When ef­fi­ca­cy is bor­der­line: FDA needs to get more con­sis­tent on close-call drug ap­provals, agency-fund­ed re­search finds

In the ex­ceed­ing­ly rare in­stances in which clin­i­cal ef­fi­ca­cy is the on­ly bar­ri­er to a new drug’s ap­proval, new FDA-fund­ed re­search from FDA and Stan­ford found that the agency does not have a con­sis­tent stan­dard for defin­ing “sub­stan­tial ev­i­dence” when flex­i­ble cri­te­ria are used for an ap­proval.

The re­search comes as the FDA is at a cross­roads with its ex­pe­dit­ed-re­view path­ways. The ac­cel­er­at­ed ap­proval path­way is un­der fire as the agency re­cent­ly signed off on a con­tro­ver­sial new Alzheimer’s drug, with lit­tle prece­dent to ex­plain its de­ci­sion. Mean­while, top of­fi­cials like Rick Paz­dur have called for a ma­jor push to sim­pli­fy and clar­i­fy all of the var­i­ous ex­pe­dit­ed path­ways, which have grown to be must-haves for spon­sors of near­ly every new­ly ap­proved drug.

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