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Tag: Brazil

  • Which LATAM countries mandate post-trial access for medical devices?

    Four Latin American jurisdictions textually mandate post-trial access (PTA) for medical devices: Costa Rica (Ley 9234 Art. 53(k)), Brazil (Lei 14.874/2024 Art. 37), Chile (Código Sanitario Art. 111 A → 111 C), and Peru (DS 021-2017-SA Art. 2.1.36). Ecuador’s AM 00069-2024 does not. Argentina’s Disp. 12792/2016 is inferential.

    Most LATAM PTA statutes were drafted for medicines. Device sponsors who assume drug rules apply without reading product-class language understate exposure in four countries and overstate it in others.

    Short answer: which countries mandate device PTA?

    Express textual reach (4): Costa Rica, Brazil, Chile, Peru.

    Inferential / confirm-with-regulator: Argentina (productos y materiales; no dispositivo médico); Panama (Art. 68 “el producto” — confirm import pathway with DNFD).

    Medicines-only among binding PTA countries: Ecuador.

    Ten-country PTA mandate list: Argentina, Brazil, Panama, Chile, Peru, Ecuador, Costa Rica, Guatemala, Honduras, and Nicaragua (LATAM PTA operator map).

    Colombia disclaimer: Colombia does not currently mandate post-trial access by statute. When post-trial supply is required, bioaccess® can operate voluntary continuity programs on sponsor request. PTA statutory mandates in LATAM currently apply to Argentina, Brazil, Panama, Chile, Peru, Ecuador, Costa Rica, Guatemala, Honduras, and Nicaragua.

    Which jurisdictions expressly cover medical devices?

    Costa Rica — strongest express device language. Ley 9234 Art. 53(k) obliges free post-study provision of “el medicamento, dispositivo o procedimiento que ha sido objeto de investigación,” with enumerated exits. Art. 28 sets duration at “mientras lo requieran.” No other LATAM PTA instrument states device and procedure coverage this plainly (Map hub).

    Brazil — Chapter VI extends to devices and ATMPs. Lei 14.874/2024 Art. 37 applies the post-trial chapter to “produtos e dispositivos médicos” and experimental advanced therapies “no que couber.” Decreto 12.651/2025 Art. 31 speaks of produto sob investigação. Full analysis: Brazil PTA pillar.

    Chile — Art. 111 A pulls devices into Art. 111 C. Código Sanitario Art. 111 A requires the provisional-use authorization for “todo producto farmacéutico o dispositivo médico.” Art. 111 C then binds that authorization holder — and later the sanitary-registration holder — to free continuity “por todo el tiempo que persista su utilidad terapéutica” (Chile PTA pillar). ISP’s April 2026 device GCP guide (Res. Ex. N° 341 / 2.050) cites Art. 111 A but is silent on Art. 111 C; guidance silence does not erase the statute.

    Peru — definitional inclusion. DS 021-2017-SA Art. 2.1.36 defines producto en investigación as “un producto farmacéutico o dispositivo médico.” Título X (Arts. 115–118) operates on that term with no device carve-out (Peru PTA pillar).

    Which mandate countries are silent, inferential, or medicines-only?

    Ecuador — medicines-only. AM 00069-2024 Arts. 80–81 create a sponsor free-supply duty inside a medicines / natural-medicinal-products reglamento. Device exposure there runs through ethics-committee expectations and informed consent, not those articles (Map hub).

    Argentina — inferential. Disp. 12792/2016 Art. 3(f) covers products and “los materiales” that must match the approved study. Dispositivo médico does not appear. Confirm with ANMAT before assuming the cohort import route applies (Argentina PTA pillar).

    Panama — product language; confirm pathway. Decreto Ejecutivo 21/2026 Art. 68 refers to “el producto”; Chapter XIII covers medicines and other products for human health. Device studies fit a fair reading, but sponsors should confirm the import-permit-extension pathway with DNFD. Primary-source verification required for any device-class DNFD circular not already cited on the Panama pillar.

    Guatemala, Honduras, and Nicaragua sit in the ten-country PTA mandate set (Map hub); device-specific textual reach is thinner than the four express jurisdictions and should be verified before protocol lock. Guatemala AM 82-2019 vs AM 206-2021 supersession status remains primary-source verification required.

    What operational gaps remain after a device duty attaches?

    Obligation is not pathway. Costa Rica Art. 53(k) mandates free device provision, but Art. 55 addresses importation only before an approved study begins — no post-trial import route is identified in the statute (Map hub). Brazil Art. 37 is clear, yet RDC 38/2013 speaks of medicamento; build post-close import from the trial’s own authorizations (Brazil pillar).

    Chile’s open-ended “utilidad terapéutica” raises replacement, consumable, explant, and end-of-life questions the statute does not answer — close them in the protocol (Chile pillar). Peru’s duty can mean continued consumables or support for an implanted system with no device-specific carve-out (Peru pillar).

    Before first site activation: classify each country as express / inferential / medicines-only / no PTA statute; quote the device-scope article; name the post-close import mechanism or document that none exists; define device-system continuity in the protocol; appoint an importer of record after trial authorizations lapse.

    Working on a LATAM device PTA program? bioaccess® is a US-headquartered, LATAM-native operator for regulatory, importadora, and 2–8 °C GDP cold-chain functions. Contact Julio Martinez-Clark, Co-Founder & CEO, at jmclark@bioaccessla.com or +1 (954) 903-7210. More at bioaccessla.com/roadmap.

    Related pillar

    For the full 20-country mandate matrix, cost allocation, and duration comparative — including the ten binding-statute countries and Colombia’s no-PTA framing — read Post-trial access in Latin America: the operator’s map.

    Sources

    • Costa Rica — Ley N.º 9234 (Arts. 28, 53(k), 55): https://documentos.una.ac.cr/bitstream/handle/unadocs/5670/Texto%20Completo%20Norma%209234.pdf?sequence=1&isAllowed=y
    • Brazil — Lei nº 14.874/2024 Art. 37: https://www.planalto.gov.br/ccivil_03/_ato2023-2026/2024/lei/l14874.htm
    • Brazil — Decreto nº 12.651/2025 Art. 31: https://www2.camara.leg.br/legin/fed/decret/2025/decreto-12651-7-outubro-2025-798105-publicacaooriginal-176652-pe.html
    • Brazil — ANVISA RDC nº 38/2013: https://anvisalegis.datalegis.net/action/ActionDatalegis.php?acao=abrirTextoAto&tipo=RDC&numeroAto=00000038&seqAto=000&valorAno=2013&orgao=RDC/DC/ANVISA/MS&codTipo=&desItem=&desItemFim=&cod_menu=1696&cod_modulo=134&pesquisa=true
    • Chile — Código Sanitario Arts. 111 A, 111 C: https://www.bcn.cl/leychile/navegar?idNorma=5595
    • Chile — Ley 20.850: https://www.bcn.cl/leychile/navegar?idNorma=1078148
    • Chile — ISP Res. Ex. N° 341 / Res. Ex. 2.050: https://www.bcn.cl/leychile/navegar?idNorma=1223885
    • Peru — DS 021-2017-SA Arts. 2.1.36, 115–118: https://ensayosclinicos-repec.ins.gob.pe/images/Reglamento_de_EC.pdf
    • Ecuador — AM 00069-2024 Arts. 80–81, 95(c): https://www.espoch.edu.ec/wp-content/uploads/2025/10/ac-00069-2024_dic_31_compressed_1-1.pdf
    • Argentina — ANMAT Disposición 12792/2016 Art. 3(f): https://www.boletinoficial.gob.ar/detalleAviso/primera/154162/20161117
    • Colombia — Resolución 2378 de 2008: https://www.ins.gov.co/Normatividad/Resoluciones/RESOLUCION%202378%20DE%202008.pdf
    • LATAM PTA Operator Map: https://bioaccessla.com/blog/latam-post-trial-access-operator-map
    • Brazil PTA pillar: https://bioaccessla.com/blog/brazil-post-trial-access-lei-14874
    • Chile PTA pillar: https://bioaccessla.com/blog/chile-post-trial-access-ley-20850
    • Peru PTA pillar: https://bioaccessla.com/blog/peru-post-trial-access-ds-021-2017-sa
    • Argentina PTA pillar: https://bioaccessla.com/blog/argentina-post-trial-access-anmat-disposicion-12792
    • Panama PTA pillar: https://bioaccessla.com/blog/panama-post-trial-access-decreto-ejecutivo-21-2026

  • Who pays for post-trial access under Brazil Lei 14.874?

    The sponsor pays. Under Lei nº 14.874/2024 Article 31 §4, free post-trial supply of the experimental medicine is the sponsor’s responsibility; Decreto nº 12.651/2025 Article 31 restates that duty as fornecimento gratuito.

    Brazil is the only Latin American country where free post-trial supply is an explicit, sponsor-funded statutory duty that reaches drugs, medical devices, and advanced therapies. Brazil’s Ministry of Health puts it plainly: continued treatment after the study “não é uma expectativa, mas um dever legal” — not an expectation, but a legal duty (INAEP FAQ). Sponsors budgeting a Brazilian trial in 2026 budget the product, the cold chain, pharmacovigilance, and the ANVISA import trail against that duty — not against an ethics-committee expectation.

    Who pays for post-trial access under Brazil Lei 14.874?

    The sponsor, exclusively, and free of charge to the participant.

    Three instruments say the same thing in slightly different words:

    • Lei 14.874/2024 Article 31 §4 — where continued treatment with the experimental medicine is necessary after trial end, “o fornecimento do medicamento será de responsabilidade do patrocinador.”
    • Lei 14.874/2024 Article 34 §1 — the sponsor guarantees free post-trial supply whenever the investigator considers the product the best therapy for that participant’s condition and the risk-benefit ratio is more favorable than available alternatives.
    • Decreto 12.651/2025 Article 31 — the sponsor “deverá garantir aos participantes da pesquisa o fornecimento gratuito do produto sob investigação” whenever the responsible investigator reaches that same clinical judgment.

    ANVISA’s RDC nº 38/2013 Article 18 adds operational content to the same rule for medicines assistance programs: the sponsor funds complete free treatment (inciso I), keeps custody and storage of the product (II), may not commercialize it under the program (III), and funds integral assistance for complications arising from its use (VI). Separately, Lei 14.874/2024 Article 35 §2 makes the sponsor responsible for care needed because of study-caused reactions.

    Neither the participant, the treating institution, nor the public health network is the primary payer for investigational-product supply under Chapter VI. Availability of the product in the public network is an interruption ground under Article 33 VII, not a cost-shift rule during the program.

    How does the statute allocate cost before the trial even starts?

    Cost allocation is planned before first patient in. Lei 14.874/2024 Article 30 requires the sponsor and the investigator to submit a plano de acesso pós-estudo to the research ethics committee (CEP) before the trial starts, justifying whether free post-trial supply will be needed. If it will, Article 30 §1 requires a programa de fornecimento pós-estudo, and §2 requires that program to guarantee continued safety follow-up and receipt of the experimental treatment “por prazo determinado.” Article 30 §3 adds a scheduling constraint sponsors routinely miss: the program may only begin after regulatory approval, and the request must be filed early enough for participants to transition without a treatment gap.

    At trial end, Article 31 requires an individual assessment for each participant, performed by the investigator with the sponsor and the participant heard. Under Article 31 §2, free supply is triggered whenever the investigational product is the best therapy for that participant’s condition and shows a more favorable risk-benefit ratio than available alternatives. Article 32 sets the four evaluation criteria: disease severity, availability of satisfactory alternatives in the participant’s locality, whether the product addresses an unmet clinical need, and whether evidence of benefit exceeds evidence of risk. Article 31 §3 and Article 34 §2 both provide that the participant “deverá migrar automaticamente” into the post-study program — migration is automatic, not opt-in.

    Article 37 is why MedTech and cell-and-gene sponsors cannot treat cost allocation as a pharma-only issue: “Aplicar-se-ão aos produtos e dispositivos médicos e aos produtos de terapias avançadas experimentais, objeto de ensaio clínico, as disposições deste Capítulo, no que couber.” The whole post-trial chapter — including who pays — applies to medical devices and experimental advanced therapy products, insofar as applicable. Decreto 12.651/2025 Article 31 reinforces the point by using produto sob investigação rather than medicamento.

    How long must the sponsor fund free supply?

    There is no fixed end date measured from trial close. Lei 14.874/2024 Article 33 permits interruption only on seven grounds, each requiring a justification submitted to the CEP:

    1. participant decision;
    2. cure or introduction of a satisfactory alternative;
    3. absence of continued benefit;
    4. a disqualifying adverse reaction;
    5. technical or safety impossibility of manufacture (provided the sponsor supplies an equivalent or better marketed alternative);
    6. inciso VI — “transcurso do prazo de 5 (cinco) anos, contado da disponibilidade comercial do medicamento experimental no País”;
    7. availability in the public health network.

    Inciso VI carries visible veto history on the Planalto text: the original statute showed “VI – (VETADO),” then the five-year text was marked “(Promulgação partes vetadas)” and promulgated on 1 July 2025 (DOU 2 July 2025). The five-year cap is in force after that promulgation.

    The practical effect is that the five-year clock only starts when the product becomes commercially available in Brazil. A sponsor that never commercializes there, or commercializes late, has no five-year backstop running in its favor. The exposure terminates on clinical or supply events under the other six grounds, or on the commercial-availability clock once it has started — not on a date fixed at trial close. That is why Brazil’s Ministry of Health describes the duty as running “desde o planejamento da pesquisa até o período pós-estudo.”

    What roles do the CEP and ANVISA play in who pays?

    The CEP and ANVISA do not pay. They gate the program that the sponsor funds.

