PDUFA: Funny Name; Vital Program

By jschneidewind on October 24, 2011 in Policy/Advocacy, Uncategorized

by Ronald Johnson, Vice President of Policy and Advocacy, AIDS United

Today, October 24, 2011, the Food and Drug Administration (FDA) held a public meeting to discuss proposed recommendations for reauthorizing PDUFA, the Prescription Drug User Fee Act.  For many people, PDUFA may be just another funny, “government-speak” acronym but it is in fact a vital initiative in disease treatment that has impacted thousands of lives and was achieved with the strong support of AIDS advocates.

In 1992, Congress passed PDUFA to streamline the drug approval review process and make it more timely and predictable. Under PDUFA, user fees are collected from pharmaceutical companies that apply for approval of new drugs and companies that apply for biologics license. The fees are used strictly to enhance and support FDA’s drug and biologics review process.  The fees supplement and do not supplant FDA funding from the annual appropriation process.  The law also mandates FDA to set a standard goal of reviewing new drug applications within 10 months and a priority review goal of six months.

For Americans living with serious or chronic diseases and disabilities, new treatments can’t come fast enough. As a person living with HIV/AIDS, I’ve certainly benefited from FDA approval of new drugs that have improved HIV treatment regimens dramatically.  Many thousands of people like me are alive and healthy because of treatment advances.  Prior to PDUFA, the FDA’s review process for new drugs was slow compared with other countries.  AIDS activism in the late 1980s, including large protest demonstrations organized by ACT-UP, brought increased attention to the lengthy review process and its impact on delaying approval of medications that could be used to fight HIV and the opportunistic infections that then were responsible for the preponderance of AIDS-related deaths.  PDUFA enactment allowed the FDA to have the funds needed to hire additional reviewers and support staff and to upgrade its information technology systems.  FDA committed to complete reviews in a predictable timeframe.

PDUFA has been reauthorized three times since its original adoption.  The current 5-year period, PDUFA IV, ends September 2012.  The user fees account for about two-thirds of the FDA’s budget for new drugs and biologics review.

PDUFA has improved the new drug approval process significantly, enabling FDA to speed up the review process without compromising high standards for safety, efficacy, and quality of new drugs prior to approval.  This has allowed faster patient access to new drugs and biologics and has enabled the U.S. to be a world leader in introducing new drugs.  In testimony to the House Energy and Commerce Committee’s Subcommittee on Health this past July, Dr. Janet Woodcock, who heads the FDA’s drug review unit, noted that the public has gained faster access to over 1,500 new drugs and biologics since 1992.  The U.S. now leads the world in the initial introduction of new drugs.

Following negotiations with industry and consultations with public stakeholders, FDA issued recommendations for reauthorizing PDUFA for another 5-year period, through FY 2017.  FDA’s recommendations for PDUFA V address concerns and priorities raised by industry and stakeholders, including consumers and include three proposals that were specifically advocated for by patients.  The recommendations include a proposed new review model intended to improve communication between the FDA review team and the applying drug sponsor and to improve the effectiveness of the first cycle review process so as to decrease the number of review cycles needed to review a drug and thus to speed up patients’ access to safe, effective and high quality new drugs and biologics.  This would reverse a creeping increase in review times over the past few years that has compromised FDA’s performance goals.

An important feature of the recommendations is an increase in the user fee revenue to $693 million in FY 2013.  In a time when federal appropriations are being cut and facing even more devastating cuts, the funding stability that PDUFA provides is critical.

Scientific advances over the past 18 months in HIV vaccine research, microbicide research, pre-exposure prophylaxis for HIV infection, and HIV treatment as prevention underscore the need not only for maintaining a robust research and development process but also for maintain a process for timely, efficient review of new drugs.  Once the recommendations for reauthorization are submitted to Congress sometime early in 2012, both houses should move forward quickly towards a clean reauthorization before the September expiration.  AIDS United strongly supports reauthorizing PDUFA and will stay engaged to insure the continuation of this vital program with the funny name.

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