An FDA advisory panel's recommendation to pull an early birth drug from the market is only the latest controversy surrounding a popular program aimed at getting promising new treatments to patients faster, Axios' Caitlin Owens writes. Why it matters: Critics — including the FDA itself — say the program lacks appropriate guardrails, putting expensive, unproven treatments in consumers' hands while drugmakers often delay proving the drugs' effectiveness. Driving the news: Wednesday's recommendation that the FDA pull Makena, a drug owned by Covis Pharmaceuticals marketed as preventing pre-term births, came after years of tension between the company, the agency, consumer protection groups and medical associations. The big picture: Accelerated approval began drawing policymakers' attention after it was used last year to approve Aduhelm, a controversial Alzheimer's drug that an FDA advisory panel recommended the agency not approve. The manufacturer Biogen later largely gave up marketing the compound. - The more routine issue with the program is that drugmakers frequently miss deadlines for completing confirmatory trials, yet their products remain on the market.
- Both the House and the Senate have proposed reforms to the program, and the FDA asked specifically for more authority to ensure confirmatory studies "progress in a timely manner."
- Lawmakers punted on legislative reforms when they debated a must-pass FDA bill last month. The issue could resurface during a post-election lame-duck session.
By the numbers: A report by HHS's internal watchdog found nearly 40% of the 278 drug applications granted accelerated approvals from 1992 to the end of 2021 haven't completed their confirmatory trials. What we're watching: The FDA will now officially decide whether to pull Makena from the market, likely ending this particular saga. - The question then becomes whether Congress will enact reforms to the program after the midterms, and how far those reforms will go.
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