Expanded Access to Investigational Drugs for Treatment Use - Questions and Answers

U.S. Food and Drug Administration (FDA)
U.S. Food and Drug Administration (FDA)Jun 17, 2026

Why It Matters

By tightening procedures and enhancing transparency, the guidance speeds access to life‑saving investigational therapies while ensuring patient safety, a critical balance for innovators and regulators alike.

Key Takeaways

  • FDA's 2025 guidance updates expanded access pathways for investigational drugs.
  • Three access categories: individual, intermediate-size, and treatment IND protocols.
  • Form 3926 and eRequest streamline physician‑submitted individual patient requests.
  • IRB review required except emergency use; waivers reduce administrative burden.
  • Sponsors must publicly post access policies and meet ongoing safety reporting.

Summary

The FDA released a 2025 guidance document that revises the expanded‑access program for investigational drugs, outlining how patients with serious or immediately life‑threatening conditions can obtain treatment when no approved therapy exists.

The guidance defines three regulatory categories—individual patient, intermediate‑size patient population, and treatment IND/protocol—each with specific eligibility criteria and submission pathways. It clarifies when manufacturers versus licensed physicians act as sponsors, and details the required forms, including the streamlined Form 3926 and the eRequest web app for non‑emergency individual requests.

A key operational change is the ability to obtain an IRB waiver for full‑board review on individual non‑emergency requests, simply by checking a box on Form 3926. The document also mandates that manufacturers post their expanded‑access policies publicly within 15 days of a phase‑2/3 start or breakthrough‑therapy designation, listing contact information, evaluation criteria, and response timelines.

These updates reduce administrative delays, increase transparency, and impose clearer safety‑reporting obligations, enabling faster patient access while preserving oversight. Pharmaceutical companies, clinicians, and patient advocates must adjust their processes to comply, potentially accelerating treatment options for high‑need patients.

Original Description

This webinar provided a comprehensive understanding of the expanded access pathway for patients with serious or immediately life-threatening diseases or conditions to gain access to investigational drugs outside of clinical trials when no comparable treatment options are available. The presentation detailed the three categories of Expanded Access (EA): individual patient, intermediate-size population, and treatment INDs and protocols. Regulatory requirements, FDA recommendations, criteria, submission requirements, and responsibilities of all parties involved were explained to support effective implementation of this critical treatment pathway.
Timestamps
00:25 – Expanded Access to Investigational Drugs for Treatment Use - Questions and Answers
38:08 – Discussion Panel
01:07:00 – Q&A Panel
01:24:25 – Webinar Closeout
Speaker:
Atasi Poddar, PhD
Health Science Policy Analyst
Division of Medical Policy Development (DMPD)
Office of Medical Policy (OMP)
Center for Drug Evaluation and Research (CDER) | FDA
Discussion Panel:
Moderator
Mathilda Fienkeng, PharmD, MS
Captain
United States Public Health Service (USPHS)
Director
DMPD | OMP | CDER | FDA
Mitchell Chan, PharmD, MSDA, BCPS
Commander | USPHS
Clinical Analyst, Team Lead
Project Facilitate
Oncology Center of Excellence (OCE) | FDA
David Faranda, JD
Senior Regulatory Counsel
Division of Regulatory Policy IV (DRPIV)
Office of Regulatory Policy (ORA)
CDER | FDA
Xiaoqiu Tang, MD, MS
Consumer Safety Officer
Office of Regulatory Operations (ORO)
Center for Biologics Evaluation and Research CBER | FDA
And
Atasi Poddar
-----------------------
FDA CDER’s Small Business and Industry Assistance (SBIA) educates and provides assistance in understanding the regulatory aspects of human drug products & clinical research.
Upcoming Training - https://www.fda.gov/cdersbia
SBIA Training Resources - https://www.fda.gov/cdersbialearn
Email - CDERSBIA@fda.hhs.gov
Phone - (301) 796-6707 I (866) 405-5367

Comments

Want to join the conversation?

Loading comments...