Thought the following would be of interest to this great group.
All the best
Jan Stoeten, the Netherlands
FDA announces reform plans
Agency hopes to reduce development costs by using diagnostic and imaging 
technologies | By Paula Park



The Food and Drug Administration (FDA), citing a gap between investment in 
pharmaceutical research and new drug approvals, announced plans Tuesday (March 
16) to reform the regulatory path to therapy development.

The plans represent the agency's attempt to reduce the cost of developing drugs 
by using new diagnostic and imaging technologies to better design clinical 
trials. "We're not seeing the increases in new products that we expected based 
on all the advances in science," said Janet Woodcock, the FDA's director of 
cross-center initiatives. "The professional staff at the agency is also 
concerned about how the new scientific knowledge is going to be worked up to 
apply to product development."

The FDA estimates that a new drug costs from $800,000 to $1.7 billion to bring 
to market, but most drugs do not work on most people, Woodcock told The 
Scientist. According to the FDA report, despite a growth in government and 
private investment, the number of new drugs with novel chemical structures has 
fallen from roughly 70 in 1993 to less than 30 in 2003. New biologics 
applications have fallen from just under 30 to just under 20 during the same 
time period.

"The big story, I think, here, is that if you were to write a description of 
how drugs are developed in 2004, that really hasn't changed very much in the 
last 30 years," said Alastair J.J. Wood, assistant vice chancellor for research 
at Vanderbilt University. "This is an early attempt on the FDA's part to make 
the case that maybe we should at least start a conversation on how we should 
change that," said Wood, who was at one time considered a candidate for FDA 
commissioner.

Reducing the cost of drug development, as proposed in the FDA's plan, could 
help open opportunities for smaller biotechs daunted by the huge costs, Wood 
told The Scientist. It would also give the pharmaceutical industry, under 
tremendous pressure to develop new drugs, a needed boost. Officials from both 
sectors welcomed the proposed changes. "The proposed FDA initiative is timely 
and significant," Merck spokeswoman Anita Larsen told The Scientist. "The FDA 
is in a unique position to identify new processes, technologies, and best 
practices and to spearhead this improvement initiative."

Carl B. Feldman, president of the Biotechnology Industry Organization, in a 
written statement, applauded what he called a "courageous statement. 
recognizing the serious problems that are preventing new, innovative drugs and 
biologics from getting to the patients who need them."

The FDA report outlines three phases in drug development-ensuring safety, 
demonstrating efficacy, and manufacturing effective treatments-that may require 
reform. Tools for testing safety have changed little in the last few years, the 
report says. Trials to determine efficacy are a source of "innumerable 
failures," and problems in designing, characterizing, and scaling up products 
"routinely derail" or delay development programs and keep needed treatments 
from patients.

The report outlines no concrete plans for change, but lists "opportunities" to 
use new techniques and technologies. For example, the report cites "proteomic 
and toxico-genomic approaches" that could better test safety, and suggests they 
be used early in the drug-development process. The agency also advocates 
targeted toxicology research. "Take liver toxicity. it's one reason that drugs 
fail," Woodcock said. "It's very rare. why does one in 10,000 fail?"

The agency hopes that by improving safety testing tools, companies can identify 
patients who will most likely experience liver toxicity, exclude them from 
trials, and inform them of the dangers of taking the drug once they are on the 
market. "We can't make it safer by testing it," Woodcock said. "We can only 
make it safer by getting information about who can take it."

In streamlining drug development, FDA hopes to work in tandem with the National 
Institutes of Health (NIH), and the report says the agency's work will 
complement the NIH Roadmap, a plan to invest an estimated $2.1 billion over the 
next 5 years to linking basic research with clinical benefits. The FDA also 
invites industry and advocacy officials to help develop a list of "critical 
path opportunities," a kind of a task list for change.

Woodcock said that she expects the first phase-gathering information for its 
task list-to be complete in 6 months and that the agency has already started 
internal "refocusing" to align its research with the new approach.

Jamie Love, director of the Consumer Project on Technology, said that the most 
critical opportunity would be improving the financing of research and 
development so that drugs could get to people who need them but who cannot 
afford their high costs. 

Those costs have also prompted a flurry of realignments and mergers in the 
pharmaceutical industry. Merck's Larsen said that the company has already 
developed alliances with diagnostic technology or biotechnology companies that 
can streamline the development process. The pharmaceutical giant signed 10 such 
deals and alliances in 1996 and closed 46 of them in 2003, she said.

Wood called the FDA report "an opening salvo" in a long "conversation" that 
could eventually be beneficial to both industry and patients. He stressed that 
it is important for the discussion to take place outside the FDA, because 
industry officials tend to treat the agency as many Soviet officials once 
regarded the Kremlin, trying to decode every word as if it was an important 
pronouncement. 

Still, the agency's willingness to change is a good sign, he told The 
Scientist: "The bottom line is that it's in everybody's interest to reduce the 
cost of drug development and to increase the likelihood of success."

Links for this article
Challenge and Opportunity on the Critical Path to New Medical Products, Food 
and Drug Administration report, March 2004.
http://www.fda.gov/oc/initiatives/criticalpath/whitepaper.pdf 

NIH Roadmap: Accelerating Discovery to Improve Health
http://nihroadmap.nih.gov/ 

E. Russo, "NIH presents new research 'roadmap'" The Scientist, October 1, 2003
http://www.biomedcentral.com/news/20031001/04