Dive Brief:

• The U.S. Food and Drug Administration is “moving forward with rulemaking” on laboratory developed tests (LDTs) without waiting for new powers from Congress, a senior FDA official said at an industry conference.
• Elizabeth Hillebrenner said on a panel Wednesday that the agency cannot “just stand by” given the perceived public health problem created by LDTs and the failure of Congress to pass legislation.
• The FDA has yet to set a timeline for LDT rulemaking or provide a close look at its plans, Hillebrenner said, noting that the agency will follow a three-tier risk framework, but giving few other details.

Dive Insight:

Lawmakers have been trying to pass LDT legislation for years. An earlier form of the Verifying Accurate Leading-Edge IVCT Development (VALID) Act was introduced to Congress in 2018. Key aspects of the draft advanced as part of the FDA’s user fee package last year, only to be cut from the final version. A push to pass the VALID Act as standalone law fell short late last year.

The FDA identified a need to reconsider its policy of enforcement discretion for LDTs in 2010, reflecting the increasing complexity and risks of the tests, and shared a discussion paper in 2017. However, the paper is not enforceable. 

Legislation would clarify the FDA’s authority to regulate LDTs and give the agency new powers, but in the ongoing absence of action from Congress, work is now advancing under the current statutory authority. Hillebrenner, associate director for scientific and regulatory programs at the FDA’s Center for Devices and Radiological Health, outlined the situation at an American Clinical Laboratory Association event.

In comments reported by BioWorld, Hillebrenner noted that FDA Commissioner Robert Califf “has already said all options are on the table, including rulemaking, and we are moving forward.” The FDA continues to support legislation such as the VALID Act that provides a regulatory framework in line with modern diagnostics but is no longer willing to wait on Congress to address the problems posed by LDTs, she said.