GRIPUM LLC v. FDA ( 2022 )


Menu:
  •                                In the
    United States Court of Appeals
    For the Seventh Circuit
    ____________________
    No. 21-2840
    GRIPUM, LLC,
    Petitioner,
    v.
    UNITED STATES FOOD AND DRUG ADMINISTRATION,
    Respondent.
    ____________________
    On Petition for Review of a Final Marketing Denial Order by the
    U.S. Food and Drug Administration.
    No. PM0001689
    ____________________
    ARGUED APRIL 20, 2022 — DECIDED AUGUST 29, 2022
    ____________________
    Before WOOD, HAMILTON, and KIRSCH, Circuit Judges.
    WOOD, Circuit Judge. Gripum, LLC, manufactures and dis-
    tributes hundreds of flavored liquids for use in e-cigarette de-
    vices. Seeking to take its products to market, Gripum submit-
    ted a “premarket tobacco product application” to the federal
    Food and Drug Administration (FDA) in September 2021. But
    the agency denied the application, reasoning that Gripum had
    failed to demonstrate public-health benefits as required by
    the Family Smoking Prevention and Tobacco Control Act (the
    2                                                    No. 21-2840
    Act), see 21 U.S.C. § 387j. We now deny Gripum’s petition for
    review of the FDA’s decision, finding that the agency’s ap-
    proach to adjudicating the application was both reasoned and
    consistent with the Act.
    I
    A
    Commonly known as “e-cigarettes,” electronic nicotine
    delivery systems (called ENDS in bureaucratese) vaporize
    nicotine-laden “e-liquid” for users to inhale. Users have a
    choice of devices that accomplish that function and thus allow
    “vaping.” The delivery systems come in an open form, which
    takes refillable cartridges, and a closed form, which requires
    single-use cartridges. There is a huge number of flavor op-
    tions for the cartridges. Some e-liquids mimic traditional cig-
    arette flavors such as tobacco or menthol. Others, like the e-
    liquid products at issue in this case, taste like candy, fruit, or
    baked goods. All, however, are laced with nicotine.
    Under the Act, manufacturers of a “new tobacco prod-
    uct”—defined as a product that was not on the market as of
    February 15, 2007—must receive authorization from the FDA
    prior to marketing that product. As concern grew over the
    dangerous health consequences of vaping and e-cigarette use,
    the FDA promulgated the “Deeming Rule” in May 2016. See
    
    81 Fed. Reg. 28,974
     (May 10, 2016). This brought all “tobacco”
    products, including e-cigarettes and their delivery systems,
    under the Act’s premarket-authorization requirements.
    Most relevant for our purposes is the Act’s command that
    the Secretary of Health and Human Services “shall deny an
    application” to market a new tobacco product if the manufac-
    turer fails to show that the product would be “appropriate for
    No. 21-2840                                                  3
    the protection of public health.” This is commonly referred to
    as the “APPH” standard, but in the interest of using plain
    English, we will call it the “appropriateness” standard. 21
    U.S.C. § 387j(c)(2). To determine whether a product meets the
    appropriateness standard, the Secretary must consider “the
    risks and benefits to the population as a whole, including us-
    ers and nonusers of the tobacco product.” Id. That assessment,
    in turn, must take into account the “increased or decreased
    likelihood that”:
    (A) “existing users of tobacco products will stop using
    such products”; and
    (B) “those who do not use tobacco products will start us-
    ing such products.”
    Id. § 387j(c)(4). In other words, the Secretary must weigh a
    product’s risks of hooking new users (typically youth) into
    the world of tobacco, broadly defined, against its potential to
    help existing users (typically adults) wean themselves from
    tobacco’s unhealthier forms (namely, combustible cigarettes).
    As a matter of enforcement discretion, the FDA specified
    in its 2016 Deeming Rule that manufacturers would be given
    two to three years to prepare market applications for the
    e-cigarette products already on the market. See 81 Fed. Reg.
    at 28,978. Soon thereafter, youth e-cigarette use exploded
    across the country. From 2017 to 2018, the number of high
    schoolers using e-cigarettes rose by over seventy-five percent.
