by Mark Hostetler
Ever
since Adam and Eve first consulted their lawyer about claims for “the better
for you” apple, marketers, R&D groups and lawyers have grappled with issues
of claims substantiation. Marketers may desire broad product claims based upon
the media reports of one study; corporate R&D may be looking for that
perfect study which establishes the claim beyond any question. However, there
is regulatory guidance available to help answer the question of how much and
what kind of claims support is required.
FDA’s Center for Drug Evaluation and Research has recently stepped into the
fray, having issued draft guidance for “Developing Products for Weight
Management.” (72 Federal Register 7441—February
15, 2007.) While the guidance targets drug products, its
discussion of the elements of “a well-conducted clinical trial” reaffirms basic
principles of claims substantiation that are applicable to foods and dietary
supplements.
I. The Draft Guidance for Weight Management (the guidance). The guidance
includes basic recognized study parameters and rigorous drug research
protocols, both adult and pediatric. A study to assess weight-control efficacy
should be random, double-blinded and well-controlled, including a placebo; the
sample size should be large enough to include sufficient sub-group populations
by sex, weight (BMI), ethnicity and any other relevant determiners.
Efficacy should be measured at two endpoints: mean—“the difference in mean
percent loss of baseline body weight in the active-product versus
placebo-treated group” and categorical—“the proportion of subjects who lose at
least 5% of baseline body weight in the active-product versus placebo-treated
group.”
Secondary endpoint measures would include blood pressure, pulse and changes in
body measurements. The guidance includes specific measurements of statistical
significance for the product to be considered “effective for weight management”
for one year.
II. Draft Guidance for Structure/Function Claims. The Dietary Supplement Health
and Education Act of 1994 (DSHEA) permits companies to make structure/function
claims without agency pre-approval. This FDA (11/04) draft guidance proposes a “competent
and reliable scientific evidence” standard. Without defining that standard, it
suggests that in applying the standard, companies should consider the meaning
of the claim; the relevance of the evidence to the claim; the quality of the
evidence; and the totality of the evidence. FDA’s structure/function guidance
gives the following example:
“The labeling of a dietary supplement includes the statement ‘promotes weight
loss.’ The dietary supplement contains various vitamins and minerals and a botanical
extract. The manufacturer relies on a randomized, controlled, double-blind
clinical study showing that subjects who took the botanical extract had a small
but significant increase in metabolism over subjects taking a placebo over a
24-hour period. The study did not examine the effect of the extract on
subjects' weight, and there is no research showing that a short-term increase
in metabolism will translate into any measurable weight loss. The weight loss
claim would likely not be adequately substantiated.”
III. The Federal Trade Commission (FTC) standard generally (and for dietary
supplements). The FTC shares claims oversight with the FDA and is most active
in claims interpretation. To determine the “reasonable basis” required to
support a particular claim, the FTC posits that the standard is the amount of
evidence that experts in the field would find to be adequate. In the health
claims arena, an advertiser is expected to possess “competent and reliable
scientific” evidence defined as “tests, analyses, research, studies or other
evidence based upon 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.”
Conclusion. Companies looking to make weight management or other claims—whether
for a drug, a dietary supplement or a conventional food—should carefully plan
their claims support and design any required studies or clinical research to
meet the relevant regulatory standards for their anticipated claims.