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<article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" article-type="research-article" dtd-version="1.1d1" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher">REMEDIUM</journal-id><journal-title-group><journal-title>REMEDIUM</journal-title></journal-title-group><issn publication-format="print">1561-5936</issn><issn publication-format="electronic">2658-3534</issn><publisher><publisher-name>Joint-Stock Company Chicot</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">1318</article-id><article-id pub-id-type="doi">10.21518/1561-5936-2018-11-6-20</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Article</subject></subj-group></article-categories><title-group><article-title>Issues of breakthrough therapy and accelerated market authorization in Russia and the EAEU</article-title></title-group><contrib-group><contrib contrib-type="author"><name name-style="western"><surname>Niyazov</surname><given-names>R. R.</given-names></name><bio></bio><email>noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author"><name name-style="western"><surname>Vasiliev</surname><given-names>A. N.</given-names></name><bio></bio><email>noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author"><name name-style="western"><surname>Gavrishina</surname><given-names>E. V.</given-names></name><bio></bio><email>noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author"><name name-style="western"><surname>Dranitsyna</surname><given-names>M. A.</given-names></name><bio></bio><email>noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author"><name name-style="western"><surname>Kulichev</surname><given-names>D. A.</given-names></name><bio></bio><email>noemail@neicon.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff id="aff-1">Center for Scientific Advice LLC</aff><pub-date date-type="epub" iso-8601-date="2018-12-11" publication-format="electronic"><day>11</day><month>12</month><year>2018</year></pub-date><issue>11</issue><fpage>6</fpage><lpage>20</lpage><history><pub-date date-type="received" iso-8601-date="2022-03-18"><day>18</day><month>03</month><year>2022</year></pub-date></history><permissions><copyright-statement>Copyright © 2018,</copyright-statement><copyright-year>2018</copyright-year></permissions><abstract>The time needed for the development and placing medicinal products on the market is rather long, which, among others, is due to the need for stepwise approval of many different aspects by the regulatory authorities. In other countries, procedures streamlining the approval and decision-making processes based on the preliminary data were instituted to accelerate the market access for medicines satisfying unmet healthcare needs. In Russia and the EAEU, there is also a need in the accelerated market access for the medicinal products, which are beneficial for the patients. However, the current infrastructure and regulatory environment need a great deal of reflection to assess advantages and drawbacks of the accelerated pathways, and a robust approach should be taken. In this paper, the analysis of the foreign regulatory procedures enabling the accelerated access for the medicinal products on the market has been performed, and current impediments within the domestic regulatory framework and the possible ways to overcome thereof have been discussed.</abstract><kwd-group xml:lang="en"><kwd>healthcare needs</kwd><kwd>serious or life-threatening diseases</kwd><kwd>breakthrough therapy</kwd><kwd>expedited access</kwd><kwd>accelerated assessment</kwd><kwd>scientific advice</kwd><kwd>priority review</kwd><kwd>biomarkers</kwd><kwd>surrogate endpoints</kwd></kwd-group><kwd-group xml:lang="ru"><kwd>нужды здравоохранения</kwd><kwd>серьезные или жизнеугрожающие заболевания</kwd><kwd>прорывная терапия</kwd><kwd>ускоренная регистрация</kwd><kwd>научное консультирование</kwd><kwd>приоритетная экспертиза</kwd><kwd>биомаркеры</kwd><kwd>суррогатные конечные точки</kwd></kwd-group></article-meta></front><body></body><back><ref-list><ref id="B1"><label>1.