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Why Compliance Is A Tough Pill
To Swallow - Nutraceuticals
Affiliate Summit West Conference | January 13, 2014

Rachel Hirsch, Senior Associate
Ifrah PLLC

David Graff, General Counsel
50 on Red

© Ifrah PLLC and 50 on Red. Proprietary and Confidential. / (202) 912-4823 / ifrahlaw.com
What Are Nutraceuticals?

 Has No Fixed Meaning In U.S. Law
 Coined From Words “Nutrition” And “Pharmaceutical”

 Applies To Products That Range From Isolated Nutrients, Dietary
Supplements and Herbal Products, Specific Diets and Processed Foods

© Ifrah PLLC. Proprietary and Confidential. / (202) 912-4823 / ifrahlaw.com
What Are Dietary Supplements?
 The Term is Defined In The Dietary Supplement Health and Education Act
(DSHEA) of 1994.
 It Is A Product Taken By Mouth That Contains a “Dietary Ingredient To
Supplement The Diet.”
 It May Include:
•
•
•
•

Vitamins
Minerals
Herbs/Botanicals
Amino Acids

•
•
•
•

Enzymes
Organ Tissue
Glandulars
Metabolites

 It Can Also Be Extracts Or Concentrates And Can Be Found In Many
Forms Such As: Tablets, Capsules, Softgels, Gelcaps, Liquids, Or
Powders.

© Ifrah PLLC. Proprietary and Confidential. / (202) 912-4823 / ifrahlaw.com
How Are Dietary Supplements Different Than Drugs?

 Generally, Dietary Supplements Do Not Have To Be Approved By The
FDA Before Marketing.
 BUT: Companies Must Register Their Manufacturing Facilities With
the FDA.
 With A Few Well-Defined Exceptions, Dietary Supplements May Only Be
Marketed To Support The Structure Or Function of the Body And May
Not Claim To Treat A Disease Or Condition.

 It Must Be Labeled As a Dietary Supplement And Include FDA
Disclosure: “These statements have not been evaluated by the Food
and Drug Administration. This product is not intended to diagnose,
treat, cure, or prevent any disease.”

© Ifrah PLLC. Proprietary and Confidential. / (202) 912-4823 / ifrahlaw.com
When Does The FDA Need To Be Notified Of A Dietary Supplement?

The DSHEA Requires That A Manufacturer Or Distributor Notify
FDA If It Intends To Market A “New Dietary Ingredient” (“NDI”).
An NDI Is Defined By Statute As:
“a dietary ingredient that was not marketed in the United States before
October 15, 1994.”
There Is No Authoritative List Of Dietary Ingredients That Were
Marketed Before October 15, 1994.

Changes In The Manufacturing Process For A Pre-DSHEA Dietary
Ingredient May Create An NDI – e.g., extract of plant leaves.

© Ifrah PLLC. Proprietary and Confidential. / (202) 912-4823 / ifrahlaw.com
Which Agency Oversees The Marketing Of Dietary Supplements?

The FDA and FTC Share Jurisdiction Through A Liaison Agreement.
FDA Has Primary Enforcement Responsibility for Claims Made In
Labeling And Packaging Under The Food, Drug and Cosmetic Act, As
Amended By The DSHEA.
 Tends To Focus On Product Composition
And Safety And Structure/Function Claims
Vs. Drug Claims.

FTC Has Primary Enforcement Responsibility For Claims Made In
Advertising Generally Under Section 5 Of The FTC Act.


Focused Solely On Advertising – Is it
Truthful? Is It Misleading? Is It Adequately
Substantiated?

© Ifrah PLLC. Proprietary and Confidential. / (202) 912-4823 / ifrahlaw.com
How Do The FTC And FDA Work Together?


FDA Warning Letters Referencing
Potential Violations Of The FTC Act,
Which Document FDA’s Position
That Certain Claims In Advertising
Materials Would Not Be Approved
By FDA For Use In Labeling.



FTC Orders Requiring Marketers To
Gain FDA Approval Prior To Using
Certain Claims In Advertising
Regulated By The FTC.



Press Releases Announcing The
FTC And FDA’s Simultaneous
Investigation Of Specific
Companies To Assess Violations Of
The FDCA And The FTC Act.

