FDA's Accelerated Approval Pathway Criticized for Inconsistencies and Lack of Transparency
The FDA's accelerated approval pathway, designed to expedite the availability of new medicines for serious conditions, is under scrutiny for its inconsistencies and lack of transparency. A report by the Institute for Clinical and Economic Review (ICER) highlights frustrations among patients, manufacturers, payers, and purchasers regarding the program's shortcomings. The pathway allows for accelerated approval based on surrogate or intermediate endpoints, provided there is a strong biological rationale and developers commit to confirmatory trials. While the pathway has facilitated access to transformative treatments like Novartis' Gleevec and MSD's Keytruda, it has also faced controversy. Notable examples include Biogen/Eisai's Alzheimer's drug Aduhelm, which was removed from the market due to efficacy concerns, and Sarepta's gene therapy Elevidys, restricted over liver toxicity issues. ICER's report recommends improvements such as better selection of surrogate endpoints, increased use of randomized control...