Hugh Pickens DOT Com writes
"Bloomberg reports that 23andMe Inc., the Google-backed DNA analysis company, has been told by US regulators to halt sales of its main product, the Saliva Collection Kit and Personal Genome Service, or PGS that tells users whether they carry a disease, are at risk of a disease and would respond to a drug because the kit is being sold without FDA's marketing clearance or approval. 'FDA is concerned about the public health consequences of inaccurate results from the PGS device,' says the agency. 'The main purpose of compliance with FDA's regulatory requirements is to ensure that the tests work.' 23andMe was founded six years ago by Anne Wojcicki, who recently separated from her husband, Google co-founder Sergey Brin. The FDA decided in 2010 that services claiming to evaluate a customer's risk of disease must be cleared by regulators if the companies sell directly to consumers. Most FDA-cleared genetic tests are for a single disease while 23andMe's would be the first to test for multiple conditions. 23andMe submitted FDA applications in July and September of 2012 for the least stringent of two types of medical device reviews but the FDA said the company failed to address 'the issues described during previous interactions'."
Re:Democracy?
By nbauman
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2013-Nov-25 15:49
• Score: 5, Insightful
• Thread
The FDA bears the brunt of all public outrage of anything even tangentially related to medicine. They are bureaucrats who want to avoid responsibility at any cost. The FDA also bears none of the costs of testing new products.
What outcome did you expect?
A different model might take the utility of public safety into account. Instead of "safety at any cost", it might be "more good than harm".
That's not true. I've read the FDA regulations, and I've read transcripts of FDA hearings, which are now online. They have to weigh the benefits of the new drugs against the dangers. They have long debates in the hearings over the benefits and the potential harm. And some of the people on the panel are sympathetic to the industry. It's a difficult balance http://www.reuters.com/article/2013/10/18/us-ariad-cancer-idUSBRE99H0BP20131018
There were lots of drugs, like erythropoetin, that the drug companies over-promoted and made lots of money on, even though they were killing people. Their excuse was, "We didn't get a statistical signal." Every time a pro-business administration takes over, the FDA loosens up its regulations, and the bodies start dropping, so they tighten up the regulations again.
The FDA is not allowed to take the financial cost of the new drugs into account. That's not in their legal mandate.
Sounds like 23andMe gave the FDA the finger
By AdamHaun
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2013-Nov-25 16:16
• Score: 5, Informative
• Thread
If even half of the FDA's letter is correct (and I see no reason to doubt it), they've been bending over backwards to work with 23andMe for years. The company made a deliberate decision to both ignore the regulators and (more damningly) fail to study the effectiveness of their own product, and now they're paying for it. Here's the relevant section of the letter:
Your company submitted 510(k)s for PGS on July 2, 2012 and September 4, 2012, for several of these indications for use. However, to date, your company has failed to address the issues described during previous interactions with the Agency or provide the additional information identified in our September 13, 2012 letter for (b)(4) and in our November 20, 2012 letter for (b)(4), as required under 21 CFR 807.87(1). Consequently, the 510(k)s are considered withdrawn, see 21 C.F.R. 807.87(1), as we explained in our letters to you on March 12, 2013 and May 21, 2013. To date, 23andMe has failed to provide adequate information to support a determination that the PGS is substantially equivalent to a legally marketed predicate for any of the uses for which you are marketing it; no other submission for the PGS device that you are marketing has been provided under section 510(k) of the Act, 21 U.S.C. 360(k).