© Ifrah PLLC. Proprietary and Confidential. / (202) 912-4823 / ifrahlaw.com
CASE STUDY #1

© Ifrah PLLC. Proprietary and Confidential. / (202) 912-4823 / ifrahlaw.com
CASE STUDY #2

© Ifrah PLLC. Proprietary and Confidential. / (202) 912-4823 / ifrahlaw.com
What Does the FTC Consider Obvious Advertising “Red Flags?”

 Section 5 of the FTC Act Prohibits “Unfair Or Deceptive Acts Or
Practices In Or Affecting Commerce.”
Causes Weight Loss Of Two Pounds
Or More A Week For A Month Or
More Without Dieting Or Exercise

Blocks The Absorption Of Fat Or
Calories To Enable Consumers To
Lose Substantial Weight

Causes Substantial Weight Loss
No Matter What Or How Much
The Consumer Eats

Causes Substantial Weight
Loss For All Users

Causes Permanent Weight
Loss (Even When
Consumer Stops Using
Product)

Causes Substantial Weight Loss By
Wearing It On The Body Or Rubbing It
Into The Skin

 FTC’s Response: “Show Us The Study!”

© Ifrah PLLC. Proprietary and Confidential. / (202) 912-4823 / ifrahlaw.com
Which Claims Should Advertisers Beware Of In Marketing Dietary Supplements?

 Claims Based On Consumer Experiences Or Expert Endorsements.
 Require Clear And Conspicuous Disclosures
 “Results May Vary” Not Enough

 Claims Based On Traditional Uses.
 Consumer Perception Matters
 Competent And Reliable Evidence May Be Necessary.

 Use Of The DSHEA Disclaimer.
 May Be Necessary If Text Or Image Leads Consumer To Believe
Product Has Undergone FDA Review
 Will Not Cure Otherwise Deceptive Ad – i.e. Claims About
Disease Benefit Of Product

 Third Party Literature.
 May Not Be Used Deceptively and Must Be Explained In Context.
 May Impact What Claims Advertiser Will Be Responsible for Substantiating.

© Ifrah PLLC. Proprietary and Confidential. / (202) 912-4823 / ifrahlaw.com
What Constitutes Health Claims Substantiation Under The FTC Guidelines?

 FTC Has Typically Applied A “Substantiation Standard” Of “Competent And Reliable
Scientific Evidence” To Claims About The Benefits And Safety of Dietary Supplements And
Other Health-Related Products.
 “Competent And Reliable Scientific Evidence” Has Been Defined in FTC Case
Law As “Tests, Analyses, Research, Studies, Or Other Evidence Based On The
Expertise Of Professionals In The Relevant Area, That Has Been Conducted And
Evaluated In An Objective Manner By Persons Qualified To Do So, Using
Procedures Generally Accepted In The Profession To Yield Accurate and
Reliable Results.”

 There Is No Pre-Established Formula As To How Many Or What Type Of Studies Are
Needed To Substantiate A Claim.
 The Absence Of An FDA Determination That A Health Claim Is Scientifically Valid
Will Be A Significant Factor In The Commission’s Assessment Of The Adequacy Of
Substantiation For The Claim.

© Ifrah PLLC. Proprietary and Confidential. / (202) 912-4823 / ifrahlaw.com
How Does the FTC Health Claims Substantiation Guidance Compare To FDA Guidance?

Type of Claim

Type of
Product

Meaning of Claim

Benefit of a
Truthful Claim

FTC
Amount of
Substantiation
Believed to be
Reasonable

FDA

vs.
Cost of
Developing
Substantiation

Consequences
of False Claim

© Ifrah PLLC. Proprietary and Confidential. / (202) 912-4823 / ifrahlaw.com

Relationship of
Evidence to Claim

Quality of
Evidence

Totality of
Evidence
To Whom Does This Guidance Apply?

 The Guidance Applies Not Only To Product Manufacturers, But
To Product Distributors As Well.

 According to the FDA, A Distributor Who Contracts With A Manufacturer to
Manufacture Dietary Supplements, Which the Distributor Then Distributes
Under Its Own Label, Has An Obligation To Oversee Product Labeling,
Manufacturing Activities, and Product Distribution.