    • CEP — approves the pre-trial plan (Art. 30), the post-study program (Decreto Art. 31 §1), and any interruption justification (Art. 33). The INAEP FAQ states that the program must be submitted for CEP evaluation — “Não basta notificar” — and that the competent CEP is, as a rule, the coordinating centre’s CEP. Decreto Article 31 §2 reserves detailed guidelines to a future INAEP norm.
    • ANVISA — Article 34 §3 requires that importation and dispensing during the post-study program be previously authorized by the competent sanitary authority. For medicines, RDC 38/2013 remains the operative assistance-program instrument: the sponsor or a contracted organização representativa do patrocinador files the anuência; for post-study supply ANVISA issues “um ofício autorizando o fornecimento” (Art. 3 §2), not a comunicado especial.
    • INAEP — the Instância Nacional de Ética em Pesquisa issues ethics norms and acts as appellate instance over CEP decisions (Lei Art. 8). It does not fund supply.

    The cost driver for a sponsor is therefore not a regulator invoice. It is the tail: free product, GDP distribution, pharmacovigilance, ANVISA reporting, and CEP maintenance running until one of the seven Article 33 events occurs, with the five-year clock not starting until Brazilian commercial availability. Price that tail in the Article 30 pre-trial plan. For devices and advanced therapies, also decide in the protocol how the product will physically be imported and dispensed after close — RDC 38/2013 speaks of medicamento, while Article 37 of the statute already attaches the duty.

    Related pillar

    For the full Brazil framework — Chapter VI Arts. 30–37, Decreto 12.651/2025 Art. 31, the RDC 38/2013 import sequence, INAEP’s role, and device/ATMP scope — read Post-trial access in Brazil under Lei 14.874/2024 and Decreto 12.651/2025.

    Working on a LATAM post-trial access program? bioaccess® is a US-headquartered, LATAM-native operator running regulatory, importadora, and 2–8 °C GDP cold-chain functions directly across the region. If you’re evaluating PTA feasibility in Brazil or elsewhere in Latin America, contact Julio Martinez-Clark, Co-Founder & CEO, at jmclark@bioaccessla.com or +1 (954) 903-7210. More at bioaccessla.com/roadmap.

    Sources

    • Lei nº 14.874, de 28 de maio de 2024 (Marco Legal de Pesquisa Clínica), Arts. 30–37, 65; promulgação das partes vetadas (Art. 33 VI), DOU 2.7.2025 — https://www.planalto.gov.br/ccivil_03/_ato2023-2026/2024/lei/l14874.htm
    • Decreto nº 12.651, de 7 de outubro de 2025, Art. 31 — https://www2.camara.leg.br/legin/fed/decret/2025/decreto-12651-7-outubro-2025-798105-publicacaooriginal-176652-pe.html
    • ANVISA RDC nº 38, de 12 de agosto de 2013, Arts. 3, 18 — https://anvisalegis.datalegis.net/action/ActionDatalegis.php?acao=abrirTextoAto&tipo=RDC&numeroAto=00000038&seqAto=000&valorAno=2013&orgao=RDC/DC/ANVISA/MS&codTipo=&desItem=&desItemFim=&cod_menu=1696&cod_modulo=134&pesquisa=true
    • Ministério da Saúde / INAEP FAQ, “O acesso (fornecimento) pós-estudo é opcional? Como a regra funciona?” (20 Feb 2026) — https://www.gov.br/saude/pt-br/composicao/orgaos-colegiados/inaep/faq/faq/acesso-pos-estudo/o-acesso-fornecimento-pos-estudo-e
    • bioaccess® Brazil PTA pillar — https://bioaccessla.com/blog/brazil-post-trial-access-lei-14874

  • The legal architecture of Latin American post-trial access: SDEA, DPA, product liability, sponsor accession

    A Latin American post-trial access (PTA) program is a regulatory filing wrapped in four contracts. The filing is the visible part — an ANMAT import expediente, an ANVISA ofício, a DIGEMID authorization. The four contracts are what determine who answers to a regulator, who answers to a patient, and who answers to a plaintiff’s lawyer three years after the last shipment.

    Those four instruments are a Safety Data Exchange Agreement, a country-specific Data Processing Agreement, a product-liability allocation, and — the one most often missing — a sponsor accession mechanism that binds the marketing-authorization holder to the same schedules the operator signed. This piece sets out how we paper each of them and the five architectural mistakes that recur in draft PTA agreements we review.

    Why the paperwork carries more weight than the filing

    In nine Latin American jurisdictions the continued-supply duty is statutory and sits on the sponsor. Brazil’s Lei nº 14.874/2024 Art. 31 §4 states that “o fornecimento do medicamento será de responsabilidade do patrocinador,” and Art. 33 inciso VI releases the sponsor only five years after commercial availability in Brazil. Chile’s Código Sanitario Art. 111 C, inserted by Art. 34 of Ley 20.850, attaches the free-supply duty to the holder of the provisional-use authorization and then to the sanitary-registration holder — including a successor that acquired the registration later. Peru’s DS 021-2017-SA Art. 40(p) and Art. 89 put both the access duty and the funding on the sponsor. Panama’s Decreto Ejecutivo 21/2026 Art. 68 (Gaceta Oficial Digital 30510-C, 23 April 2026, which reglamentates Titles III and IV of Ley 84 de 14 de mayo de 2019) names investigadores y patrocinadores as co-obligors.

    None of those statutes names an operator, an importadora, or a managed-access vendor. The obligation is the sponsor’s by law. Everything the operator does — the import authorization under Disposición ANMAT 12792/2016 Art. 4, the cold-chain leg, the pharmacovigilance intake — is performed on behalf of an obligor that remains the obligor. If the contract does not say so with precision, the operator has effectively assumed a statutory duty it has no legal standing to discharge.

    Pillar 1: the Safety Data Exchange Agreement

    The SDEA is the instrument that connects local adverse-event intake to the sponsor’s global pharmacovigilance system. It should be executed within 30 days of the Work Order, not left to a later “PV annex to follow.”

    Three ICH guidelines set the substance. ICH E2A fixes the expedited-reporting clock: fatal or life-threatening unexpected adverse drug reactions require notification “as soon as possible but no later than 7 calendar days after first knowledge by the sponsor,” followed by a fuller report “within 8 additional calendar days” (§III.B.1), while all other serious unexpected ADRs run on a 15-calendar-day clock (§III.B.2). Because the clock starts on sponsor knowledge, the SDEA must set an internal onward-transmission deadline for the local operator that is materially shorter — otherwise the sponsor’s regulatory clock is being consumed by the operator’s intake queue. ICH E2F governs periodic reporting: the DSUR is an annual report with a data lock point on “the last day of the one-year reporting period” and submission “no later than 60 calendar days after the DSUR data lock point” (§2.2), so the SDEA must specify who supplies PTA-cohort line listings into that cycle and by when. ICH E3 §12 sets the safety-evaluation structure the underlying trial report already follows, which is the format PTA safety data should feed into rather than a parallel one.

    Practical drafting points: name the sponsor’s global PV mailbox and the operator’s PV contact by role, define the reconciliation cadence, and state expressly that regulatory reporting to the local authority is the sponsor’s obligation performed through the operator as agent, with the operator’s duty limited to timely, accurate onward transmission.

    Pillar 2: the Data Processing Agreement — country by country

    There is no single Latin American data-protection instrument, so there is no single DPA. The controlling article set changes by jurisdiction:

    Jurisdiction Instrument Transfer article Notes for PTA drafting
    Argentina Ley 25.326 Art. 12(1)–(2) Transfer to countries without adequate protection is prohibited; Art. 12(2)(b) carves out medical-data exchange where the affected person’s treatment requires it. Art. 11(4) makes the transferee subject to the transferor’s obligations and imposes joint liability.
    Argentina (clauses) AAIP Resolución 198/2023 Anexo I Approves two model clause sets: responsable–responsable and responsable–encargado. Use the latter where the operator processes only on sponsor instruction (Cláusula 6.1).
    Brazil Lei nº 13.709/2018 (LGPD) Arts. 33–36 Art. 33 II(a)–(b) permits transfer on specific or standard contractual clauses; Art. 33 VIII permits it on specific, highlighted consent distinguished from other purposes.
    Mexico LFPDPPP (DOF 20 March 2025) Arts. 35–36 Health data is sensitive (Art. 2 fr. VI) and requires express written consent (Art. 8). Art. 36 fr. II exempts transfers necessary for medical treatment or health-service management.
    Chile Ley 19.628 → Ley 21.719 Art. 10 → Arts. 27–29 Ley 21.719 was published 13 December 2024 and enters into force 1 December 2026. Any Chilean PTA DPA signed now should be drafted to the Arts. 27–29 transfer regime, not only to Ley 19.628 Art. 10.
    Peru DS 016-2024-JUS (Reglamento, Ley 29733) Arts. 18–20 In force 120 calendar days after publication (31 March 2025). Art. 20.1 permits model contractual clauses imposing “cuando menos las mismas obligaciones” on the importer.
    Colombia Ley Estatutaria 1581 de 2012 Art. 26 Health data is sensitive (Art. 5); Art. 26(b) carves out medical-data exchange required by the data subject’s treatment. Otherwise the SIC issues a declaración de conformidad (Art. 26, par. 1).

    The operator-side drafting position is the same everywhere: the sponsor is responsable/controller, the operator is encargado/operator, processing is limited to documented instructions, sub-processing requires prior written consent, and the operator returns or deletes on termination subject to statutory retention. Where the destination country has no adequacy finding, attach the applicable model clauses as a schedule rather than describing them in the body.

    The Argentina adequacy mistake

    The most common error in Argentine PTA drafting is treating Commission Decision 2003/490/EC as if it authorised outbound transfers from Argentina. Article 1 reads: “Argentina is regarded as providing an adequate level of protection for personal data transferred from the Community.” Article 2 confines the decision to adequacy in Argentina “with a view to meeting the requirements of Article 25(1) of Directive 95/46/EC.” The instrument is unidirectional — EU to Argentina.

    A PTA data flow from Argentine sites to a sponsor in the United States, or to an access vendor in the Netherlands, is an Argentine outbound transfer governed by Ley 25.326 Art. 12, and the correct instrument is the AAIP responsable–encargado model agreement under Resolución 198/2023, not a citation to the 2003 decision. Treating the adequacy finding as reciprocal is a defect that survives review because it looks like a considered legal position.

    Pillar 3: product liability sits with the sponsor

    The operator is not the manufacturer, does not hold the marketing authorization, and cannot practically bear product-liability risk for the product itself. A managed-access or expanded-access vendor is in the same position. Neither controls design, manufacture, batch release, labelling content, or the safety profile — so neither can defend a product claim on the merits or insure it economically.

    Our drafting position, and the position we recommend to any operator in this role:

    • The sponsor or titular defends and indemnifies the operator against third-party claims arising from the product itself, including design, manufacture, and labelling defects.
    • The sponsor maintains product-liability insurance covering the PTA territories for the duration of the program plus a tail, and provides certificates on request.
    • The operator’s liability cap covers operator services only. Product liability sits outside the cap.
    • Carve-outs outside the cap in both directions: gross negligence, wilful misconduct, breach of confidentiality, intellectual-property infringement, and breach of data-protection obligations.

    The cap itself is negotiable, usually expressed against fees paid under the Work Order over a defined lookback. Its composition is not: a cap that silently absorbs product liability converts a services agreement into an uninsured product warranty.

    Pillar 4: sponsor accession as a condition precedent

    Because the sponsor holds the statutory supply duty, the product liability, the marketing authorization, and the primary pharmacovigilance obligation, an operator’s Work Order should be conditioned on sponsor accession. Two mechanisms work:

    1. Direct accession — the sponsor executes a short accession instrument to the schedules that allocate safety data exchange, data processing, and liability (in our template set, schedules C, E and F).
    2. Tripartite side letter — the sponsor, the access vendor or intermediary, and the operator sign a single side letter confirming the sponsor’s indemnity, insurance, PV ownership, and patient-continuity funding, with the underlying Work Order otherwise unchanged.

    Either way the Work Order should not become effective until accession is signed. Without it, the operator holds a services contract with a counterparty that cannot deliver the indemnity the contract assumes, and the patient-continuity commitment has no funded obligor behind it.

    Five architectural mistakes we see repeatedly

    1. No sponsor accession condition. The operator signs with an intermediary and inherits an unfunded, uninsurable duty.
    2. Product liability inside the operator’s cap. Structurally wrong for a non-manufacturer.
    3. The reciprocal-adequacy error. Argentina→US or Argentina→NL flows papered as if Decision 2003/490/EC covered them.
    4. No patient-continuity run-off. Termination should trigger a defined run-off — our default is 90 days — during which supply, PV intake, and cold-chain continue at the sponsor’s cost.
    5. No sponsor-funded continuity trigger. If the sponsor terminates the program or the access vendor disengages, the continuity obligation must be expressly sponsor-funded, or patients absorb the commercial dispute.

    Governing law, dispute resolution, and pre-send gates

    For cross-border PTA services agreements with a US-headquartered operator, Delaware law with AAA-ICDR arbitration seated in New York is a sensible default: neutral to the LATAM performance jurisdictions, familiar to sponsor counsel, and enforceable across the region under the New York Convention. Local-law carve-outs remain necessary for the statutory duties themselves, which are not contractible away.

    Before any PTA agreement leaves our desk it passes four gates: (1) a counsel memo verifying the regulatory framework and article citations for each performance jurisdiction; (2) named performing entities, including the habilitada local entity and the importadora of record; (3) sponsor accession path agreed in principle, in writing, before signature; and (4) harmonized statutory-obligation language, so that the same duty is not described one way in the recitals and another way in the schedules.

