Look MAA, no hands

  • by: |
  • 03/28/2012

Two important news items courtesy of BioCentury:

The first concerns the necessary and timely updating of how the FDA determines risk/benefit for medical devices.

Final FDA guidance on risk-benefit determinations for devices

FDA released final guidance that seeks to clarify how the agency determines the risk-benefit profile of a medical device during a premarket review. The guidance, which is in line with a draft released last August, says that in addition to safety and efficacy, FDA reviewers will consider criteria such as the novelty of the technology, the characterization of the disease and the availability of alternative treatments or diagnostics.

The guidance includes a worksheet that reviewers will use to make risk-benefit determinations during a review. FDA said it is developing training modules to help industry and sponsors understand how the Center for Devices and Radiological Health (CDRH) will apply the guidance. Reviewers will begin applying it to incoming submissions and to submissions already under review beginning May 1.

Of particular interest to those following the agency’s arduous journey in search of a risk/benefit “grid” is how CDRH will both develop and use its “worksheet” and whether or not that document will be public information after a regulatory decision is reached. Transparency would certainly go a long way towards holding the Center’s feet to the fire vis-à-vis regulatory predictability and consistency.

And, speaking of consistency, some news from our Regulatory Cousins across the pond.

EMA finalizes guidance on MAA transparency

The EMA and the Heads of Medicines Agencies (HMA) adopted a joint guidance for a Europe-wide approach to identify which information included in an MAA can be publicly released after approval, should a request for access to information be submitted. The guidance is part of EMA's policy to increase transparency and access to documents, which came into effect in 2010.

According to the guidance, sections of an MAA dossier that would not be released include detailed information on manufacturing processes and synthesis of the active ingredient, as well as contractual agreements. In general, reports on non-clinical and clinical trials, including efficacy and safety trials, would be made available, although exceptions may be considered when innovative study designs or analytical methods have been used. Identifiable patient information would be redacted. Scientific advice received by a sponsor on an agreed indication would be available, while advice related to new developments and formulations would remain confidential.

(For you Yanks, “MAA” = “Marketing Authorization Application.”)

This is interesting for a number of reasons, let me mention two. First, it points to the ability to harmonize across borders. Need an ocean separate us from this concept? And, second, is this at all predictive of where the FDA might go relative to “going public” with redacted Complete Response Letters?

Inquiring minds want to know.


Center for Medicine in the Public Interest is a nonprofit, non-partisan organization promoting innovative solutions that advance medical progress, reduce health disparities, extend life and make health care more affordable, preventive and patient-centered. CMPI also provides the public, policymakers and the media a reliable source of independent scientific analysis on issues ranging from personalized medicine, food and drug safety, health care reform and comparative effectiveness.

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