FDA Continues Focus on Rare Disease Drug Development, Announces Evidence Principles

September 8, 2025

Reading Time : 1 min

On September 3, 2025, the Food and Drug Administration (FDA) announced Rare Disease Evidence Principles (RDEP) with processes aimed at providing greater predictability and facilitating the development and review of drugs intended to treat rare diseases with very small patient populations and significant unmet medical needs driven by a known genetic defect. In conjunction with the agency’s announcement of the new processes jointly proposed by the Center for Drug Evaluation and Research (CDER) and Center for Biologics Evaluation and Research (CBER), the agency also unveiled additional information regarding eligibility and the potential for post-marketing requirements for those sponsors who participate in it.

The agency aims to provide greater regulatory certainty through RDEP, including providing sponsors with greater clarity on the kind of evidence that can demonstrate substantial evidence of effectiveness given the inherent challenges in developing medicines for such small patient populations. Drug development is not one-size-fits-all and rare disease drug development presents particularly unique challenges not typically encountered in the development of drugs intended to treat larger disease patient populations. It can be particularly challenging to produce evidence to meet the statutory requirements for demonstrating efficacy through traditional trial designs and the required number of clinical studies for rare diseases given the smaller patient population. Under the RDEP process, effectiveness may be established based on one adequate and well-controlled study with robust confirmatory evidence, which may include strong mechanistic or biomarker evidence, evidence from relevant non-clinical models, clinical pharmacodynamic data and/or case reports, expanded access data, or natural history studies.

Drug developers may want to consider how RDEP may fit within their rare disease drug development programs. RDEP may also be of interest to rare disease patients and Congress given the ongoing interest in these policy areas and ahead of the next Prescription Drug User Fee Act (PDUFA) reauthorization which is often a time in which lawmakers focus on FDA’s rare disease focused work.

Share This Insight

Previous Entries

Eye on FDA

September 29, 2025

FDA recently released two draft guidance documents for industry related to cell and gene therapy (CGT) products as the agency seeks to advance the efficient development and review of safe and effective CGT products and fulfill related commitments set forth in the 2022 reauthorization of the Prescription Drug User Fee Act (PDUFA VII). This latest guidance may be of particular interest to CGT developers and various patient groups.

...

Read More

Eye on FDA

September 24, 2025

On Tuesday, September 23, 2025, FDA published guidance titled “Consideration of Enforcement Policies for In Vitro Diagnostic Tests During a Section 564 Declared Emergency.” The guidance, a draft of which was published on May 6, 2024, specifies the factors that FDA intends to assess in deciding whether to issue an enforcement discretion policy with regard to in vitro diagnostics (IVD) manufacturers offering unapproved IVDs, among other devices, during a declared emergency. These factors include:

...

Read More

Eye on FDA

September 23, 2025

Last week, the U.S. Food and Drug Administration (FDA) issued a proposed rule to revoke the color additive listing for Orange B, a synthetic dye historically used on the casings and surfaces of frankfurters and sausages. This action is part of the broader “Make America Healthy Again” (MAHA) initiative to phase out petroleum-based foods from the American food supply by the end of 2026 and efforts to modernize the agency’s regulations.

...

Read More

Eye on FDA

September 12, 2025

The White House’s Make America Healthy Again (MAHA) Commission, led by the Department of Health and Human Services (HHS) Secretary Robert F. Kennedy Jr., released its highly anticipated strategy outlining a multi-agency approach focused on addressing childhood chronic disease. The strategy builds on the Commission’s inaugural health assessment, a report which examined the rising rates of childhood chronic diseases in the country and identified four primary drivers: poor diet due to consumption of ultra-processed foods (UPFs), exposure to environmental chemicals; increased technological use; and overmedicalization. To combat these challenges, the strategy released on September 9, 2025, outlines a four-prong approach which provides further insight into the areas the administration sees as key areas of MAHA going forward: advancing research, realigning incentives, increasing public awareness and fostering private sector collaborations.

...

Read More

Eye on FDA

September 8, 2025

On September 3, 2025, the Food and Drug Administration (FDA) announced Rare Disease Evidence Principles (RDEP) with processes aimed at providing greater predictability and facilitating the development and review of drugs intended to treat rare diseases with very small patient populations and significant unmet medical needs driven by a known genetic defect. In conjunction with the agency’s announcement of the new processes jointly proposed by the Center for Drug Evaluation and Research (CDER) and Center for Biologics Evaluation and Research (CBER), the agency also unveiled additional information regarding eligibility and the potential for post-marketing requirements for those sponsors who participate in it.

...

Read More

Eye on FDA

August 27, 2025

Food dye reform has been an area of focus for the Trump administration as part of its Make America Healthy Again (MAHA) initiative, giving momentum to an effort the Food and Drug Administration (FDA) had already started by banning Red No. 3 for use in food and ingested drugs. FDA has continued to prioritize this work by taking actions to phase out the use of synthetic dyes and move to natural dyes since calling for these changes earlier this year, as discussed in our previous blog on the related announcement by the administration.

...

Read More

Eye on FDA

August 12, 2025

Last week, former Food and Drug Administration (FDA) Commissioner David Kessler submitted a citizen petition urging FDA to revoke the generally recognized as safe (GRAS) status of refined carbohydrates used in industrial food processing. The petition follows FDA’s and the United States Department of Agriculture’s (USDA) joint request for information (RFI) to establish a formal definition for ultra-processed foods (UPFs) and offers FDA a legal pathway to change the regulatory status of these ingredients.

...

Read More

Eye on FDA

August 6, 2025

On August 6, 2025, the U.S. Food and Drug Administration (FDA) became the latest governmental agency to confirm that fluoropolymers are both safe and necessary. After an independent safety review of fluoropolymers in medical devices showed no conclusive evidence of health issues, FDA concluded that fluoropolymers are “very unlikely to cause toxicity” because of molecular size and further that they are essential for medical devices to function. As a result, “FDA’s evaluation is that currently there is no reason to restrict their continued use in devices.” This announcement will be a source of relief to the device and diagnostics industries.

...

Read More

© 2025 Akin Gump Strauss Hauer & Feld LLP. All rights reserved. Attorney advertising. This document is distributed for informational use only; it does not constitute legal advice and should not be used as such. Prior results do not guarantee a similar outcome. Akin is the practicing name of Akin Gump LLP, a New York limited liability partnership authorized and regulated by the Solicitors Regulation Authority under number 267321. A list of the partners is available for inspection at Eighth Floor, Ten Bishops Square, London E1 6EG. For more information about Akin Gump LLP, Akin Gump Strauss Hauer & Feld LLP and other associated entities under which the Akin Gump network operates worldwide, please see our Legal Notices page.