© Ifrah PLLC. Proprietary and Confidential. / (202) 912-4823 / ifrahlaw.com
What Can Dietary Supplement Marketers Do To Protect Themselves?
Claims

Labeling
 Review All Labels (Including Referenced
Website Materials) For Indications for Health
Or Nutrient Content Claims And Implied
Disease Claims (vs. Allowed Structure/Function
Claims

 Do NOT Make Overblown And Exaggerated
Claims.
 Include Substantiation For All Claims Of Product
Safety Or Effectiveness.

 Include: Statement Of Identity, Ingredients
Statement, Net Ingredients, Name And Place Of
Business, Phone Number, Any Material
Information About Use Of The Product,
Including Warnings Or Side Effects.

 Do NOT Base Your Marketing On Another
Product’s Marketing – No Copy And Paste Jobs.

 Do NOT Base Labeling On What’s Already In The
Market.

Manufacturing Practices

Clinical Studies
 Only Reference Clinical Studies That Are
Relevant To Your Product And Qualify Them –
i.e. Active Ingredient vs. Finished Product.

Select A Manufacturer Wisely – Do
Your Homework!






Conduct A Mini FDA-Style Inspection
– Employ Good Manufacturing
Practices



Negotiate A Manufacturing
Agreement – Do NOT Be Left Holding
The Bag For Product Recall Or Safety
Issues.

If You Conduct Clinical Trials, Register Them
With ClinicalTrials.Gov.

 Do NOT Reference Clinical Studies On Your
Website That Make Implied Drug Claims.

© Ifrah PLLC. Proprietary and Confidential. / (202) 912-4823 / ifrahlaw.com
WHAT ARE THE CONSEQUENCES OF NON-COMPLIANCE?

FTC
Enforcement

FDA
Enforcement








The FTC Enforcement Process
Regarding Advertising Usually Begins
In One Of Two Ways: (1) A Letter
From An FTC Attorney (Access
Letter); or (2) A Civil Investigation
Demand (CID) That the FTC Itself
Issues.
The Investigation Generally Remains
Non-Public Until The FTC Decides
Whether To Initiate A Formal Action
– Either Announcement Of Proposed
Consent Order Or Decree Or A Press
Release Regarding Charges Filed.
If You’re Lucky, The FTC Can Issue A
“Closing Letter,” Which is Available
On Its Website.
If The FTC Choose To File Charges, It
Will Seek Disgorgement of “IllGotten Gains.”

© Ifrah PLLC. Proprietary and Confidential. / (202) 912-4823 / ifrahlaw.com



The FDA May Conduct An
Unexpected Inspection Of
Your Facility At Any Time And
May Issue A Form FDA 483 To
Communicate Concerns
Discovered During Inspection.



A Recipient Of a 483 Should
Respond Within 15 Business
Days Regarding Plan Of Action
– Do NOT Tell The FDA To
Pound Sand!



All FDA Warning Letters Are
Public, Even If The Matter Is
Ultimately Closed.



Even After Clean Inspections,
FDA May Take Action That
Results In A Consent Decree,
Seizure, Product Recall, Or
Criminal Action.
SAMPLE FDA WARNING LETTER #1

© Ifrah PLLC. Proprietary and Confidential. / (202) 912-4823 / ifrahlaw.com
SAMPLE FDA WARNING LETTER #2

© Ifrah PLLC. Proprietary and Confidential. / (202) 912-4823 / ifrahlaw.com
HOW DO MARKETERS LAND ON THE GOVERNMENT’S RADAR?

