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Indication · Base-Rate Reference

Rare Disease / Orphan FDA Approval Rates

Historical first-cycle FDA approval rates for Rare Disease / Orphan assets across 8 regulatory pathways — NDA Standard, NDA Priority, BLA, sBLA, Class 2 Resubmission, Accelerated Approval, Breakthrough Therapy, Fast Track.

What's specific about Rare Disease / Orphan at FDA?

Orphan Drug Act flexibilities on endpoint choice and sample size drive higher first-cycle approval rates. Roughly half of all new molecular entities since 2018 have had orphan designation.

Rare Disease / Orphan base rates by pathway

Pathway First-cycle approval Sample size Typical clock AdCom Notes
sBLA 85% n~80 priority 6 months rarely Pediatric and adjacent-indication expansions; high approval rates with concise supplements.
Breakthrough Therapy 85% n~80 priority 6 months sometimes Breakthrough + orphan combination drives among the highest approval rates.
NDA Priority 80% n~150 priority 6 months sometimes Strong first-cycle performance; CRLs typically CMC or confirmatory evidence adequacy.
BLA 75% n~60 priority 6 months sometimes Enzyme replacement and gene therapy products; manufacturing inspections a frequent bottleneck.
Accelerated Approval 75% n~50 priority 6 months usually Surrogate endpoint acceptance variable; AdComs increasingly convened for non-oncology rare disease.
NDA Standard 72% n~120 standard 10 months sometimes Higher first-cycle approvals due to orphan flexibility on endpoints; CRLs often CMC-related.
Fast Track 72% n~120 varies; often priority 6 months sometimes Widely used in rare disease; commonly paired with orphan and often accelerated approval.
Class 2 Resubmission 70% n~40 6 months from resubmission sometimes Additional data requests (confirmatory, CMC) drive resubmissions; generally successful when addressed.

Base rates drawn from published FDA approval analyses covering roughly 2008-2022. Approximate — use as framing, not prediction.

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