---
kind: "section"
citation: "21 U.S.C. § 360bbb–0a"
title: "21"
title_heading: "Food and Drugs"
number: "360bbb–0a"
heading: "Investigational drugs for use by eligible patients"
release: "119-102"
date: "2026-07-12"
url: "https://uscodex.org/usc/21/360bbb-0a"
units:
  - "Chapter 9 — Federal Food, Drug, and Cosmetic Act"
  - "Subchapter V — Drugs and Devices"
  - "Part E — General Provisions Relating to Drugs and Devices"
---

# §360bbb–0a. Investigational drugs for use by eligible patients

- (a) **Definitions—** For purposes of this section—
  - (1) the term “eligible patient” means a patient—
    - (A) who has been diagnosed with a life-threatening disease or condition (as defined in section 312.81 of title 21, Code of Federal Regulations (or any successor regulations));
    - (B) who has exhausted approved treatment options and is unable to participate in a clinical trial involving the eligible investigational [drug](/usc/21/321.md?p=g-1), as certified by a physician, who—
      - (i) is in good standing with the physician’s licensing organization or board; and
      - (ii) will not be compensated directly by the [manufacturer](/usc/21/360hh.md?p=3) for so certifying; and
    - (C) who has provided to the treating physician written informed consent regarding the eligible investigational [drug](/usc/21/321.md?p=g-1), or, as applicable, on whose behalf a legally [authorized](/usc/21/360eee.md?p=2) representative of the patient has provided such consent;
  - (2) the term “eligible investigational [drug](/usc/21/321.md?p=g-1)” means an investigational [drug](/usc/21/321.md?p=g-1) (as such term is used in [section 360bbb of this title](/usc/21/360bbb.md))—
    - (A) for which a Phase 1 clinical trial has been completed;
    - (B) that has not been approved or [licensed](/usc/21/360eee.md?p=9) for any use under [section 355 of this title](/usc/21/355.md) or section 351 of the Public Health Service Act [[42 U.S.C. 262](/usc/42/262.md)];
    - (C)
      - (i) for which an application has been filed under [section 355(b) of this title](/usc/21/355.md?p=b) or section 351(a) of the Public Health Service Act [[42 U.S.C. 262(a)](/usc/42/262.md?p=a)]; or
      - (ii) that is under investigation in a clinical trial that—
        - (I) is intended to form the primary basis of a claim of effectiveness in support of approval or licensure under [section 355 of this title](/usc/21/355.md) or section 351 of the Public Health Service Act [[42 U.S.C. 262](/usc/42/262.md)]; and
        - (II) is the subject of an active investigational [new drug](/usc/21/321.md?p=p) application under [section 355(i) of this title](/usc/21/355.md?p=i) or section 351(a)(3) of the Public Health Service Act [[42 U.S.C. 262(a)(3)](/usc/42/262.md?p=a-3)], as applicable; and
    - (D) the active development or production of which is ongoing and has not been discontinued by the [manufacturer](/usc/21/360hh.md?p=3) or placed on clinical hold under [section 355(i) of this title](/usc/21/355.md?p=i); and
  - (3) the term “phase 1 trial” means a phase 1 clinical investigation of a [drug](/usc/21/321.md?p=g-1) as described in section 312.21 of title 21, Code of Federal Regulations (or any successor regulations).
- (b) **Exemptions—** Eligible investigational [drugs](/usc/21/321.md?p=g-1) provided to eligible patients in compliance with this section are exempt from sections [352(f)](/usc/21/352.md?p=f), [353(b)(4)](/usc/21/353.md?p=b-4), [355(a)](/usc/21/355.md?p=a), and [355(i)](/usc/21/355.md?p=i) of this title, section 351(a) of the Public Health Service Act [[42 U.S.C. 262(a)](/usc/42/262.md?p=a)], and parts 50, 56, and 312 of title 21, Code of Federal Regulations (or any successor regulations), provided that the [sponsor](/usc/21/360fff.md?p=8) of such eligible investigational [drug](/usc/21/321.md?p=g-1) or any [person](/usc/21/321.md?p=e) who manufactures, [distributes](/usc/21/360eee.md?p=5), prescribes, dispenses, introduces or delivers for introduction into [interstate commerce](/usc/21/321.md?p=b), or provides to an eligible patient an eligible investigational [drug](/usc/21/321.md?p=g-1) pursuant to this section is in compliance with the applicable requirements set forth in sections 312.6, 312.7, and 312.8(d)(1) of title 21, Code of Federal Regulations (or any successor regulations) that apply to investigational [drugs](/usc/21/321.md?p=g-1).
- (c) **Use of clinical outcomes—**
  - (1) **In general—** Notwithstanding any other provision of this chapter, the Public Health Service Act [[42 U.S.C. 201](/usc/42/201.md) et seq.], or any other provision of Federal law, the [Secretary](/usc/21/321.md?p=d) may not use a clinical outcome associated with the use of an eligible investigational [drug](/usc/21/321.md?p=g-1) pursuant to this section to delay or adversely affect the review or approval of such [drug](/usc/21/321.md?p=g-1) under [section 355 of this title](/usc/21/355.md) or section 351 of the Public Health Service Act [[42 U.S.C. 262](/usc/42/262.md)] unless—
    - (A) the [Secretary](/usc/21/321.md?p=d) makes a determination, in accordance with [paragraph (2)](#c-2), that use of such clinical outcome is critical to determining the safety of the eligible investigational [drug](/usc/21/321.md?p=g-1); or
    - (B) the [sponsor](/usc/21/360fff.md?p=8) requests use of such outcomes.
  - (2) **Limitation—** If the [Secretary](/usc/21/321.md?p=d) makes a determination under [paragraph (1)(A)](#c-1-A), the [Secretary](/usc/21/321.md?p=d) shall provide written notice of such determination to the [sponsor](/usc/21/360fff.md?p=8), including a public health justification for such determination, and such notice shall be made part of the administrative record. Such determination shall not be delegated below the director of the agency center that is charged with the premarket review of the eligible investigational [drug](/usc/21/321.md?p=g-1).
- (d) **Reporting—**
  - (1) **In general—** The [manufacturer](/usc/21/360hh.md?p=3) or [sponsor](/usc/21/360fff.md?p=8) of an eligible investigational [drug](/usc/21/321.md?p=g-1) shall submit to the [Secretary](/usc/21/321.md?p=d) an annual summary of any use of such [drug](/usc/21/321.md?p=g-1) under this section. The summary shall include the number of doses supplied, the number of patients treated, the uses for which the [drug](/usc/21/321.md?p=g-1) was made available, and any known serious adverse events. The [Secretary](/usc/21/321.md?p=d) shall specify by regulation the deadline of submission of such annual summary and may amend section 312.33 of title 21, Code of Federal Regulations (or any successor regulations) to require the submission of such annual summary in conjunction with the annual report for an applicable investigational [new drug](/usc/21/321.md?p=p) application for such [drug](/usc/21/321.md?p=g-1).
  - (2) **Posting of information—** The [Secretary](/usc/21/321.md?p=d) shall post an annual summary report of the use of this section on the internet website of the [Food](/usc/21/321.md?p=f) and [Drug](/usc/21/321.md?p=g-1) Administration, including the number of [drugs](/usc/21/321.md?p=g-1) for which clinical outcomes associated with the use of an eligible investigational [drug](/usc/21/321.md?p=g-1) pursuant to this section was—
    - (A) used in accordance with [subsection (c)(1)(A)](#c-1-A);
    - (B) used in accordance with [subsection (c)(1)(B)](#c-1-B); and
    - (C) not used in the review of an application under [section 355 of this title](/usc/21/355.md) or section 351 of the Public Health Service Act [[42 U.S.C. 262](/usc/42/262.md)].

