RCTs Are Not Required
Recognizing the many health benefits of dietary supplements, Congress enacted the Dietary Supplement Health and Education Act of 1994 (DSHEA) to ensure that supplements can be marketed and sold without following the stringent requirements imposed on prescription drugs. In April 2001, the Federal Trade Commission (FTC) promulgated guidance stating that the relevant standard for dietary supplements is “competent and reliable scientific evidence.”
The FTC guidance makes clear that drug-level randomized clinical trials are not required. Instead, “competent and reliable scientific evidence” is a “flexible” standard and “[t]here is no fixed formula for the number or type of studies required.” Even “[r]esults obtained in animal and in vitro studies will . . . be examined, particularly where they are widely considered to be acceptable substitutes for human research or where human research is infeasible.” “[E]pidemiologic evidence may be an acceptable substitute for clinical data” in some circumstances.
In conflict with its own published guidance, however, the FTC and class action lawyers have brought a number of suits against dietary supplement companies on the grounds that the supplement claims are not supported by RCTs. Courts have rejected these attempts to ignore federal law. The most recent defeat for the FTC came in U.S. v. Bayer, where the Court denied the FTC’s attempt to demand drug-level clinical trials to support proper structure function claims for the same probiotic product, Phillips’ Colon Health. U.S. v. Bayer, No. 07-0001 (D.NJ).
Unfortunately, despite this defeat, the FTC continues to demand RCTs for dietary supplements. And, following that decision, an FTC attorney reportedly stated: “I don’t think [the US v. Bayer decision] was about whether you need clinical trials.”1 The most recent judicial decision makes clear that this statement is incorrect.
The Court in In re Bayer Phillips Colon Health reinforced that clinical trials are not required. The Court relied heavily on the FTC case (U.S. v. Bayer) and explained that the FTC opinion held that “RCTs are not required to meet the standard of ‘competent and reliable scientific evidence’” and that “dietary supplements do not” need to meet the “higher standard” that applies to drugs. Op. at 15. At bottom, the U.S. v. Bayer opinion means what it says: dietary supplements must be regulated as Congress intended. They are supplements, not drugs.
Private Plaintiffs Cannot Pursue a Lack of Substantiation Claim
The Court also closed the door to a claim favored by private plaintiffs — a “lack of substantiation” claim. Plaintiffs often sue manufacturers under state consumer fraud laws arguing that a particular food or supplement claim is not adequately substantiated by scientific evidence, where they cannot prove that the claim is scientifically false.
In In re Bayer Phillips Colon Health, the Court held that “[m]erely proving that the claims are unsubstantiated is insufficient.” Op. at 20. Rather, “a plaintiff must put forth affirmative evidence of falsity.” Op. at 19. Plaintiffs’ expert in this case testified that his only basis for saying that Bayer’s claims were false was that Bayer had no supportive RCT and that a number of existing RCTs did not show positive results. The Court rejected this testimony and explained that it “is nothing more than a lack-of-substantiation theory.” Op. at 24. The Court further described the expert’s opinion as “pure speculation” or an “educated guess,” both of which are wholly insufficient to survive summary judgment.
Plaintiffs around the country are pursuing similar claims based on a lack of substantiation theory and are tendering experts that apply the drug-level standard. Following the Phillips Colon Health case, courts should similarly reject these claims.
1“FTC Attorney Hoists RCT Standard For Supplement Claims, Industry Swings Back” Malcolm Spicer, Elsevier Business Intelligence, July 6, 2016.
Sidley Global Life Sciences Practice
Sidley FDA Practice