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Breakthrough Devices Program

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What is the Breakthrough Devices Program?

The Breakthrough Devices Program is a voluntary program for certain medical devices and device-led combination products that provide for more effective treatment or diagnosis of life-threatening or irreversibly debilitating diseases or conditions.

The goal of the Breakthrough Devices Program is to provide patients and health care providers with timely access to these medical devices by speeding up their development, assessment, and review, while preserving the statutory standards for premarket approval, 510(k) clearance, and De Novo marketing authorization, consistent with the Agency's mission to protect and promote public health.

The Breakthrough Devices Program replaces the Expedited Access Pathway and Priority Review for medical devices. The FDA considers devices granted designation under the Expedited Access Pathway to be part of the Breakthrough Devices Program.

What are the benefits of the Breakthrough Devices Program?

The Breakthrough Devices Program offers manufacturers an opportunity to interact with the FDA's experts through several different program options to efficiently address topics as they arise during the premarket review phase, which can help manufacturers receive feedback from the FDA and identify areas of agreement in a timely way. Manufacturers can also expect prioritized review of their submission. Learn more about the Breakthrough Devices Program principles and features in Sections II and IV of the Breakthrough Devices Program final guidance.

Is my device eligible?

Devices subject to premarket approval applications (PMAs), premarket notification (510(k)) or requests for De Novo designation are eligible for breakthrough device designation if both of the following criteria are met:

Criteria Description Refer to Guidance
First Criterion The device provides for more effective treatment or diagnosis of life-threatening or irreversibly debilitating human disease or conditions Section III.B.1
Second Criterion The device also meets at least one of the following:  
  1. Represents Breakthrough Technology
Section III.B.2.a
  1. No Approved or Cleared Alternatives Exist
Section III.B.2.b
  1. Offers Significant Advantages over Existing Approved or Cleared Alternatives
Section III.B.2.c
  1. Device Availability is in the Best Interest of Patients
Section III.B.2.d

When to request a Breakthrough Devices Designation

You can send a Breakthrough Designation request for your device at any time prior to sending your marketing submission (for example, premarket approval (PMA), premarket notification (510(k)), or De Novo classification request).

How to request a Breakthrough Devices Designation

You can request the Breakthrough Device designation by submitting a "Designation Request for Breakthrough Device" Q-Submission. Your designation request should be the only request in the Q-Submission. If you are pursuing the Breakthrough Device designation while you have other requests for feedback pending, you may want to send the requests for feedback after the FDA makes a designation decision because the designation may affect the feedback that the FDA provides on your other requests. The procedures for submitting a Q-Submission are outlined in the guidance Requests for Feedback and Meetings for Medical Device Submissions: The Q-Submission Program.

The FDA may find devices that could be good candidates for the Breakthrough Devices Program and recommend that sponsors of such devices consider applying to the program.

What to include in a request for a Breakthrough Devices Designation

The FDA recommends that your designation request include information to describe the device, the proposed indication for use, regulatory history, how your device meets the statutory criteria for a Breakthrough Device, and what type of marketing submission you plan to submit to the FDA for your device. Learn more about what to include in your request in Appendix 1 of the Breakthrough Devices Program final guidance.

When will I find out if my device received Breakthrough Device Designation

The FDA intends to request any other information needed to inform the Breakthrough Device designation decision within 30 days of receiving your request. You can expect to receive a letter communicating the FDA's decision to grant or deny the Breakthrough Device designation request within 60 calendar days of the FDA receiving your request.

It is helpful when a sponsor is available and responsive to the FDA's requests throughout the review timeline. If the FDA does not receive the other information needed to decide on a designation request promptly, it may result in denial of the Breakthrough Device designation request.

What a sponsor can expect from FDA if Breakthrough Designation is Granted

If your device is granted the Breakthrough Device Designation, you can choose to interact with the FDA to obtain feedback on your device development through a variety of options including sprint discussions, request for discussion on a data development plan, and request for clinical protocol agreement. Learn more about these options in Section IV of the Breakthrough Devices Program guidance.

