title: Regulatory review of novel therapeutics--comparison of three regulatory agencies.
abstract: BACKGROUND
  The upcoming reauthorization of the Prescription Drug User Fee Act focuses on improving the review process for new drug applications at the Food and Drug Administration (FDA).
  
  
  METHODS
  Using publicly available information from the FDA, the European Medicines Agency (EMA), and Health Canada, we compared the time for completion of the first review and the total review time for all applications involving novel therapeutic agents approved by the three regulatory agencies from 2001 through 2010 and determined the geographic area in which each novel therapeutic agent was first approved for use.
  
  
  RESULTS
  There were 510 applications for novel therapeutic agents approved from 2001 through 2010--225 by the FDA, 186 by the EMA, and 99 by Health Canada; among the applications, there were 289 unique agents. The median length of time for completion of the first review was 303 days (interquartile range, 185 to 372) for applications approved by the FDA, 366 days (interquartile range, 310 to 445) for those approved by the EMA, and 352 days (interquartile range, 255 to 420) for those approved by Health Canada (P<0.001 for the comparison across the three agencies). The median total review time was also shorter at the FDA than at the EMA or Health Canada (P=0.002). Among the 289 unique novel therapeutic agents, 190 were approved in both the United States and Europe (either by the EMA or through the mutual recognition process), of which 121 (63.7%) were first approved in the United States; similarly, 154 were approved in both the United States and Canada, of which 132 (85.7%) were first approved in the United States.
  
  
  CONCLUSIONS
  For novel therapeutic agents approved between 2001 and 2010, the FDA reviewed applications involving novel therapeutics more quickly, on average, than did the EMA or Health Canada, and the vast majority of these new therapeutic agents were first approved for use in the United States. (Funded by the Pew Charitable Trusts.).
authors.affiliation: School of Medicine, Yale University, New Haven, CT 06520, USA.
authors.forename: Nicholas S
authors.initials: NS
authors.lastname: Downing
authors.forename: Jenerius A
authors.initials: JA
authors.lastname: Aminawung
authors.forename: Nilay D
authors.initials: ND
authors.lastname: Shah
authors.forename: Joel B
authors.initials: JB
authors.lastname: Braunstein
authors.forename: Harlan M
authors.initials: HM
authors.lastname: Krumholz
authors.forename: Joseph S
authors.initials: JS
authors.lastname: Ross
mesh_terms: D002170:Canada; D003132:Commerce; D017277:Drug Approval / Q000191:economics / Q000458:organization & administration*; D004345:Drug Industry / Q000191:economics*; D005060:Europe; D005249:Fees and Charges; D006077:Government Agencies; D033161:Government Regulation; D006801:Humans; D055553:Prescription Drugs / Q000191:economics; D013997:Time Factors; D014481:United States; D014486:United States Food and Drug Administration
chemical_list: D055553:Prescription Drugs