title: How drugs are developed and approved by the FDA: current process and future directions.
abstract: OBJECTIVE
  This article provides an overview of FDA's regulatory processes for drug development and approval, and the estimated costs associated with the development of a drug, and also examines the issues and challenges facing the FDA in the near future.
  
  
  METHODS
  A literature search was performed using MEDLINE to summarize the current FDA drug approval processes and future directions. MEDLINE was further utilized to search for all cost analysis studies performed to evaluate the pharmaceutical industry R&D productivity and drug development cost estimates.
  
  
  RESULTS
  While the drug approval process remains at high risk and spans over multiple years, the FDA drug review and approval process has improved, with the median approval time for new molecular drugs been reduced from 19 months to 10 months. The overall cost to development of a drug remains quite high and has been estimated to range from $868M to $1,241M USD. Several new laws have been enacted, including the FDA Safety and Innovation Act (FDASIA) of 2013, which is designed to improve the drug approval process and enhance access to new medicines.
  
  
  CONCLUSIONS
  The FDA's improved processes for drug approval and post-market surveillance have achieved the goal of providing patients with timely access to effective drugs while minimizing the risk of drug-related harm. The FDA drug approval process is not without controversy, as a number of well-known gastroenterology drugs have been withdrawn from the US market over the past few years. With the approval of the new FDASIA law, the FDA will continue to improve their processes and, working together with the ACG through the FDA-Related Matters Committee, continue to develop safe and effective drugs for our patients.
authors.affiliation: Global Regulatory Affairs, Alcon Laboratories, Fort Worth, Texas, USA.
authors.forename: Arthur A
authors.initials: AA
authors.lastname: Ciociola
authors.affiliation: Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
authors.forename: Lawrence B
authors.initials: LB
authors.lastname: Cohen
authors.affiliation: Gastroenterology, University of South Florida, Tampa, Florida, USA.
authors.forename: Prasad
authors.initials: P
authors.lastname: Kulkarni
mesh_terms: D017277:Drug Approval / Q000191:economics / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D055808:Drug Discovery / Q000458:organization & administration; D011358:Product Surveillance, Postmarketing; D014481:United States; D014486:United States Food and Drug Administration / Q000191:economics / Q000331:legislation & jurisprudence / Q000458:organization & administration*