## Source credit

(June 25, 1938, ch. 675, § 561B, as added Pub. L. 115–176, § 2(a), May 30, 2018, 132 Stat. 1372.)

## Notes

### Editorial Notes

### References in Text

The Public Health Service Act, referred to in subsec. (c)(1), is act July 1, 1944, ch. 373, 58 Stat. 682, which is classified generally to chapter 6A (§ 201 et seq.) of Title 42, The Public Health and Welfare. For complete classification of this Act to the Code, see Short Title note set out under section 201 of Title 42 and Tables.

### Statutory Notes and Related Subsidiaries

### Limitation of Liability

Pub. L. 115–176, § 2(b), May 30, 2018, 132 Stat. 1374, provided that: Alleged acts or omissions.—With respect to any alleged act or omission with respect to an eligible investigational drug provided to an eligible patient pursuant to section 561B of the Federal Food, Drug, and Cosmetic Act [21 U.S.C. 360bbb–0a] and in compliance with such section, no liability in a cause of action shall lie against— a sponsor or manufacturer; or a prescriber, dispenser, or other individual entity (other than a sponsor or manufacturer), unless the relevant conduct constitutes reckless or willful misconduct, gross negligence, or an intentional tort under any applicable State law. Determination not to provide drug.—No liability shall lie against a sponsor manufacturer, prescriber, dispenser or other individual entity for its determination not to provide access to an eligible investigational drug under section 561B of the Federal Food, Drug, and Cosmetic Act. Limitation.—Except as set forth in paragraphs (1) and (2), nothing in this section shall be construed to modify or otherwise affect the right of any person to bring a private action under any State or Federal product liability, tort, consumer protection, or warranty law.”