State Attorney Generals

Private Litigants

© Ifrah PLLC. Proprietary and Confidential. / (202) 912-4823 / ifrahlaw.com

“Surf” Days

Your Competitors
FINAL THOUGHT

Spending A Little Money Now, Can Save You A Lot Of Money Later –
COMPLIANCE, COMPLIANCE, COMPLIANCE

© Ifrah PLLC. Proprietary and Confidential. / (202) 912-4823 / ifrahlaw.com
Thank You
Rachel Hirsch
email: rhirsch@ifrahlaw.com
website: www.ifrahlaw.com
blog: www.ftcbeat.com
@FTCLawyer

David Graff
email: dgraff@50onred.com
website: www.50onred.com

© 2010 Ifrah PLLC. Proprietary and Confidential. / (202) 912-4823 / ifrahlaw.com

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Why Compliance is a Tough Pill to Swallow – Nutraceuticals

  • 1. Why Compliance Is A Tough Pill To Swallow - Nutraceuticals Affiliate Summit West Conference | January 13, 2014 Rachel Hirsch, Senior Associate Ifrah PLLC David Graff, General Counsel 50 on Red © Ifrah PLLC and 50 on Red. Proprietary and Confidential. / (202) 912-4823 / ifrahlaw.com
  • 2. What Are Nutraceuticals?  Has No Fixed Meaning In U.S. Law  Coined From Words “Nutrition” And “Pharmaceutical”  Applies To Products That Range From Isolated Nutrients, Dietary Supplements and Herbal Products, Specific Diets and Processed Foods © Ifrah PLLC. Proprietary and Confidential. / (202) 912-4823 / ifrahlaw.com
  • 3. What Are Dietary Supplements?  The Term is Defined In The Dietary Supplement Health and Education Act (DSHEA) of 1994.  It Is A Product Taken By Mouth That Contains a “Dietary Ingredient To Supplement The Diet.”  It May Include: • • • • Vitamins Minerals Herbs/Botanicals Amino Acids • • • • Enzymes Organ Tissue Glandulars Metabolites  It Can Also Be Extracts Or Concentrates And Can Be Found In Many Forms Such As: Tablets, Capsules, Softgels, Gelcaps, Liquids, Or Powders. © Ifrah PLLC. Proprietary and Confidential. / (202) 912-4823 / ifrahlaw.com
  • 4. How Are Dietary Supplements Different Than Drugs?  Generally, Dietary Supplements Do Not Have To Be Approved By The FDA Before Marketing.  BUT: Companies Must Register Their Manufacturing Facilities With the FDA.  With A Few Well-Defined Exceptions, Dietary Supplements May Only Be Marketed To Support The Structure Or Function of the Body And May Not Claim To Treat A Disease Or Condition.  It Must Be Labeled As a Dietary Supplement And Include FDA Disclosure: “These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.” © Ifrah PLLC. Proprietary and Confidential. / (202) 912-4823 / ifrahlaw.com
  • 5. When Does The FDA Need To Be Notified Of A Dietary Supplement? The DSHEA Requires That A Manufacturer Or Distributor Notify FDA If It Intends To Market A “New Dietary Ingredient” (“NDI”). An NDI Is Defined By Statute As: “a dietary ingredient that was not marketed in the United States before October 15, 1994.” There Is No Authoritative List Of Dietary Ingredients That Were Marketed Before October 15, 1994. Changes In The Manufacturing Process For A Pre-DSHEA Dietary Ingredient May Create An NDI – e.g., extract of plant leaves. © Ifrah PLLC. Proprietary and Confidential. / (202) 912-4823 / ifrahlaw.com
  • 6. Which Agency Oversees The Marketing Of Dietary Supplements? The FDA and FTC Share Jurisdiction Through A Liaison Agreement. FDA Has Primary Enforcement Responsibility for Claims Made In Labeling And Packaging Under The Food, Drug and Cosmetic Act, As Amended By The DSHEA.  Tends To Focus On Product Composition And Safety And Structure/Function Claims Vs. Drug Claims. FTC Has Primary Enforcement Responsibility For Claims Made In Advertising Generally Under Section 5 Of The FTC Act.  Focused Solely On Advertising – Is it Truthful? Is It Misleading? Is It Adequately Substantiated? © Ifrah PLLC. Proprietary and Confidential. / (202) 912-4823 / ifrahlaw.com
