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Treats a population of < 200,000 in the US
Same review and development standards as for a nonorphan product
Numbers of patients in clinical trials will be smaller
FDA has two special units to deal with orphan products
Office of Orphan Products Development/Office of
the Commissioner
Associate Director for Orphan Products in the
Office of New Drugs (OND)/CDER
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7 years exclusive marketing for that drug for that disease
Tax credits for clinical development – 20 yr carry
forward; 1 year fall back
Waiver of NDA filing fees ($1.5 million FY 2011)
Grant support - $450,000/annum for 4 years
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More than 7,000 rare diseases
More than 350 drugs for orphan diseases have been
developed since 1983
Burgeoning field – large and small companies involved
Money to be made
Review times may be faster as majority of orphan
diseases serious or life threatening
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Measure of effect of effect of treatment that may
correlate with a real endpoint
No guaranteed relationship
Needs validation
E.g. cholesterol is related to heart disease, but many with
high cholesterol do not develop heart disease.
So cholesterol lowering drugs lower cholesterol but that
alone does not prevent death. Proof of efficacy in
preventing heart disease took 5 years to show.
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May be able to shorten a clinical trial with the us of
VALIDATED endpoints
Great interest currently; may not correlate
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Indicates a disease state or some physiological state of
the organism
May be used to measure the progression of disease or
the effects of treatment
Rheumatoid Factors as a marker for Rheumatoid
Arthritis; elevated PSA for prostate cancer
May relate to how a drug will/will not act in the body –
KRAS gene expression in Colorectal Cancer
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May assist in identifying high-risk individuals so they can
either be treated prior to onset of disease of shortly
thereafter
Test must be rapidly available and easy to carry out
Must be validated and related to a positive outcome
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Treatment of Serious or life-threatening illness
Must have meaningful benefit over existing therapies
May utilize a surrogate endpoint that is “reasonably
likely…to predict clinical benefit”
May have restricted prescribing
Most likely will have post marketing requirements
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Must address a serious or life threatening
illness
Potential to treat unmet need
Multiple meetings with FDA to discuss
development plans
Options to submit sections of the NDA/BLA
as they are ready
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Begins on submission of NDA/BLA
Shortens review time from 10 months to 6
months
May also have “Fast Track”