Expedited Programs Updated January 14, 2026

What is Accelerated Approval?

Accelerated Approval allows FDA to approve drugs based on surrogate endpoints before clinical benefit is confirmed. Learn about requirements and post-approval obligations.

Definition

Accelerated Approval is an FDA pathway allowing approval of drugs for serious conditions based on surrogate endpoints or intermediate clinical endpoints reasonably likely to predict clinical benefit. Post-approval confirmatory trials are required to verify the predicted benefit.

How Accelerated Approval Works

Drugs receive approval based on surrogate markers rather than clinical outcomes. Sponsors must then conduct Phase 4 confirmatory trials to verify the surrogate truly predicts meaningful benefit.

Eligibility Criteria

  • Treats a serious or life-threatening condition
  • Provides meaningful advantage over available treatments
  • Uses surrogate endpoint reasonably likely to predict clinical benefit
  • Sponsor commits to confirmatory trials

Accelerated Approval Process

PhaseRequirement
Pre-ApprovalDemonstrate effect on surrogate endpoint
ApprovalFDA grants based on surrogate data
Post-ApprovalConduct confirmatory trials
ConversionFull approval upon confirmation
WithdrawalIf benefit not confirmed

Common Surrogate Endpoints

Therapeutic AreaSurrogate Endpoint
OncologyTumor response rate, progression-free survival
HIVCD4 count, viral load
CardiovascularLDL cholesterol reduction
HematologyHemoglobin levels

Why BD Teams Track Accelerated Approval

For business development professionals, Accelerated Approval presents unique considerations:

  • Deal Implication: Accelerated Approval provides early market access but carries confirmatory trial risk
  • Due Diligence Focus: Assess confirmatory trial design and probability of verifying clinical benefit
  • Opportunity Signal: Post-approval confirmatory trials may require partnership support

Frequently Asked Questions

What is Accelerated Approval?

Accelerated Approval allows FDA to approve drugs for serious conditions based on surrogate endpoints reasonably likely to predict clinical benefit, with confirmatory trials required.

What is a surrogate endpoint?

A surrogate endpoint is a marker (like tumor shrinkage or viral load) that predicts clinical benefit without measuring the actual outcome (survival, cure).

What happens after Accelerated Approval?

Sponsors must conduct confirmatory trials to verify clinical benefit. If trials fail, FDA can withdraw approval through expedited procedures.

Can Accelerated Approval be withdrawn?

Yes, FDA can withdraw Accelerated Approval if confirmatory trials don't verify clinical benefit or sponsors fail to conduct required studies.

What percentage of drugs maintain Accelerated Approval?

Most drugs maintain approval, but FDA has increased enforcement, withdrawing approvals for drugs failing to confirm benefit in recent years.

Track Regulatory Filings with PharmaDB

Get real-time access to FDA approvals, pipeline data, and regulatory intelligence for BD teams.

Join the Waitlist