    Frequently asked questions

    What legal architecture does a LATAM post-trial access program require?
    Four instruments beyond the services agreement itself: a Safety Data Exchange Agreement connecting local adverse-event intake to the sponsor’s global pharmacovigilance system; a country-specific Data Processing Agreement built on the applicable transfer article (Argentina Ley 25.326 Art. 12, Brazil LGPD Arts. 33–36, Colombia Ley 1581 Art. 26, and so on); a product-liability allocation placing defence, indemnity, and insurance on the sponsor or titular; and a sponsor accession mechanism binding the marketing-authorization holder to those schedules. The regulatory filing — import authorization, ethics submission — is separate and downstream.

    What is a Safety Data Exchange Agreement (SDEA) in PTA?
    An SDEA is the bilateral agreement that defines how safety information moves from the PTA site and local operator into the sponsor’s global pharmacovigilance system. It should be executed within 30 days of the Work Order and built on ICH principles: ICH E2A §III.B for the 7-day and 15-calendar-day expedited-reporting clocks, ICH E2F §2.2 for annual DSUR periodicity and the 60-day post-data-lock-point submission window, and ICH E3 §12 for the safety-evaluation structure the data must fit. It names PV contacts, sets onward-transmission deadlines shorter than the sponsor’s regulatory clock, and fixes a reconciliation cadence.

    What is a Data Processing Agreement (DPA) in Argentine PTA?
    It is the instrument that makes an Argentine PTA data flow lawful under Ley 25.326. Art. 12(1) prohibits transfer to countries or organisations that do not provide adequate protection levels, and Art. 11(4) makes the transferee subject to the transferor’s obligations with joint liability. Where the sponsor sits in a country without an Argentine adequacy finding, the practical route is the responsable–encargado model agreement approved by AAIP Resolución 198/2023, attached as a schedule. Cláusula 6.1 limits the importer to the exporter’s documented instructions, with no decision-making power over scope or content.

    Does EU Commission Decision 2003/490/EC cover Argentina→US or Argentina→EU data flows?
    No. Article 1 of Decision 2003/490/EC regards Argentina as adequate for “personal data transferred from the Community,” and Article 2 limits the decision to adequacy in Argentina for the purposes of Article 25(1) of Directive 95/46/EC. The decision is unidirectional: EU to Argentina. An outbound transfer from Argentine sites to a US sponsor or a Dutch access vendor is governed by Ley 25.326 Art. 12 and requires its own adequacy basis, statutory exception, or model clauses. Article 3 of the decision, in fact, gives EU authorities power to suspend flows to recipients in Argentina — the opposite of a reciprocal permission.

    Who bears product liability in a PTA program — the sponsor, the manufacturer, or the operator?
    The sponsor or the titular of the marketing authorization. The operator is not the manufacturer, does not hold the authorization, and does not control design, manufacture, batch release, or labelling — so it cannot defend a product claim on the merits or insure it at a rational price. The correct architecture has the sponsor defend and indemnify the operator for product-related third-party claims, maintain product-liability insurance covering the PTA territories for the program term plus a tail, and accept that product liability sits outside the operator’s services liability cap.

    Why should PTA operators condition the Work Order on sponsor accession?
    Because the sponsor holds every obligation the Work Order depends on: the statutory continued-supply duty, the marketing authorization, primary pharmacovigilance responsibility, product liability, and the funding for patient continuity. An operator that contracts only with an intermediary holds an indemnity from a party that does not control the product and a continuity commitment with no funded obligor. Making accession a condition precedent — rather than a post-signature action item — is the only reliable way to ensure the risk allocation in the schedules is enforceable against the party that can actually perform it.

    What is a tripartite side letter in LATAM PTA?
    A single short instrument signed by the sponsor, the access vendor or intermediary, and the local operator, used where the sponsor will not accede directly to the operator’s schedules. It confirms four things: the sponsor’s defence and indemnity for product-related claims; the sponsor’s product-liability insurance covering the PTA territories; sponsor ownership of primary pharmacovigilance and regulatory reporting; and sponsor funding of patient continuity, including any run-off period. It leaves the underlying Work Order commercial terms untouched, which is usually why it is the faster path to signature.

    What is the standard liability cap in a LATAM PTA Work Order?
    There is no single market standard, and any figure quoted as one should be treated with suspicion. Caps are typically expressed as a ceiling tied to fees paid under the Work Order over a defined lookback period. The more consequential negotiation is not the number but the composition — what the cap covers and what sits outside it. A cap that quietly includes product liability turns a services agreement into an uninsured product warranty, which is a worse outcome for the operator than a low number with clean carve-outs.

    What carve-outs should sit outside the liability cap?
    Five, in both directions: gross negligence, wilful misconduct, breach of confidentiality, intellectual-property infringement, and breach of data-protection obligations. Product liability should also sit outside the operator’s cap, because the operator is not the manufacturer. Data-protection breach deserves particular attention in Latin America: Argentina’s Ley 25.326 Art. 11(4) imposes joint liability between transferor and transferee, and Mexico’s LFPDPPP Art. 59 fr. IV allows sanctions for sensitive-data infractions to be increased up to twofold, so capped data-protection exposure can be materially lower than actual statutory exposure.

    What is the standard patient-continuity run-off period?
    Our default drafting position is 90 days from the effective date of termination. During that window, product supply, pharmacovigilance intake, and cold-chain and importation services continue at the sponsor’s cost while the sponsor arranges an alternative route — a successor operator, an extension study, or transition into commercial or public-system supply. The reason to fix a defined period rather than “a reasonable transition” is that the statutory obligations do not pause: Brazil’s Lei 14.874/2024 Art. 33 lists exhaustive interruption grounds, and contract termination between a sponsor and its operator is not one of them.

    Should managed-access-program specialists require sponsor accession too?
    Yes, and for the same structural reason. A managed-access or expanded-access specialist occupies the same position as a regional operator: it is not the manufacturer, does not hold the marketing authorization, and cannot bear product-liability risk for the product. Whether the intermediary is a global access platform, a specialty distributor, or a regional CRO, the party with the statutory supply duty and the insurable product risk is the sponsor. Any access architecture that leaves the sponsor outside the contractual chain has a gap at exactly the point where a patient-harm claim would land.

    Working on a LATAM post-trial access program? bioaccess® is a US-headquartered, LATAM-native operator running regulatory, importadora, and 2–8 °C GDP cold-chain functions directly across the region. If you’re evaluating PTA feasibility in Argentina, Brazil, Chile, Peru, Panama, Mexico or Colombia, contact Julio Martinez-Clark, Co-Founder & CEO, at jmclark@bioaccessla.com or +1 (954) 903-7210. More at bioaccessla.com/roadmap.

    Sources

    • ICH E2A, Clinical Safety Data Management: Definitions and Standards for Expedited Reporting — https://database.ich.org/sites/default/files/E2A_Guideline.pdf
    • ICH E2F, Development Safety Update Report — https://database.ich.org/sites/default/files/E2F_Guideline.pdf
    • ICH E3, Structure and Content of Clinical Study Reports — https://database.ich.org/sites/default/files/E3_Guideline.pdf
    • Commission Decision 2003/490/EC of 30 June 2003 (Argentina adequacy) — https://eur-lex.europa.eu/legal-content/EN/TXT/HTML/?uri=CELEX:32003D0490
    • Argentina, Ley 25.326 (Protección de los Datos Personales) — https://servicios.infoleg.gob.ar/infolegInternet/anexos/60000-64999/64790/texact.htm
    • Argentina, AAIP Resolución 198/2023 (RESOL-2023-198-APN-AAIP, BO 18/10/2023), model international-transfer clauses — https://servicios.infoleg.gob.ar/infolegInternet/anexos/390000-394999/391538/norma.htm
    • Argentina, AAIP Resolución 198/2023 Anexo I (IF-2023-108581614-APN-DNPDP#AAIP) — https://servicios.infoleg.gob.ar/infolegInternet/anexos/390000-394999/391538/res198.pdf
    • Argentina, Disposición ANMAT 12792/2016 (post-study import procedure) — https://www.boletinoficial.gob.ar/detalleAviso/primera/154162/20161117
    • Argentina, Disposición ANMAT 7516/2025 (GCP, in force 1 December 2025) — https://www.boletinoficial.gob.ar/detalleAviso/primera/332695/20251009
    • Brazil, Lei nº 13.709/2018 (LGPD) — https://www.planalto.gov.br/ccivil_03/_ato2015-2018/2018/lei/l13709.htm
    • Brazil, Lei nº 14.874/2024, Arts. 30–37 — https://www.planalto.gov.br/ccivil_03/_ato2023-2026/2024/lei/l14874.htm
    • Brazil, Decreto nº 12.651/2025, Art. 31 — https://www2.camara.leg.br/legin/fed/decret/2025/decreto-12651-7-outubro-2025-798105-publicacaooriginal-176652-pe.html
    • Mexico, Ley Federal de Protección de Datos Personales en Posesión de los Particulares (DOF 20 March 2025; last reform DOF 14 November 2025) — https://www.diputados.gob.mx/LeyesBiblio/pdf/LFPDPPP.pdf
    • Chile, Ley 19.628 sobre Protección de la Vida Privada — https://www.bcn.cl/leychile/navegar?idNorma=141599
    • Chile, Ley 21.719 (published 13 December 2024; in force 1 December 2026) — https://www.bcn.cl/leychile/navegar?idNorma=1209272
    • Chile, Ley 20.850 and Código Sanitario Art. 111 C — https://www.bcn.cl/leychile/navegar?idNorma=1078148
    • Peru, Decreto Supremo N° 016-2024-JUS (Reglamento de la Ley 29733) — https://www.gob.pe/institucion/anpd/normas-legales/6554453-16-2024-jus
    • Peru, Reglamento de Ensayos Clínicos, DS 021-2017-SA, Arts. 115–118 — https://ensayosclinicos-repec.ins.gob.pe/images/Reglamento_de_EC.pdf
    • Colombia, Ley Estatutaria 1581 de 2012 — https://www.funcionpublica.gov.co/eva/gestornormativo/norma.php?i=49981
    • Panama, Decreto Ejecutivo No. 21 de 23 de abril de 2026, Art. 68, Gaceta Oficial Digital No. 30510-C (primary-source Gaceta PDF, read 6 September 2026)

  • Post-trial access in Brazil under Lei 14.874/2024 and Decreto 12.651/2025

    Brazil is the only Latin American country where free post-trial supply of an investigational product is an explicit, sponsor-funded statutory duty that reaches drugs, medical devices and advanced therapies alike. Brazil’s Ministry of Health puts it plainly: continued treatment after the study “não é uma expectativa, mas um dever legal” — not an expectation, but a legal duty (INAEP FAQ).

    The duty has two layers. Lei nº 14.874, de 28 de maio de 2024 — the Marco Legal de Pesquisa Clínica — created it in Chapter VI, Articles 30 to 37, entering into force 90 days after its 29 May 2024 publication under Article 65. Decreto nº 12.651, de 7 de outubro de 2025 supplied the mechanics, taking effect on publication in the Diário Oficial da União of 8 October 2025 under Article 41. Sponsors budgeting a Brazilian trial in 2026 budget against both.

    What the statute actually requires

    Chapter VI of Lei 14.874/2024 is titled “Da continuidade do tratamento pós-ensaio clínico,” and it front-loads the work. Article 30 requires the sponsor and the investigator, before the trial starts, to submit a plano de acesso pós-estudo to the research ethics committee, justifying whether free post-trial supply will be needed. If it will, Article 30 §1 requires a programa de fornecimento pós-estudo, and §2 requires that program to guarantee continued safety follow-up and receipt of the experimental treatment “por prazo determinado.” Article 30 §3 adds a scheduling constraint sponsors routinely miss: the program may only begin after regulatory approval, and the request must be filed early enough for participants to transition without a treatment gap.

    At the end of the trial, Article 31 requires an individual assessment for each participant, performed by the investigator with the sponsor and the participant heard. Under Article 31 §2, free supply is triggered whenever the investigational product is the best therapy for that participant’s condition and shows a more favorable risk-benefit ratio than available alternatives. Article 32 sets the four criteria: disease severity, availability of satisfactory alternatives in the participant’s locality, whether the product addresses an unmet clinical need, and whether evidence of benefit exceeds evidence of risk. Article 31 §3 and Article 34 §2 both provide that the participant “deverá migrar automaticamente” into the post-study program — migration is automatic, not opt-in.

    Article 31 of the Decreto: the operative sentence

    Decreto 12.651/2025 Article 31 states the duty in the language sponsors should quote in their own SOPs: the sponsor, after the trial ends, “deverá garantir aos participantes da pesquisa o fornecimento gratuito do produto sob investigação sempre que este for considerado pelo pesquisador responsável como a melhor alternativa terapêutica para a condição clínica do participante, com base em evidências disponíveis e em avaliação favorável da relação risco-benefício.”

    Two details matter. First, the decree says produto sob investigação — investigational product — not medicamento. Second, Article 31 §1 requires the program to be drafted by the sponsor and submitted to the competent CEP, and to contain the supply strategy for the period after individual participation ends. Article 31 §2 reserves the detailed guidelines to a future norm from the Instância Nacional de Ética em Pesquisa.

    Brazil’s Ministry of Health has already closed the obvious loophole. Asked whether the program can simply be notified, the INAEP FAQ answers: “Deve ser submetido para avaliação do CEP competente. Não basta notificar” (INAEP FAQ on submission). Pending the INAEP norm, the same page recommends a minimum submission package: program description, technical and risk-benefit justification, inclusion and maintenance criteria, a participant safety follow-up plan, expected supply duration and termination conditions under Article 33, allocation of sponsor, investigator and institution responsibilities, care-transition strategy, and whether ANVISA authorization is required.