</label><mixed-citation>Tufts CSDD, "Briefing: Cost of Developing a New Drug," http://csdd. tufts.edu/files/uploads/Tufts_CSDD_briefing_on_RD_cost_study_-_ Nov_18,_2014.pdf, Nov 2014 (доступ: 23.09.2018).</mixed-citation></ref><ref id="B2"><label>2.</label><mixed-citation>The International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH), 2009. Guidance on Nonclinical Safety Studies for the Conduct of Human Clinical Trials and Marketing Authorization for Pharmaceuticals (ICH M3(R2)). URL: http:// www.ich.org/fileadmin/Public_Web_Site/ICH_Products/Guidelines/ Multidisciplinary/M3_R2/Step4/M3_R2_Guideline.pdf (23.09.2018).</mixed-citation></ref><ref id="B3"><label>3.</label><mixed-citation>The International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH), 2011. Preclinical Safety Evaluation of Biotechnology-Derived Pharmaceuticals (ICH S6(R1)). URL: http://www.ich.org/fileadmin/Public_Web_Site/ICH_Products/Guidelines/ Safety/S6_R1/Step4/S6_R1_Guideline.pdf (23.09.2018).</mixed-citation></ref><ref id="B4"><label>4.</label><mixed-citation>The International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH), 1997. General Considerations for Clinical Trials (E8). URL: http://www.ich.org/fileadmin/Public_Web_ Site/ICH_Products/Guidelines/Efficacy/E8/Step4/E8_Guideline.pdf (23.09.2018).</mixed-citation></ref><ref id="B5"><label>5.</label><mixed-citation>Duijnhoven R.G., Straus S.M.J.M., Raine J.M., de Boer A., Hoes A.W., De Bruin M.L. Number of Patients Studied Prior to Approval of New Medicines: A Database Analysis. PLoS Med. 2013 Mar; 10(3): e1001407. Published online 2013 Mar 19. doi: 10.1371/journal.pmed.1001407.</mixed-citation></ref><ref id="B6"><label>6.</label><mixed-citation>U.S. Food and Drug Administration (1998). Providing Clinical Evidence of Effectiveness for Human Drug and Biological Products. URL: https://www.fda.gov/downloads/Drugs/ GuidanceComplianceRegulatoryInformation/Guidances/UCM072008.pdf (дата обращения: 23.09.2018).</mixed-citation></ref><ref id="B7"><label>7.</label><mixed-citation>European Medicines Agency (2001). Application with 1. Meta-analyses; 2. One pivotal study (CPMP/EWP/2330/99). URL: http://www.ema. europa.eu/docs/en_GB/document_library/Scientific_guideline/2009/09/WC500003657.pdf (дата обращения: 23.09.2018).</mixed-citation></ref><ref id="B8"><label>8.</label><mixed-citation>European Medicines Agency (2015). European Public Assessment Report for Zontivity (voraxapar) (EMA/CHMP/671361/2015 Rev. 1). URL: https:// www.ema.europa.eu/medicines/human/EPAR/zontivity (дата обращения: 28.09.2018).</mixed-citation></ref><ref id="B9"><label>9.</label><mixed-citation>Title 21, Chapter I, Subchapter D, Part 312, Subpart I, §312.300. Electronic Code of Federal Regulations. URL: https://www.ecfr.gov/cgi-bin/text-idx?SID=9b68ec1c8a822864a43f46c2627ce0a8&amp;mc=true&amp;node =se21.5.312_1300&amp;rgn=div8 (дата обращения: 23.09.2018).</mixed-citation></ref><ref id="B10"><label>10.</label><mixed-citation>U.S. Food and Drug Administration (2017). Expedited Programs for Serious Conditions-Drugs and Biologics. URL: https://www.fda. gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/ Guidances/UCM358301.pdf (дата обращения: 23.09.2018).</mixed-citation></ref><ref id="B11"><label>11.</label><mixed-citation>Commission Regulation (EC) No 507/2006 of 29 March 2006 on the conditional marketing authorisation for medicinal products for human use falling within the scope of Regulation (EC) No 726/2004 of the European Parliament and of the Council (Text with EEA relevance). OJ L 92, 30.3.2006, p. 6-9. URL: https://eur-lex.europa.eu/legal-content/EN/ TXT/?qid=1537833856212&amp;uri=CELEX:32006R0507 (дата обращения: 25.09.2018).</mixed-citation></ref><ref id="B12"><label>12.</label><mixed-citation>USC 356: Expedited approval of drugs for serious or life-threatening diseases or conditions. Text contains those laws in effect on September 23, 2018. URL: http://uscode.house.gov/view.xhtml?req=granuleid:USC-prelim-title21-section356&amp;num=0&amp;edition=prelim (дата обращения: 24.09.2018).</mixed-citation></ref><ref id="B13"><label>13.