Accelerated drug approval: Meeting the ethical yardstick

Drugs addressing unmet medical needs can change the lives of millions. Developing and validating new drugs can, however, take many years. To streamline the assessment of new drugs, regulatory agencies have long established shortened review pathways. Among these programs, Accelerated Approval (AA) ha...

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Bibliographic Details
Authors: Andreoletti, Mattia (Author) ; Blasimme, Alessandro (Author)
Format: Electronic Article
Language:English
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Published: Wiley-Blackwell 2023
In: Bioethics
Year: 2023, Volume: 37, Issue: 7, Pages: 647-655
RelBib Classification:KBQ North America
NCH Medical ethics
NCJ Ethics of science
XA Law
Further subjects:B drug regulation
B Aducanumab
B Accelerated Approval
B ethics of clinical research
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Summary:Drugs addressing unmet medical needs can change the lives of millions. Developing and validating new drugs can, however, take many years. To streamline the assessment of new drugs, regulatory agencies have long established shortened review pathways. Among these programs, Accelerated Approval (AA) has recently come under scrutiny due to the U.S. Food and Drug Administration's decision to authorize Aducanumab, the first Alzheimer's disease drug. This decision attracted fierce criticism due to the allegedly insufficient evidence about the safety and efficacy of the drug. While considerable scholarly attention has been devoted to this case, the ethical aspects of the AA regulatory pathway have so far remained relatively unexplored. In this paper, we set out to fill this gap. We illustrate six conditions that should be met for AA to be ethically acceptable: moral solicitude, evidence, risk mitigation, impartiality, sustainability, and transparency. We discuss such conditions and suggest practical steps to implement them in regulatory and oversight processes. Taken together, our six conditions represent a benchmark for assessing the ethical validity of AA processes and decisions.
ISSN:1467-8519
Contains:Enthalten in: Bioethics
Persistent identifiers:DOI: 10.1111/bioe.13191