    Who pays, and for how long

    Cost allocation is unambiguous. Lei 14.874/2024 Article 31 §4 states that where continued treatment with the experimental drug is necessary after trial end, “o fornecimento do medicamento será de responsabilidade do patrocinador.” Article 34 §1 repeats that the sponsor guarantees free post-trial supply, and Decreto 12.651/2025 Article 31 says fornecimento gratuito. ANVISA’s own RDC nº 38, de 12 de agosto de 2013 Article 18 assigns the sponsor complete free treatment (inciso I), product custody and storage (II), a bar on commercializing the product (III), and funding of integral assistance for complications arising from its use (VI). Article 35 §2 of the statute separately makes the sponsor responsible for care needed because of study-caused reactions.

    Duration is where Brazil diverges from every other regime in the region. Article 33 permits interruption only on seven grounds, each requiring a justification submitted to the CEP: participant decision, cure or introduction of a satisfactory alternative, absence of continued benefit, a disqualifying adverse reaction, technical or safety impossibility of manufacture (provided the sponsor supplies an equivalent or better marketed alternative), inciso VI “transcurso do prazo de 5 (cinco) anos, contado da disponibilidade comercial do medicamento experimental no País,” and inciso VII availability in the public health network.

    Inciso VI carries visible veto history: the Planalto text shows “VI – (VETADO)” immediately followed by the five-year text marked “(Promulgação partes vetadas)” — the vetoed passage was subsequently promulgated. The practical effect is that the five-year clock only starts when the product becomes commercially available in Brazil. A sponsor that never commercializes there, or commercializes late, has no five-year backstop running in its favor. The exposure terminates on clinical or supply events, not on a date fixed at trial close.

    Devices and advanced therapies are in scope

    Article 37 of Lei 14.874/2024 is one sentence, and it is why MedTech and cell-and-gene sponsors cannot treat this as a pharma-only issue: “Aplicar-se-ão aos produtos e dispositivos médicos e aos produtos de terapias avançadas experimentais, objeto de ensaio clínico, as disposições deste Capítulo, no que couber.” The whole post-trial chapter applies to medical devices and experimental advanced therapy products, insofar as applicable. Decreto 12.651/2025 Article 31 reinforces this by using produto sob investigação.

    The caveat is operational, not legal: RDC 38/2013 was written in 2013 and speaks only of medicamento. ANVISA maintains a separate service channel for advanced-therapy product programs, but there is no equivalent device-specific post-study petition. For an implantable or an active device, the statutory duty exists while the import and dispensing pathway has to be built from the trial’s own authorization documents — a problem to solve in the protocol, not at trial close.

    CEP, ANVISA and INAEP: three approvals, three functions

    Lei 14.874/2024 Article 5 splits Brazil’s Sistema Nacional de Ética em Pesquisa into a national ethics instance and the CEPs. In post-trial access, the division of labor is:

    • CEP — approves the pre-trial plan (Art. 30), the post-study program (Decreto Art. 31 §1), and any interruption justification (Art. 33). The INAEP FAQ states this is, as a rule, the coordinating centre’s CEP.
    • ANVISA — Article 34 §3 requires that importation and dispensing during the post-study program be previously authorized by the competent sanitary authority.
    • INAEP — the Instância Nacional de Ética em Pesquisa issues ethics norms, credentials and accredits CEPs, and acts as appellate instance over CEP decisions (Art. 8). Decreto Article 31 §2 assigns it the post-study guidelines.

    INAEP became operational during 2026. It adopted its internal regulation by Resolução nº 1 of 2 April 2026 and transitional CEP accreditation procedures by Resolução RCI nº 2 of 8 May 2026 (INAEP legislation index), and held its first ordinary meeting with full membership in Brasília on 14 August 2026, seating 15 titular and 15 alternate members from the scientific community alongside representatives of ANVISA, the Conselho Nacional de Saúde and three ministries (Ministério da Saúde). No post-study-specific INAEP norm appears in its legislation index yet. Two transitional rules still shape practice: Decreto Article 39 keeps Conselho Nacional de Saúde norms valid until INAEP replaces them, and Article 40 keeps CONEP as the appellate instance until INAEP’s members are seated.

    The import mechanism

    For medicines, RDC 38/2013 is still the operative instrument — ANVISA’s own programas assistenciais page lists post-study supply as one of three assistance programs under it. The sequence:

    1. The sponsor or a contracted organização representativa do patrocinador (ORP) files the anuência request with ANVISA (Art. 4).
    2. For post-study supply specifically, ANVISA does not issue a comunicado especial. Article 3 §2 provides that it issues “um ofício autorizando o fornecimento.”
    3. The import licence (LI) is filed on the RDC 39/2008 form and, per Article 16 parágrafo único, may be filed together with the anuência process.
    4. The dossier per Anexo I §IV is the Anexo IV petition form, the sponsor’s Anexo VI commitment declaration, the physician’s Anexo VII declaration, the physician’s CV, the Anexo VIII import quantity estimate, and the comunicado especial that authorized the trial.
    5. Post-anuência, imports follow the trial’s own comunicado especial or import document, and under Orientação de Serviço nº 01/2020 no pre-shipment authorization is required.
    6. Reporting continues: annual reports from the date of anuência, a final report within 90 days of program close, discontinuation notice within 60 days, and serious adverse event notification within 15 calendar days, or 7 in case of death (Arts. 17 and 18).

    On timing, ANVISA’s service pages state an average of 20 calendar days for the medicines and biologics post-study petition service and 10 calendar days for advanced therapies. Those are service-level averages, not statutory deadlines — RDC 38/2013 sets no analysis period. Treat the CEP submission and the ANVISA filing as parallel critical-path items.

    One watch item: ANVISA Consulta Pública nº 1.210/2023 proposed a risk-based revision of RDC 38/2013 allowing the post-study program to proceed by notification. Comments closed 2 January 2024 and the revision has not been finalized. The same notice disclosed that between 2019 and 2023 ANVISA received 256 post-study supply requests, alongside 558 compassionate use and 41 expanded access requests.

    Brazil converts post-trial access from an ethics-committee expectation into a balance-sheet item with an indeterminate end date. The cost driver is not the product; it is the tail — free supply, cold-chain distribution, pharmacovigilance, ANVISA reporting and CEP maintenance running until one of seven Article 33 events occurs, with the five-year clock not starting until Brazilian commercial availability. Price that tail in the Article 30 pre-trial plan, decide in the protocol how a device or advanced therapy will physically be imported and dispensed post-close, and treat the eventual INAEP norm under Decreto Article 31 §2 as a change-control trigger.

    Working on a LATAM post-trial access program? bioaccess® is a US-headquartered, LATAM-native operator running regulatory, importadora, and 2–8 °C GDP cold-chain functions directly across the region. If you’re evaluating PTA feasibility in Brazil or elsewhere in Latin America, contact Julio Martinez-Clark, Co-Founder & CEO, at jmclark@bioaccessla.com or +1 (954) 903-7210. More at bioaccessla.com/roadmap.

    Frequently asked questions

    Does Brazil require post-trial access?
    Yes, as a matter of statute. Lei 14.874/2024 Chapter VI (Arts. 30–37) and Decreto 12.651/2025 Article 31 require the sponsor to guarantee free continued supply of the investigational product to participants whenever the responsible investigator considers it the best therapeutic alternative for that participant’s clinical condition and the risk-benefit assessment is favorable. Brazil’s Ministry of Health describes this as “não é uma expectativa, mas um dever legal.” The obligation begins before the trial does: Article 30 requires a post-study access plan to be filed with the research ethics committee before enrollment starts.

    What is Lei 14.874/2024?
    Lei nº 14.874 of 28 May 2024 is Brazil’s Marco Legal de Pesquisa Clínica, the statute governing research with human subjects. It created the Sistema Nacional de Ética em Pesquisa com Seres Humanos, split into a national ethics instance and the CEPs, and devoted Chapter VI to continuity of treatment after the clinical trial. It entered into force 90 days after its 29 May 2024 official publication under Article 65. Its post-trial provisions replaced a regime that previously rested largely on Conselho Nacional de Saúde resolutions.

    What is Decreto 12.651/2025?
    Decreto nº 12.651 of 7 October 2025 is the implementing decree for Lei 14.874/2024. It took effect on publication in the Diário Oficial da União of 8 October 2025 under Article 41. Article 31 restates the sponsor’s free-supply duty using the broader phrase produto sob investigação, requires the sponsor to draft the post-study access program and submit it to the competent CEP with its supply strategy, and reserves detailed elaboration and review guidelines to a future INAEP norm. Articles 39 and 40 set transitional rules preserving CNS norms and CONEP’s appellate role.

    Who pays for post-trial supply in Brazil?
    The sponsor, exclusively and free of charge to the participant. Lei 14.874/2024 Article 31 §4 provides that supply of the medicine is the sponsor’s responsibility; Article 34 §1 requires the sponsor to guarantee free post-trial supply; and Decreto 12.651/2025 Article 31 uses fornecimento gratuito. RDC 38/2013 Article 18 adds that the sponsor must fund complete free treatment, keep the product properly stored, refrain from commercializing it, and fund integral assistance for complications arising from its use. Article 35 §2 of the statute separately covers care for study-caused reactions.

    How long must sponsors provide post-trial access in Brazil?
    There is no fixed end date. Lei 14.874/2024 Article 33 allows interruption only on seven grounds, each requiring justification submitted to the CEP: participant decision, cure or a satisfactory alternative, absence of continued benefit, a disqualifying adverse reaction, technical or safety impossibility of manufacture with an equivalent alternative supplied, five years counted from commercial availability in Brazil, or availability in the public health network. Because the five-year clock starts at Brazilian commercial availability rather than trial close, the practical tail is the longest in Latin America.

    Does Brazil PTA apply to medical devices?
    Yes. Article 37 of Lei 14.874/2024 extends the entire post-trial chapter to produtos e dispositivos médicos used in clinical trials, insofar as applicable, and Decreto 12.651/2025 Article 31 speaks of the investigational product rather than the medicine. The operational gap is that ANVISA’s RDC 38/2013 assistance-program framework addresses medicamento only, so device sponsors have a clear statutory duty but must build the post-close import and dispensing route from the trial’s own authorization documents. Resolve this in the protocol, not at close-out.

    Does Brazil PTA apply to advanced therapy medicinal products (ATMPs)?
    Yes. Article 37 names produtos de terapias avançadas experimentais alongside devices, so the post-trial chapter applies to cell, gene and tissue-engineered investigational products insofar as applicable. Unlike devices, ATMPs have a dedicated ANVISA service channel for compassionate use, expanded access and post-study supply of advanced therapy products, for which ANVISA states an average service time of 10 calendar days. Lei 14.874/2024 Article 28 §2 separately requires that import and export of experimental advanced therapies be authorized under specific regulation.

    What is INAEP and what role does it play?
    INAEP is the Instância Nacional de Ética em Pesquisa, the national ethics instance created by Lei 14.874/2024 Article 5 and structured by Decreto 12.651/2025. Under Article 8 of the statute it issues research ethics norms, credentials and accredits CEPs, monitors and inspects them, and serves as appellate instance over CEP decisions. For post-trial access specifically, Decreto Article 31 §2 assigns INAEP the complementary guidelines for preparing, presenting and ethically reviewing the post-study plan and program. INAEP adopted its internal regulation on 2 April 2026 and held its first full-membership ordinary meeting on 14 August 2026.

    What is the import mechanism for post-trial supply in Brazil?
    For medicines, ANVISA RDC 38/2013. The sponsor or a contracted ORP files an anuência request; for post-study supply ANVISA issues not a comunicado especial but “um ofício autorizando o fornecimento” (Art. 3 §2). The import licence is filed on the RDC 39/2008 form and may be submitted together with the anuência process (Art. 16). The Anexo I §IV dossier comprises the Anexo IV petition, the sponsor’s Anexo VI and physician’s Anexo VII declarations, the physician’s CV, the Anexo VIII quantity estimate, and the trial’s comunicado especial. Lei 14.874/2024 Article 34 §3 makes this prior authorization mandatory.

    How does Brazil’s 5-year commercial-availability tail work in practice?
    Article 33 inciso VI permits interruption after “transcurso do prazo de 5 (cinco) anos, contado da disponibilidade comercial do medicamento experimental no País.” The trigger is Brazilian commercial availability, not trial completion, marketing authorization elsewhere, or first commercial sale in another market. A sponsor that obtains ANVISA registration but delays Brazilian launch delays the start of its own five-year clock. Sponsors that never commercialize in Brazil cannot rely on inciso VI at all and must exit through one of the other six grounds, each of which requires a CEP-reviewed justification.

