The Pandemic Changed Clinical Trials for Good.

Two-thirds of the sponsors of clinical trials intend to continue remote clinical trials post-pandemic. Trials that are entirely run using electronic documentation, digital communications, and remote monitoring cost more than conventional studies due to the initial investment in technology acquisition, but the increased cost was off-set last year by reduced travel and conference costs, and … Read more

Vaccine Misinformation Highlights the Limits of FDA’s Powers

Despite more than half of the population fully vaccinated in the US, it is ironic that the vaccine misinformation has barely waned. A wide swath of population still believes scientifically implausible myths about the vaccines. It may seem disturbing that a large section of the population believes that Covid vaccines can cause infertility, or that … Read more

Good Quality Real World Evidence is Hard to Come by

A report on a systematic analysis of the real world studies conducted with FDA-approved cancer drugs found that almost all such studies were of poor quality and hence led to erroneous conclusions. The list of challenges noted in the report are likely applicable to most real world data collected by researchers to either support conclusion … Read more

Was FDA Short-Staffed to Handle the Pandemic?

The FDA has more than 18,000 full time employees and an annual budget of over $6 billion. It is high organized, and its regulators are considered some of the smartest in the World. It can handle challenges, or so it would appear to the lay person. Last year, FDA delayed many of its review activities … Read more

Is FDA’s Accelerated Approval Pathway in Danger of Being Scrapped?

A review published in the British Medical Journal this week reported that almost 44% of drugs approved by the FDA under the accelerated approval pathway over the last 28 years have not yet been confirmed to be clinically effective, and despite that most of these unconfirmed drugs are on the US market for 5 years … Read more

FDA’s First Interchangeable Biosimilar: Floodgate for Others?

Yesterday’s approval of the first interchangeable biosimilar by the FDA provides a proof of concept for biosimilars that will be treated like generic drugs in that they can be substituted for the reference product at the pharmacy without needing a specific prescription. This is a major milestone that has been almost 10 years in the … Read more

Is FDA Taking Too Long to Approve the Covid Vaccines?  

With 343 million doses administered and 163 million people fully vaccinated in the US, it may be annoying for the layman as to why has FDA not yet fully approved any vaccine. And it would not be an unreasonable question to ask, although probably unfair to the FDA. It is important to understand a few … Read more

FDA Would Like Inclusion of Pregnant Women in Clinical Research: Easier Said Than Done  

Pregnant women are almost always excluded from clinical trials and pregnancy is usually considered an adverse event leading to dropping women from ongoing clinical trials. FDA, along with European regulators, would like to change that. But it is not easy to implement. There is no law that could mandate inclusion of pregnant women in clinical … Read more

FDA’s Decision-Making Process is Immune to Buyer’s Remorse

Once FDA has approved a product, it almost never reverses that decision unless there are compelling safety reasons such as previously unknown life-threatening events related to the drug. FDA vigorously defends its decisions and never expresses “buyer’s remorse”. A recent case emphasized this policy when FDA rejected a petition filed by a professor at Ohio … Read more