FDA Policy Tracker 2026: Priority Vouchers Questioned, PRVs Return

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A year of significant policy change at the FDA brought momentum and scrutiny into the new year. As 2026 gets underway, biopharma companies are responding to sweeping vaccine changes while concerns surface about the politicization of the agency.

2025 was a dizzying year of regulatory change for the biopharma industry. FDA guidance to accelerate the development of cell and gene therapies and rare disease treatments, along with the introduction of new expedited approval pathways, drove considerable momentum—which remains palpable heading into 2026.

But a series of sweeping vaccine policy changes enacted by Health Secretary Robert F. Kennedy, Jr., along with concerns around the Commissioner’s National Priority Voucher (CNPV) program and greater FDA disagreement with its advisory committees, are contributing to a persistent air of controversy.

Indeed, criticism of the FDA, Kennedy and the Department of Health and Human Services has begun to grow. In late January, Moderna halted all late-stage development of its mRNA vaccines for infectious diseases, citing a lack of return on investment due to policy headwinds in the U.S. That same week, Albert Bourla, CEO of Moderna’s COVID-19 rival Pfizer, had harsh words for the secretary, calling Kennedy’s vaccine rhetoric and policies “anti-science” and “almost like a religion.”

Regulatory experts are also sounding the alarm about what they say is the politicization of the agency, particularly alluding to a possible connection between the CNPV program and other Trump administration priorities, such as drug pricing.

As 2026 continues, BioSpace will keep a close eye on key policy changes as they are made, updating this space with our coverage.


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Rare Pediatric Vouchers Reauthorized After 13-Month Delay

February 3

President Donald Trump signed a spending package into law that ended a short partial government shutdown—and restarted the FDA’s rare pediatric disease priority review voucher (PRV) program, which was tucked into the legislation.

The program, which lapsed at the end of 2024 when Congress failed to reauthorize it, provides a PRV to a company or other drug sponsor upon approval of a rare disease therapy. Companies can then either use the voucher to secure a speedier review for another product in their pipeline or sell the voucher for much-needed revenue to continue their development efforts. The going price for a PRV was $150 million at the time the program lapsed.

Its reauthorization was welcome news to biotech companies developing rare disease therapies and rare disease advocates. According to a recent pipeline review by the Rare Disease Company Coalition, there were 200 or more therapies that were at risk of losing eligibility for a PRV if the program was not reinstated, at a potential cost of more than $4 billion in lost revenue.

Some 200 rare disease therapies are at risk of losing eligibility for a pediatric priority review voucher, a recent analysis by the Rare Disease Company Coalition shows. That could mean $4 billion in missed revenue for already cash-strapped biotechs.
U.S. President Donald Trump signed a spending package into law Tuesday that reauthorizes the FDA’s previously stalled rare pediatric disease priority review voucher program, among other initiatives, while ending a three-day partial government shutdown.
The FDA’s rare pediatric disease priority review voucher program missed reauthorization at the last minute in 2024; advocates have been fighting to get it back ever since.

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FDA Launches PreCheck Manufacturing Program

February 1

On Feb. 1, the FDA began accepting applications for its PreCheck Pilot program, an initiative undertaken in response to an executive order issued by President Donald Trump in August 2025 aimed at providing regulatory relief for U.S.-based pharma manufacturers. Applications will be accepted until March 1, with finalists selected a month later.

The goal of the program is to make the pharmaceutical supply chain more predictable by “facilitating the construction of manufacturing sites in the U.S,” the FDA said in a press release.

In developing the program, the agency met with representatives from Eli Lilly, Merck and other pharma companies. The primary feedback revolved around eliminating the possibilities of FDA product rejections due to shortfalls at manufacturing facilities, possibly by frontloading the facility evaluation process. Lucy Chang, associate vice president in Global Regulatory Affairs CMC Biologics at Merck, called on the FDA to say whether it will waive inspections of facilities that participate in PreCheck and clarify how much faster the evaluation process will be.

