Sunday, October 20, 2013

FDA Regulations



FDA Regulations on Medical Devices

Now that it has been crunch time for Senior Design. My group’s bio-medical device has stringent FDA regulations that need to be met to even be considered to be used.  After much research for our device and similar devices in the past; I realized that their path to being approved is sometimes quite absurd. It is understandable that “devices” such as band- aids are Class I and less stringent because most likely they will not cause harm to the person. But when you get into Class II and Class III devices that have direct contact and a direct possibility of causing harm is where the FDA cracks down. Now I believe that it is great that they crack down but in some circumstances it is too extreme.



There are bioabsorable stents which provide transient support to the vessel and degrade over time. These are alternatives to the permanent bare-metal stent and drug-eluting stents. The benefit of the absorbable stent is that you do not have to have a new one put in after the previous one breaks down. That means that the patient will only have to have one surgery instead of multiple, and every surgery comes with its associated risks.

In 2011 the first drug-eluting bioabsorbable stent was approved for commercial use in Europe. Abott Vascular received CE mark approval for the bioabsorbable vascular scaffold. It was approved in Europe to treat coronary artery disease.  At this time there was not much research proven that the stents were beneficial and did not cause harm, so two years ago I agree with the FDA for not allowing for commercialized use.

The first fully biodegradable coronary stent was used in a patient in India. Barely a week after the Drug Controller General of India approved the usage of biodegradable coronary stent in India a local doctor performed the surgery. Just a week after being approved the cardiologist had no qualms in providing this implant to his patients. He said “the artery will behave like a natural artery. Thrombosis is reduced by six months to a year. Another advantage of using this stent is that even if the patient develops a new disease, surgery can be done on the artery which was risky earlier," said Dr Chopda. The Times of India reports that doctors have implanted more than 2,500 Absorb stents since the device's launch in late September, spread across 250 centers in 45 cities. It is clear that the device has much more positive effects for the patients then continuing to hold out

Absorb that was first approved in 2011 is currently authorized for sale in more than 30 countries in Europe and parts of Asian Pacific and Latin America. This will most likely to be the first stent approved in the United States but not for another two to three years. It has proven to be safe and relief to heart patients with severe blockages. The question is after two years of research and statistics is there another factor they do not want the public to know about?

Recently there has been research on the financial side of this device. By early 2019, the sales are likely to be over USD 700 million. Despite not being FDA approved in the US, they are expected to be the owner of the largest market share once approval is received. At present, Abbott Vascular and Kyoto Medical Planning rein in the global market but new companies (e.g. Biotronik) are likely to start participating actively in the market activity. Now if this device has such a large financial benefit, has been proven to work in Europe and other countries what is the FDA waiting for. The scope of this device and the market it has to reach could be a reason why the FDA is holding out. Financial benefits do drive many decisions in the medical field since there is not socialized medicine like in Europe.  It is just extremely interesting to me how the FDA works and how many devices get approved while some do not. In this case maybe they are still waiting to find out long term affects and if the patient will not react well. But there are many people already benefiting from the hours and hours of research scientists have put in to provide such a device to the world. 

Sources:

http://online.wsj.com/article/PR-CO-20130207-907830.html?mod=crnews





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