This document discusses definitions of rare diseases and considerations for drug development in rare diseases. It notes that rare diseases are defined differently in various regions but generally refer to diseases affecting fewer than 5 in 10,000 people in Canada, 1 in 2,000 in Europe, 50,000 in Japan, and 200,000 in the US. However, cumulatively over all rare disease families, about 1 in 12 people are affected by a rare disease. The document outlines challenges in rare disease drug development including small patient populations, lack of natural history data and treatment guidelines, need for alternative clinical trial designs, and difficulties detecting adverse events. It emphasizes the need to involve patients, families, regulators early in the process and consider broader views of value