You will also receive prioritized review on future regulatory submissions, including Q-Submissions, Investigational Device Exemption (IDE) applications, and marketing submissions.

Are there related programs designed to expedite the availability of certain devices that might apply to my device?

If your device is not eligible for a Breakthrough Device Designation because it is not intended for the treatment or diagnosis of a life-threatening or irreversibly debilitating human disease or condition, you may consider whether or not it would be a candidate for the Safer Technologies Program.

Will the FDA announce when a device has been granted Breakthrough Device designation?

Prior to marketing authorization, the FDA generally cannot publicly disclose whether a sponsor has submitted a Breakthrough Device designation request for a device, or whether FDA has granted or denied the request unless the sponsor decides to make that information available to the public. Additionally, the FDA plans to maintain a list of devices granted Breakthrough Device designation on its webpage, adding devices to the list once the device has received marketing authorization.

Breakthrough Devices Program Metrics

As of March 31, 2022, CDRH and CBER have granted 657 Breakthrough Device designations, including devices originally designated under the Expedited Access Pathway (EAP) program. The following graphs provide the distribution of these designations by fiscal year as well as by clinical panel.

Graph 1: Number of Granted Breakthrough Device Designations by Fiscal Year

Bar graph showing the number of breakthrough device designations granted by fiscal year. 12 devices granted in 2015. 12 devices granted in 2016. 22 devices granted in 2017. 62 devices granted in 2018. 122 devices granted in 2019. 147 devices granted in 2020. 216 devices granted in 2021. 64 devices granted to date in 2022. Footnote asterisks on all years before 2019.

Of the 657 devices granted Breakthrough Device designation, CDRH has granted 652 and CBER has granted 5.

* Data includes devices that were designated under the precursor Expedited Access Pathway (EAP). Due to consistency in vision and designation criteria between the precursor EAP Program and the Breakthrough Devices Program, FDA considers devices granted designation under the EAP to be part of the Breakthrough Devices Program.

Graph 2: Number of Granted Breakthrough Device Designations by Clinical Panel

Graphing showing the number of breakthrough devices granted by clinical panel. 158 Cardiovascular. 114 Neurology. 71 Orthopedic. 47 Gastroenterology and Urology. 43 General and Plastic Surgery. 32 Anesthesiology. 31 Immunology. 27 Clinical Chemistry. 24 Molecular Genetics. 23 Pathology. 20 Microbiology. 17 Radiology. 17 Ophthalmic. 7 Physical Medicine. 6 Ear, Nose, Throat. 4 General Hospital. 8 Hematology. 4 Obsetrics. 3 Dental. 1 Clinical Toxicology.

CDRH and CBER Breakthrough Device Marketing Authorizations

Below is a list of CDRH and CBER Breakthrough Devices that have obtained marketing authorization.

CDRH and CBER Breakthrough Device Marketing Authorizations
Data as of March 31, 2022
Total of 44 Marketing Authorizations, including 42 CDRH devices and 2 CBER devices

