Given the urgent need to help oncology and rare disease patients facing limited treatment options, many health authorities have established expedited review pathways and have formed international partnerships that optimise their regulatory resources. Their common aim is to accelerate access to innovative therapies, improve agencies’ review efficiency and tackle scientific challenges in a more unified manner.
Each key market’s expedited review pathway has its own set of criteria, processes and expectations. For example, while the US Food and Drug Administration’s (FDA’s) Breakthrough Therapy designation emphasises intensive guidance and rolling review, the European Medicines Agency’s PRIME scheme focuses on early scientific support and enhanced dialogue. Japan’s Sakigake designation and China’s Priority Review pathway offer additional incentives but have their own distinct eligibility requirements and procedural nuances.
The collaborative programs between health authorities vary in formality and depth, ranging from simultaneous regulatory submissions, joint reviews and shared assessments to independently made—but harmonised—decisions among participating countries. For example, FDA’s Project Orbis enables concurrent submission, review and decision making for oncology products across multiple countries, while the World Health Organization’s (WHO’s) Collaborative Registration Procedure allows participating countries to conduct abridged reviews using assessments made by WHO or other stringent regulatory authorities.
Despite these initiatives, the regulatory landscape remains complex. Overlapping objectives, differing procedures and multiple jurisdictions can make it challenging for sponsors to identify the most efficient path for securing approval of new therapies across multiple countries. In practice, these programs do not always simplify the process but require careful navigation as part of a broader global development strategy. The key challenge is: How can companies maximize regional regulatory opportunities to align data requirements, avoid duplication of effort and accelerate timelines?
The answer lies in proactive planning, with extensive regulatory intelligence and cross-functional collaboration from early development stages onward. Most sponsors find that adopting such a comprehensive, tailored approach requires specialized resources that an experienced Contract Research Organisation (CRO), such as ICON, is uniquely positioned to provide.
We recommend that sponsors address the challenge with this broad advice in mind:
- Begin planning early. This means defining your target product label early in development to ensure your clinical program generates the necessary data to support it. And it means engaging cross-functional teams in each target country well in advance of developing a global dossier.
- Become and stay familiar with the regulatory landscape. A foundational knowledge of the coordinated review options available and how they align with the expedited approval pathways will inform your regulatory and clinical development strategies. Since regulatory frameworks are dynamic, it is important to monitor their evolution continuously.
- Map out the criteria and timelines of expedited programs across major markets. This will allow you to synchronise clinical trial design, regulatory engagement and submission planning.
- Engage regulators proactively. By treating health authorities as strategic partners, you can gain valuable feedback on your target product profile, clinical development plan and regulatory expectations. This should help de-risk your program and align it with local requirements.
- Design with the end in mind. Consider how your product will be evaluated in each market. Tailor your clinical trial designs to reflect local standards of care and regulatory expectations and to generate the data needed to support the desired label claims in each jurisdiction.
- Remain flexible. Regulatory advice can vary across review teams (Health Authorities) and timelines and may diverge from published guidance. If access to a collaborative pathway is not possible, be prepared to pivot to sequential, country-specific submissions.
- Leverage the experience of partners. Consider partnering with a company that has deep expertise, coordinates activities across functions and demonstrates operational agility.
By capitalising on Health Authorities’ momentum in creating expedited approval pathways and collaborative assessment programs, sponsors can accelerate global access to critical therapies. However, developing an integrated strategy is inherently complex and requires careful planning and adequate resourcing. Time invested early in formulating a global approach will yield significant benefits at the marketing authorisation stage.
For a more detailed examination of how submission regulations are converging, where they differ and how to meet them most efficiently, download our whitepaper, Accelerating access: Expedited and harmonised pathways for innovative therapies.
In this section
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Digital Disruption
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Clinical strategies to optimise SaMD for treating mental health
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Digital Disruption: Surveying the industry's evolving landscape
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Clinical trial data anonymisation and data sharing
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Clinical Trial Tokenisation
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Closing the evidence gap: The value of digital health technologies in supporting drug reimbursement decisions
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Digital disruption in biopharma
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Disruptive Innovation
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Personalising Digital Health
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The triad of trust: Navigating real-world healthcare data integration
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Decoding AI in software as a medical device (SaMD)
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Software as a medical device (SaMD)
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Clinical strategies to optimise SaMD for treating mental health
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Patient Centricity
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Agile Clinical Monitoring
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Capturing the voice of the patient in clinical trials
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Charting the Managed Access Program Landscape
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Developing Nurse-Centric Medical Communications
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Exploring the patient perspective from different angles
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Patient safety and pharmacovigilance
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A guide to safety data migrations
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Taking safety reporting to the next level with automation
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Outsourced Pharmacovigilance Affiliate Solution
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The evolution of the Pharmacovigilance System Master File: Benefits, challenges, and opportunities
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Sponsor and CRO pharmacovigilance and safety alliances
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Understanding the Periodic Benefit-Risk Evaluation Report
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A guide to safety data migrations
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Patient Voice Survey - Decentralised and Hybrid Trials
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Reimagining Patient-Centricity with the Internet of Medical Things (IoMT)
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Using longitudinal qualitative research to capture the patient voice
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Prioritising patient-centred research for regulatory approval
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Agile Clinical Monitoring
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Regulatory Intelligence
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Accelerating access
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Navigating the regulatory landscape in the US and Japan:
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An innovative approach to rare disease clinical development
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Using innovative tools and lean writing processes to accelerate regulatory document writing
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Current overview of data sharing within clinical trial transparency
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Keeping the end in mind: key considerations for creating plain language summaries
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Navigating orphan drug development from early phase to marketing authorisation
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Early engagement and regulatory considerations for biotech
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Regulatory Intelligence Newsletter
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Requirements & strategy considerations within clinical trial transparency
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Spotlight on regulatory reforms in China
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Demystifying EU CTR, MDR and IVDR
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Transfer of marketing authorisation
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Exploring FDA guidance for modern Data Monitoring Committees
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Streamlining dossier preparation
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Accelerating access
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Endocrine and Metabolic Disorders
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Central Nervous System
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Challenges and opportunities in Parkinson’s Disease clinical trials
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A mind for digital therapeutics
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Respiratory
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Rare and orphan diseases
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Advanced therapies for rare diseases
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Cross-border enrollment of rare disease patients
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Diversity, equity and inclusion in rare disease clinical trials
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Patient Centricity in Orphan Drug Development
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Advanced therapies for rare diseases
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