    Sources

    • Lei nº 14.874, de 28 de maio de 2024 (Marco Legal de Pesquisa Clínica), Arts. 5, 8, 28, 30–37, 65 — https://www.planalto.gov.br/ccivil_03/_ato2023-2026/2024/lei/l14874.htm
    • Decreto nº 12.651, de 7 de outubro de 2025, Arts. 3, 30–31, 39–41 — https://www2.camara.leg.br/legin/fed/decret/2025/decreto-12651-7-outubro-2025-798105-publicacaooriginal-176652-pe.html
    • ANVISA RDC nº 38, de 12 de agosto de 2013, Arts. 1–4, 15–18, 26, Anexo I §IV — https://anvisalegis.datalegis.net/action/ActionDatalegis.php?acao=abrirTextoAto&tipo=RDC&numeroAto=00000038&seqAto=000&valorAno=2013&orgao=RDC/DC/ANVISA/MS&codTipo=&desItem=&desItemFim=&cod_menu=1696&cod_modulo=134&pesquisa=true
    • Ministério da Saúde / INAEP FAQ, “O acesso (fornecimento) pós-estudo é opcional? Como a regra funciona?” (20 Feb 2026) — https://www.gov.br/saude/pt-br/composicao/orgaos-colegiados/inaep/faq/faq/acesso-pos-estudo/o-acesso-fornecimento-pos-estudo-e
    • Ministério da Saúde / INAEP FAQ, “O programa de acesso pós-estudo deve ser submetido para aprovação ou basta notificar?” (20 Feb 2026) — https://www.gov.br/saude/pt-br/composicao/orgaos-colegiados/inaep/faq/faq/acesso-pos-estudo/o-programa-de-acesso-pos-estudo
    • Ministério da Saúde / INAEP, Legislação (Resolução nº 1 of 2 Apr 2026; Resolução RCI nº 2 of 8 May 2026) — https://www.gov.br/saude/pt-br/composicao/orgaos-colegiados/inaep/legislacao
    • Ministério da Saúde, “Inaep amplia colegiado com especialistas de diferentes regiões do Brasil” (18 Aug 2026) — https://www.gov.br/saude/pt-br/assuntos/noticias-ms/2026/agosto/inaep-amplia-colegiado-com-especialistas-de-diferentes-regioes-do-brasil
    • ANVISA, Programas assistenciais (RDC 38/2013 programs; Orientação de Serviço nº 01/2020) — https://www.gov.br/anvisa/pt-br/assuntos/medicamentos/pesquisaclinica/programas-assistenciais
    • gov.br service, “Solicitar autorização para uso compassivo, acesso expandido e fornecimento de medicamentos e produtos biológicos pós-estudo” — https://www.gov.br/pt-br/servicos/solicitar-autorizacao-para-uso-compassivo-acesso-expandido-e-fornecimento-de-medicamentos-e-produtos-biologicos-pos-estudo
    • gov.br service, “Solicitar autorização para uso compassivo, acesso expandido e fornecimento de produtos de terapias avançadas” — https://www.gov.br/pt-br/servicos/solicitar-autorizacao-para-uso-compassivo-acesso-expandido-e-fornecimento-de-produtos-de-terapias-avancadas
    • ANVISA, “Anvisa abre consulta pública sobre programas assistenciais” (Consulta Pública nº 1.210/2023) — https://www.gov.br/anvisa/pt-br/assuntos/noticias-anvisa/2023/anvisa-abre-consulta-publica-sobre-programas-assistenciais

  • Post-trial access in Latin America: the operator’s map

    Ten Latin American countries legally require a trial sponsor to keep supplying the investigational product after the study closes. Three more address post-trial continuation in binding instruments with weak or unassigned duties. Seven impose nothing. If your Phase 3 has LATAM sites, that distinction is a line item, not an ethics footnote.

    We built this map because the region is now diverging fast. Brazil enacted a statute in 2024 and its regulation in 2025. Honduras went from zero to a mandate in February 2026. Panama replaced its research decree in April 2026. Meanwhile most global vendor and law-firm summaries still cite instruments that have been repealed, and several repeat citation errors that a regulator would catch on the first review cycle.

    Where the mandates actually are

    Across 20 jurisdictions, the classification breaks down as follows.

    Binding statutory mandate (10): Argentina, Brazil, Chile, Peru, Ecuador, Costa Rica, Guatemala, Honduras, Nicaragua, Panama. Each has a law, decree, resolution or ministerial normativa that obliges continued provision of the investigational product after the trial ends.

    Binding instrument, weak or unassigned duty (3): Uruguay, Bolivia, Venezuela. Venezuela’s Buenas Prácticas Clínicas §6.12.1 requires the sponsor only to “procurar… la provisión del tratamiento” after the trial — endeavour, not provide (INHRR). Uruguay’s Decreto 158/019 Anexo numeral 24 says participants “deben tener la certeza de que contarán con los beneficios demostrados” but names no obligor at all (IMPO). Bolivia’s Art. 99 routes continuation entirely into the compassionate-use chapter, requiring per-patient DINAMED authorization (AGEMED).

    No mandate (7): Mexico, Colombia, Paraguay, El Salvador, Dominican Republic, Cuba, Puerto Rico. In each case we read the operative clinical-trial instrument and it contains no post-trial supply obligation.

    The comparative matrix

    Country Mandate status Primary instrument Cost allocation Import mechanism
    Argentina Binding statute Disp. ANMAT 12792/2016; GCP base reset by Disp. 7516/2025 Sponsor, free to participant, site and payer (Art. 3(g)) Dedicated PTA import expediente to ANMAT–DERM, valid 12 months (Art. 4); physical import via INAME (Art. 5)
    Brazil Binding statute Lei 14.874/2024 Arts. 30–37 + Decreto 12.651/2025 Art. 31 Sponsor (Lei Art. 31 §4); free supply (Decreto Art. 31) ANVISA authorization + import licence under RDC 38/2013
    Chile Binding statute Ley 20.850 Art. 17; Cód. Sanitario Art. 111 C “Sin costo para el paciente”; duty on provisional-authorization holder, then registration holder ISP special provisional-use authorization (Art. 111 A); CENABAST exceptional import
    Peru Binding statute DS 021-2017-SA Arts. 115–118 Sponsor-funded, provided free (Arts. 40(p), 89) OGITT extension trial or case-by-case ANM/DIGEMID authorization (Art. 116) with a seven-document set (Art. 117)
    Panama Binding statute Decreto Ejecutivo 21/2026 Art. 68, Gaceta Oficial 30510-C, 23 Apr 2026 Investigators and sponsors co-obligated to ensure access; cost not stated verbatim Extension of the trial import permit for exclusive participant use (Art. 68); RESEGIS registration + DNFD authorization (Art. 99)
    Ecuador Binding statute AM 00069-2024 Arts. 80–81, 95(c) Sponsor or legal representative, “entrega gratuita” (Art. 80) No PTA-specific route; general ARCSA import authorization
    Costa Rica Binding statute Ley 9234 Arts. 28, 53(k) Sponsor, free, “mientras lo requieran” None identified in the statute for post-trial product
    Guatemala Binding statute (instrument version unconfirmed) AM 82-2019 Art. 64; MSPAS index lists AM 206-2021 Supply “podrá ser solicitada al patrocinador” — request-driven, not automatic Compassionate-use authorization by the DRCPFA (Art. 65)
    Honduras Binding statute (new) Acuerdo 0256-ARSA-2025 Art. 63 Sponsor or legal representative, “sin costo” (Art. 63) Extension trial or compassionate use (Art. 63); special ARSA import authorization (Art. 86)
    Nicaragua Binding statute Normativa-166 Cap. VI num. 16 Sponsor obliged; free-of-charge stated for the trial phase only General trial import rules; no PTA route
    Uruguay Binding guidance Decreto 158/019 Anexo num. 24 No obligor named n.a.
    Bolivia Binding guidance Norma para Estudios Clínicos Art. 99 → Arts. 74–76 Not allocated post-trial Per-patient DINAMED compassionate-use authorization
    Venezuela Binding guidance Normas de BPC §§5.4.5, 6.12.1 Free during trial only; post-trial duty is “procurar” None described
    Mexico No mandate for product supply NOM-012-SSA3-2012 §11.2.2 Investigator must arrange continued “tratamiento y cuidados” — not IP supply n.a.
    Colombia No mandate Res. 2378/2008 n.a. n.a.
    Paraguay No mandate Resol. DINAVISA 238/2024 n.a. n.a.
    El Salvador No mandate Lineamientos Técnicos, Ac. Ejec. 1530 (2025) n.a. n.a.
    Dominican Republic No mandate Manual CONABIOS, 2ª ed. n.a. — §7.1 gives an information right only n.a.
    Cuba No mandate BPC en Cuba (CECMED) n.a. — §4.3.2 covers adverse-event medical care only n.a.
    Puerto Rico (US) No mandate 21 CFR 312 Subpart I n.a. — permissive expanded-access framework n.a. (US customs territory)

    Why this is a closing cost, not an ethics footnote

    A sponsor that runs sites in Brazil, Chile, Peru, Panama and Argentina and then closes the study has, in five jurisdictions, a legally enforceable duty to keep shipping product to responders — free of charge, under separate authorizations, for a period the sponsor does not control.

    Brazil’s Ministry of Health states the position without hedging: continued post-study treatment “não é uma expectativa, mas um dever legal, aplicável desde o planejamento da pesquisa até o período pós-estudo” (INAEP FAQ). That duty is priced nowhere in a standard Phase 3 budget. It requires a cohort-scale filing distinct from the trial dossier, an import authorization with its own clock, GDP-compliant cold chain for as long as the cohort persists, and pharmacovigilance reporting after database lock.

    The obligation also survives corporate events. Chile’s Código Sanitario Art. 111 C states the duty “afectará al titular del registro sanitario, aun cuando no haya sido el titular de la autorización provisional o haya adquirido con posterioridad el registro sanitario” (BCN). Buy a Chilean registration and you buy the free-supply obligation attached to it. That belongs in diligence, not in a site-activation checklist.

    The five strongest sponsor obligations

    Brazil. Lei 14.874/2024 Art. 30 requires the sponsor and investigator to file a post-study access plan with the CEP before the trial starts. Art. 31 §4 puts the cost on the sponsor. Art. 33 permits interruption only on listed grounds, including the “transcurso do prazo de 5 (cinco) anos, contado da disponibilidade comercial do medicamento experimental no País.” Decreto 12.651/2025 Art. 31 restates the free-supply duty whenever the investigator judges the product the best therapeutic alternative. Full detail in our Brazil post-trial access pillar.

    Chile. Art. 111 C obliges continuity “sin costo para el paciente… por todo el tiempo que persista su utilidad terapéutica” — no commercialization endpoint, no five-year cap. See the Chile Ley 20.850 analysis.

    Panama. Article 68 of Decreto Ejecutivo 21/2026 (Gaceta Oficial 30510-C, 23 April 2026) reads: “Los investigadores y patrocinadores deben asegurar a todos los participantes el acceso al producto, siempre que se haya comprobado el beneficio clínico o de salud pública de la intervención durante el estudio; hasta su comercialización en el país.” It then requires the sponsor to apply for “una extensión del permiso de importación del producto utilizado durante la investigación para uso exclusivo de los participantes.” The decree entered into force on promulgation under Art. 105. Detail in the Panama Decreto 21/2026 pillar.

    Argentina. Disposición ANMAT 12792/2016 is the only instrument in the region that is purely a post-trial access import procedure. Art. 3(g) requires a sworn sponsor declaration that supply will be “sin costo alguno para el participante, el establecimiento asistencial o su cobertura de salud” — note that the site and the payer are named, not just the patient. Art. 4 gives the DERM authorization a 12-month validity. Art. 2 excludes authorized extension studies, which run on a different track. See the Argentina Disposición 12792 pillar.

    Peru. DS 021-2017-SA is the best-drafted operational regime in the region: Art. 115 defines the obligation and its trigger conditions, Art. 116 names two authorization routes (OGITT extension trial or case-by-case ANM/DIGEMID authorization), Art. 117 lists the documents, Art. 118 assigns post-access pharmacovigilance. Art. 40(p) makes it a sponsor duty. See the Peru DS 021-2017-SA pillar.

    Where the duty reaches devices

    Most LATAM post-trial provisions were drafted for medicines. Four jurisdictions reach hardware textually.

    Costa Rica is the clearest. Ley 9234 Art. 53(k) obliges the sponsor to provide, free of charge and after the study concludes, “el medicamento, dispositivo o procedimiento que ha sido objeto de investigación,” with four exhaustive exits — including a reasoned treating-physician resolution filed in the record and communicated to the CEC within three working days. Art. 28 sets the duration at “mientras lo requieran.”

    Brazil reaches devices through Lei 14.874/2024 Art. 37: “Aplicar-se-ão aos produtos e dispositivos médicos e aos produtos de terapias avançadas experimentais… as disposições deste Capítulo, no que couber.” Chile reaches them through Código Sanitario Art. 111 A, which covers “los productos farmacéuticos y los elementos de uso médico.” Peru reaches them through the definition of producto en investigación in Art. 2.1.36.

    Ecuador does not. AM 00069-2024 is a reglamento for medicines and processed natural medicinal products, so a device sponsor’s Ecuadorian exposure runs through ethics-committee expectations and the informed consent, not through Arts. 80–81.

    What changed between 2024 and 2026

    Honduras added a mandate. Acuerdo 0256-ARSA-2025 Art. 63 defines post-trial access as “la entrega sin costo por parte del patrocinador o su representante legal,” even where the product has no Honduran sanitary registration, subject to three cumulative conditions. Published in La Gaceta on 28 January 2026, in force 30 days later. The predecessor Acuerdo 041-2020 had no post-trial provision at all. Read Art. 63 alongside Art. 18 numeral 5, which softens the duty to facilitating access “cuando el patrocinador lo considere” — a real internal tension, and a reason not to treat Honduras as equivalent to Brazil.

    Panama replaced its research decree. Decreto Ejecutivo 21/2026 reglamenta Titles III and IV of Ley 84 de 14 de mayo de 2019 and entered into force on promulgation, 23 April 2026. Its Art. 104 repeals Decreto Ejecutivo 1843 of 2014, Decreto Ejecutivo 6 of 2015 and Resolución 390 of 2003.

    Ecuador deleted its endpoint. AM 00069-2024 Art. 80 states the free-supply duty with no termination point. The repealed AM 0075-2017 had capped it: Art. 39(w) ran only “hasta que el producto se comercialice en el país” (MSP Ecuador). Art. 81 narrowed the trigger to three cumulative conditions while the duration became open-ended. Almost nobody has flagged that trade.

    Brazil completed a two-step build. Statute in 2024, regulation in 2025, with further INAEP guidance promised by Decreto 12.651/2025 Art. 31 §2.

