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`DEPARTMENT OF HEALTH AND HUMAN SERVICES
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` NDA 021897/S-032
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`Food and Drug Administration
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` Silver Spring MD 20993
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`SUPPLEMENT APPROVAL
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` Alkermes, Inc.
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` 852 Winter Street
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` Waltham, MA 02451-1420
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`Attention: Meenal Pai, PharmD, RPh
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`Director, Regulatory Affairs
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`Dear Dr. Pai:
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`Please refer to your Supplemental New Drug Application (sNDA) dated March 4, 2016, received
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`March4, 2016, and your amendments, submitted pursuant to section 505(b)(2) of the Federal
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`Food, Drug, and Cosmetic Act (FDCA) for Vivitrol® (naltrexone for extended-release injectable
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`suspension).
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`This supplemental new drug application provides for proposed modifications to the approved
`risk evaluation and mitigation strategy (REMS) for Vivitrol. This supplement is in response to
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`our February 29, 2016, teleconference during which we informed you of the minor modifications
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`needed for the Vivitrol REMS communication plan.
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`We have completed our review of this supplemental application, as amended. It is approved,
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`effective on the date of this letter.
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`REQUIRED PEDIATRIC ASSESSMENTS
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`Under the Pediatric Research Equity Act (PREA) (21 U.S.C. 355c), all applications for new
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`active ingredients, new indications, new dosage forms, new dosing regimens, or new routes of
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`administration are required to contain an assessment of the safety and effectiveness of the
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`product for the claimed indication(s) in pediatric patients unless this requirement is waived,
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`deferred, or inapplicable.
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`Because none of these criteria apply to your application, you are exempt from this requirement.
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`RISK EVALUATION AND MITIGATION STRATEGY REQUIREMENTS
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`The REMS for Vivitrol® (naltrexone for extended-release injectable suspension) was originally
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`approved on March 22, 2010, and the most recent modification was approved on December 8,
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`2015. The REMS consists of a Medication Guide, a communication plan, and a timetable for
`submission of assessments of the REMS. Your proposed modification to the REMS consists of
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`Reference ID: 3933289
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` NDA 021897 S-032
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` Page 2
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` changes to clarify the implementation date of the communication plan and the timetable for
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` submission of assessments of the REMS.
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`Your proposed modified REMS, submitted on March 10, 2016, and appended to this letter, is
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`approved.
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`The timetable for submission of assessments of the REMS remains the same as that approved on
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`July 29, 2013.
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`There are no changes to the REMS assessment plan described in our July 29, 2013, approval
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`letter.
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`We remind you that in addition to the REMS assessments submitted according to the timetable in
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`the approved REMS, you must include an adequate rationale to support a proposed REMS
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`modification for the addition, modification, or removal of any goal or element of the REMS, as
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`described in section 505-1(g)(4) of the FDCA.
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`We also remind you that you must submit a REMS assessment when you submit a supplemental
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`application for a new indication for use as described in section 505-1(g)(2)(A) of the FDCA.
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`This assessment should include:
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`a) An evaluation of how the benefit-risk profile will or will not change with the new
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`indication;
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`b) A determination of the implications of a change in the benefit-risk profile for the current
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`REMS;
`c) If the new indication for use introduces unexpected risks: A description of those risks
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`and an evaluation of whether those risks can be appropriately managed with the currently
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`approved REMS.
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`d) If a REMS assessment was submitted in the 18 months prior to submission of the
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`supplemental application for a new indication for use: A statement about whether the
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`REMS was meeting its goals at the time of the last assessment and if any modifications
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`of the REMS have been proposed since that assessment.
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`e) If a REMS assessment has not been submitted in the 18 months prior to submission of the
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`supplemental application for a new indication for use: Provision of as many of the
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`currently listed assessment plan items as is feasible.
`f) If you propose a REMS modification based on a change in the benefit-risk profile or
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`because of the new indication of use, submit an adequate rationale to support the
`modification, including: Provision of the reason(s) why the proposed REMS
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`modification is necessary, the potential effect on the serious risk(s) for which the REMS
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`was required, on patient access to the drug, and/or on the burden on the health care
`delivery system; and other appropriate evidence or data to support the proposed change.
