Regulatory Documentation Requirements

Investigational New Drug (IND) Application

This application is filed with the US Food and Drug Administration (FDA) prior to the initiation of human trials and includes the proposed clinical protocols, animal pharmacology and toxicology studies, and manufacturing information. After submission, the sponsor must wait 30 days before initiation in human trials. During this time, the FDA has the opportunity to review the IND for safety.67 

New Drug Application (NDA)

As discussed in the Pharmaceuticals section, an NDA is filed with the FDA to seek approval to market a pharmaceutical drug in the United States. The goals of an NDA are to convey information regarding safety and effectiveness in its proposed uses, whether the drug’s proposed labeling is appropriate, and the methods used to manufacture the product are adequate to preserve strength, quality, and purity.31

Biologics License Application (BLA)

A request for permission to introduce a biologic pharmaceutical product into the United States. This application is similar to an NDA for small molecule drugs.33 (BLA)

Premarket Notification (510(k))

This is a required document that must be sent to the FDA stating the intent to market a medical device or diagnostic at least 90 days in advance of marketing. This process is discussed further in the Medical Devices and Diagnostics section.56

501(k) is not required in the following situations:

  • Selling unfinished devices to another firm for further processing or selling components to be used in the assembling of devices by other firms
  • Device is not being marketed or commercially distributed
  • Distributing another firm’s domestically manufactured device
  • Repackaging or relabeling and the existing label has no significant change
  • Device was legally in commercial distribution before May 28, 1976 and has not been significantly changed or modified in design, components, method of manufacture, or intended use
  • Device is made outside the United States and you are an importer of the foreign made medical device
  • Device is exempted from 510(k) by regulation (21 CFR 862-892)

Premarket Approval (PMA)

A PMA is the FDA process of regulatory review to evaluate the safety and effectiveness of Class III medical devices. This process is discussed further in the Medical Devices and Diagnostics section. 56

Formulary Decision Making Documentation Requirements


Role of the AMCP Format and dossier in the reimbursement process47

Academy of Managed Care Pharmacy (AMCP) Format aims to identify comprehensive evidence and information for healthcare decision makers (HCDMs). It encourages sharing of objective and credible information to seek important goals for reimbursement and distribution of products to HCDMs.

The AMCP format improves the timeliness, scope, quality, and relevance of clinical and economic evidence by furnishing manufacturers with recommendations and guidelines on the nature of the evidence expected for a product. It streamlines the evidence and acquisition information for HCDMs’ review process. The manufacturer may be a valuable source for reimbursement evidence, but the AMCP dossier and format allows standardized presentation and formal evaluation of distribution and reimbursement of a product.

magnifying glass next to paper with line chart

There are 3 types of evidence dossiers used in product reimbursement and dossiers:

Unapproved Product Dossier

  • Product approval by FDA is pending
  • It is used by manufacturers to communicate information with HCDMs before FDA approval process

Approved Product Dossier

Contains information on FDA- approved products disseminated to HCDMs by the manufacturers

Unapproved Use Dossier

Contains information on the product’s off-label use where the manufacturer is seeking FDA approval

Communication of Healthcare Economic Information (HCEI) Prior to FDA Approval

FDA guidance from June 2018 was a recent clarification by the regulator regarding the preapproval communication of HCEI between industry sponsors and payers related to drugs and devices, originally described in the 21st Century Cures Act in 2016. HCEI may include analysis of the economic consequences of a drug’s or device’s clinical outcomes to alternative options or no intervention. Additionally, HCEI may be presented in a variety of ways, including evidence dossiers, peer-reviewed publications, software-based models, or slide presentations. With this guidance, the FDA takes steps to define the appropriate audience for preapproval HCEI, how unapproved information should be labeled and presented, and what is inappropriate to present for unapproved products.68 The overall goal of this guidance is to hasten the time from drug approval to patient access by allowing for communications between manufacturers and payers prior to approval. This should, in theory, decrease the time from approval to formulary review and placement.

 


 

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Published August 26, 2025

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