  • 7. How Do The FTC And FDA Work Together?  FDA Warning Letters Referencing Potential Violations Of The FTC Act, Which Document FDA’s Position That Certain Claims In Advertising Materials Would Not Be Approved By FDA For Use In Labeling.  FTC Orders Requiring Marketers To Gain FDA Approval Prior To Using Certain Claims In Advertising Regulated By The FTC.  Press Releases Announcing The FTC And FDA’s Simultaneous Investigation Of Specific Companies To Assess Violations Of The FDCA And The FTC Act. © Ifrah PLLC. Proprietary and Confidential. / (202) 912-4823 / ifrahlaw.com
  • 8. CASE STUDY #1 © Ifrah PLLC. Proprietary and Confidential. / (202) 912-4823 / ifrahlaw.com
  • 9. CASE STUDY #2 © Ifrah PLLC. Proprietary and Confidential. / (202) 912-4823 / ifrahlaw.com
  • 10. What Does the FTC Consider Obvious Advertising “Red Flags?”  Section 5 of the FTC Act Prohibits “Unfair Or Deceptive Acts Or Practices In Or Affecting Commerce.” Causes Weight Loss Of Two Pounds Or More A Week For A Month Or More Without Dieting Or Exercise Blocks The Absorption Of Fat Or Calories To Enable Consumers To Lose Substantial Weight Causes Substantial Weight Loss No Matter What Or How Much The Consumer Eats Causes Substantial Weight Loss For All Users Causes Permanent Weight Loss (Even When Consumer Stops Using Product) Causes Substantial Weight Loss By Wearing It On The Body Or Rubbing It Into The Skin  FTC’s Response: “Show Us The Study!” © Ifrah PLLC. Proprietary and Confidential. / (202) 912-4823 / ifrahlaw.com
  • 11. Which Claims Should Advertisers Beware Of In Marketing Dietary Supplements?  Claims Based On Consumer Experiences Or Expert Endorsements.  Require Clear And Conspicuous Disclosures  “Results May Vary” Not Enough  Claims Based On Traditional Uses.  Consumer Perception Matters  Competent And Reliable Evidence May Be Necessary.  Use Of The DSHEA Disclaimer.  May Be Necessary If Text Or Image Leads Consumer To Believe Product Has Undergone FDA Review  Will Not Cure Otherwise Deceptive Ad – i.e. Claims About Disease Benefit Of Product  Third Party Literature.  May Not Be Used Deceptively and Must Be Explained In Context.  May Impact What Claims Advertiser Will Be Responsible for Substantiating. © Ifrah PLLC. Proprietary and Confidential. / (202) 912-4823 / ifrahlaw.com
  • 12. What Constitutes Health Claims Substantiation Under The FTC Guidelines?  FTC Has Typically Applied A “Substantiation Standard” Of “Competent And Reliable Scientific Evidence” To Claims About The Benefits And Safety of Dietary Supplements And Other Health-Related Products.  “Competent And Reliable Scientific Evidence” Has Been Defined in FTC Case Law As “Tests, Analyses, Research, Studies, Or Other Evidence Based On The Expertise Of Professionals In The Relevant Area, That Has Been Conducted And Evaluated In An Objective Manner By Persons Qualified To Do So, Using Procedures Generally Accepted In The Profession To Yield Accurate and Reliable Results.”  There Is No Pre-Established Formula As To How Many Or What Type Of Studies Are Needed To Substantiate A Claim.  The Absence Of An FDA Determination That A Health Claim Is Scientifically Valid Will Be A Significant Factor In The Commission’s Assessment Of The Adequacy Of Substantiation For The Claim. © Ifrah PLLC. Proprietary and Confidential. / (202) 912-4823 / ifrahlaw.com
  • 13. How Does the FTC Health Claims Substantiation Guidance Compare To FDA Guidance? Type of Claim Type of Product Meaning of Claim Benefit of a Truthful Claim FTC Amount of Substantiation Believed to be Reasonable FDA vs. Cost of Developing Substantiation Consequences of False Claim © Ifrah PLLC. Proprietary and Confidential. / (202) 912-4823 / ifrahlaw.com Relationship of Evidence to Claim Quality of Evidence Totality of Evidence