    See FDA, Results From 2018 National Youth Tobacco Survey
    Show Dramatic Increase in E-Cigarette Use Among Youth Over
    Past Year (Nov. 15, 2018). With the urgency of the situation in
    mind, the FDA began around late 2017 to step up its enforce-
    ment efforts against products that targeted youth. See Enforce-
    ment Priorities for Electronic Nicotine Delivery Systems (ENDS)
    4                                                   No. 21-2840
    and Other Deemed Products on the Market Without Premarket Au-
    thorization (Revised): Guidance for Industry 6–7 (Apr. 2020)
    (hereinafter 2020 Guidance).
    In 2019, the FDA issued a guidance document to help
    manufacturers prepare applications. See Premarket Tobacco
    Product Applications for Electronic Nicotine Delivery Systems:
    Guidance for Industry (June 2019) (2019 Guidance). In that doc-
    ument, the FDA stated that it “understands that limited data
    may exist from scientific studies and analyses.” Id. at 12. To
    address the paucity of data, it indicated that it “intends to re-
    view” “information on other products (e.g., published litera-
    ture, marketing information)” provided by an applicant, so
    long as the application also included “appropriate bridging
    studies” tying extant data to the applicant’s own products. Id.
    By 2020, nearly twenty percent of high-school students
    were active users of e-cigarettes, making e-cigarettes “the
    most widely used tobacco product among youth by far.”
    FDA, Technical Project Lead Review of PMTAs (2020). The
    agency adjusted its enforcement priorities accordingly and
    publicized those changes in a guidance document issued that
    year. It announced that it planned to pay particular attention
    to flavored, cartridge-based e-cigarettes given their “extraor-
    dinary popularity” among youth. See 2020 Guidance at 13
    (describing how ninety-three percent of e-cigarette users aged
    12–17 reported that their first e-cigarette was a flavored prod-
    uct). The guidance document also recounted the many efforts
    undertaken by both the agency and manufacturers to reduce
    youth access. Regrettably, measures such as age-limited sale
    restrictions had failed to stem the tide, even after the FDA had
    sent over 6,000 warning letters and 1,000 civil monetary pen-
    alty complaints to retailers accused of illegal sales to minors.
    No. 21-2840                                                       5
    See id. at 7. Because youths often obtain e-cigarettes from
    friends rather than by direct purchases, sales restrictions
    proved to be largely ineffective. The 2020 Guidance also clar-
    ified that the agency would “make enforcement decisions on
    a case-by-case basis” and that it “retains discretion to pursue
    enforcement action at any time against any deemed new to-
    bacco product marketed without premarket authorization.”
    Id. at 11.
    B
    Since 2013, petitioner Gripum has manufactured and dis-
    tributed flavored e-liquids for use in open-system devices
    (that is, the refillable cartridges). It claims to have had 291 pri-
    vate label e-cigarette products under contract as of January
    2022. On September 7, 2020, Gripum submitted a premarket
    application to the FDA seeking authorization to market hun-
    dreds of its flavored e-liquids, which carried colorful and
    evocative names such as “Peanut Butter Milk Pie,” “Bad Mon-
    key Giovanni,” and “Sunshine Vape Dragon Berry Balls.” In
    its application it included a review of the scientific literature
    and consumer surveys assessing trends in the use of e-ciga-
    rettes, though none of these materials discussed or referred to
    Gripum’s own products.
    About a year later, on September 8, 2021, the FDA issued
    a “marketing denial order” for Gripum’s application, explain-
    ing that “the new products … lack sufficient evidence to
    demonstrate that the marketing of these products is appropri-
    ate for the protection of public health.” The denial order went
    on to say that “robust and reliable evidence is needed regard-
    ing the magnitude of the potential benefit to adult smokers.”
    Reliable evidence, the denial order explained, could have
    taken the form of a “randomized controlled trial and/or
    6                                                    No. 21-2840
    longitudinal cohort study that demonstrated the benefit of
    your flavored ENDS products over an appropriate compara-
    tor tobacco-flavored ENDS.” Although Gripum’s application
    mentioned randomized controlled trials and longitudinal co-
    hort studies of other products, Gripum never explained how or
    why its products were sufficiently similar to those other prod-
    ucts so that the latter were relevant to its application. In other
    words, it failed to provide a “bridge” between the data about
    other products and its own proposed offering. In addition, the
    denial order concluded that the alleged public-health benefits
    of Gripum’s products were too speculative to outweigh the
    risks of youth initiation. The agency thus concluded that it
    was required to deny Gripum’s application in its entirety.
