Hacker News new | ask | show | jobs
by mlyle 2040 days ago
"Getting a bit more speculative, why aren’t scientists at Pfizer and Moderna already in conversation with decision makers at the FDA so that the evaluation process can be started based on preliminary data?"

They -are-. The FDA has been in the loop every step of the way.

Still, there is a need for comprehensive review of safety and for everyone to understand the possible risks. You can really only begin to complete this when you have a full application.

I hope the FDA manages to shave a few days off the process from our anticipated mid-December timeline, but it's not like a few days makes very much difference. We'll have approximately the same number of doses produced and administered by December 31st no matter when approval happens; moving forward the timeline a day or two doesn't stop very many cases. Production is the critical path.

On the other hand, fully vetting an application and detecting a substantial gotcha could make a very big difference.

We're already talking of approving this with far less safety and efficacy data, and calendar time, than we're used to. There's not too much fat left to trim in the process. (This is why an initial EUA may be fairly narrowly crafted, too, and not authorize giving the vaccine to all subpopulations... with a few more months opening the door to wider use).

1 comments

Very interesting and good to hear. So drug companies are sharing early trial data with the FDA?
Trial design and trial data are shared with the FDA underway during an ordinary drug or device trial. But applications subject to FDA Fast-Track authorization processes also undergo "rolling review" where portions of the new drug application are reviewed as they are partially complete. This has narrowed the set of action items that remain.

I'm sure a lot of people are staying up late as the EUA applications come in, and skimming the documents and working to identify remaining weaknesses that can be proactively addressed. But sometime in this, they need to get a good night's sleep, and begin meticulously going through the document and make sure the remaining, necessary (i.e. not waived) conditions for emergency use approval are met.

Could you point me to any sort of reference on this? I'd love to update my post with this info.
Googling 'FDA fast track' yields https://www.fda.gov/patients/learn-about-drug-and-device-app...

Adding 'covid' to this yields https://www.biopharma-reporter.com/Article/2020/11/10/Novava...

etc.

There's more information on the process with Europe's regulator, because they're a bit less tight-lipped than the FDA. But data sharing (particularly on adverse events) has been continually happening throughout many jurisdictions and we should see approvals in a similar timeframe between Europe and the US.

Thanks for these links.

I'm seeing that Pfizer and Moderna are participating in a rolling review in Europe, but I haven't yet found anything about that in the US. Is it automatically part of the Fast Track program?

What do press releases like these mean: https://www.pfizer.com/news/press-release/press-release-deta... Are they announcing the _conclusion_ of the application process? It sort of presents the application as an atomic event.

Sure, the application is an "atomic event" in both Europe and the US, even if data has been previously shared and technical assistance from the regulator has been previously offered.

In the end, regulators need to give an emergency authorization or not, based on information at a certain point in time, which is also an atomic event.