EMA approval and Brexit13 Nov 2020 12:41
Hi all. I think people asked about this. I wrote a long answer this morning and then either this site or my internet crashed. Anyhow, will write again.
Why will ema approval (if it happens) be at least Q3 2021? Because in 95-99% of cases, the EMA do not approve on first submission. I work in this field. They have some questions or clarifications. These can be minor, medium, severe or ask for a new trial or ask for new phase 3 trial. In order of severity. So you see, the FDA asking for a new trial is not "minor". So there will be at least some questions. EMA have not yet responded to the approval submission by FUM. So will be Jan now at earliest. Then FUM need to see the response, clarify and then respond. Taking us to at least April. Then the EMA need to assess the response and then either approve or ask for more clarifications or say the answers were not good enough. This takes us to July/August. Then this "positive recommendation for approval" needs to be rubber stamped - procedural, taking us to Sept/Oct. This is for relatively minor clarifications. I agree, if very minor, will be sooner (but not before July - Q3 2021).
Now, i think the EMA, like the FDA ,will have fairly major questions. Maybe not a new trial, but maybe. And they could want to wait to see the outcome of the FDA trial. This is due to start in March 2021, going to Sept/October 2021, so FDA approval not until Q1/Q2 2022. And same timing for EMA if they wait to see the results (they risk looking stupid if they approve and the FDA trial fails).
In addition, at least medium questions are likely as for the last 10 years it was the active ingredient prescription medicine that was being investigated (Med2005). This "failed" in December 2019 (no difference to med3000 - the vehicle or "placebo"). This is a very unusual result, no real mechanism of action why has been explained.... and EMA will think it strange that after 10 years, a sudden change to in effect just the "unstable solvent that works by evaporation and the cooling sensation sparking nerves in the pen1s to get an erection - like deicer on hands or sanitiser alcohol gel). The EMA will look at this and have at least medium questions (as I say they always have questions even when Phase 3 results have been totally as expected/hoped for).
Lastly, brexit. Will have no delay. Anything submitted before brexit is binding on all signatories. Hope that comes across as objective analysis and is helpful
Your friendly Odysseus :)