    On October 8, 2021, Gripum timely filed its petition for re-
    view of the denial order pursuant to 21 U.S.C. § 387l(a)(1)(B).
    Seeking emergency relief from this court, Gripum filed a mo-
    tion for a stay pending review on October 17, 2021. On No-
    vember 4, 2021, we entered an order granting Gripum the re-
    quested relief.
    Since Gripum lodged its petition, similar challenges to e-
    cigarette marketing denial orders have percolated across the
    courts of appeals. Not long after we entered our stay, the Sixth
    Circuit denied a stay pending review in one such case. See
    Breeze Smoke, LLC v. FDA, 
    18 F.4th 499
    , 503 (6th Cir. 2021). The
    Sixth Circuit petitioners then sought a stay from the Supreme
    Court, but that was denied. See Breeze Smoke, LLC v. FDA, 
    142 S. Ct. 638
     (2021) (mem.). We are informed that Breeze Smoke
    has now voluntarily withdrawn its petition in the Sixth Cir-
    cuit challenging its marketing denial order. In another case,
    the Fifth Circuit entered a stay of the marketing denial orders
    before it, see Wages & White Lion Invs., LLC v. FDA, 16 F.4th
    No. 21-2840                                                   7
    1130 (5th Cir. 2021), but later the merits panel sided against
    the flavored e-cigarette manufacturers and upheld the
    agency’s decisions, see Wages & White Lion Invs., LLC v. FDA,
    Nos. 21-60766 & 21-60800 (5th Cir. July 18, 2022). The Eleventh
    Circuit issued an opinion that was the mirror image of the
    Fifth Circuit’s. In Bidi Vapor LLC v. U.S. Food and Drug Admin.,
    No. 21-13340 (11th Cir. Aug. 23, 2022), a panel majority va-
    cated denial orders relating to six different companies, be-
    cause it concluded that the agency had failed adequately to
    consider the companies’ marketing and sale-access-restriction
    plans; the dissenting judge thought that the agency had said
    enough, and that in any event any error was harmless. Finally,
    the D.C. Circuit recently upheld FDA orders denying market
    authorization for certain flavored e-cigarette products. See
    Prohibition Juice Co. v. FDA, Nos. 21-1201, 21-1203, 21-1205 &
    21-1207 (D.C. Cir. July 26, 2022). (There are also some addi-
    tional pending challenges. See https://vaping360.com/vape-
    news/111563/vape-companies-challenging-fda-marketing-
    denials/.)
    II
    This case arises under section 912(a)(1)(B) of the Federal
    Food, Drug, and Cosmetic Act, 21 U.S.C. § 387l(a)(1)(B)),
    which provides that any person adversely affected by the
    FDA’s issuance of a marketing denial order may file a petition
    for review either in the D.C. Circuit or in the circuit in which
    the person resides or has its principal place of business.
    Gripum’s principal place of business is in Skokie, Illinois, and
    so its challenge to the marketing denial order is properly be-
    fore us.
    Because denial orders are reviewed in accordance with
    section 706(2)(A) of the Administrative Procedure Act (APA),
    8                                                          No. 21-2840
    an order may be held unlawful and set aside only if it is found
    to be “arbitrary, capricious, an abuse of discretion, or other-
    wise not in accordance with law.” 
    5 U.S.C. § 706
    (2)(A); see 21
    U.S.C. § 387l(b). To meet the APA’s arbitrary-and-capricious
    standard, “the agency must examine the relevant data and ar-
    ticulate a satisfactory explanation for its action including a ra-
    tional connection between the facts found and the choice
    made.” Motor Vehicle Mfrs. Ass’n of U.S., Inc. v. State Farm Mut.
    Auto. Ins. Co., 
    463 U.S. 29
    , 43 (1983); see also FCC v. Prometheus
    Radio Project, 
    141 S. Ct. 1150
    , 1158 (2021) (“The APA’s arbi-
    trary-and-capricious standard requires that agency action be
    reasonable and reasonably explained.”).
    Gripum advances three theories for why the FDA’s adju-
    dication of its application was arbitrary: (1) the agency failed
    to announce ascertainable standards prior to its adjudication
    of the application; (2) the agency quietly shifted the eviden-
    tiary standard after inviting reliance on an earlier, easier-to-
    meet standard; and (3) it failed to undertake an individual-
    ized approach to the application, instead applying general-
    ized, and thereby arbitrary, presumptions. 1 We address these
    points in that order.
