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Evolution and Current Status of the Orphan Drug Act

Published online by Cambridge University Press:  10 March 2009

Carolyn H. Asbury
Affiliation:
The Pew Charitable Trusts

Abstract

The 1983 Orphan Drug Act was designed in response to market and regulatory disincentives that limited industrial interest in developing drugs needed by people in the United States with rare diseases and conditions. These disincentives evolved from changes in the pharmaceutical industry and in regulatory testing requirements. In the eight years since the Act and subsequent amendments have been in effect, the law has been associated with the new development and approval of 40 marketed drugs and 12 biologicals to treat rare (orphan) diseases. An additional 281 drugs and 141 biologicals have been entered into development and designated as orphans. Finally, the law has mandated exploration of whether the incentives of the Act are necessary and appropriate for stimulating industrial development of orphan medical drugs and devices. Despite this progress, controversies have arisen over three profitable orphan products that have benefited from the law's provisions. This has created the need for continued assessment of the Act's benefits and costs.

Type
Special Section: Orphan Technologies
Copyright
Copyright © Cambridge University Press 1992

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References

REFERENCES

1.Althius, T.Orphan Drugs: Debunking a myth. New England Journal of Medicine, 1980, 303, 1004–05.Google Scholar
2.Althius, T. Contributions of the pharmaceutical industry. In Karch, F. (ed.), Orphan drugs. New York: Marcel Dekker, 1982, 185–87.Google Scholar
3.Asbury, C. H., & Stolley, P.Orphan drugs: Creating a policy. Annals of Internal Medicine, 1981, 95, 221–24.CrossRefGoogle ScholarPubMed
4.Asbury, C. H.Orphan drugs: Medical vs. market value. Lexington, MA: Lexington Books, 1985.Google Scholar
5.Asbury, C. H.The Orphan Drug Act: The first seven years. Journal of the American Medical Association, 1991, 265(7), 893–97.CrossRefGoogle Scholar
6. Bachrach, W. H., et al. Round-table discussion. In Scheinberg, I. H. & Walshe, J. M. (eds.), Orphan diseases and orphan drugs. Manchester: University Press, 1986.Google Scholar
7.Devita, V. T., et al. The drug development and clinical trials programs of the division of cancer treatment, National Cancer Institute. Cancer Clinical Trials, 1979, 2, 195216.Google Scholar
8.Federal Register. Orphan Drug Act Regulations. Proposed Rule, January 29, 1991; Part 5, 21CFR Part 316, 3383351.Google Scholar
9.Finkel, M.Drugs of limited commercial value. New England Journal of Medicine, 1980, 302, 643–44.CrossRefGoogle ScholarPubMed
10.Food and Drug Administration. NMEs approved 1983–90. Rockville, MD: FDA (compiled annually).Google Scholar
11.Food and Drug Administration. Interim guidelines for obtaining orphan designation of a drug as an orphan drug. Rockville, MD: FDA, 11 1984.Google Scholar
12.Food and Drug Administration. Orphan designations pursuant to Section 526 of the Federal Food, Drug, and Cosmetic Act as amended by the Orphan Drug Act (PL 97–414) through December 31, 1989. Rockville MD: FDA, 1990.Google Scholar
13.Food and Drug Administration. Orphan drug designation listing, 1990. Rockville, MD: FDA, 1991.Google Scholar
14.Hansen, R. W.The pharmaceutical development process: Estimates of development costs and times and effects of proposed regulatory changes. In Chen, R. (ed.), Issues in pharmaceutical economics, 1980, 151–81.Google Scholar
15. H.R. 5238, 97th Congress, 2nd Session, 1982.Google Scholar
16. H.R. 4638, 101st Congress, 2nd Session, 04 26, 1990.Google Scholar
17.Karch, F. (ed.), Orphan drugs. New York: Marcel Dekker, 1982.Google Scholar
18.Kennedy, D.A calm look at drug lag. Journal of the American Medical Association, 1978, 239(5), 423–26.CrossRefGoogle Scholar
19.Krall, R., et al. Anti-epileptic drug development I. History and a program for progress. Epilepsia, 1978, 19(4), 393408.CrossRefGoogle Scholar
20.Mossinghoff, G. J., & Copmann, T. L.Orphan drugs in development. Washington, DC: Pharmaceutical Manufacturers Association, 1989.Google Scholar
21.Mossinghoff, G. J. Comments to the Health and Environment Subcommittee, 02 7, 1990, 2.Google Scholar
22.NHLBIfact book for fiscal year 1978. Washington, DC: Department of Health, Education and Welfare, 1979, 7999.Google Scholar
23.Orphan Drug Act oversight, Hearings before the Subcommittee on Health and the Environment, 98th Congress, 2nd Session, 1984, 719–20.Google Scholar
24.Orphan Drug Act report, 97th Congress, 2nd Session, Report 97–840, part 1, 09 17, 1982.Google Scholar
25.Orphan Drug Amendments of 1987 report, 100–473,100th Congress, 1st Session, 12 10, 1987.Google Scholar
26.Orphan Drug Amendments of 1987. Report 100–473, 100th Congress, 1st Session.Google Scholar
27. Pharmaceutical Manufacturers Association. Public Service Drugs (unpublished). Washington, DC, 1965.Google Scholar
28.Preliminary report of the survey on drugs for rare disease. Washington, DC: U.S. Government Printing Office, 03 8, 1982.Google Scholar
29. Public Law 99–91, 99th Congress, 2nd Session, 08 15, 1985.Google Scholar
30. Public Law 100–290, 100th Congress, 2nd Session, 04 18, 1988.Google Scholar
31.Report of the panel on chemicals and health of the President’s Science Advisory Committee. NSF 73–500. Washington, DC: U.S. Government Printing Office, 1973.Google Scholar
32.Russo, J.Profitable and non-profitable drugs. New England Journal of Medicine, 1978, 299, 156.Google Scholar
33. S.771, 98th Congress, 2nd Session, 1984.Google Scholar
34.Scrip World Pharmaceutical News, 01 1989.Google Scholar
35.Silverman, M., & Lee, P. R.Pills, profits and politics. Berkeley, CA: University of California Press, 1974, 8687.CrossRefGoogle Scholar
36.Stavro, B. Investors tracking insiders’ stock sales for clues on Amgen. Los Angeles Times, 03 27, 1991, D1.Google Scholar
37.Temin, P.Technology, regulation and market structure in the modern pharmaceutical industry. Bell Journal of Economics, 1979, 10, 427–46.CrossRefGoogle Scholar
38.Van Woert, M.Profitable and non-profitable drugs. New England Journal of Medicine, 1978, 298(16), 903–06.CrossRefGoogle Scholar
39.Walshe, J. M. Triethylene tetramine dihydrochloride. In Karch, F. (ed.), Orphan drugs. New York: Marcel Dekker, 1982, 5871.Google Scholar
40.Waxman, H. The history and development of the orphan drug act. In Scheinberg, H. & Walshe, J. (eds.), Orphan diseases and orphan drugs. Manchester: University Press, 1986.Google Scholar
41.Young, F. Testimony before the House Subcommittee on Health on the Environment, 99th Congress, 1st Session, 1985.Google Scholar