The Office of In Vitro Diagnostics and Radiological Health (OIR) has a long history of working with companies to help them come into compliance with the FD&C Act. Since July of 2009, we have been diligently working to help you comply with regulatory requirements regarding safety and effectiveness and obtain marketing authorization for your PGS device. FDA has spent significant time evaluating the intended uses of the PGS to determine whether certain uses might be appropriately classified into class II, thus requiring only 510(k) clearance or de novo classification and not PMA approval, and we have proposed modifications to the device’s labeling that could mitigate risks and render certain intended uses appropriate for de novo classification. Further, we provided ample detailed feedback to 23andMe regarding the types of data it needs to submit for the intended uses of the PGS. As part of our interactions with you, including more than 14 face-to-face and teleconference meetings, hundreds of email exchanges, and dozens of written communications, we provided you with specific feedback on study protocols and clinical and analytical validation requirements, discussed potential classifications and regulatory pathways (including reasonable submission timelines), provided statistical advice, and discussed potential risk mitigation strategies. As discussed above, FDA is concerned about the public health consequences of inaccurate results from the PGS device; the main purpose of compliance with FDA’s regulatory requirements is to ensure that the tests work.
However, even after these many interactions with 23andMe, we still do not have any assurance that the firm has analytically or clinically validated the PGS for its intended uses, which have expanded from the uses that the firm identified in its submissions. In your letter dated January 9, 2013, you stated that the firm is “completing the additional analytical and clinical validations for the tests that have been submitted” and is “planning extensive labeling studies that will take several months to complete.” Thus, months after you submitted your 510(k)s and more than 5 years after you began marketing, you still had not completed some of the studies and had not even started other studies necessary to support a marketing submission for the PGS. It is now eleven months later, and you have yet to provide FDA with any new information about these tests. You have not worked with us toward de novo classification, did not provide the additional information we requested necessary to complete review of your 510(k)s, and FDA has n
Re:Fuck these government pricks
By ausekilis
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2013-Nov-25 16:19
• Score: 4, Insightful
• Thread
Assessments for drug responses carry the risks that patients relying on such tests may begin to self-manage their treatments through dose changes or even abandon certain therapies depending on the outcome of the assessment
I am a 23andme member and my genetic test showed that I am sensitive to warfarin. That's something I never knew before. If I ever get into a situation where that drug is used, having informed the doctor of this potential problem just might have saved my life. There is no possibility that this information could result in any harm, because if the doctor gives a lower than normal dose and it's not effective, he can simply give more.
First, it's not that the FDA wants a monopoly on genetic tests. Their interest is in the safety and education of the populous (queue conspiracy theorists). They focus on making sure the public is getting accurate, validated information on treatments/drugs that do only what they advertise.
Second, you are putting your trust into something that may or may not be peer-reviewed and ensured to be accurate. Just because your genetic makeup says you may have a sensitivity doesn't mean you actually do. Would you really risk not having a surgery if you discovered through a mail-order cheek swab that you "may be sensitive" to penicillin?
Third, sensitivities and allergens are certainly not something to be played with. The difference between mild rash to anaphylactic shock can be pretty small for some people and some allergens. I know people that are resistant to the standard anasthesias, and in some cases the only way to get them numb is to get dangerously close to an LD50 injection (sometimes an alternative doesn't work or is not available).
I'm not belittling the information that you received from them or that it may have been useful to you. What the FDA is doing is making sure that the claim of someones sensitivity to something is accurate and informative for that individual. Too many people out there will find out they are sensitive to wheat, then go out of their way to make sure not only do they not eat wheat, but they purge their houses of wheat, refuse to touch flour or wheat products, then start some non-profit organization to start feeding fear to the populous that wheat is a poison that must be purged.
Re:Fuck these government pricks
By TsuruchiBrian
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2013-Nov-25 16:28
• Score: 5, Insightful
• Thread
Being aware of false information can have a negative impact, in the same way that bogus leads can hinder a police investigation.
That said, I think the FDA should be allowed to put their stamp of approval on things, but they shouldn't be allowed to prevent people from deciding what medical tests and procedures they do to themselves.
Re:Democracy?
By Anonymous Coward
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2013-Nov-25 16:40
• Score: 5, Insightful
• Thread
Pregnancy tests are also regulated as medical devices. They cost $5.
23andMe can grow up and have their work validated clinically. Or they can find an industry where accuracy is not regulated.