Expedited Programs Updated January 14, 2026

What is Breakthrough Therapy?

Breakthrough Therapy is an FDA designation for drugs showing substantial improvement over existing treatments. Learn about criteria, benefits, and approval rates.

Definition

Breakthrough Therapy Designation is an FDA program for drugs intended to treat serious conditions where preliminary clinical evidence indicates substantial improvement over available therapies on clinically significant endpoints. Created by FDASIA in 2012.

How Breakthrough Therapy Works

Sponsors submit requests with preliminary clinical data demonstrating substantial improvement. FDA evaluates whether evidence supports clear advantage over existing treatments on meaningful endpoints.

Eligibility Criteria

  • Intended to treat a serious condition
  • Preliminary clinical evidence (not just preclinical)
  • Demonstrates substantial improvement over available therapy
  • Improvement on clinically significant endpoint(s)

Breakthrough Therapy Benefits

Breakthrough Therapy provides the most intensive FDA support:

  1. All Fast Track Features: Rolling review, frequent meetings
  2. Intensive Guidance: FDA helps design efficient development program
  3. Senior Leadership Involvement: Organizational commitment
  4. Cross-Disciplinary Meetings: Multiple FDA divisions engaged
  5. Expedited Review: Often combined with Priority Review

Breakthrough Therapy Statistics

MetricValue
BTDs Granted (as of 2025)600+
Approval Rate~65-70%
Average Development Time Reduction30%
Percentage of Novel Approvals with BTD~35-40%

Why BD Teams Track Breakthrough Therapy

For business development professionals, BTD is a strong value signal:

  • Deal Implication: BTD assets command premium valuations due to higher approval probability and faster timelines
  • Due Diligence Focus: Review the clinical data supporting BTD and FDA’s assessment of substantial improvement
  • Opportunity Signal: BTD-designated programs are attractive acquisition targets

Frequently Asked Questions

What is Breakthrough Therapy?

Breakthrough Therapy is an FDA designation for drugs treating serious conditions where preliminary clinical evidence shows substantial improvement over available therapies.

What are Breakthrough Therapy benefits?

Benefits include intensive FDA guidance, organizational commitment from senior managers, rolling review, and eligibility for Priority Review and Accelerated Approval.

How is Breakthrough different from Fast Track?

Breakthrough requires preliminary clinical evidence of substantial improvement; Fast Track requires only potential to address unmet need based on any evidence.

What percentage of Breakthrough drugs get approved?

Approximately 65-70% of Breakthrough Therapy designated drugs that complete development receive FDA approval, compared to about 10% for non-designated drugs.

When should you request Breakthrough Therapy?

Request should be made no later than End of Phase 2, ideally after Phase 1b or Phase 2a data showing substantial improvement over available therapy.

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