or "Drug Efficacy Amendment" is a 1962 amendment to the
Federal Food, Drug, and Cosmetic Act The United States Federal Food, Drug, and Cosmetic Act (abbreviated as FFDCA, FDCA, or FD&C) is a set of laws passed by the United States Congress in 1938 giving authority to the U.S. Food and Drug Administration (FDA) to oversee the food safety ...
. It introduced a requirement for drug manufacturers to provide proof of the effectiveness and safety of their drugs before approval,Peltzman, Sam
An Evaluation of Consumer Protection Legislation: The 1962 Drug Amendments
The Journal of Political Economy, Vol. 81, No. 5. (Sep. - Oct., 1973), pp. 1051.
required drug advertising to disclose accurate information about side effects, and stopped cheap generic drugs being marketed as expensive drugs under new trade names as new "breakthrough" medications.


Background

The amendment was a response to the thalidomide tragedy, in which thousands of children were born with birth defects as a result of their mothers taking
thalidomide Thalidomide, sold under the brand names Contergan and Thalomid among others, is an oral administered medication used to treat a number of cancers (e.g., multiple myeloma), graft-versus-host disease, and many skin disorders (e.g., complication ...
for morning sickness during pregnancy. The bill by
U.S. Senator The United States Senate is a chamber of the bicameral United States Congress; it is the upper house, with the U.S. House of Representatives being the lower house. Together, the Senate and House have the authority under Article One of the ...
Estes Kefauver Carey Estes Kefauver ( ; July 26, 1903 – August 10, 1963) was an American politician from Tennessee. A member of the Democratic Party, he served in the U.S. House of Representatives from 1939 to 1949 and in the U.S. Senate from 1949 until h ...
, of
Tennessee Tennessee (, ), officially the State of Tennessee, is a landlocked U.S. state, state in the Southeastern United States, Southeastern region of the United States. It borders Kentucky to the north, Virginia to the northeast, North Carolina t ...
, and
U.S. Representative The United States House of Representatives is a chamber of the bicameral United States Congress; it is the lower house, with the U.S. Senate being the upper house. Together, the House and Senate have the authority under Article One of th ...
Oren Harris Oren Harris (December 20, 1903 – February 5, 1997) was a United States representative from Arkansas and a United States district judge of the United States District Court for the Eastern District of Arkansas and the United States District Court ...
, of
Arkansas Arkansas ( ) is a landlocked state in the West South Central region of the Southern United States. It borders Missouri to the north, Tennessee and Mississippi to the east, Louisiana to the south, Texas to the southwest, and Oklahoma ...
, required drug manufacturers to provide proof of the effectiveness and safety of their drugs before approval. The majority of the tragic birth defects that occurred were in other countries because Thalidomide had not been approved for use in the United States. However, samples were distributed to physicians in the US and 17 birth defects were attributed to its use.
Frances Oldham Kelsey Dr Frances Kathleen Oldham Kelsey ( Oldham; July 24, 1914 – August 7, 2015) was a Canadian-American pharmacologist and physician. As a reviewer for the U.S. Food and Drug Administration (FDA), she refused to authorize thalidomide for market ...
was the FDA reviewer who refused to approve Thalidomide for use. It introduced a "proof-of-efficacy" requirement for the first time. In addition, the Amendment required drug advertising to disclose accurate information about side effects and efficacy of treatments. Finally, cheap generic drugs could no longer be marketed as expensive drugs under new trade names as new "breakthrough" medications. The law was signed by President
John F. Kennedy John Fitzgerald Kennedy (May 29, 1917 – November 22, 1963), also known as JFK, was the 35th president of the United States, serving from 1961 until his assassination in 1963. He was the first Roman Catholic and youngest person elected p ...
on October 10, 1962.