    Argentina reset its GCP base. Disposición 7516/2025 took effect 1 December 2025 (Art. 8). Its Art. 7 repealed Disposiciones 6677/10, 4008/17, 9929/19 and 2172/25 plus Circulares 0001/11 and 004/18. Disp. 12792/2016 is absent from that repeal list, so the post-trial import procedure stands — but the substantive continuity duty moved into the new GCP annex, and sponsors are filing against instruments that no longer exist. The legal architecture of LATAM PTA piece works through how the obligation layer and the import layer interact.

    Colombia: no binding post-trial access statute

    We read Resolución 2378 de 2008 and Resolución 8430 de 1993 in full, checking expressly for post-trial supply language. Neither contains any. Res. 8430/1993 allocates only harm-related costs — Art. 13 medical care for research-related injury, Art. 15(j) treatment availability and indemnification, Art. 15(k) additional costs against the research budget.

    That makes Colombia a cost-certainty jurisdiction: no statutory tail obligation, no separate post-trial filing, no open-ended supply exposure. It does not make post-trial access impossible. A sponsor that wants to continue supplying responders in Colombia can run a voluntary continuity program on its own initiative, handled through the ethics committee, the informed consent and the general product import rules. The exposure is contractual and reputational rather than statutory, which means it has to be allocated in the CRO and site agreements rather than assumed away.

    Mexico sits in an adjacent position and is routinely misdescribed. NOM-012-SSA3-2012 §11.2.2 obliges “el investigador principal” to arrange continuation of “el tratamiento y cuidados” to prevent withdrawal effects. That is an investigator duty about care, not a sponsor duty to supply the investigational product.

    What sponsors get wrong

    Citing repealed instruments. Argentina’s Disp. 6677/2010, which historically carried the continuity obligation, is repealed. Ecuador’s AM 0075-2017 is repealed. Honduras’s Acuerdo 041-2020 is revoked in its entirety. Panama’s Decreto Ejecutivo 1843/2014 and 6/2015 are repealed. Filings and legal memos still quote all of them.

    The “Ley 419/2023” error. Panama’s medicines statute is Ley 419 of 1 February 2024, not 2023 — and it is a commercial-medicines law, not the post-trial access instrument. The binding post-trial duty sits in Decreto Ejecutivo 21/2026 Art. 68, under Ley 84 of 2019. Getting this wrong signals to a Panamanian reviewer that the filer has not read the current framework.

    Treating Argentina’s RAEM as post-trial access. Disposición 4616/2019 approves the Régimen de Accesibilidad de Excepción a Medicamentos: an individual-patient exceptional import route with 90-day, 180-day and one-year quantity windows (Boletín Oficial). It contains no reference to clinical trials or post-trial access. Filing a trial cohort through RAEM means one expediente per patient, per renewal, on the wrong legal basis. Cohort post-trial access in Argentina runs on Disp. 12792/2016.

    Assuming an obligation implies a pathway. Costa Rica mandates continued free provision of the device or medicine under Art. 53(k), but Art. 55 addresses importation only before an approved study begins. No post-trial import route is identified in the statute. Ecuador and Nicaragua have the same shape. The obligation is real; the mechanism has to be constructed.

    The fastest route to compliance

    For a sponsor closing a multi-country LATAM Phase 3, the sequence that works is: classify each participating country into mandate / soft / none using the operative current instrument; identify which mandate countries require a filing distinct from the trial dossier (Argentina, Brazil, Panama, Peru at minimum); confirm whether your product class is textually in scope, which matters most for devices; establish who the legal importer of record will be in each country, since the trial import authorization frequently expires with the trial; and only then estimate cohort size, duration and cold-chain cost. Countries with no mandate still need a documented position, because the ethics committee and the informed consent will ask.

    Working on a LATAM post-trial access program? bioaccess® is a US-headquartered, LATAM-native operator running regulatory, importadora, and 2–8 °C GDP cold-chain functions directly across the region. If you’re evaluating PTA feasibility in Argentina, Brazil, Chile, Peru, Panama, Costa Rica or elsewhere in Latin America, contact Julio Martinez-Clark, Co-Founder & CEO, at jmclark@bioaccessla.com or +1 (954) 903-7210. More at bioaccessla.com/roadmap.

    Frequently Asked Questions

    Which Latin American countries require post-trial access?
    Ten jurisdictions impose a binding statutory duty: Argentina, Brazil, Chile, Peru, Ecuador, Costa Rica, Guatemala, Honduras, Nicaragua and Panama. Three more — Uruguay, Bolivia and Venezuela — address post-trial continuation in binding instruments but with weak verbs, no named obligor, or routing into per-patient compassionate use. Seven impose nothing: Mexico, Colombia, Paraguay, El Salvador, the Dominican Republic, Cuba and Puerto Rico. The classification depends on reading the operative current instrument, not a secondary summary, because five of these countries changed their framework between 2024 and 2026.

    Which LATAM country has the strongest post-trial access mandate?
    Brazil. Lei 14.874/2024 Art. 30 requires a post-study access plan to be filed with the ethics committee before the trial begins, Art. 31 §4 assigns the cost to the sponsor, and Art. 33 permits interruption only on listed grounds — one of which is the passage of five years from the product’s commercial availability in Brazil. Decreto 12.651/2025 Art. 31 restates the free-supply duty. Brazil’s Ministry of Health describes this as a legal duty rather than an expectation. Chile is the closest runner-up because Art. 111 C has no endpoint at all and the obligation follows the sanitary registration to any subsequent holder.

    Does post-trial access in LATAM apply to medical devices or only drugs?
    Both, in four jurisdictions. Costa Rica’s Ley 9234 Art. 53(k) is the most explicit, obliging free post-study provision of “el medicamento, dispositivo o procedimiento.” Brazil extends its post-trial chapter to devices and advanced therapies through Lei 14.874/2024 Art. 37. Chile’s Código Sanitario Art. 111 A covers “elementos de uso médico.” Peru’s definition of producto en investigación in DS 021-2017-SA Art. 2.1.36 includes devices. Ecuador’s AM 00069-2024 does not cover devices. Argentina’s Disp. 12792/2016 covers products and “materiales” without using the word dispositivo médico, so device coverage there is inferential.

    Which LATAM countries do NOT require post-trial access?
    Mexico, Colombia, Paraguay, El Salvador, the Dominican Republic, Cuba and Puerto Rico. Colombia’s Resoluciones 2378/2008 and 8430/1993 contain no post-trial supply obligation; Res. 8430/1993 allocates only harm-related costs. Mexico’s NOM-012-SSA3-2012 §11.2.2 imposes a continuity duty on the principal investigator covering treatment and care, not on the sponsor to supply the investigational product. Notably, both Paraguay (2024) and El Salvador (2025) rewrote their research frameworks in this window and declined to add a post-trial provision, which cuts against the assumption that the whole region is converging on mandatory access.

    What changed in LATAM post-trial access regulation in 2024-2026?
    Five substantive moves. Brazil completed a two-step build with Lei 14.874/2024 and Decreto 12.651/2025. Ecuador’s AM 00069-2024 repealed AM 0075-2017 and deleted the “until commercialized in the country” endpoint, converting a bounded duty into an open-ended one. Argentina’s Disposición 7516/2025 took effect 1 December 2025 and repealed Disp. 6677/10 among others, resetting the GCP base while leaving the 2016 post-trial import procedure standing. Honduras moved from no mandate to a binding mandate via Acuerdo 0256-ARSA-2025 Art. 63, in force from late February 2026. Panama’s Decreto Ejecutivo 21/2026 entered into force 23 April 2026 with a binding post-trial duty in Art. 68.

    What is the difference between cohort PTA (Argentina) and individual expanded access (RAEM)?
    They are separate legal regimes with separate instruments. Post-trial access under Disposición ANMAT 12792/2016 is a cohort-level procedure: one expediente covering the named participants from an ANMAT-authorized trial, approved by the ethics committee, filed with the Dirección de Evaluación y Registro de Medicamentos, with a 12-month import authorization under Art. 4. The Régimen de Accesibilidad de Excepción a Medicamentos under Disposición 4616/2019 is an individual-patient exceptional import route with 90-day, 180-day and one-year quantity limits, and it makes no reference to clinical trials. Using RAEM for a trial cohort produces per-patient filings on the wrong basis.

    Who pays for post-trial access in Latin America?
    The sponsor, in every country where the duty is clearly allocated. Brazil’s Lei 14.874/2024 Art. 31 §4 puts the supply on the sponsor. Peru’s DS 021-2017-SA Art. 89 requires products to be sponsor-financed and provided free. Costa Rica’s Ley 9234 Art. 53(k) and Ecuador’s AM 00069-2024 Art. 80 both name the sponsor. Chile’s Art. 111 C places the duty on the provisional-authorization holder and then the registration holder. Argentina goes furthest: Disp. 12792/2016 Art. 3(g) requires a sworn declaration that supply carries no cost to the participant, the treating institution or the health coverage. Uruguay, Bolivia, Nicaragua and Honduras leave the cost-bearer partly or wholly unstated.

    How does a sponsor find a qualified PTA operator in Latin America?
    Test three capabilities separately. First, regulatory: can the operator file the country-specific post-trial authorization itself, naming the correct current instrument and article, rather than subcontracting it blind. Second, importation: can it act as legal importer of record after the trial import authorization lapses, which it does in several countries. Third, distribution: can it hold and ship the product under 2–8 °C GDP conditions for the life of the cohort, with pharmacovigilance reporting after database lock. Global post-trial supply vendors market the service regionally without naming Latin American countries or local filing capability on their public pages, so ask for the specific article and the specific authorizing office.

    What is the fastest route to compliance for a sponsor closing a multi-country LATAM Phase 3?
    Start from the operative instrument in each participating country, not from a regional summary. Classify each country as binding mandate, weak instrument or no mandate; determine which mandate countries require a filing distinct from the trial dossier — Argentina, Brazil, Panama and Peru at minimum; confirm your product class is textually in scope, which is the decisive question for devices; appoint a legal importer of record in each country because trial import authorizations frequently expire with the trial; then size the cohort, the duration and the cold chain. Countries with no mandate still need a documented, defensible position for the ethics committee.

    Sources

    • Argentina — Disposición ANMAT 12792/2016: https://www.boletinoficial.gob.ar/detalleAviso/primera/154162/20161117
    • Argentina — Disposición ANMAT 7516/2025: https://www.boletinoficial.gob.ar/detalleAviso/primera/332695/20251009
    • Argentina — Disposición ANMAT 4616/2019 (RAEM): https://www.boletinoficial.gob.ar/detalleAviso/primera/208794/20190604
    • Brazil — Lei nº 14.874/2024: https://www.planalto.gov.br/ccivil_03/_ato2023-2026/2024/lei/l14874.htm
    • Brazil — Decreto nº 12.651/2025: https://www2.camara.leg.br/legin/fed/decret/2025/decreto-12651-7-outubro-2025-798105-publicacaooriginal-176652-pe.html
    • Brazil — ANVISA RDC nº 38/2013: https://anvisalegis.datalegis.net/action/ActionDatalegis.php?acao=abrirTextoAto&tipo=RDC&numeroAto=00000038&seqAto=000&valorAno=2013&orgao=RDC/DC/ANVISA/MS&codTipo=&desItem=&desItemFim=&cod_menu=1696&cod_modulo=134&pesquisa=true
    • Brazil — Ministério da Saúde / INAEP FAQ on acesso pós-estudo: https://www.gov.br/saude/pt-br/composicao/orgaos-colegiados/inaep/faq/faq/acesso-pos-estudo/o-acesso-fornecimento-pos-estudo-e
    • Chile — Ley 20.850 and Código Sanitario Arts. 111 A–111 C: https://www.bcn.cl/leychile/navegar?idNorma=1078148
    • Peru — Reglamento de Ensayos Clínicos, DS 021-2017-SA: https://ensayosclinicos-repec.ins.gob.pe/images/Reglamento_de_EC.pdf
    • Panama — Decreto Ejecutivo No. 21 de 23 de abril de 2026, Gaceta Oficial Digital No. 30510-C (Arts. 68, 99, 104, 105); primary text read from the Gaceta Oficial PDF
    • Panama — Ley 419 de 1 de febrero de 2024 (medicamentos): https://www.minsa.gob.pa/sites/default/files/normatividad/ley-419-de-2024-ley-de-medicamentos.pdf
    • Ecuador — Acuerdo Ministerial 00069-2024: https://www.espoch.edu.ec/wp-content/uploads/2025/10/ac-00069-2024_dic_31_compressed_1-1.pdf
    • Ecuador — Acuerdo Ministerial 0075-2017 (repealed): https://www.salud.gob.ec/wp-content/uploads/2022/09/A.M.-0075-REGLAMENTO-ENSAYOS-CLINICOS-1.pdf
    • Costa Rica — Ley N.º 9234, Ley Reguladora de Investigación Biomédica: https://documentos.una.ac.cr/bitstream/handle/unadocs/5670/Texto%20Completo%20Norma%209234.pdf?sequence=1&isAllowed=y
    • Guatemala — Acuerdo Ministerial 82-2019: https://medicamentos.mspas.gob.gt/phocadownload/Acuerdo%20Ministerial%2082-2019.pdf
    • Guatemala — MSPAS legislación vigente index (AM 206-2021): https://medicamentos.mspas.gob.gt/index.php/legislacion-vigente/acuerdos
    • Honduras — Acuerdo No. 0256-ARSA-2025: https://www.tsc.gob.hn/web/leyes/Acuerdo-0256-ARSA-2025.pdf
    • Nicaragua — Normativa-166, Norma para la Regulación de Ensayos Clínicos: https://www.minsa.gob.ni/sites/default/files/2022-10/Norma%20de%20Ensayos%20Clinicos.11833.pdf
    • Uruguay — Decreto N° 158/019, Anexo: https://www.impo.com.uy/bases/decretos-originales/158-2019/8
    • Bolivia — Norma para Estudios Clínicos (AGEMED): https://www.agemed.gob.bo/archivos_agemed/ensayosclinicos/001-2021.pdf
    • Venezuela — Normas de Buena Práctica Clínica (INHRR): https://inhrr.gob.ve/pdf/pdf_jr/JR-1311-2013.pdf
    • Mexico — NOM-012-SSA3-2012: https://sidof.segob.gob.mx/notas/docFuente/5284148
    • Colombia — Resolución 2378 de 2008: https://www.ins.gov.co/Normatividad/Resoluciones/RESOLUCION%202378%20DE%202008.pdf
    • Colombia — Resolución 8430 de 1993: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/de/dij/resolucion-8430-DE-1993.PDF
    • Paraguay — Resolución DINAVISA 238/2024: https://dinavisa.gov.py/wp-content/uploads/2024/10/2.-Requisitos-de-Ensayos-Clinicos.-Resol.-238_2024.pdf
    • El Salvador — Lineamientos Técnicos para la Investigación en Salud, Acuerdo Ejecutivo 1530 (2025): https://asp.salud.gob.sv/regulacion/pdf/lineamientos/lineamientostecnicosparalainvestigacionensalud-Acuerdo-Ejecutivo-1530-29052025_v1.pdf
    • Dominican Republic — Manual de Normas y Procedimientos Operativos, CONABIOS: https://conabios.gob.do/wp-content/uploads/2025/02/1.Manual-de-Normas-y-Procedimientos-Operativos-V2-13-02.pdf
    • Cuba — Buenas Prácticas Clínicas en Cuba (CECMED): https://www.cecmed.cu/sites/default/files/adjuntos/Reglamentacion/Dir_BPC.pdf
    • United States / Puerto Rico — 21 CFR 312.310 (Expanded Access, Subpart I): https://www.ecfr.gov/current/title-21/chapter-I/subchapter-D/part-312/subpart-I/section-312.310
    • FDA — Expanded Access training materials: https://www.fda.gov/media/193381/download