  • 14. To Whom Does This Guidance Apply?  The Guidance Applies Not Only To Product Manufacturers, But To Product Distributors As Well.  According to the FDA, A Distributor Who Contracts With A Manufacturer to Manufacture Dietary Supplements, Which the Distributor Then Distributes Under Its Own Label, Has An Obligation To Oversee Product Labeling, Manufacturing Activities, and Product Distribution. © Ifrah PLLC. Proprietary and Confidential. / (202) 912-4823 / ifrahlaw.com
  • 15. What Can Dietary Supplement Marketers Do To Protect Themselves? Claims Labeling  Review All Labels (Including Referenced Website Materials) For Indications for Health Or Nutrient Content Claims And Implied Disease Claims (vs. Allowed Structure/Function Claims  Do NOT Make Overblown And Exaggerated Claims.  Include Substantiation For All Claims Of Product Safety Or Effectiveness.  Include: Statement Of Identity, Ingredients Statement, Net Ingredients, Name And Place Of Business, Phone Number, Any Material Information About Use Of The Product, Including Warnings Or Side Effects.  Do NOT Base Your Marketing On Another Product’s Marketing – No Copy And Paste Jobs.  Do NOT Base Labeling On What’s Already In The Market. Manufacturing Practices Clinical Studies  Only Reference Clinical Studies That Are Relevant To Your Product And Qualify Them – i.e. Active Ingredient vs. Finished Product. Select A Manufacturer Wisely – Do Your Homework!    Conduct A Mini FDA-Style Inspection – Employ Good Manufacturing Practices  Negotiate A Manufacturing Agreement – Do NOT Be Left Holding The Bag For Product Recall Or Safety Issues. If You Conduct Clinical Trials, Register Them With ClinicalTrials.Gov.  Do NOT Reference Clinical Studies On Your Website That Make Implied Drug Claims. © Ifrah PLLC. Proprietary and Confidential. / (202) 912-4823 / ifrahlaw.com
  • 16. WHAT ARE THE CONSEQUENCES OF NON-COMPLIANCE? FTC Enforcement FDA Enforcement     The FTC Enforcement Process Regarding Advertising Usually Begins In One Of Two Ways: (1) A Letter From An FTC Attorney (Access Letter); or (2) A Civil Investigation Demand (CID) That the FTC Itself Issues. The Investigation Generally Remains Non-Public Until The FTC Decides Whether To Initiate A Formal Action – Either Announcement Of Proposed Consent Order Or Decree Or A Press Release Regarding Charges Filed. If You’re Lucky, The FTC Can Issue A “Closing Letter,” Which is Available On Its Website. If The FTC Choose To File Charges, It Will Seek Disgorgement of “IllGotten Gains.” © Ifrah PLLC. Proprietary and Confidential. / (202) 912-4823 / ifrahlaw.com  The FDA May Conduct An Unexpected Inspection Of Your Facility At Any Time And May Issue A Form FDA 483 To Communicate Concerns Discovered During Inspection.  A Recipient Of a 483 Should Respond Within 15 Business Days Regarding Plan Of Action – Do NOT Tell The FDA To Pound Sand!  All FDA Warning Letters Are Public, Even If The Matter Is Ultimately Closed.  Even After Clean Inspections, FDA May Take Action That Results In A Consent Decree, Seizure, Product Recall, Or Criminal Action.
  • 17. SAMPLE FDA WARNING LETTER #1 © Ifrah PLLC. Proprietary and Confidential. / (202) 912-4823 / ifrahlaw.com
  • 18. SAMPLE FDA WARNING LETTER #2 © Ifrah PLLC. Proprietary and Confidential. / (202) 912-4823 / ifrahlaw.com
  • 19. HOW DO MARKETERS LAND ON THE GOVERNMENT’S RADAR? State Attorney Generals Private Litigants © Ifrah PLLC. Proprietary and Confidential. / (202) 912-4823 / ifrahlaw.com “Surf” Days Your Competitors
  • 20. FINAL THOUGHT Spending A Little Money Now, Can Save You A Lot Of Money Later – COMPLIANCE, COMPLIANCE, COMPLIANCE © Ifrah PLLC. Proprietary and Confidential. / (202) 912-4823 / ifrahlaw.com
  • 21. Thank You Rachel Hirsch email: rhirsch@ifrahlaw.com website: www.ifrahlaw.com blog: www.ftcbeat.com @FTCLawyer David Graff email: dgraff@50onred.com website: www.50onred.com © 2010 Ifrah PLLC. Proprietary and Confidential. / (202) 912-4823 / ifrahlaw.com