    A
    Gripum first argues that the FDA’s failure to promulgate
    rules governing the premarket application process, or other-
    wise to announce ascertainable standards, rendered its
    1  We note in this connection that in our case Gripum did not present
    the argument that persuaded the Eleventh Circuit in Bidi Vapor, namely,
    that the FDA’s analysis was flawed because it did not explain why it
    placed no weight on the companies’ marketing and sales-access-re-
    strictions. Gripum has thus waived, or at a minimum forfeited, this point.
    No. 21-2840                                                      9
    adjudication of Gripum’s application arbitrary. But the rele-
    vant standard applied by the agency—that benefits to adult
    users must outweigh the risk of fomenting youth use—flows
    directly from the Act, and the agency reasonably could have
    thought that no further elaboration on that point was needed.
    As the statute says, the FDA must evaluate “the risks and ben-
    efits to the population as a whole, including users and nonus-
    ers”; and to carry out that task, it must weigh “the increased
    or decreased likelihood that existing users of tobacco prod-
    ucts will stop” against “the increased or decreased likelihood
    that those who do not use tobacco products will start.” 21
    U.S.C. § 387j(c)(4). That language expressly orders the agency
    to conduct the described balancing process and to consider
    both the risks and benefits attendant to each application that
    it adjudicates. The statute does not, contrary to Gripum’s con-
    tention, obligate the agency to define threshold levels of like-
    lihoods or the minimum number of users who must be aided
    for a product to pass muster. Indeed, bright lines of this sort
    would be difficult to square with the statute’s comparative
    language.
    Furthermore, Congress’s intent to allow the FDA to de-
    velop its premarket policy through a flexible, case-by-case ad-
    judicative approach is apparent in the structure of the Act.
    The statute delegates broad authority to the agency to regu-
    late the marketing of tobacco products both through rulemak-
    ing, see 21 U.S.C. § 387g(a)(3), and through individual adju-
    dications, see id. § 387j(c). It also obligates the agency to issue
    interpretative rules and regulations in some contexts. See, e.g.,
    21 U.S.C. § 387e(j)(3)(B) (specifying that the FDA “shall issue
    regulations” with respect to the registration of tobacco manu-
    facturers); id. § 387k(l)(1) (specifying that the FDA “shall issue
    regulations or guidance” with respect to the review of
    10                                                   No. 21-2840
    “modified risk tobacco products”). But in the premarket-ad-
    judication context of section 387j(c), there is no such obliga-
    tion for the FDA to promulgate implementing regulations.
    In a related vein, Gripum argues that the agency’s adjudi-
    cative approach was inconsistent with the statutory appropri-
    ateness standard, and instead amounted to an ersatz “prod-
    uct-efficacy assessment” borrowed from the drug-review pro-
    vision of 
    21 U.S.C. § 355
    (b)(1)(A)(i). Under such an “efficacy”
    standard, an applicant needs to show that a product is effec-
    tive at meeting some fixed result (say, the killing of a bacte-
    rium at a minimum rate). But all the FDA required Gripum to
    do here is to show that its flavored e-cigarette products were
    relatively better at reducing rates of tobacco use than products
    already on the market. The agency properly applied the com-
    parative standard mandated by the statute; Gripum simply
    failed to meet it.
    B
    Gripum next claims that the FDA changed course by re-
    quiring product-specific clinical studies to meet the appropri-
    ateness standard. It contends that in so doing, the agency
    failed to respect the reliance interests that manufacturers had
    in the administrative guidance they had received, and thus it
    acted arbitrarily. See DHS v. Regents of the Univ. of Cal., 
    140 S. Ct. 1891
    , 1913 (2020) (“When an agency changes course, … it
    must be cognizant that longstanding polices may have engen-
    dered serious reliance interests that must be taken into ac-
    count.”); FCC v. Fox Television Stations, Inc., 
    556 U.S. 502
    , 514–
    16 (2009). But like our sister circuits, we conclude that the
    FDA’s e-cigarette guidance materials have consistently re-
    flected that product-specific long-term data are required only
    No. 21-2840                                                  11
    if existing studies are inadequately related to the proposed
    product.