</label><mixed-citation>CFR, Subpart H-Accelerated Approval of New Drugs for Serious or Life-Threatening Illnesses (current as of September 20, 2018). URL: https:// www.ecfr.gov/cgi-bin/text-idx?SID=4549523904af93d53e78a645cd55e24e &amp;mc=true&amp;node=sp21.5.314.h&amp;rgn=div6 (дата обращения: 24.09.2018).</mixed-citation></ref><ref id="B14"><label>14.</label><mixed-citation>U.S. Food and Drug Administration (2017). Drug Development Tools (DDT) Qualification Programs. URL: https://www.fda.gov/Drugs/DevelopmentApprovalProcess/ DrugDevelopmentToolsQualificationProgram/default.htm (дата обращения: 24.09.2018).</mixed-citation></ref><ref id="B15"><label>15.</label><mixed-citation>U.S. Food and Drug Administration (2018). Drug Development Tool Programs and Initiatives. URL: https://www.fda.gov/Drugs/ DevelopmentApprovalProcess/ucm426815.htm (дата обращения: 24.09.2018).</mixed-citation></ref><ref id="B16"><label>16.</label><mixed-citation>U.S. Food and Drug Administration and U.S. National Institutes of Health (2018). BEST (Biomarkers, EndpointS, and other Tools) Resource. URL: https://www.ncbi.nlm.nih.gov/books/NBK326791/pdf/Bookshelf_ NBK326791.pdf (дата обращения: 24.09.2018).</mixed-citation></ref><ref id="B17"><label>17.</label><mixed-citation>U.S. Food and Drug Administration and U.S. National Institutes of Health (2018). BEST (Biomarkers, EndpointS, and other Tools) Resource / Ресурс BEST (биомаркеры, конечные точки и другие инструменты). PharmAdvisor. URL: http://pharmadvisor.ru/document/tr3877/ (дата обращения: 24.09.2018).</mixed-citation></ref><ref id="B18"><label>18.</label><mixed-citation>Hwang T.J., Darrow J.J., Kesselheim A.S. The FDA's Expedited Programs and Clinical Development Times for Novel Therapeutics, 2012-2016. JAMA. 2017; 318(21): 2137-2138.</mixed-citation></ref><ref id="B19"><label>19.</label><mixed-citation>European Medicines Agency (2016). Guideline on the scientific application and the practical arrangements necessary to implement the procedure for accelerated assessment pursuant to Article 14(9) of Regulation (EC) No 726/2004 (EMA/CHMP/671361/2015 Rev. 1). URL: http:// www.ema.europa.eu/docs/en_GB/document_library/Scientific_guide-line/2016/03/WC500202629.pdf (дата обращения: 25.09.2018).</mixed-citation></ref><ref id="B20"><label>20.</label><mixed-citation>European Medicines Agency (2018). Qualification of novel methodologies for medicine development. URL: http://www.ema.europa. eu/ema/index.jsp?curl=pages/regulation/document_listing/docu-ment_listing_000319.jsp&amp;mid=WC0b01ac0580022bb0 (дата обращения: 25.09.2018).</mixed-citation></ref><ref id="B21"><label>21.</label><mixed-citation>U.S. Food and Drug Administration and U.S. National Institutes of Health (2018). CDER Small Business &amp; Industry Assistance (SBIA). URL: https://www.fda.gov/Drugs/DevelopmentApprovalProcess/ SmallBusinessAssistance/default.htm (дата обращения: 25.09.2018).</mixed-citation></ref><ref id="B22"><label>22.</label><mixed-citation>European Medicines Agency (2018). User guide for micro, small and medium-sized enterprises. URL: http://www.ema.europa.eu/docs/en_GB/ document_library/Regulatory_and_procedural_guideline/2009/10/ WC500004134.pdf (дата обращения: 25.09.2018).</mixed-citation></ref><ref id="B23"><label>23.</label><mixed-citation>U.S. Food and Drug Administration (2013). Drug Approval Package for Sovaldi (sofosbuvir) tablet, oral / Summary Review. URL: https://www. accessdata.fda.gov/drugsatfda_docs/nda/2013/2046710rig1s000SumR.pdf (дата обращения: 28.09.2018).</mixed-citation></ref><ref id="B24"><label>24.</label><mixed-citation>European Medicines Agency (2013). European Public Assessment Report for Sovaldi (EMA/CHMP/688774/2013). URL: http://www.ema. europa.eu/docs/en_GB/document_library/EPAR_-_Public_assessment_ report/human/002798/WC500160600.pdf (дата обращения: 26.09.2018).</mixed-citation></ref><ref id="B25"><label>25.</label><mixed-citation>Wieschowski S., Chin W., Federico C., et al. Preclinical efficacy studies in investigator brochures: Do they enable risk-benefit assessment? PLoS Biol. 2018 Apr; 16(4): e2004879. doi: 10.1371/journal.pbio.2004879.</mixed-citation></ref><ref id="B26"><label>26.