Executives from Eli Lilly, Merck and other companies foresee the FDA’s new onshoring proposal being anything from a bureaucratic waste of time to a transformative program that will eliminate inspection-related complete response letters.
Under PreCheck, the FDA will communicate more frequently with pharmaceutical companies, helping them as they establish or expand manufacturing sites in the U.S.
The initiative could tackle the first-mover disadvantage some CDMOs believe deters early customers, but leaders at companies including Novo Nordisk see hurdles to implementing the changes.

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FDA Positions New Endpoints for Multiple Myeloma Trials

January 20

Due to recent success in treating multiple myeloma, the FDA issued draft guidance in January recommending that clinical trials for novel therapies for the disease use an additional endpoint, minimal residual disease (MRD), to secure accelerated approval.

MRD refers to a small, difficult-to-spot population of cancer cells that can cause a relapse of disease even after a patient is said to have achieved a complete response. If patients have fewer than one myeloma cell out of 100,000 healthy cells, they can be declared MRD negative, according to the draft guidance.

In an interview with BioSpace last month, Nicholas Richardson, former deputy director of the FDA’s Division of Hematologic Malignancies 2, explained the rationale behind the move.

Therapies in myeloma are reaching an 80–90% overall response rate (ORR), he said. “So if you’re thinking about new therapies, it’s harder to tell if there’s an improvement.”

For full approval, companies will still need to provide ORR and complete response data.

New draft guidance from the FDA on multiple myeloma endpoints reflects the new technology available to assess disease and how patient journeys have changed with better treatments.

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FDA Lifts Suicide Warnings From GLP-1 Drug Labels

January 13

In another boost to the already soaring GLP-1 space, the FDA requested that market leaders Eli Lilly and Novo Nordisk remove warnings about suicidal behavior and ideation from their products. In mid-2023, reports of such adverse effects in patients taking the popular weight loss and diabetes treatments prompted regulators around the world—including the FDA and European Medicines Agency—to investigate the potential risks. But these probes ultimately found no causal connection between GLP-1 medicines and suicidality. The FDA announced the results of its preliminary review in January 2024.

These early analyses, however, were hindered by a small number of reported incidences of suicidal thoughts and behaviors, resulting in what the FDA on Jan. 13 called “considerable uncertainty in the risk estimate.” In an announcement that same day, the regulator revealed that a more detailed meta-analysis of different GLP-1 trials, encompassing more than 90 studies and nearly 108,000 patients, did not indicate a heightened risk of suicidality in patients taking these medicines.

A more detailed review of data by the FDA showed that GLP-1 drugs do not increase the risk of suicidal ideation or behavior.

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FDA Manufacturing Carve-Out Aims To Accelerate CGT Development

January 11

The FDA is implementing what Commissioner Marty Makary called “common-sense reforms” in how it regulates the manufacturing of cell and gene therapies. These reforms, communicated in a press release on Jan. 11, take into account the complexity of these medicines, which are often individualized to a patient or are manufactured in small batches.

Among the FDA’s concessions, investigational gene therapies will not require a manufacturer to comply with certain manufacturing specifications for biologics, as outlined in Chapter 600 of the Code of Federal Regulations. The regulator will also be lenient regarding “minor manufacturing changes,” as a cellular or genetic medicine moves into later stages of development, providing a sponsor is able to show that such alterations in production do not meaningfully change the product.

These modifications “will enable progress while not compromising or undermining the FDA’s ability to assure safety, purity and potency of a product,” according to the agency’s announcement.

FDA Commissioner Marty Makary called these changes “common-sense reforms” that could expedite the development of cell and gene therapies.

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Heather McKenzie is senior editor at BioSpace. You can reach her at heather.mckenzie@biospace.com. Also follow her on LinkedIn.
Dan Samorodnitsky is the news editor at BioSpace. You can reach him at dan.samorodnitsky@biospace.com.
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