Manufacturer Trade Name Marketing Submission Number Marketing Submission Decision Date
CARTIHEAL, LTD. AGILI-C P210034 03/29/2022
SPECTRANETICS, INC. CAVACLEAR LASER SHEATH DEN210024 12/21/2021
KOIOS MEDICAL, INC. KOIOS DS K212616 12/16/2021
APPLIEDVR, INC. EASEVRX DEN210014 11/16/2021
SYNCTHINK, INC. EYE-SYNC K202927 10/02/2021
CANARY MEDICAL, INC. CANARY TIBIAL EXTENSION WITH CANARY HEALTH IMPLANTED REPORTING PROCESSOR (CHIRP) SYSTEM DEN200064 08/27/2021
MICROTRANSPONDER, INC. VIVISTIM PAIRED VNS SYSTEM P210007 08/27/2021
SIEMENS HEALTHCARE DIAGNOSTICS, INC. ADVIA CENTAUR ENHANCED LIVER FIBROSIS (ELF) DEN190056 08/20/2021
CARLSMED, INC. APREVO TRANSFORAMINAL IBF K210542 06/30/2021
COGNOA, INC. COGNOA ASD DIAGNOSIS AID DEN200069 06/02/2021
PAIGE.AI PAIGE PROSTATE DEN200080 09/21/2021
NEUROLUTIONS, INC. NEUROLUTIONS IPSIHAND UPPER EXTREMITY REHABILITATION SYSTEM DEN200046 04/23/2021
HELIUS MEDICAL, INC. PORTABLE NEUROMODULATION STIMULATOR (PONS) DEN200050 03/26/2021
MEDTRONIC, INC. HARMONY TPV SYSTEM P200046 03/26/2021
SHOCKWAVE MEDICAL, INC. SHOCKWAVE INTRAVASCULAR LITHOTRIPSY (IVL) SYSTEM WITH SHOCKWAVE C2 CORONARY INTRAVASCULAR LITHOTRIPSY (IVL) CATHETER P200039 02/12/2021
ABBOTT LABORATORIES I-STAT ALINITY SYSTEM K201778 01/08/2021
CARLSMED, INC. APREVO INTERVERTEBRAL BODY FUSION DEVICE K202034 12/03/2020
CERUS CORPORATION INTERCEPT BLOOD SYSTEM FOR PLASMA BP130076/S034 11/24/2020
NIGHTWARE, INC. NIGHTWARE KIT DEN200033 11/06/2020
FOUNDATION MEDICINE, INC. FOUNDATIONONE LIQUID CDX P200006 10/26/2020
ROCHE MOLECULAR SYSTEMS, INC. COBAS BKV K202215 09/02/2020
MEDTRONIC MINIMED, INC. MiniMed 770G System P160017/S076 08/31/2020
FOUNDATION MEDICINE, INC. FOUNDATIONONE LIQUID CDx P190032 08/26/2020
GUARDANT HEALTH, INC. GUARDANT360 CDx P200010 08/07/2020
ROCHE MOLECULAR SYSTEMS, INC. COBAS EBV DEN200015 07/30/2020
AMBU INNOVATION GMBH AMBU DUODENO SYSTEM K201098 07/17/2020
BAY LABS, INC. CAPTION GUIDANCE DEN190040 02/07/2020
BOSTON SCIENTIFIC EXALT MODEL D, SINGLE-USE DUODENOSCOPE, EXALT CONTROLLER K193202 12/13/2019
TUSKER MEDICAL TULA SYSTEM P190016 11/25/2019
ORASURE TECHNOLOGIES ORAQUICK EBOLA RAPID ANTIGEN TEST DEN190025 10/10/2019
CVRX, INC. BAROSTIM NEO SYSTEM P180050 08/16/2019
IMPULSE DYNAMICS, INC. OPTIMIZER SMART SYSTEM P180036 03/21/2019
PEAR THERAPEUTICS RESET-O K173681 12/10/2018
SPIRATION, INC. SPIRATION VALVE SYSTEM P180007 12/03/2018
AVITA MEDICAL, LLC. RECELL AUTOLOGOUS CELL HARVESTING DEVICE BP170122 09/20/2018
PULMONX CORPORATION ZEPHYR ENDOBRONCHIAL VALVE SYSTEM P180002 06/29/2018
MEDTRONIC MINIMED, INC. MINIMED 670G SYSTEM P160017/S031 06/21/2018
CLINICAL RESEARCH CONSULTANTS, INC. CUSTOMFLEX ARTIFICIAL IRIS P170039 05/30/2018
IDX, LLC IDX-DR DEN180001 04/11/2018
CONCENTRIC MEDICAL, INC. TREVO PRO VUE RETRIEVER AND TREVO XP PRO VUE RETRIEVER (TREVO RETRIEVER) K173352 02/15/2018
BANYAN BIOMARKERS, INC. BANYAN BTI DEN170045 02/14/2018
EMPATICA SRL EMBRACE K172935 01/26/2018
FOUNDATION MEDICINE, INC. FOUNDATIONONE CDX P170019 11/30/2017
INSIGHTEC EXABLATE P150038 07/11/2016

Guidances related to Breakthrough Devices

Contact Us

For any questions about the Breakthrough Devices program, please contact [email protected].

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