    In 2019, the FDA issued a nonbinding guidance document
    stating that “in general, FDA does not expect that applicants
    will need to conduct long-term studies to support an applica-
    tion.” 2019 Guidance at 13. Gripum makes much hay of that
    sentence. But the broader document tells a more complicated
    story. It begins by describing how “[n]onclinical studies alone
    are generally not sufficient to support” the statutory showing.
    Id. at 12. It then describes how “in some cases, it may be pos-
    sible to support a marketing order for an [e-cigarette] product
    without conducting new nonclinical or clinical studies,”
    though that depends on whether “an established body of ev-
    idence … can be adequately bridged to [the] product, such as
    data from the published literature or government-sponsored
    databases.” Id. at 46. This explanation underscores the case-
    by-case and open-ended nature of FDA review. Nowhere
    does it confer blanket permission to forego product-specific
    testing.
    As the Sixth Circuit concluded, the agency indicated only
    that “it might accept evidence other than long-term studies, if
    that evidence had sufficient scientific underpinnings.” Breeze
    Smoke, 18 F.4th at 506–07. So too the D.C. Circuit read the 2019
    Guidance as “nowhere guarantee[ing] that unspecified other
    forms of evidence would necessarily be sufficient—only that
    they might be.” Prohibition Juice Co., Nos. 21-1201 etc. at 23.
    We conclude the same.
    C
    Gripum also argues that the agency failed to conduct a
    careful, individualized review of its evidence and instead
    12                                                  No. 21-2840
    relied on a general presumption that e-liquids increase youth
    tobacco use. But according to Gripum, the belief that young
    people will be attracted to its e-liquids rests on a more tenu-
    ous base than the agency thinks, in part because evidence
    demonstrates that young users prefer closed-system devices
    to open-system ones.
    Gripum’s arguments rest on a questionable reading of
    both the agency’s marketing denial order and the statutory
    burden. The Act requires the denial of an application unless
    the manufacturer can affirmatively demonstrate that it meets
    the appropriateness standard through the section 387j(c) com-
    parative assessment. Even if Gripum is right when it asserts
    that young people are much less interested in e-liquids in
    open-system devices than they are in closed-system ones, the
    FDA reasoned that the marketing and sale of open-system de-
    vices still are responsible for some portion of youth initiation.
    To succeed under the appropriateness standard—a compara-
    tive one, as we have stressed—Gripum had the burden of
    demonstrating that its flavored e-liquids would “switch”
    some users of combustible cigarettes over to e-cigarettes. But
    as we already have noted, Gripum failed to provide evidence
    specific to its products. And though it did include studies of
    other products, those studies did not even compare tobacco-
    flavored e-cigarette products (which we will assume do have
    a “switching” effect) to flavored products resembling those
    Gripum wants to offer.
    Before concluding, we have one unusual new item of busi-
    ness that requires our attention. Almost four months after the
    oral argument in this case, Gripum filed something it called
    an “Opposed Motion To Correct Administrative Record.” In
    that motion, it asked us to re-open the underlying
    No. 21-2840                                                    13
    administrative record and add a memorandum dated August
    19, 2020, entitled “Bundling and Bracketing Approach for Review
    of ENDS Open E-Liquid PMTAs.” This document, it contended,
    had just come to its attention when it was released by the FDA
    in response to a third party’s freedom-of-information request.
    We invited the FDA to respond, which it has now done. Aside
    from remarking that, despite calling the motion “opposed,”
    Gripum had not communicated with the agency before filing
    its motion, the FDA noted that Gripum has not identified an-
    ything that would undermine the presumption of regularity
    that attaches to an agency’s certification of its record, see Cit-
    izens to Preserve Overton Park, Inc. v. Volpe, 
    401 U.S. 402
    , 415
    (1971). On the merits, the FDA pointed out that Gripum’s pe-
    tition founders on the utter lack of evidence showing that the
    benefits of its products outweigh the harms. The further sci-
    entific review process described in the memorandum is trig-
    gered only for cases that pass that first threshold.
    We agree with the FDA that the time has long passed for
    amendments or changes to the administrative record in the
    present case, and that the 2020 memorandum is in any event
    of dubious relevance. We therefore deny Gripum’s motion.
    *      *      *
    In adjudicating Gripum’s application, the FDA hewed to
    the statutory standard and issued a reasoned marketing de-
    nial order. Its determination that Gripum’s products lack a
    clear benefit to current tobacco users was not arbitrary or un-
    reasonable. We therefore DENY Gripum’s petition for review.