The document discusses guidelines for supplemental new drug applications (sNDAs) according to the US FDA. It outlines three categories of variations - major, moderate, and minor - based on their potential impact. Major changes require prior approval and could impact safety or efficacy. Moderate changes require submission 30 days before distribution or upon FDA receipt. Minor changes only require description in the annual report. The document provides examples of changes in manufacturing sites, processes, specifications, container closure systems, and labeling that would fall under each category. Close monitoring and reporting of any post-approval changes is recommended to ensure the quality, safety and efficacy of pre-qualified products are not adversely affected.