  • Choosing a Local Comparator for MedTech Reimbursement Dossiers in Brazil, Colombia, and Mexico

    Choosing a Local Comparator for MedTech Reimbursement Dossiers in Brazil, Colombia, and Mexico

    For a MedTech company entering Latin America, the local comparator is more than a line in a clinical-evidence table. It is the reference point that lets a payer, hospital, or health technology assessment (HTA) team judge whether a new device changes outcomes, workflow, resource use, or total cost. A comparator that is scientifically convenient but disconnected from local practice can weaken a reimbursement dossier even when the device performs well.

    The right approach is to choose a comparator by country and care pathway, then build a bridge back to the evidence collected during early clinical development. Brazil, Colombia, and Mexico each have distinct institutions and decision contexts. A common evidence core can support all three, but the comparator rationale and resource-use assumptions should be localized.

    Why comparator choice determines payer credibility

    A comparator should represent the decision a local clinician or purchaser would make if the new technology were not available. That may be an established device, a procedure, a diagnostic pathway, watchful waiting, or a combination of services. The relevant question is not “What is the closest product?” It is “What happens to this patient in this health system today?”

    This distinction matters because HTA considers more than technical performance. Brazil’s CONITEC describes technology assessment in terms that include clinical evidence, economic evaluation, and budget impact. Colombia’s IETS defines HTA as a systematic, multidisciplinary examination of effectiveness, safety, and social, economic, and ethical consequences. Mexico’s CENETEC publishes guidance for the economic evaluation of medical devices. These official frameworks point to the same practical lesson: the comparator must make the consequences of adoption measurable.

    Brazil: anchor the dossier in SUS practice and budget impact

    For a public-system strategy in Brazil, begin by describing the current SUS pathway for the target patient: who provides care, what procedure or technology is used, what resources are consumed, and where delays or complications arise. The comparator should be the realistic alternative within that pathway, not merely the device with the closest engineering specifications.

    Build the evidence package around three layers. First, show comparative clinical outcomes that matter to the patient and provider. Second, quantify resource use, including procedure time, staff, consumables, repeat visits, training, maintenance, and downstream events. Third, model the eligible population and adoption scenarios so the decision maker can see the budget effect under conservative and expanded use.

    Use the current CONITEC HTA materials and methodological guidance to confirm the applicable submission expectations. For an early-stage sponsor, the immediate goal is not to claim a final cost-effectiveness result from a small FIH study. It is to capture the baseline workflow and resource variables that a later model will need.

    Colombia: make the local care pathway explicit

    In Colombia, the comparator should reflect how the service is delivered through the relevant network and what the decision maker can actually change. A global standard of care may not be the operational baseline if local hospitals use a different procedure, staffing model, referral pattern, or purchasing arrangement.

    Start with a pathway map: entry point, diagnostic work-up, treatment or intervention, follow-up, complications, and referral. For each step, document who performs it, how long it takes, what equipment and supplies are required, and which outcomes are visible to the payer or hospital. Then explain why the selected comparator is the appropriate reference for that pathway.

    IETS materials emphasize clinical effectiveness, safety, and the economic and social implications of health technologies. Translate that multidimensional view into a dossier structure: comparative outcomes, adverse events, quality-of-life or functional measures where relevant, staff and infrastructure requirements, and costs that are material to the Colombian setting. The IETS overview of HTA is a useful official reference when defining the scope of the evidence plan.

    Mexico: connect the comparator to implementation and economics

    For Mexico, a credible comparator must fit the institution and service context in which the device would be adopted. Ask whether the alternative is delivered in public hospitals, private facilities, or both; whether the required equipment is already installed; and whether the new technology changes training, staffing, maintenance, or referral patterns.

    Separate acquisition price from total implementation cost. A device can appear inexpensive while requiring new imaging, specialized staff, software, service contracts, or additional visits. Conversely, a higher purchase price may be offset by shorter procedure time or fewer repeat interventions. Record these variables prospectively during early studies so that a later economic model can compare like with like.

    Review the Mexican CENETEC guidance for economic evaluation of medical devices and adapt the evidence plan to the intended decision setting. Current institutional requirements should be confirmed before a formal submission, especially when the product will be evaluated by more than one payer or hospital network.

    Build one comparator matrix across three countries

    A sponsor can reduce rework by maintaining a master comparator matrix with country-specific annexes. Capture at least:

    • Clinical baseline: the patient population, indication, current intervention, and relevant outcomes.
    • Workflow baseline: procedure steps, care setting, staff time, equipment, and referral pattern.
    • Safety baseline: complications, repeat procedures, contraindications, and follow-up burden.
    • Economic baseline: acquisition, consumables, personnel, maintenance, admissions, and downstream resource use.
    • Adoption baseline: training, infrastructure, procurement, and implementation constraints.
    • Decision use: the payer, hospital, or HTA question the comparison is intended to answer.

    Do not wait for a pivotal trial to collect these fields. Even a small early-feasibility program can record procedure duration, staff mix, consumables, unplanned visits, technical failures, and patient-reported measures using a prespecified template. Those observations will not replace comparative evidence, but they can reveal which assumptions need validation and which outcomes matter locally.

    Frequently asked questions

    Should the comparator be the cheapest available option?
    No. It should be the realistic alternative used in the target care pathway. The lowest purchase price may not be the lowest-cost or most relevant option after staff time, complications, maintenance, and follow-up are included.

    Can one comparator serve Brazil, Colombia, and Mexico?
    Sometimes the clinical concept is shared, but the service pathway, staffing, infrastructure, and purchasing context may differ. Use a common evidence core with country-specific comparator definitions and assumptions.

    Is comparator planning relevant during an FIH study?
    Yes. FIH studies are not designed to prove final reimbursement value, but they can capture baseline workflow, safety, resource use, and patient-centered measures that prevent avoidable evidence gaps later.

    A locally credible comparator turns a MedTech dossier from a product description into a decision analysis. By defining the reference pathway early and documenting how it differs across Brazil, Colombia, and Mexico, sponsors can make later regulatory, HTA, and reimbursement conversations more focused and more defensible.

  • Brazil’s 90 Day Clinical Trial Review Cap: What Medtech Sponsors Should Do Before Submitting

    Brazil’s 90-Day Clinical Trial Review Cap: What MedTech Sponsors Should Do Before Submitting

    Brazil has moved from being a “high-potential but unpredictable” country for early-stage MedTech studies to a jurisdiction with a defined statutory review clock. For sponsors, that shift is not just a speed story — it is a planning story. When review timelines become shorter and more predictable, the relative impact of preventable sponsor-side errors gets larger.

    This article is written for MedTech founders, clinical operations leaders, and regulatory directors who want to run first-in-human (FIH) or early feasibility work in Brazil without losing weeks to rework. We focus on what you can control before submission: dossier readiness, ethics strategy, local operational prerequisites, and vendor orchestration.

    Why a faster regulatory clock changes the sponsor playbook

    Short timelines compress decision-making. If you used to “fix it after ANVISA feedback,” you may no longer have that luxury — because site contracts, import permits, radiology workflows, and ethics committee coordination can become the rate-limiting steps. A faster clock also forces clearer internal governance: who owns the final protocol, the risk assessment, the device technical file, and the country-specific annexes?

    Practically, the sponsor question becomes: How do we arrive at Day 0 with no missing pieces? The goal is to avoid pauses caused by translation gaps, document format mismatches, incomplete investigator packages, or unaligned device documentation.

    Pre-submission checklist: what to lock down before Day 0

    • Protocol version control: Confirm the final protocol, synopsis, schedule of assessments, and statistical plan are aligned — and that the same versions appear in every submission component.
    • Risk classification and device description: Ensure the device description, intended use, instructions for use, and risk analysis are consistent across documents. Inconsistency is one of the most common sources of questions.
    • Investigator and site packages: Collect CVs, training evidence, GCP documentation, and site capabilities early. In Brazil, the operational readiness of sites can become as important as the regulatory dossier.
    • Translations and local formatting: Build time for Portuguese localization and formatting checks. A strong translation is not only linguistic — it must preserve clinical meaning and match annex references.
    • Informed consent strategy: Prepare consent language that is clear, compliant, and aligned to local norms. If your device includes software, connectivity, or data transfer, incorporate that into consent and data handling text.
    • Import and logistics planning: Map the path for device shipment, labeling, and storage. Even for non-radioactive devices, customs, temperature needs, and distribution responsibilities can derail timelines.

    Parallel ethics + regulatory review: how to operationalize it

    When a system allows parallel tracks, the bottleneck often shifts to coordination. Sponsors should treat ethics submission as a project with its own critical path, not as an administrative afterthought. Build a unified submission calendar and align on:

    • Sequence of internal approvals: Decide who signs off on ethics content and who owns final responses.
    • Site-by-site variance: Even with a national framework, each site can introduce operational nuance. Standardize as much as possible, but plan for local adjustments.
    • Response management: Pre-write response templates for common questions (risk/benefit, recruitment strategy, device safety, data management) so you can move quickly.

    For FIH and early-stage work, ethics committees will often focus on patient protection and feasibility: training, emergency procedures, follow-up, and the practical ability of the site to manage adverse events. Your dossier should show readiness, not just compliance.

    What MedTech sponsors often underestimate in Brazil

    Speed-friendly frameworks do not eliminate complexity; they amplify the cost of under-planning. The most common underestimates include:

    • Data and privacy workflows: If your study uses digital endpoints or remote monitoring, align data flows, storage, and access controls early.
    • Device accountability: Plan how devices will be tracked, stored, returned, and reconciled. Accountability gaps create audit risk and can slow activation.
    • Training: Documented training is not optional in early-stage device studies. Build training into your timeline and capture evidence systematically.
    • Vendor interdependencies: CRO, imaging core lab, shipping/logistics, and local regulatory support must operate from the same timeline assumptions and document set.

    FAQ

    1) Does a statutory review cap guarantee approval in 90 days?
    No. A cap can improve predictability, but the practical timeline still depends on dossier quality, completeness, and how quickly questions are resolved.

    2) Should we treat Brazil as a first-choice country for FIH studies?
    Brazil can be compelling when the patient population, investigator expertise, and activation path fit the product. Sponsors should evaluate Brazil alongside other Latin American jurisdictions based on feasibility, ethics speed, and operational readiness.

    3) What’s the biggest sponsor-side mistake?
    Submitting with misaligned documents (protocol vs. device description vs. risk file) and assuming issues can be fixed “during review.” In faster systems, that approach often costs more time, not less.

    Bottom line: If your goal is to capture the benefit of a faster review framework, your work starts well before Day 0. A sponsor-side checklist — executed early — is often the difference between a fast approval and a slow cycle of preventable questions.

  • Brazil’s 2025 Clinical Research Rulebook: What Early-Stage Sponsors Should Do Differently

    Brazil’s 2025 Clinical Research Rulebook: What Early-Stage Sponsors Should Do Differently

    Brazil continues to be one of the most important anchors for early-stage clinical development in Latin America, but the compliance baseline is moving. In 2026, Anvisa highlighted that Brazil’s clinical research environment has been updated through Law No. 14.874/2024 (ethical aspects of research with human beings) and the newer regulatory package RDC 945/2024 plus IN 338/2024 for clinical research supporting registration of medicines, which Anvisa notes took effect in early 2025 (Anvisa).

    For MedTech founders and regulatory directors planning first-in-human (FIH) or early pivotal work in the region, the strategic opportunity remains: access to experienced investigators, high-quality sites, and diverse patient populations. The operational requirement, however, is to design submissions, vendor oversight, and essential documentation so you can demonstrate control at any moment—especially as inspection programs mature.

