Cited by 366Healthcare RegulationBiomedical Ethics and RegulationPharmaceutical Economics and Policy

Drugs, Devices, and the FDA: Part 1

Open access
Van Norman, Gail A.·2016·JACC: Basic to Translational Science

Abstract

Over the last 150 years, the U.S. Food and Drug Administration (FDA) has evolved from a small division of the U.S. Patent Office to 1 of the largest consumer protection agencies in the world. Its mission includes ensuring that new medical treatments reach the public as quickly as possible while simultaneously ensuring that new treatments are both safe and effective. In the face of urgent consumer need, the FDA has faced criticism that its processes are too lengthy and costly and that the time to new drug release is significantly longer in the United States than in other Western countries. Calls from the public to loosen FDA regulations to facilitate more rapid approval of drugs and devices have been countered by the occurrence of patient harm and deaths after some approved drugs have reached the marketplace. New drug and device approval in the United States take an average of 12 and 7 years, respectively, from pre-clinical testing to approval. Costs for development of medical devices run into millions of dollars, and a recent study suggests that the entire cost for a new drug is in excess of $1 billion. For investigators seeking approval for new drugs and devices, FDA processes can be formidable. This 2-part series is intended to provide an overview of the steps involved in bringing new drugs and devices through the FDA process. Part 1 concerns the process of new drug approvals. Part 2 continues with approval of medical devices.

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Integrity signals

Registry

Crossref · 10.1016/j.jacbts.2016.03.002

Cites

4 of 4 references verified0 citation errors · 0 not checkable

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  • Combining organ, length of exposure, and sex, PPV between mice and rats hovered around 50%, which is no greater than random chance.

    “Combining organ, length of exposure, and sex, PPV between mice and rats hovered around 50%, which is no greater than random chance (12).”

    From Limitations of Animal Studies for Predicting Toxicity in Clinical Trials (2019) · cites this paper as [12]

    The clinical-trials section discusses animal safety studies as a basis for initial human doses, but does not report predictive values between mice and rats. Searches for PPV, organ, exposure duration, sex, and interspecies toxicity found no passage addressing the claimed approximately 50% result or its comparison with chance. Page numbers were not available in our copy. (LLM, conf=0.76)

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  • Of those, only 60% successfully complete phase I trials.

    “Of those, only 60% successfully complete phase I trials (16).”

    From Limitations of Animal Studies for Predicting Toxicity in Clinical Trials (2019) · cites this paper as [16]

    The ‘Phase I trials’ section describes the purpose and size of these trials but gives no completion rate. I searched the indexed copy for ‘60%’ and Phase I success rates; the Figure 1 caption discusses failure rates generally but does not state that 60% complete Phase I. No page numbers were available for these passages. (LLM, conf=0.73)

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  • Review of 37 chemicals in the U.S. National Toxicology Program concluded that toxicities other than carcinogenesis were not reproducible between rats and mice, between sexes, or compared with historic control animals.

    “Review of 37 chemicals studied in the U.S. National Toxicology Program concluded that toxicities other than carcinogenesis were not reproducible between rats and mice, between sexes, or compared with historic control animals.”

    From Limitations of Animal Studies for Predicting Toxicity in Clinical Trials (2019) · cites this paper as [12]

    The clinical-trials section discusses animal safety studies and single-dose toxicity trials, but not a review of 37 National Toxicology Program chemicals. Searches for that review and for reproducibility across rats, mice, sexes, and historic controls found no passage addressing the claim. (LLM, conf=0.75)

    Experimental — accuracy not yet measured
  • Average positive predictive value from mouse to rat was 55.3% for long-term studies and 44.8% for short-term studies.

    “Average positive predictive value (PPV) from mouse to rat was 55.3% and 44.8% for long-term and short-term studies, respectively.”

    From Limitations of Animal Studies for Predicting Toxicity in Clinical Trials (2019) · cites this paper as [12]

    The Clinical Trials section discusses animal safety studies and human trial phases, but does not report mouse-to-rat positive predictive values. Searches for both percentages and for mouse-to-rat predictive value in long- and short-term studies found no matching passage in our copy. (LLM, conf=0.75)

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Cites

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Research works printed but not linked: 13

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Authors
Van Norman, G. A.
Venue
JACC: Basic to Translational Science
Publisher
Elsevier BV
Published
2016-04
Volume
1
Issue
3
Pages
170-179
ISSN
2452-302X (ISSN-L)
OpenAlex
W2344408149
Cited by
366
References
4
Citations by year
2026: 29 · 2025: 39 · 2024: 42 · 2023: 40 · 2022: 53 · 2021: 56 · 2020: 47 · 2019: 31 · 2018: 22 · 2017: 5 · 2016: 2
FWCI
34.06
Type
journal article
Language
en
Open access
Locations
  • JACC Basic to Translational Science (publishedVersion, cc-by-nc-nd)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Health Sciences › Health Professions › Health Information Management › Healthcare Regulation
  • Health Sciences › Medicine › Physiology › Biomedical Ethics and Regulation
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Pharmaceutical Economics and Policy
Keywords
FDA regulatory process, new drug approvals, medical device approval, drug development timelines, drug development costs, drug safety and efficacy, regulatory approval pathways

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