- FDA promotional regulation
- FDA reviews advertising and promotional labeling for regulated products — for prescription drugs through the Office of Prescription Drug Promotion (OPDP). Promotional material must be truthful, non-misleading, consistent with the approved labeling, and adequately substantiated. Enforcement arrives as untitled letters and warning letters, which are public.
- On-label vs off-label promotion
- A company may promote a product only for the uses in its FDA-approved or cleared labeling. Physicians may prescribe off-label; the manufacturer may not promote off-label. Scientific exchange, responses to unsolicited requests and certain payer communications are separate, narrowly defined channels.
- Fair balance
- Promotional material presenting benefit must present risk with comparable prominence and readability — not a footnote after a headline claim. The most common reason promotional pieces are cited.
- Substantial evidence
- The statutory standard for a drug efficacy claim: adequate and well-controlled investigations. It is why 'shown to improve outcomes' is a regulated assertion, not a marketing phrase, and why claims must be traceable to a specific trial or to the label.
- 510(k) vs De Novo vs PMA
- Three device routes. A 510(k) demonstrates substantial equivalence to a legally marketed predicate. De Novo creates a new classification for a novel low-to-moderate-risk device with no predicate. PMA is the most demanding — an approval requiring valid scientific evidence of safety and effectiveness, typically for Class III devices.
- IDE (Investigational Device Exemption)
- The authorization allowing an unapproved device to be used in a clinical study to collect the safety and effectiveness data a PMA or De Novo needs. Significant-risk studies require FDA approval of the IDE plus IRB approval.
- CE mark and EU MDR/IVDR
- The European conformity route. The Medical Device Regulation and In Vitro Diagnostic Regulation replaced the older directives, raising clinical-evidence and post-market requirements sharply and routing most products through a Notified Body. A CE mark is not an FDA clearance and cannot be presented as one in US material.
- LDT (laboratory developed test) and the FDA rule
- A test designed, manufactured and used within a single CLIA-certified high-complexity laboratory. FDA historically exercised enforcement discretion; its 2024 final rule sought to phase LDTs into device regulation. A federal court vacated that rule in 2025 — so LDTs remain governed primarily through CLIA, with the policy question unresolved.
- CLIA waiver
- A CLIA-waived test is simple enough and carries a low enough risk of erroneous result that it may be run outside a high-complexity lab — in a clinic, pharmacy or at the point of care. Waiver dramatically widens the addressable market, and is granted by FDA on its own application track.
- RUO (research use only) labeling
- A product labeled 'For Research Use Only. Not for use in diagnostic procedures.' may not be promoted for clinical diagnostic use. Marketing an RUO product with clinical claims — or supporting customers who use it clinically — is the classic way a tools company creates regulatory exposure.
- IVD (in vitro diagnostic)
- A reagent, instrument or system intended for use in the diagnosis of disease from specimens taken from the body. IVDs are regulated as medical devices, so a diagnostic company lives under device rules — design control, QMS, MDR reporting — not drug rules.
- Companion diagnostic (CDx)
- A test that is essential to the safe and effective use of a corresponding therapeutic — identifying which patients should receive it. CDx and drug are typically co-developed and cross-referenced in each other's labeling, which links two regulatory timelines and two commercial organizations.
- GxP (GMP, GLP, GCP)
- The good-practice regulations: GMP governs manufacturing, GLP governs non-clinical safety studies, GCP governs clinical trial conduct. They are quality-system requirements enforced by inspection, and non-compliance can invalidate data an entire program depends on.
- 21 CFR Part 11
- FDA's rule on electronic records and electronic signatures — audit trails, access controls, system validation and record integrity. It is the reason regulated software procurement is slow and the reason a general-purpose tool cannot simply be adopted for GxP data.
- Design control
- The mandated device development discipline: design inputs and outputs, review, verification, validation, transfer to manufacturing, change control and the design history file. Verification asks whether you built it right; validation asks whether you built the right thing for the user need.
- QMS and ISO 13485
- ISO 13485 is the international quality management system standard for medical devices; in the US, 21 CFR Part 820 was harmonized toward it as the Quality Management System Regulation. Certification is table stakes for selling into Europe and for most serious device partnerships.
