MHRA Proposal for Accelerating Rare Disease Treatments
Join CamRARE online on 15 July, to delve into the detail of the MHRA’s proposed new framework, designed to help accelerate treatments and therapies for rare conditions.
A New Framework for Accelerating Rare Disease Treatments
The traditional method for developing medicines requires a large number of people to take part in clinical trials. This process just doesn’t work for most rare conditions, where there are few patients with each condition. As a result, only 5%, of the 10,000 rare conditions that we currently know of, have an approved treatment.
The MHRA (Medicines and Healthcare Products Regulatory Agency) is the government body who approve new treatments and therapies in the UK, and in order to address the challenge that developers have in gathering enough evidence to approve new treatments for rare conditions, they have drafted a new framework designed to help create a more appropriate process for conditions with smaller numbers of people.
The Big Idea: The Investigational Marketing Authorisation (IMA)
At the heart of their proposal is a new type of approval called the IMA. Currently, running a clinical trial and getting permission to supply a medicine are two separate, often long, steps. The IMA combines them into one process.
Under this new route, a promising treatment can be given to patients and studied at the same time. Instead of waiting years for a final “yes” or “no,” the MHRA will review the evidence continuously. This means people could access life-changing therapies much earlier, while regulators keep a close watch on safety and effectiveness.
Patients as Partners
One of the most important parts of this framework is that patients are treated as partners, not an afterthought. This means:
- Ongoing Consent: Your agreement to take part is treated as a continuous conversation, not just a single signature. As new information about a treatment’s risks or benefits emerges, you are kept informed.
- Your Priorities Matter: When judging if a treatment works, the MHRA will look at whether a therapy impacts your quality of life and personal experience, not just lab results.
- Direct Involvement: Patient organisations will be involved throughout the entire process.
Is “Faster” Safe?
The MHRA emphasises that faster access will not mean lower standards. Because evidence is still being gathered while you use the medicine, safety will be watched the entire time.
Every treatment will have a Clinical Monitoring Plan to track how well it works and catch any issues quickly. If the evidence eventually shows the treatment isn’t safe or effective, the MHRA can restrict or withdraw it immediately.
Treatments entering the IMA process will also be subject to independent ethics reviews, as they would be under a traditional clinical trial, to ensure patients are protected and treated fairly.
Gathering Evidence Differently
Because rare disease patient groups are small, the MHRA will use “flexible” evidence. This includes real-world evidence (data from your everyday medical care) and smart computer models to assess if a medicine works, without needing thousands of trial participants.
What comes after the IMA (Investigational Marketing Authorisation)?
Approval is only the first step; you also need to be able to access the medicine through the NHS. The MHRA is planning to work closely with NICE (National Institute for Health and Care Excellence) and NHS England to ensure that once a medicine is approved, the funding and rollout happen smoothly.
How you can help
This framework is currently a draft, and the MHRA wants to hear from you!
The document is quite a heavy read, so CamRARE are holding a workshop on 15 July to delve in and ask some of the big questions:
- Does it protect patients well enough?
- Is consent meaningful and genuinely ongoing?
- Will access to treatments really be faster?
- Is the safety monitoring strong enough to reassure you?
The workshop will run at 3 different times throughout the day (morning, lunchtime or evening) where we’ll look through the main priorities and challenges addressed in the framework, ask the big questions and hear from each other about our thoughts.
CamRARE will be submitting a group response to the MHRA consultation based on the feedback we gather at the workshops, but remember you can also submit a response from your organisation, patient group or your personal perspective. The more feedback the better to make the guidance the best it can be!





















































