The labeling change encourages healthcare providers to use genetic tests before prescribing warfarin. The agency believes the tests would help physicians better determine the reasonable warfarin dose for individual patients, optimize the use of warfarin, and lower the risk of bleeding complications from the drug. The labeling changes result from an analysis of recent studies that found that certain genetic variations influence the way people respond to the drug.

"Today's approved labeling change is one step in our commitment to personalized medicine. By using modern science to get the right drug in the right dose for the right patient, FDA will further enhance the safety and effectiveness of the medicines Americans depend on," FDA Commissioner Andrew C. von Eschenbach said in an agency press release. The agency's personalized medicine initiative is based on pharmacogenomics, the science that predicts a response to drugs based upon a person's genetic makeup. –Erik Greb

STRATEGY

The US Food and Drug Administration's Interagency Working Group on Import Safety released a Strategic Framework on Sept. 10, based on a cost-effective, risk-based approach for ensuring the safety of products exported to the United States. Instead of assessing products at the border, the strategy recommends examining products' entire life cycles. The strategy requires cooperation with foreign manufacturers to identify and mitigate risk during crucial parts of the production and distribution process.

The Strategic Framework follows several months of scandals involving contaminated products manufactured in China. The problems prompted the US government to send a fact-finding team to China to address concerns about food and drug safety.

The Working Group aims to achieve continuous improvement in import safety by using the following six building blocks:

• Advance a common vision
• Increase accountability, enforcement, and deterrence
• Focus on risk over the life cycle of an imported product
• Build interoperable systems
• Foster a culture of collaboration
• Promote technological innovation and new science.

The building blocks recommend changes to the oversight process, including shared goals among federal agencies that promote import safety, better communication between parties in the global supply chain, and collaboration between government and industry.

The Framework says FDA has made 34 confidential arrangements with agencies in 17 countries to share approval, inspection, adverse-event, and emergency information about products manufactured in a partners' territories. FDA currently has more than two such exchanges each day.

In a public statement, FDA Commissioner Andrew von Eschenbach strongly endorsed the Strategic Framework, commending Health and Human Services Secretary Michael Leavitt for leading the Working Group and developing the Framework. President Bush established the Working Group in July to develop better ways to work with importers, manufacturers, and other governments to ensure the safety of imported products. -Erik Greb

PHARMACEUTICAL MARKETING

FDA Proposes Study of DTC Advertising

The purpose of the proposed study is, in part, to determine whether the use of competing, compelling visual information about potential drug benefits interferes with viewers' processing and comprehension of risk information about drugs in direct-to-consumer (DTC) advertising or with their cognitive representations of the drugs, according to the notice. "Positive visual images could influence the processing of risk-related information and the final representation of the advertised drug in multiple ways," says the notice.