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Updated: May 26, 2026

Quadruple-Checkerboard: A Modification of the Three-Dimensional Checkerboard for Studying Drug Combinations
Published on: July 24, 2021
Lessons from innovation in drug-device combination products
Daniela S Couto1, Luis Perez-Breva, Pedro Saraiva
1Department of Chemical Engineering, Massachusetts Institute of Technology, Cambridge, MA 02139, USA. dcouto@mit.edu
Navigating regulatory pathways for drug-device combination products is key. Determining the primary function early reduces uncertainty and guides market entry for novel medical innovations.
Area of Science:
- Medical Product Development
- Regulatory Science
- Biotechnology
Background:
- Drug-device combination products represent a significant evolution in medical technology.
- These products integrate therapeutic agents with medical devices, presenting unique development and regulatory challenges.
- Existing literature often focuses on individual components rather than the synergistic aspects of combination products.
Purpose of the Study:
- To analyze the challenges and opportunities in developing drug-device combination products.
- To provide lessons for future generations of combination products based on case studies.
- To understand the impact of regulatory pathways on market introduction and corporate strategy.
Main Methods:
- Case study analysis of drug-eluting stents and transdermal patches.
- Examination of regulatory approval dynamics for novel combination products.
- Analysis of the influence of primary function determination on market leadership and corporate structure.
Main Results:
- The primary barrier for new combination products is identifying the correct regulatory oversight center.
- The first product approval in a new class establishes the precedent and reduces uncertainty for subsequent products.
- Sponsors play a crucial role in defining the primary function, influencing regulatory pathways and market entry.
Conclusions:
- Early definition of the primary function is critical for successful drug-device combination product development.
- Regulatory clarity is essential for reducing uncertainty and facilitating market access.
- The strategic decisions made during the initial development phase shape the future landscape for combination products and associated industries.
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