Did Sarepta Expose the Flaw in FDA Review Process?   

FDA’s decisions about the products it reviews can be mind-bogglingly subjective. When two products, for the same indication, with almost identical clinical development plans, and developed by the same company, have extremely contrasting FDA review outcomes it makes it impossible for the public to know the true reasons for such diverse decisions. Three year ago, … Read more

Is Novartis a Victim or the Villain: Perhaps Both?

Last couple of weeks would have been a nightmare for a crisis manager working for Novartis. The company has been accused of fraud by FDA and threatened with fines and other punitive actions, investigated by the US Congress, subject to public ridicule, and apparently deceived by its acquisition target. In all that, one cannot forget … Read more

FDA Takes Measures to Clean Its Drug Registration Database in 30 Days   

FDA drug establishment database is filled with tens of thousands of outdated entries for drugs that are no longer being marketed. In 30 days, FDA will remove all such listings to assure that the drugs establishment list contains only those that are current. The drug established database is critical for FDA’s regulation of the drug … Read more

FDA’s Quality By Design (QBD) Guidance for Clinical Trials

The general quality expectations for clinical trials are described in a new ICH guidance adopted by the FDA this week. The concept of Quality-by-Design (QbD) has been the gold standard for defining quality expectations in manufacturing operations but similar standards lack for the conduct of clinical trials. It is generally accepted that the quality of … Read more

FDA Offers Practical Tips on How to Address CMC for BTD Products  

Manufacturers of breakthrough therapy (BTD) products often face challenges meeting all the CMC requirements for the NDA/BLA for their product. Similar issues are faced by those developing new products under the PRIME program in EU. This week the regulators published a detailed discussion using case studies on how manufacturers can satisfy regulatory requirements in the … Read more

Early Adopters of Smartphone-Based Healthcare Show Interesting Trends

An editorial in the British Medical Journal provides one of the first clinical perspective on smartphone based basic healthcare from a large real world data. Patients in London were provided a smartphone app-based algorithm, called GP at Hand, where almost all initial contacts between patients and physicians were through smartphone consultations, with the patients having … Read more

Diagnostic Errors Are Mostly Due to Clinical Judgement: Opportunity for AI 

A recent study reported that almost 90% of diagnostic errors cases are attributed to errors in clinical judgement by physicians in outpatient settings. These findings have a strong implication for developers of AI algorithms to automate diagnosis aiming to reduce human errors. Common clinical judgement errors are delayed ordering of diagnostic tests, failure to review … Read more

FDA and EU Finish cGMP Inspection Integration

As of last week, FDA has fully implemented its Mutual Recognition Agreement (MRA) with the European Union (EU) whereby FDA and regulators from all 28 member countries of the EU would share GMP inspection findings at drug manufacturing sites. The MRA is but the first step to integrating GMP audits across various regulators to avoid … Read more

Conflict of Interest and FDA’s Revolving Door

Should FDA officials be restricted in what jobs they can pursue after leaving office? A few days after leaving the FDA, the last Commissioner Scott Gottlieb joined the same venture firm he left to join FDA. Then a few weeks later he joined the Board of Pfizer. In that he joined the long tradition of … Read more