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        Medical products for rare diseases and conditions

Humanitarian Use Device (HUD) Designation Program

                        
                2018 FDA/NCATS Report on Unmet Medical Device Needs for Patients with Rare Diseases
          Education and Media Resources for HUD Program
          Frequently Asked Questions ( FAQs)


                Humanitarian Use Device Laws, Regulations, and Guidances Home
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          Humanitarian Use Device (HUD) Designation ProgramMedical products for rare diseases and conditions Humanitarian Use Device (HUD) Designation Program
  	
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On December 13, 2016, Section 3052 of the 21st Century Cures Act (Pub. L. No. 114-255) changed the population estimate required to qualify for Humanitarian Use Device (HUD) designation from "fewer than 4,000" to "not more than 8,000." Accordingly, a HUD is now defined as a medical device intended to benefit patients in the treatment or diagnosis of a disease or condition that affects or is manifested in not more than 8,000 individuals in the United States per year. The full text of the 21st Century Cures Act is available at:https://www.congress.gov/114/bills/hr34/BILLS-114hr34eah.pdf.

The Humanitarian Use Device or HUD program was established in 1990 with passage of the Safe Medical Devices Act and creates an alternative pathway for getting market approval for medical devices that may help people with rare diseases or conditions. As defined by 21 CFR 814.3(n), and updated by the 21st Century Cures Act, a HUD is a “medical device intended to benefit patients in the treatment or diagnosis of a disease or condition that affects or is manifested in not more than 8,000 individuals in the United States per year.” In order to obtain HUD designation, the applicant must provide documentation, with appended authoritative references, to demonstrate that the device meets this definition.

In addition to the documentation describing the disease or condition, the applicant must also provide the proposed indications for use of the device, and the reasons why such a device is needed for the patient population. One aspect that has become increasingly difficult is if the HUD is proposed for an indication that represents a subset of a common disease or condition. In these situations, the applicant must demonstrate that the subset is an “orphan subset.”

An “orphan subset” is a regulatory phrase used to describe the subset of individuals with a non-rare disease or condition on whom use of a device is appropriate, where use of the device on the remaining individuals with that disease or condition would be inappropriate given some intrinsic feature of the device (e.g., adverse event profile or mode of action). An “orphan subset” is not a readily identifiable subset or a group of patients who meet or do not meet the inclusion and exclusion criteria for a clinical study. Likewise, they are not patients with an unmet medical need. If the HUD application is designated, the applicant can then submit the HDE marketing application to the Center for Devices and Radiological Health (CDRH) or Center for Biologics Evaluation and Research (CBER) for marketing review.

Additional Humanitarian Use Device Resources

Understanding HUDs and HDEs
	Humanitarian Device Exemption (HDE) Program Guidance
	Device Advice: Comprehensive Regulatory Assistance
	Medical Device User Fee
	Listing of CDRH Humanitarian Device Exemptions
	Pediatric Humanitarian Device Exemptions Reviewed by the FDA Pediatric Advisory Committee
	IDE Early/Expanded Access**Request for Humanitarian Use Device designation should be sent to orphan@fda.hhs.gov or by mail to:**

Office of Orphan Products Development 
Food and Drug Administration
WO32-5295
10903 New Hampshire Avenue
Silver Spring, MD  20993-0002

Sponsors and others who plan to email information to FDA that is private, sensitive, proprietary or commercial confidential are strongly encouraged to send it from an FDA-secured email address so the transmission is encrypted. The agency will assume the addresses of emails received or email addresses provided as a point of contact are secure when responding to those email addresses. Sponsors and others can establish a secure email address link to FDA by sending a request to SecureEmail@fda.hhs.gov. There may be a fee to a commercial enterprise for establishing a digital certificate before encrypted emails can be sent to FDA.

                                                                                  Content current as of:
      12/15/2023Humanitarian Use Device (HUD) Designation Program                
                          

                        2018 FDA/NCATS Report on Unmet Medical Device Needs for Patients with Rare Diseases
          Education and Media Resources for HUD Program
          Frequently Asked Questions ( FAQs)


                        Humanitarian Use Device Laws, Regulations, and Guidances
 
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