</label><mixed-citation>Moscicki R.A. and Tandon P.K. Drug-Development Challenges for Small Biopharmaceutical Companies. N Engl J Med. 2017; 376:469-474. doi: 10.1056/NEJMra1510070.</mixed-citation></ref><ref id="B27"><label>27.</label><mixed-citation>Решение Совета Евразийской экономической комиссии от 3 ноября 2016 г. № 78 «О правилах регистрации и экспертизы лекарственных средств для медицинского применения». Евразийская экономическая комиссия (2016). URL: https://docs.eaeunion.org/docs/ ru-ru/01411969/cncd_21112016_78 (дата обращения: 28.09.2018).</mixed-citation></ref><ref id="B28"><label>28.</label><mixed-citation>Chabner B.A. Considerations About the Use of Biomarkers in Cancer Clinical Trials. Clin Pharmacol Ther. 2018 Jan; 103(1): 25-27. doi: 10.1002/ cpt.895. Epub 2017 Nov 14.</mixed-citation></ref><ref id="B29"><label>29.</label><mixed-citation>Puthumana J., Wallach J.D., Ross J.S., Puthumana J., Wallach J.D., Ross J.S. JAMA. 2018; 320(3): 301-303. doi:10.1001/jama.2018.7619.</mixed-citation></ref><ref id="B30"><label>30.</label><mixed-citation>Sherman R.E., Li J., Shapley S., Robb M., Woodcock J. Expediting drug development -- the FDA's new «breakthrough therapy» designation. N Engl J Med. 2013 Nov 14; 369(20): 1877-80. doi: 10.1056/NEJMp1311439.</mixed-citation></ref><ref id="B31"><label>31.</label><mixed-citation>European Medicines Agency (2018). PRIME: a two-year overview. URL: https://www.ema.europa.eu/documents/report/prime-two-year-overview_ en.pdf (дата обращения: 28.09.2018).</mixed-citation></ref><ref id="B32"><label>32.</label><mixed-citation>Kim C., Prasad V. Cancer drugs approved on the basis of a surrogate end point and subsequent overall survival: an analysis of 5 years of US Food and Drug Administration approvals. JAMA Intern Med. 2015 Oct 19. doi:10.1001/jamainternmed.2015.5868.</mixed-citation></ref><ref id="B33"><label>33.</label><mixed-citation>Naci H., Wouters O.J., Gupta R., Ioannidis J.P.A. Timing and characteristics of cumulative evidence available on novel therapeutic agents receiving Food and Drug Administration accelerated approval. Milbank Q. 2017; 357: 261-90. doi:10.1111/1468-0009.12261. pmid: 28589600.</mixed-citation></ref><ref id="B34"><label>34.</label><mixed-citation>Kesselheim A.S., Hwang T.J., Franklin J.M. Two decades of new drug development for central nervous system disorders. Nat Rev Drug Discov. 2015 Dec; 14(12): 815-6. doi: 10.1038/nrd4793. Epub 2015 Nov 20.</mixed-citation></ref><ref id="B35"><label>35.</label><mixed-citation>Marciniak Th.A., Serebruany V. Are drug regulators really too slow? BMJ. 2017; 357: j2867 doi: 10.1136/bmj.j2867.</mixed-citation></ref><ref id="B36"><label>36.</label><mixed-citation>Bejan-Angoulvant T., Cornu C., Archambault P., et al. Is HbA1c a valid surrogate for macrovascular and microvascular complications in type 2 diabetes? Diabetes Metab. 2015 Jun; 41(3): 195-201. doi: 10.1016/j.dia-bet.2015.04.001. Epub 2015 May 6.</mixed-citation></ref><ref id="B37"><label>37.</label><mixed-citation>Kogure S., Koyama N., and Hidaka Sh. Utilization of the Bridging Strategy for the Development of New Drugs in Oncology to Avoid Drug Lag. J Clin Pharmacol. 2017 Nov; 57(11): 1479-1490. doi: 10.1002/ jcph.951. Epub 2017 Jun 19.</mixed-citation></ref><ref id="B38"><label>38.</label><mixed-citation>Watters J.T., Pitzen J.H., Sanders L.J., et al. Transforming the Activation of Clinical Trials. Clin Pharmacol Ther. 2018 Jan; 103(1): 43-46. doi: oi:10.1002/cpt.898. Epub 2017 Nov 6.</mixed-citation></ref><ref id="B39"><label>39.</label><mixed-citation>Pinnow E., Amr S., Bentzen S.M., et al. Postmarket Safety Outcomes for New Molecular Entity (NME) Drugs Approved by the Food and Drug Administration Between 2002 and 2014. Clin Pharmacol Ther. 2018 Aug; 104(2): 390-400. doi: 10.1002/cpt.944. Epub 2017 Dec 20.</mixed-citation></ref><ref id="B40"><label>40.</label><mixed-citation>Breckenridge A. &amp; Liberti L. Accelerated approval of medicines: fit for purpose? Nature Reviews Drug Discovery. 2018; 17: 379-380. doi: 10.1038/nrd.2017.245.</mixed-citation></ref></ref-list></back></article>
