Whenever there is a public health emergency, such as the Zika virus in 2016 or the current novel coronavirus, there is a rush to get diagnostic tests and other medical products to detect and treat the emergency available quickly. Given that dealing with the FDA isn’t usually a quick transaction, there is a provision in place called the Emergency Use Authorization (EUA) which allows the use of unapproved medical products when there are no other adequate or available alternatives...

1. FDA’s Emergency Use Authorization
By: Madison Wheeler
Whenever there is a public health emergency, such as the Zika virus in 2016 or the current novel
coronavirus, there is a rush to get diagnostic tests and other medical products to detect and treat
the emergency available quickly. Given that dealing with the FDA isn’t usually a quick
transaction, there is a provision in place called the Emergency Use Authorization (EUA) which
allows the use of unapproved medical products when there are no other adequate or available
alternatives.
Section 564 of the Federal Food, Drug, and Cosmetic Act (FD&C Act) gives the FDA
Commissioner the authority to allow the use of medical products that haven’t been approved or
cleared using the EUA when there is a public health emergency.1 The goal of this is to increase
public protections against health threats by making medical countermeasures (MCM’s) readily
available.2 These MCM’s are mainly diagnostic tests, of which some end up getting cleared via
the De Novo pathway after their EUA use such as a 2015 Ebola diagnostic that could diagnose
the virus within 30 minutes.3
The big topic at the moment is the novel coronavirus (2019-nCoV). On Tuesday, the FDA
officially issued an EUA to the CDC’s Real-Time RT-PCR Diagnostic Panel. Before the
authorization, the use of the test was limited to only CDC laboratories, now the test is authorized
to be used at any CDC-qualified lab in the country.4
A trend, however, that the FDA has noticed with many diagnostic’s given EUA clearance is that
they never make the full transition from emergency use to full marketing status. This is thought
to be largely due to the fact that once a health emergency winds down and use of the diagnostic
or device diminishes, so does the business case for pursuing FDA clearance. It could be
extremely costly to develop the clinical data and other evidence needed for FDA submission, and
1 FDA (Feb 2020) Emergency Use Authorization retrieved on 02/04/2020 from: https://www.fda.gov/emergency-
preparedness-and-response/mcm-legal-regulatory-and-policy-framework/emergency-use-authorization
2 FDA (September 2019) MCM Emergency Use Authorities retrieved on 02/04/2020 from:
https://www.fda.gov/emergency-preparedness-and-response/mcm-legal-regulatory-and-policy-framework/mcm-
emergency-use-authorities
3 OraSureTechnologies (January 2015) OraQuick Ebola Rapid Antigen Test retrieved on 02/05/2020 from:
https://www.orasure.com/products-infectious/products-infectious-oraquick-ebola.asp
4 FDA (Feb 2020) FDA Takes SignificantStep in Coronavirus ResponseEfforts, Issues Emergency Use Authorization
for the First2019 Novel Coronavirus Diagnostic retrieved on 02/05/2020 from: https://www.fda.gov/news-
events/press-announcements/fda-takes-significant-step-coronavirus-response-efforts-issues-emergency-use-
authorization-first

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if the emergency is over, is it worth it to spend the money to develop a product that will have
limited use? The FDA and industry experts convened a workshop on Monday to develop a
roadmap for how diagnostics are evaluated during and after public health emergencies with a
focus on the pathway to marketing post-emergency.5
If you need help navigating the FDA for your diagnostic or medical device, EMMA International
has the expertise to help! Call us at 248-987-4497 or email info@emmainternational.com to see
how we can help.
5 MDIC (February 2020) AdvancingEUA IVD Products Toward Full MarketingStatus retrieved on 02/05/2020 from:
https://mdic.org/event/advancing-eua-ivd-products-toward-full-marketing-status/