Table of Contents
Executive Summary	6
PROJECT BACKGROUND	6
RESEARCH METHODOLOGY	6
KEY FINDINGS	7
THE BENCHMARK CLASS	11
REPORT STRUCTURE AND ORGANIZATION	11
Structure and Rockville Satellite Office Overview	14
ORGANIZATIONAL STRUCTURE	15
CENTRALIZATION OF FUNCTION	17
ROLE OF ROCKVILLE SATELLITE OFFICE	20
Building Effective Relationships	26
OVERVIEW	26
FORMAL RELATIONSHIPS	27
INFORMAL RELATIONSHIPS	31
EMAILS VS. PHONE CALLS	33
ATTENDING CONFERENCES	34
Working with and Understanding the FDA and Washington Ecosystem	37
OVERVIEW	37
WORKING ON RELATIONSHIPS	38
THE ROLE OF REPUTATION	40
THE WASHINGTON ECOSYSTEM	42
Skills, Capabilities and Competencies for Success	46
OVERVIEW	46
A DYNAMIC PROFESSION	47
SKILL SETS	47
SCIENCE VERSUS REGULATORY EXPERIENCE	51
FDA EXPERIENCE	54
PERFORMANCE MEASUREMENT	55
Planning and Preparation for the NDA	58
OVERVIEW	58
STARTING WITH THE NDA	59
WHO SPEAKS, LEADS	60
MINUTES	61
WORKING WITH THE PROJECT MANAGER	63
PREPARING FOR NDA MEETINGS	64
MEETING REHEARSALS	66
NEGOTIATING FOR A WIN-WIN WITH LABELING	70
Safety and Risk Management	70
OVERVIEW	73
REFOCUSING ON SAFETY	74
RISK EVALUATION AND MITIGATION STRATEGIES	77
CHANGING SAFETY LANDSCAPE	78
List of Charts & Exhibits
TABLES AND FIGURES
Figure 1: Top Methods for Working with the FDA	7
Figure 2: Best Practices LLC benchmark Class	11
Figure 1.1: Organizational oversight of FDA Function	15
Figure 1.2: Companies choose to mirror FDA structure	16
Figure 1.3: Align your staff with their FDA peers	17
Figure 1.4: Organizational Structure for FDA Interactions	18
Figure 1.5: Regulatory oversees corporate FDA interactions	19
Figure 1.6: More utilization of Rockville office possible	21
Figure 1.7: FDA focus Vital component of Rockville Offices	22
Figure 1.8: More Emphasis places on FDA Liaison Role	22
Figure 1.9: Key competencies needed in rockville	24
Figure 2.1: Engagement Strategy for FDA Staff	27
Figure 2.2: FDA Reviewers make Optimal partners	28
Figure 2.3: Emails and Phone best ways to contact FDA	33
Figure 2.4: Email Used to build informal FDA relationships	34
Figure 3.1: Pharmas most admired for FDA navigation skills	41
Figure 3.2: Biotechs Most Admired for FDA Navigation Skills	42
Figure 4.1: RA Profession - Integral to Healthcare Product Lifecycle	47
Figure 4.2: A matrix of characteristics can help in FDA work	48
Figure 4.3: Regulatory Knowledge is most valued trait	49
Figure 4.4: Legal/Regulatory background can help	49
Figure 4.5: Regulatory or clinical Backgrounds Preferred	50
Figure 4.6: Balancing Backgrounds & skill sets	53
Figure 4.7: Hiring the right kind of FDA staff	54
Figure 4.8: Companies have few staff with FDA experience	55
Figure 4.9: Regulatory uses Multiple Performances Metrics	56
Figure 5.1: The high quality NDA support Safety	59
Figure 5.2: Gatekeeper Model Favored in FDA relationships	63
Figure 5.3: Key Roles During NDA Process	65
Figure 5.4: Companies divided about using outside expert	66
Figure 5.5: Many ways to help prepare NDA presentations	68
Figure 5.6: Mock reviews core approaches for FDA prepration	68
Figure 5.7: The draft label sets the tone	71
Figure 6.1: FDA continues to emphasize safety	74
Figure 6.2: Safety-Based Withdrawals	75