The Orphan Drug Act at 40: Legislative Triumph and the Challenges of Success

Milbank Q. 2024 Mar;102(1):83-96. doi: 10.1111/1468-0009.12680. Epub 2023 Dec 12.

Abstract

Policy Points The Orphan Drug Act (ODA) was the result of patient advocacy and by many measures has been strikingly successful. However, approximately 95% of the more than 7,000 known rare diseases still have no US Food and Drug Administration-approved treatment. The ODA's success led to sustained criticism of high drug prices, often for products that have orphan drug indications. Critics misconstrue the ODA's intent and propose reducing its incentives instead of pursuing policies focused on addressing broader prescription drug price challenges that exist in both the orphan and nonorphan drug market. Patients and their families will continue to defend the purpose and integrity of the ODA and to drive investments into rare disease research and clinical development.

Keywords: FDA; orphan drug; rare diseases.

MeSH terms

  • Drug Approval*
  • Humans
  • Orphan Drug Production*
  • Rare Diseases / drug therapy
  • United States
  • United States Food and Drug Administration