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The pediatric medical device development (PMDD) process is highly complex, beset by a variety of financial, technical, medical, and regulatory barriers. Startup company innovators and academic investigators often struggle with accessing specialized knowledge relating to regulatory requirements, product development, research, and marketing strategies.
Objectives:
The West Coast Consortium for Technology & Innovation in Pediatrics (CTIP) conducted an educational needs assessment to understand knowledge gaps and inform our educational strategy.
Methods:
We surveyed a total of 49 medical device startups and 52 academic investigators. Electronic surveys were developed for each group on Qualtrics and focused on manufacturing, regulatory, research, commercialization, and funding. Descriptive statistics were used.
Results:
A larger proportion of academic investigator respondents had a clinical background compared to the startup respondents (45% vs. 22%). The biggest barriers for academic investigators were understanding regulatory and safety requirements testing (52%) and finding and obtaining non-dilutive funding was the most difficult (54%). Among startups, understanding clinical research methods and requirements was the biggest barrier (79%).
Conclusion:
Startup companies and academic investigators have similar, but not identical, educational needs to better understand the PMD development process. Investigators need more support in identifying funding sources, while startup companies identified an increased need for education on research regulatory topics. These findings can help guide curriculum development as well as opportunities for partnerships between academia and startups.
Genetic testing and gene editing are rapidly becoming – indeed, already are – consumer Genetic testing and gene editing are rapidly becoming – indeed, already are – consumer technologies that people can experiment with and apply on their own, potentially without any involvement by traditional payers and research funding agencies, professional scientists and healthcare providers, regulators, and medical product manufacturers. This chapter explores the challenges of regulating direct-to-consumer and do-it-yourself genomic technologies that disrupt the traditional funding, supply arrangements, and roles. It is widely understood that the U.S. Coordinated Framework for biotechnology regulation, even after a 2017 update, is a patchwork of old federal statutes that were never designed for some of the genetic technologies now emerging. This chapter explores four problems that are less well understood: First, consumer genetics poses a fundamental challenge, also seen in the sharing economy exemplified by ride-sharing platforms such as Uber and Lyft. This challenge is one of scale, and the need for regulators to oversee a massive number of small-scale transactions and individual actors. A second challenge is that consumer genetics forces a rethinking of the goals of regulation – specifically, how paternalistic is it appropriate for regulators to be? A third conundrum is whether top-down regulatory approaches can be effective and, if not, how to motivate bottom-up, citizen-led norm-setting and compliance. A final challenge concerns the fact that the human genome itself is, ultimately, software, and many of the consumer products for interpreting and manipulating it also are in the nature of software, yet traditional consumer safety regulators struggle when confronted with the task of regulating software. The chapter concludes that merely expanding the jurisdiction of existing regulatory bodies and granting them new tools and powers will not suffice. A more sweeping redesign of consumer safety regulation will be required.
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