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Health Policy and Regulation

11/9 Pharma & Tech Thursday, October 6, 2022 17:20 Background Definitions Drug: chemical cmpds for cure/treatment/prevention of disease . Biologicals: vaccines, blood components, stem cells, recombinant proteins, antibodies, gene therapy . Device: -"an instrument, apparatus, implement, machine, contrivance, implant, in vitro reagent, or other similar or related article...,. FDA Deput The Executive Secretariat ntal anc office nolog Operating Divisions Office of the Assistant Secretary for Administration Administration for Children and Famies Office of the Assistant Secretary Administration for Community Living Office of the Assistant Seretary for Health Agency for Healthcare Research and for Legislation for Planning and Evaluation Officeof the Asisant Seretary Office of the Assistant Secretary for Public Affairs Food and Drug Administration* Officefor Ciil Rights Health Resources and Services Administration Departmental Appeals Board Indian Kealth Service* Office of the Genral Coune National Institutes of Health* Office f Global Affair ubstance Abuse and Mental Health Office of Medicare Hearings and Appeal Office of the National Coordinato for Health Information Technology F22 Page 32 Food and Drug Administratior September 2021 Office of the Commissioner Commissioner of Food&Drugs Janet Woodcock,MD(Acting Principal Deputy Commisioner Vacant Julia Tiemey (Acting) DCA ood Safet Appl Diredor MD.Ph FDA Approval FDA serves to ensure that drugs/pharmaceuticals (chemical drugs and also biologics) are safe and effective- not that one is better than the current options Uses clinical trial data- but by those who performed the trial Examines effectiveness against disease of interest- but only for that disease (investigates only 1 indication) Track risks of drug/biologic Manages drug safety in production (drugs not contaminated, factories safe, ensure that dose is correct, shelf life is correct, etc.) FDA approval is very clear in what the drug is approved for; doesn't mean the drug is more effective than current drugs on the market for the same thing o Once drug is approved, company can advertise it Only counts for the US, but other countries' regulatory bodies can grant reciprocity (if FDA approved, this country will approve) o However, the FDA doesn't have a lot of reciprocity from other countries' approvals to do in other countries) Much of the research on a drug is being done by academic physicians and the healthcare system, not the pharma company itself. The pharmaceutical agency sponsors the cost of the clinical trial, but they are underpaid. Thus, institution carries burden of the difference. Cost gets pushed down to basic care delivery and onto people not enrolled in clinical trials o Much of the innovation is actually happening in academia (e.g., car-T cell therapy on leukemia) Car-T cells: extract T cells from pt via phoresis, use a genetically-modified vector to add an antibody specific to CD-19, which leukemia cells express. You then reinfuse these T cells into pt. This research was done in academic hospitals o Novartis bought out this process, streamlined it, and said the price is $890k/dose. They charge closer to $1.5mn/dose. Novartis is profiting off the work academia did. Thus, innovation is happening in academia and not these companies. Special Approvals Accelerated appr