- MDR reporting (medical device reporting)
- The obligation to report device-related deaths, serious injuries and certain malfunctions to FDA within defined timelines. Reports land in the public MAUDE database, where competitors, customers and journalists can read them.
- Recall classes
- FDA classifies recalls by risk: Class I where use could cause serious injury or death, Class II where injury is temporary or reversible, Class III where a violation is unlikely to cause harm. The class drives notification scope, public visibility and remediation cost.
- Sunshine Act / Open Payments
- Manufacturers of covered drugs and devices must report payments and transfers of value to physicians and teaching hospitals; CMS publishes them in a searchable database. Every dinner, honorarium, consulting fee and grant is public, which shapes how KOL relationships are structured.
- Anti-Kickback Statute and speaker programs
- A criminal statute prohibiting remuneration to induce or reward referrals of federally reimbursed items. Speaker programs, advisory boards, consulting arrangements and educational grants are the highest-risk activities; the HHS OIG has issued a special fraud alert specifically on speaker programs.
- Preclinical and the IND
- Preclinical work — pharmacology, ADME, GLP toxicology, CMC — builds the package supporting an Investigational New Drug application. Once the IND is filed and the 30-day review passes without a clinical hold, human dosing may begin. 'IND-enabling' is the industry's standard milestone language.
- Phase I / II / III / IV
- Phase I tests safety, tolerability and dose, usually in a small group. Phase II tests preliminary efficacy and dose-ranging in patients. Phase III is the large controlled trial supporting approval. Phase IV is post-approval, covering long-term safety, new populations and commitments made at approval.
- Adaptive trial design
- A protocol that prespecifies modifications based on accumulating data — dropping arms, reallocating randomization, re-estimating sample size, or moving seamlessly between phases. Prespecification is what separates an adaptive design from data-driven improvisation that invalidates the result.
- Endpoint (primary vs secondary)
- The prespecified outcome a trial measures. The primary endpoint is what the trial is powered for and what an approval and a claim rest on; secondary endpoints are supportive and, unless hierarchically tested, cannot carry a claim. A trial that misses its primary but 'hit' a secondary has not succeeded.
- Powering
- Sizing a trial so it has an adequate probability — conventionally 80–90% — of detecting a specified effect if it exists. Underpowered trials produce ambiguous results; overpowered ones waste patients and money. Power depends on effect size, variability and alpha.
- ITT vs per-protocol
- Intention-to-treat analyzes every randomized subject in the assigned arm regardless of what happened afterward, preserving randomization and giving the conservative, regulator-preferred estimate. Per-protocol analyzes only compliant completers and typically flatters the treatment.
- DSMB / DMC
- An independent Data Safety Monitoring Board reviews unblinded accumulating safety and efficacy data and may recommend continuing, modifying or stopping a trial. Its independence from the sponsor is the point, and its charter is written before the first patient is enrolled.
- CRO and CDMO
- A Contract Research Organization runs clinical and preclinical work for a sponsor — sites, monitoring, data management, biostatistics. A Contract Development and Manufacturing Organization develops and makes the product. Both let a company convert fixed cost into variable cost, and both create dependency risk that diligence probes.
- Orphan drug designation
- A designation for products treating rare diseases, generally under 200,000 US patients, carrying tax credits, fee waivers and seven years of market exclusivity on approval for the designated indication. Designation is not approval and must never be presented as evidence a product works.
- Expedited pathways (fast track, breakthrough, accelerated approval)
- FDA mechanisms for serious conditions: fast track gives more frequent interaction and rolling review; breakthrough therapy designation adds intensive guidance where early evidence suggests substantial improvement; accelerated approval permits approval on a surrogate endpoint with required confirmatory trials. All are process designations, not efficacy findings.
- Priority review voucher
- A transferable voucher — awarded for rare pediatric, tropical or medical countermeasure approvals — entitling the holder to a shortened FDA review of a future application. Vouchers are sold on an open market and have historically been a meaningful non-dilutive asset for small companies.
- Biosimilar
- A biologic highly similar to an approved reference product with no clinically meaningful differences; an interchangeable biosimilar meets an additional standard permitting pharmacy-level substitution in many states. Biosimilars are not generics — they require their own clinical program.
