Table 1.

Expedited programs for serious conditions

ProgramDescription
Fast track designation Drug or treatment must provide theoretical rationale, mechanistic rationale, or evidence of nonclinical activity in the targeted disease or condition. 
Breakthrough therapy designation Drug or treatment must provide preliminary clinical evidence of a treatment effect, ie, substantially greater than that of available therapies. 
Accelerated approval Drug or treatment must show substantially improved benefit over the available standard of care via either of 2 primary end points: (1) a surrogate end point or biomarker or (2) an intermediate clinical end point.
Continued approval is contingent upon confirmatory trials. 
Priority review designation FDA commits to review the marketing application for a study drug within 6 months compared with the average 10 months for the standard approval pathway. 
Orphan drug designation Separate from the expedited program pathway. Drug that targets a rare disease/condition; in the United States, defined as affecting <200 000 individuals. 
ProgramDescription
Fast track designation Drug or treatment must provide theoretical rationale, mechanistic rationale, or evidence of nonclinical activity in the targeted disease or condition. 
Breakthrough therapy designation Drug or treatment must provide preliminary clinical evidence of a treatment effect, ie, substantially greater than that of available therapies. 
Accelerated approval Drug or treatment must show substantially improved benefit over the available standard of care via either of 2 primary end points: (1) a surrogate end point or biomarker or (2) an intermediate clinical end point.
Continued approval is contingent upon confirmatory trials. 
Priority review designation FDA commits to review the marketing application for a study drug within 6 months compared with the average 10 months for the standard approval pathway. 
Orphan drug designation Separate from the expedited program pathway. Drug that targets a rare disease/condition; in the United States, defined as affecting <200 000 individuals. 

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