`Additionally, include any changes to the assessment plan necessary to assess the
`proposed modified REMS. If you are not proposing REMS modifications, provide a
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`rationale for why the REMS does not need to be modified.
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`Reference ID: 3933289
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` NDA 021897 S-032
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` Page 3
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` If the assessment instruments and methodology for your REMS assessments are not included in
` the REMS supporting document, or if you propose changes to the submitted assessment
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` instruments or methodology, you should update the REMS supporting document to include
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` specific assessment instrument and methodology information at least 90 days before the
` assessments will be conducted. Updates to the REMS supporting document may be included in a
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` new document that references previous REMS supporting document submission(s) for
` unchanged portions. Alternatively, updates may be made by modifying the complete previous
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` REMS supporting document, with all changes marked and highlighted. Prominently identify the
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` submission containing the assessment instruments and methodology with the following wording
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` in bold capital letters at the top of the first page of the submission:
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`NDA 021897 REMS CORRESPONDENCE
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`(insert concise description of content in bold capital letters, e.g.,
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`UPDATE TO REMS SUPPORTING DOCUMENT - ASSESSMENT
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`METHODOLOGY
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`An authorized generic drug under this NDA must have an approved REMS prior to marketing.
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`Should you decide to market, sell, or distribute an authorized generic drug under this NDA,
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`contact us to discuss what will be required in the authorized generic drug REMS submission.
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`Prominently identify any submission containing the REMS assessments or proposed
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`modifications of the REMS with the following wording in bold capital letters at the top of the
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`first page of the submission as appropriate:
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`NDA 021897 REMS ASSESSMENT
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`NEW SUPPLEMENT FOR NDA 021897/S-000
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`CHANGES BEING EFFECTED IN 30 DAYS
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`PROPOSED MINOR REMS MODIFICATION
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`or
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`NEW SUPPLEMENT FOR NDA 021897/S-000
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`PRIOR APPROVAL SUPPLEMENT
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`PROPOSED MAJOR REMS MODIFICATION
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`or
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`NEW SUPPLEMENT FOR NDA 021897/S-000
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`PRIOR APPROVAL SUPPLEMENT
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`PROPOSED REMS MODIFICATIONS DUE TO SAFETY LABEL CHANGES
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`SUBMITTED IN SUPPLEMENT XXX
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`or
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`NEW SUPPLEMENT (NEW INDICATION FOR USE)
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`Reference ID: 3933289
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` NDA 021897 S-032
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` Page 4
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` FOR NDA 021897/S-000
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` REMS ASSESSMENT
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` PROPOSED REMS MODIFICATION (if included)
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`Should you choose to submit a REMS revision, prominently identify the submission containing
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`the REMS revisions with the following wording in bold capital letters at the top of the first page
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`of the submission:
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`To facilitate review of your submission, we request that you submit your proposed modified
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`REMS and other REMS-related materials in Microsoft Word format. If certain documents, such
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`as enrollment forms, are only in PDF format, they may be submitted as such, but the preference
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`is to include as many as possible in Word format.
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`If you do not submit electronically, please send 5 copies of REMS-related submissions.
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`REPORTING REQUIREMENTS
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`We remind you that you must comply with reporting requirements for an approved NDA
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`(21 CFR 314.80 and 314.81).
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`If you have any questions, call Ayanna Augustus, PhD, RAC, Sr. Regulatory Project Manager, at
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`(301) 796-3980.
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`REMS REVISIONS FOR NDA 021897
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`Sincerely,
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`{See appended electronic signature page}
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`Judith A. Racoosin, MD, MPH
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`Deputy Director for Safety
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`Division of Anesthesia, Analgesia,
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`and Addiction Products
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`Office of Drug Evaluation II
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`Center for Drug Evaluation and Research
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`ENCLOSURE(S):
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`REMS
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`Reference ID: 3933289
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`---------------------------------------------------------------------------------------------------------
`This is a representation of an electronic record that was signed
`electronically and this page is the manifestation of the electronic
`signature.
`---------------------------------------------------------------------------------------------------------
`/s/
`----------------------------------------------------
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`JUDITH A RACOOSIN
`05/20/2016
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`Reference ID: 3933289
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