The European Union (EU) Medical Device Regulation increased regulatory scrutiny to improve the safety and performance of new medical devices. An equally important goal is providing timely access to innovative devices to benefit patient care. The European Society of Cardiology strongly advocates for the evolution of the Medical Device Regulation system to facilitate priority access for innovative devices for unmet needs and orphan cardiovascular (CV) medical devices in EU countries. Although device approval is currently executed by Notified Bodies in the EU, it will be advantageous in the mid-term to consider a single EU regulatory agency for devices. In the short term, steps can be taken to transform the current system into a more efficient, predictable, cost-effective, and user-friendly service. Key strategies include the following: enhancing predictability of the approval process through use of early scientific advice from regulators
establishing unique regulatory pathways for CV orphan, paediatric, and innovative devices
promoting more efficient (re)certification of essential legacy CV devices
improving transparency of sponsor interactions with Notified Bodies
expanding the roles of the Expert Panels to assist in the approval of CV devices
promoting global regulatory harmonization, considering streamlined authorization of CV medical technologies across selected jurisdictions
developing an efficient system to monitor device safety
and ensuring funding for data collection platforms. Some strategies that could help include considering a pilot programme for joint approval processes of selected devices in partnership with other regions (i.e. US Food and Drug Administration)
developing priority pathways for accelerated access to innovative or orphan devices
and increasing recognition of the importance of early feasibility studies in the EU.