The Fast Track program facilitates the expedited development and review of new drugs or biologics that are intended to: 1) treat serious or life-threatening conditions and 2) demonstrate the potential to address unmet medical needs. The purpose is to get important new drugs to the patient earlier. Fast Track addresses a broad range of serious conditions. 1 . Determining whether a condition is serious is a matter of judgment, but generally is based on whether the drug will have an impact on such factors as survival, day-to-day functioning, or the likelihood that the condition, if left untreated, will progress from a less severe condition to a more serious one. 2. Filling an unmet medical need is defined as providing a therapy where none exists or providing a therapy which may be potentially better than available therapy. If there are available therapies, a fast track drug must show some advantage over available therapy, such as:
- Showing superior effectiveness, effect on serious outcomes or improved effect on serious outcomes
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Avoiding serious side effects of an available therapy
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Improving the diagnosis of a serious condition where early diagnosis results in an improved outcome
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Decreasing a clinical significant toxicity of an available therapy that is common and causes discontinuation of treatment
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Ability to address emerging or anticipated public health need
A drug that receives Fast Track designation is eligible for some or all of the following:
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More frequent meetings with FDA to discuss the drug's development plan and ensure collection of appropriate data needed to support drug approval
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More frequent written communication from FDA about such things as the design of the proposed clinical trials and use of biomarkers
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Eligibility for Accelerated Approval and Priority Review, if relevant criteria are met
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Rolling Review, which means that a drug company can submit completed sections of its Biologic License Application (BLA) or New Drug Application (NDA) for review by FDA, rather than waiting until every section of the NDA is completed before the entire application can be reviewed. BLA or NDA review usually does not begin until the drug company has submitted the entire application to the FDA
Fast Track designation must be requested by the drug company. The request can be initiated at any time during the drug development process. FDA will review the request and make a decision within sixty days based on whether the drug fills an unmet medical need in a serious condition.
Once a drug receives Fast Track designation, early and frequent communication between the FDA and a drug company is encouraged throughout the entire drug development and review process. The frequency of communication assures that questions and issues are resolved quickly, often leading to earlier drug approval and access by patients.