    1) What changed in Brazil’s research governance—and why it matters for sponsors

    Anvisa’s 2025 activity reporting explicitly connects the new ethical law and the updated clinical research regulation to the agency’s current oversight approach (Anvisa). In parallel, Anvisa’s inspection metrics reporting emphasizes inspection readiness against GCP expectations (ICH E6 (R2) or updates) while referencing RDC 945/2024 and Law 14.874/2024 as part of the inspection framework (Anvisa).

    Practical takeaway: even when timelines are competitive, sponsors should assume that documentation quality, vendor governance, and data integrity controls will be evaluated more explicitly. This is good news for well-prepared early-stage teams: strong fundamentals can shorten back-and-forth with sites and reduce downstream remediation.

    2) A sponsor-ready timeline: how to think about “FIH speed” without compliance debt

    Internal execution experience across Latin American programs repeatedly shows that speed usually breaks down in predictable places: incomplete essential documents, misaligned responsibilities between sponsor and CRO, and late-stage changes to protocol and informed consent artifacts. Treat “speed” as a systems outcome rather than a hero effort.

    • Pre-submission (4–8 weeks): lock protocol operational feasibility, confirm investigational product/device logistics, and establish a document control plan.
    • Submission-ready package: create a single source of truth for protocol, IB/IFU (as applicable), safety reporting plan, and data handling plan.
    • Site activation: standardize training, delegation, and vendor onboarding so the first site is not a one-off build.

    Many startups underestimate that “time to first patient” is often constrained by operational readiness, not just authority review. Investing early in a repeatable activation model is one of the highest ROI moves you can make.

    3) Inspection readiness: build once, benefit for years

    Anvisa’s inspection metrics report notes its focus on inspections conducted in 2024 and 2025 and positions inspections as a tool to protect participants and data integrity (Anvisa). For early-stage sponsors, the implication is clear: build inspection readiness into your operating rhythm rather than treating it as a “phase 3 problem.”

    Start with five non-negotiables:

    • Essential document discipline: version control, signatures, and clear ownership.
    • Delegation and training: role-based training mapped to tasks; keep it auditable.
    • Deviation and CAPA workflow: define severity levels and timelines; trend issues.
    • Vendor oversight: documented qualification, KPIs, and periodic review for CROs, labs, and logistics partners.
    • Data integrity: audit trails, access controls, and reconciliation between source, eCRF, and safety database.

    4) How to operationalize this across Latin America (not just Brazil)

    Brazil is rarely the only country in a Latin America strategy. Use Brazil as the quality anchor and replicate the same operating system across additional countries. You can localize what must be localized (ethics committee formats, language, import processes), while keeping your core compliance artifacts stable.

    A useful mental model: create a regional master file (core documents, SOPs, training), plus country modules (local submissions, contracts, import permits), plus site modules (delegation, logs, training, monitoring).

    FAQ

    When did Brazil’s latest clinical research regulations take effect?
    Brazil’s updated framework referenced by Anvisa includes Law 14.874/2024 (in force since 29 Aug 2024) and RDC 945/2024 plus IN 338/2024 (effective 2 Jan 2025).

    Do these changes apply to medical devices too?
    The Anvisa updates cited relate to clinical research for registration of medicines and biologics; device sponsors should still align operational quality systems and inspection readiness to ICH GCP expectations and local ethics requirements.

    How should startups prepare for inspection readiness?
    Build inspection-ready documentation from day one: role-based training, version-controlled essential documents, delegation logs, deviation management, and vendor oversight that can be demonstrated quickly.

    Need help designing a Latin America FIH plan? bioaccess® supports sponsors with regional feasibility, activation, and execution strategies built for speed and inspection readiness.

  • First-In-Human In Brazil In 2026: A Practical Timeline For Sponsors

    First-in-Human in Brazil in 2026: A Practical Timeline for Sponsors

    Primary keyword: first-in-human trial Brazil timeline

    Brazil is increasingly on the shortlist for early-stage clinical development because sponsors can combine a large patient base with growing regulatory clarity. A recent policy analysis argued that Lei 14.874 de 2024 created the basis for a more predictable environment and, for the first time, establishes timelines and greater regulatory clarity for clinical studies.

    This article gives a practical, sponsor-side timeline for launching a first-in-human (FIH) study in Brazil in 2026—what to do first, what typically slows teams down, and how to sequence work so you do not lose weeks to preventable back-and-forth.

    1) Define the “Brazil-ready” FIH package (Weeks 0–2)

    Before any submission, align internal stakeholders on what “Brazil-ready” means. For most MedTech and biopharma sponsors, FIH readiness is not only a protocol question—it is also a documentation and site execution question.

    • Protocol and IB alignment: Ensure endpoints, safety monitoring, and dose-escalation logic are consistent with your global plan.
    • Country adaptations: Identify what must be localized or supplemented (consent language, site materials, labeling, and investigator documentation).
    • Feasibility assumptions: Confirm whether required imaging, lab, or procedural capabilities exist at target sites.

    Internal best practice: Create a single “FIH Brazil master checklist” with owners and due dates. Treat it as a deliverable, not an afterthought.

    2) Select sites for speed, not just prestige (Weeks 1–4)

    In FIH, startup speed is highly correlated with site readiness. Sponsors often choose sites based on reputation, then discover contracting and operational realities late.

    • Prioritize operational maturity: Look for sites with dedicated research staff, established ethics processes, and experience with sponsor audits.
    • Validate recruitment pathways: Treatment-naive populations can be an advantage, but referral networks still matter.
    • Assess import and handling constraints: If your study uses temperature-sensitive materials, confirm storage and chain-of-custody procedures early.

    3) Build a parallel workstream plan (Weeks 2–6)

    The most common timeline mistake is running tasks sequentially that can be executed in parallel. Even when formal review clocks improve, sequential execution can erase the benefit.

    To compress time, run these workstreams at the same time:

    • Regulatory dossier preparation (quality, safety documentation, and trial authorization package)
    • Ethics submission package (site-specific documents and consent)
    • Contracts and budgets (CTA, indemnities, payment schedules, and monitoring model)
    • Supply and logistics readiness (import planning, labeling, storage validation, and back-up scenarios)

    Even when legal reforms aim to improve predictability, sponsors still need coordinated execution across stakeholders to realize those gains.

    4) Anticipate “hidden” startup time: contracts, import, and training (Weeks 4–10)

    Even when review timelines are favorable, sponsors can lose time after approvals due to operational bottlenecks:

    • Contract negotiation cycles: Build buffer time for legal review, redlines, and institutional sign-off.
    • Import and release: If your investigational product or device must be imported, confirm lead times and documentation requirements early.
    • Site initiation and training: FIH trials require strict adherence to safety procedures; schedule training sessions while approvals are in progress.

    Practical tip: Maintain a “go-live readiness dashboard” that tracks contract status, shipment readiness, and training completion. This prevents surprises when the green light arrives.

    5) A sponsor-friendly 2026 FIH timeline (example)

    Every program is different, but a realistic planning template looks like this:

    • Weeks 0–2: Brazil-ready protocol package, checklist, and internal alignment
    • Weeks 1–4: Site selection, feasibility, and early budget/CTA drafts
    • Weeks 2–6: Parallel dossier + ethics package finalization
    • Weeks 4–10: Contracts, import planning, training, and vendor setup
    • Weeks 10–14: Final site activation steps and first-patient readiness

    If you are aiming for speed, measure time-to-ready as rigorously as you measure time-to-approval. In many FIH programs, the fastest sponsors are simply the ones that avoid rework.

    FAQ: First-in-human trial Brazil timeline

    • How long does it take to start a first-in-human trial in Brazil?
      Timelines vary by protocol complexity and site readiness, but sponsors should plan for parallel regulatory and ethics pathways, early document localization, and realistic contracting and import lead times.
    • What is the biggest cause of FIH delays in Brazil?
      In practice, delays often come from incomplete documentation, late site selection, and underestimated startup logistics (contracts, import permits, and investigational product readiness), not just the formal review clock.
    • Can Brazil FIH data support US or EU submissions?
      Yes, when the trial is designed to international GCP standards and endpoints align with your global regulatory strategy, Brazilian data can be part of a broader evidence package.

    Need help planning an FIH startup in Brazil or across Latin America? bioaccess® supports sponsors with country startup planning, site activation, and operational execution—without exposing confidential details publicly.

  • Anvisa’s 2026–2027 International Convergence Agenda: What Medtech Sponsors Need To Plan For

    ANVISA’s 2026–2027 International Convergence Agenda: What MedTech Sponsors Need to Plan For

    Brazil’s medical device regulator, ANVISA, is in the middle of the most aggressive period of international regulatory convergence in its history. Between the mid-2024 Brazilian Clinical Research Law (Lei 14.874) becoming fully operative on January 1, 2025, and the agency’s published 2026–2027 priorities, the rules around clinical trial submissions, post-market surveillance, software as a medical device (SaMD), and unique device identification (UDI) are all changing simultaneously.

    For MedTech sponsors planning to use Brazilian clinical data in US, EU, or Brazilian regulatory submissions, the next 18 months are a strategic window. Here is what is changing, why it matters, and how to plan for it.

    What Is Actually Changing

    Three convergence streams are running in parallel.

    1. Stronger international cooperation on device review. ANVISA has expanded its participation in international regulatory work-sharing arrangements, including the Medical Device Single Audit Program (MDSAP) and increased reliance agreements with FDA, EMA, and Health Canada-equivalent regulators. The practical effect: a device that has cleared review in a recognized reference jurisdiction can move through Brazilian registration substantially faster than under the old country-by-country framework.

    2. New SIUD database and UDI implementation. ANVISA’s Sistema de Informação de Identificação Única de Dispositivos Médicos (SIUD) is being phased in across 2026, requiring UDI assignment, labeling, and database submission for medical devices entering the Brazilian market. The phase-in follows risk class — Class IV (highest risk) and IVDs first, then descending through Class III, II, and I over the multi-year timeline.

    3. Software-as-a-medical-device pathway clarification. ANVISA has published updated normative instructions for SaMD classification, including AI-enabled clinical decision support, aligning more closely with FDA and IMDRF frameworks. For digital health and AI MedTech sponsors, the Brazilian pathway is now substantially more predictable than it was 24 months ago.

    All three streams are happening on top of the already-operative parallel review framework under Lei 14.874, which lets sponsors submit to ANVISA and the institutional ethics review system simultaneously rather than sequentially.

    Why the Window Matters Now

    For sponsors planning a Brazilian arm of a clinical trial — or a market access registration — three strategic implications flow from the current convergence wave.

    Documentation prepared for FDA or EU MDR is increasingly leverageable in Brazil. The technical file structure, risk classification reasoning, and clinical evidence summary you build for an FDA 510(k), De Novo, or EU MDR conformity assessment now translates more directly into ANVISA’s expectations than at any prior moment. The historical penalty of duplicating documentation across regions is materially smaller in 2026 than it was in 2022.

    The window for “first to file under the new framework” is open. Regulatory teams that align Brazilian submissions with the new convergence framework now will move ahead of teams that wait for further clarification. Once a sponsor has navigated one device through the new SIUD or updated SaMD pathway, every subsequent submission moves faster.

    Post-market obligations are being modernized. The new SIUD database is not just a labeling exercise — it forms the backbone of a more sophisticated post-market surveillance regime. Sponsors who structure their data capture and adverse event tracking systems to align with the new SIUD inputs from day one save significant retrofit cost later.

    Practical Planning for the Next 12 to 18 Months

    Three actions are appropriate for any sponsor with Brazilian exposure or plans:

    • Audit your UDI strategy now. If your device class is in the early SIUD phase-in, allocate budget and labeling capacity in 2026. If your device is in a later phase, use the next 12 months to harmonize UDI assignment with the FDA UDI database and the EU EUDAMED framework so all three jurisdictions are covered with a single system.
    • Restructure your technical file with convergence in mind. The 2026 reality is that one well-organized technical file should serve FDA, EU MDR, and ANVISA submissions with mostly mechanical translation steps and only modest jurisdiction-specific addenda. If your team is still maintaining three parallel files, the next 12 months are the right window to consolidate.
    • Engage early on SaMD classification. If your device incorporates software, AI, or clinical decision support, ANVISA’s updated framework means that a pre-submission classification conversation now yields meaningfully more predictable answers than two years ago. Take advantage of that predictability before launching the trial.

    Frequently Asked Questions

    Does the new ANVISA convergence framework affect clinical trial submission timelines?
    Yes — primarily through Lei 14.874’s parallel review mechanism, which lets ANVISA and ethics committees review submissions simultaneously instead of sequentially. The practical effect is a several-week to several-month reduction in start-up timelines compared with the pre-2025 framework, depending on device complexity.

    If my device is FDA-cleared, will ANVISA accept the FDA submission as-is?
    Not as-is. ANVISA’s reliance and convergence framework reduces duplication but does not eliminate the need for a Brazil-specific submission. What it does change is that your FDA-aligned technical file, risk classification logic, and clinical evidence package now translate more directly into ANVISA expectations, with smaller jurisdiction-specific gaps to fill.

    How does the SIUD database affect sponsors who do not yet sell in Brazil?
    If you have no Brazilian commercial presence and no plans for one, SIUD does not directly apply. If you are running a clinical trial in Brazil intending to commercialize there later — or to use Brazilian data in support of a future commercial registration — building UDI alignment into your trial-stage device labeling now is materially cheaper than retrofitting it later.

    bioaccess® supports first-in-human and early-feasibility medical device trials across 10 Latin American countries, including Brazil under ANVISA’s modernized framework. Learn more at bioaccessla.com or book a strategy conversation at bioaccessla.com/book-a-meeting.