- BLA vs NDA vs ANDA
- A Biologics License Application covers biologics under the Public Health Service Act. A New Drug Application covers small molecules. An Abbreviated New Drug Application covers generics, relying on the reference product's safety and efficacy data plus bioequivalence.
- Exclusivity and the patent cliff
- Regulatory exclusivity (new chemical entity, orphan, pediatric, biologic) runs alongside patent life and blocks competing approvals for a set period. Loss of exclusivity produces the patent cliff — the revenue collapse when generics or biosimilars enter, which drives most of the industry's M&A and licensing behavior.
- Freedom to operate
- An opinion, based on a search of issued claims in the relevant jurisdictions, on whether commercializing a product would infringe someone else's patent. Distinct from patentability: you can hold a patent on something you cannot legally sell.
- Tech transfer and Bayh-Dole
- The Bayh-Dole Act lets universities and small businesses retain title to inventions made with federal funding, in exchange for disclosure, US-manufacturing preference and government march-in rights. It is why university tech-transfer offices exist and why most academic spinouts start with a license, not an assignment.
- SBIR / STTR
- Federal non-dilutive grant programs — Small Business Innovation Research and Small Business Technology Transfer, the latter requiring a research-institution partner. NIH is the largest life-science funder of both, and Phase I/Phase II awards are a standard early bridge.
- Upfront, milestones and royalties
- The three components of most licensing economics: cash at signing, payments triggered by development and sales achievements, and a percentage of net sales. Headline 'biodollars' totals add all milestones as if every one will be hit, which is why the upfront is the number that reveals real conviction.
- Out-licensing
- Granting another company rights to develop or commercialize your asset, often by territory or indication. It funds development without dilution but transfers control, and the diligence and reversion clauses matter more than the headline value.
- KOL and MSL
- A Key Opinion Leader is a clinician or researcher whose judgment shapes a field's adoption. A Medical Science Liaison is a field-based scientific role who engages KOLs non-promotionally. The medical/commercial firewall between MSLs and sales exists for regulatory reasons and is audited.
- Formulary and payer coverage
- A payer's list of covered drugs and its tiers, plus the utilization management — prior authorization, step therapy, quantity limits — attached to each. A P&T committee decision determines real-world access far more than a prescriber's preference does.
- Reimbursement code (CPT / HCPCS)
- The billing codes a procedure, test or product must have to be paid. New tests often start with an unlisted or PLA code and low or no payment; obtaining a category I CPT code and a favorable rate is frequently a multi-year commercial project of its own.
- Coverage with evidence development
- A CMS mechanism paying for an item or service only when the patient is enrolled in an approved study or registry, so coverage and evidence generation happen together. It is a partial win — revenue arrives, but with a data obligation attached.
- Cost of goods per test
- The fully loaded cost to produce one assay result — reagents, consumables, instrument depreciation, labor, QC, failed runs and repeats. Reimbursement rates are set externally, so in diagnostics the margin is won or lost almost entirely on the COGS side.
- Assay validation
- Establishing documented evidence that a test performs as intended: accuracy, precision, analytical sensitivity and specificity, reportable range, reference interval, interference and carryover. Analytical validation asks whether the assay measures the analyte; clinical validation asks whether the result means anything for the patient.
- Sensitivity and specificity
- Sensitivity is the proportion of true positives correctly identified; specificity is the proportion of true negatives correctly identified. Both are independent of prevalence — unlike positive and negative predictive value, which are not, which is why a highly specific test can still produce mostly false positives in a low-prevalence population.
- LOD (limit of detection)
- The lowest analyte concentration reliably distinguished from a blank at a stated probability, typically 95%. It is the headline analytical claim for molecular assays and must be established experimentally, per test and per specimen type — never estimated.
- Cold chain
- The temperature-controlled handling of biologics, vaccines, reagents and specimens from manufacture to use — 2–8°C, frozen, or cryogenic. Excursions are deviations requiring investigation and can destroy product value, so validated packaging, continuous monitoring and qualified couriers are part of the product, not logistics overhead.