Effect

The Kefauver–Harris Amendment strengthened the
U.S. Food and Drug Administration The United States Food and Drug Administration (FDA or US FDA) is a federal agency of the Department of Health and Human Services. The FDA is responsible for protecting and promoting public health through the control and supervision of food ...
's control of experimentation on humans and changed the way new
drugs A drug is any chemical substance other than a nutrient or an essential dietary ingredient, which, when administered to a living organism, produces a biological effect. Consumption of drugs can be via inhalation, injection, smoking, ingestio ...
are approved and regulated. Before the Thalidomide scandal in Europe, and Canada, U.S. drug companies only had to show their new products were safe. After the passage of the Amendment, an FDA
New Drug Application The Food and Drug Administration's (FDA) New Drug Application (NDA) is the vehicle in the United States through which drug sponsors formally propose that the FDA approve a new pharmaceutical for sale and marketing. Some 30% or less of initial ...
(NDA) would have to show that a new drug was both safe and effective. Previously the 1938
Food, Drug and Cosmetic Act The United States Federal Food, Drug, and Cosmetic Act (abbreviated as FFDCA, FDCA, or FD&C) is a set of laws passed by the United States Congress in 1938 giving authority to the U.S. Food and Drug Administration (FDA) to oversee the safety of ...
was the main law that regulated drug safety.
Informed consent Informed consent is an applied ethics principle that a person must have sufficient information and understanding before making decisions about accepting risk. Pertinent information may include risks and benefits of treatments, alternative treatme ...
was required of patients participating in clinical trials, and
adverse drug reaction An adverse drug reaction (ADR) is a harmful, unintended result caused by taking medication. ADRs may occur following a single dose or prolonged administration of a drug or may result from the combination of two or more drugs. The meaning of this ...
s were required to be reported to the FDA. The
Drug Efficacy Study Implementation Drug Efficacy Study Implementation (DESI) was a program begun by the Food and Drug Administration (FDA) in the 1960s after the requirement (in the Kefauver-Harris Drug Control Act) that all drugs be efficacious as well as safe, was made part of US ...
was begun to classify all pre-1962 drugs that were already on the market as either effective, ineffective, or needing further study.
Estes Kefauver Carey Estes Kefauver ( ; July 26, 1903 – August 10, 1963) was an American politician from Tennessee. A member of the Democratic Party, he served in the U.S. House of Representatives from 1939 to 1949 and in the U.S. Senate from 1949 until h ...
considered the Amendment his "finest achievement" in
consumer protection Consumer protection is the practice of safeguarding buyers of goods and services, and the public, against unfair practices in the marketplace. Consumer protection measures are often established by law. Such laws are intended to prevent business ...
.
Louis Lasagna Louis Cesare Lasagna (February 22, 1923 – August 6, 2003) was an American physician and professor of medicine, known for his revision of the Hippocratic Oath. Early life and education Lasagna was an internationally recognized and respected e ...
, then a prominent clinical pharmacologist at the
Johns Hopkins School of Medicine The Johns Hopkins University School of Medicine (JHUSOM) is the medical school of Johns Hopkins University, a private research university in Baltimore, Maryland. Established in 1893 following the construction of the Johns Hopkins Hospital, th ...
, advised Congress about the proper conduct of clinical research during the 1962 hearings leading up to passage of the Amendment. The law also exempted from the "
Delaney clause The Food Additives Amendment of 1958 is a 1958 amendment to the United States' Food, Drugs, and Cosmetic Act of 1938. It was a response to concerns about the safety of new food additives. The amendment established an exemption from the "food add ...
" (a 1958 amendment to the Food, Drugs, and Cosmetic Act of 1938) certain animal drugs and animal feed additives shown to induce cancer, but which left no detectable levels of residue in the human food supply.


See also


References

Sources * Abood, R.R., & Brushwood, D.B. (1994). Pharmacy practice and the law. Gaithersburg, MD: Aspen Publishers, Inc. * Krantz JC Jr., New Drugs and the Kefauver–Harris Amendment, J New Drugs, 1966, Mar-Apr;6(22):77-9 * Krantz JC Jr., The Kefauver-Harris amendment after sixteen years, Mil Med. 1978 Dec;143(12):883.


External links


50 Years: The Kefauver-Harris Amendments
from the U.S. Food and Drug Administration
Drug Amendments Act of 1962
Enrolled Acts and Resolutions of Congress at the U.S. National Archives and Records Administration {{DEFAULTSORT:Kefauver-Harris Amendment Pharmaceuticals policy United States federal health legislation 1962 in American law