The Lacuna Project

lacuna (n.) a gap in a record where something should be

Independent research. Not affiliated with any government, agency, or company.

Exhibit 099

How FDA used its accelerated approval pathway raised concerns in 3 of 24 drugs reviewed (OEI-01-21-00400)

Exhibit 099 · Oversight report

How FDA used its accelerated approval pathway raised concerns in 3 of 24 drugs reviewed (OEI-01-21-00400)

This review focused on a sample of 24 drugs that went through the accelerated approval pathway; it is not a compliance review. We did not independently assess the appropriateness of the decisions made by FDA.

Reviewed 24 accelerated approvals, ten selected purposively and fourteen at random. Found unplanned analyses, internal disagreements or incomplete meeting documentation in three: aducanumab, hydroxyprogesterone caproate and eteplirsen. OIG stated the work was not a compliance review and did not independently judge the appropriateness of FDA's decisions. The recommendation tracker records on 18 May 2026 that the documentation recommendation was implemented and the recommendation on council referral criteria was not.

Source
U.S. Department of Health and Human Services, Office of Inspector General
Date
2025
Quoted from
OEI-01-21-00400 (January 2025), Background, Methodology (printed pp. 7-8)
Grade
Primary record
Document
https://www.oig.hhs.gov/documents/evaluation/10160/OEI-01-21-00400.pdf
Accessed
2026-11-09
Cited by
Findings citing this exhibit
Note
Summary page and recommendation tracker: https://www.oig.hhs.gov/reports/all/2025/how-fda-used-its-accelerated-approval-pathway-raised-concerns-in-3-of-24-drugs-reviewed/ (methodology at printed pp. 7–9).

Cited by

Finding MED-4.4
Primary record Of 104 accelerated drug approvals with unfinished confirmatory trials in 2022, 35 had a trial past its original completion date. Medicare and Medicaid spent more than $18 billion on the 18 drugs involved from 2018 to 2021.