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Tag: medtech

  • 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

  • Clinical trial execution in Colombia: why we recommend it now

    Colombia is now in scope for bioaccess® clinical-trial execution across all phases — first-in-human through pivotal — for both medical devices and drugs, in every indication. That is a reversal of our prior position, and the reason is that the regulator changed faster than the market narrative about it did.

    INVIMA is one of eight national authorities certified by PAHO as a Regional Reference Regulatory Authority at Level IV, the highest level PAHO assigns for medicines regulation and surveillance in the Americas (INVIMA, Cooperación internacional; PAHO, Autoridades Regulatorias de Referencia). Since 2022 it has built a dedicated clinical-research group for devices, published its own approval and non-approval registries, and opened a public study search. Sponsors are still pricing Colombia on 2018 assumptions.

    What changed since 2022

    Three institutional facts, all documented by INVIMA itself.

    First, devices got their own clinical-research function: INVIMA created the Grupo de Investigación Clínica y Apoyo a Sala Especializada DMRDIV (GICASE) through Resolución 2022035262 of 20 September 2022 (INVIMA, Investigación Clínica — Dispositivos). Second, the Sala Especializada de Dispositivos Médicos y Reactivos de Diagnóstico In Vitro (SEDMRDIV) now has an explicit mandate to evaluate and issue technical and methodological opinions on research protocols involving devices and in vitro diagnostic reagents (INVIMA, Sala especializada DMRDIV). Device sponsors have a named technical body, not an improvised one.

    Third, INVIMA publishes what it approves and what it refuses: a register of device clinical studies approved from 2021 onward, a parallel register of studies not approved with the reason for each — non-approval, withdrawal, pending response — and a register of ethics-committee and research-site inspection status to November 2025 (INVIMA, Investigación Clínica — Dispositivos; register of non-approved device studies). Very few regulators in the region publish their rejections, and that register shows which protocol defects cost applicants a cycle. INVIMA’s public study search lists 1,157 clinical studies, 1,156 of them approved, 487 in progress and 523 completed, with a data date of 12 August 2026 (INVIMA, Lista de Estudios Clínicos).

    The device pathway: prototype authorization through pivotal

    Colombia has no single device clinical-trial regulation. It has three working instruments, and knowing which one carries which obligation is most of the job.

    Decreto 4725 de 2005 is the sanitary regime for human-use medical devices. Article 2 defines a device intended for clinical investigation as one used by a specialist physician in research in an appropriate human clinical setting. Article 36 provides that a national or imported prototype device — or controlled-technology biomedical equipment — may be authorized only for research and experimentation, may not be used in health care, and requires an INVIMA technical opinion. Article 48(b) is the import hook: exceptional importation without sanitary registration or commercialization permit where the device is the subject of clinical research authorized in Colombia, subject to a prior opinion from the relevant specialized chamber. Article 18(k) closes the loop commercially — class IIb and III devices must present clinical studies to demonstrate safety and effectiveness when they later seek Registro Sanitario (Decreto 4725 de 2005).

    Resolución 8430 de 1993 supplies the human-subjects framework — the scientific, technical and administrative rules for health research, including new prophylactic, diagnostic, therapeutic and rehabilitative resources (MinSalud) — and INVIMA names it as the governing instrument for research with human beings.

    The operative paperwork is form-driven and published: ASS-RSA-FM085 (checklist for the prototype-device technical-opinion request), ASS-RSA-FM172 (SEDMRDIV technical-opinion request), ASS-RSA-FM169 (initial study evaluation completed by the ethics committee), ASS-RSA-FM170 (periodic reports) and ASS-RSA-FM171 (serious adverse event notification) (INVIMA, Investigación Clínica — Dispositivos). There is no ambiguity about what to file. There is considerable skill in filing it in a form the SEDMRDIV will not bounce.

    The drug pathway

    For medicines the anchor is Resolución 2378 de 2008, which adopted Good Clinical Practices with mandatory application for institutions conducting research with medicines in human beings (INS, Resolución 2378 de 2008). INVIMA requires approval for Phase I, II and III protocols and for Phase IV protocols with intervention; non-interventional Phase IV studies must still be submitted with a summary so INVIMA can determine whether formal approval applies (INVIMA, Fiscalización de Ensayos Clínicos).

    Initial protocol evaluation is filed through Protocolos en Línea, the exclusive route for that procedure since 2 January 2020, under tariff 4070 for protocols and 4083 for amendments; adverse-event content and periodicity are set by Resolución 2011020764 de 2011, issued under Article 146 of Decreto 677 de 1995 (INVIMA, Fiscalización de Ensayos Clínicos).

    Import of unregistered investigational medicines runs through Article 96 of Decreto 677 de 1995, which lets INVIMA exceptionally authorize importation without sanitary registration where INVIMA or the Ministry has authorized clinical research in the country, following a Comisión Revisora opinion and against a free-sale certificate, corporate documentation and analysis-fee receipts (Decreto 677 de 1995). Where the investigational product is a controlled substance, the monopoly is administered by the Fondo Nacional de Estupefacientes, and INVIMA expressly prioritizes those files in its current contingency plan (Resolución 2025046281 de 2025). Sponsors sometimes look for a separate narcotics department in the trial pathway; the correct counterparty is the FNE, and only for controlled product.

    Timelines, and what the misconception gets wrong

    The complaint about Colombia is that it is slow and unpredictable. Half of that is true.

    Protocol volume has been flat for a decade — roughly 90 protocol-evaluation requests a year, 85 in 2014 and 87 in 2024 — and INVIMA’s average time to a definitive concept, approving or rejecting, is 5.1 months (ConsultorSalud, June 2025). Five months to a decision is not fast. It is a measured average with a published rejection register behind it, which makes it forecastable — unpredictability is the charge that does not survive contact with the data.

    Country Published regulatory clock for trial authorization Source
    Colombia No statutory day-count; measured 5.1-month average to a definitive INVIMA concept ConsultorSalud
    Argentina Disposición ANMAT 7516/2025 Art. 5 assigns evaluation to the Dirección de Investigación Clínica, states no day-count Boletín Oficial
    Chile ISP: 45 business days to authorize import of unregistered pharmaceutical products for trial use ISP Chile
    Panama Decreto Ejecutivo 21 de 2026 regulates Títulos III–IV of Ley 84 de 2019; no day-count published MINSA Panamá

    Three of the four comparators publish no binding clock at all. Colombia’s disadvantage on early-phase device work is smaller than the reputation suggests, and Colombia is the only one of the four that publishes both its approvals and its refusals.

    Sites: Bogotá, Medellín, Cali

    Colombia’s population was estimated at 53 million in 2025 (DANE, July 2025), and by December 2024 more than 160 centres held INVIMA Good Clinical Practice certification (ConsultorSalud).

    INVIMA’s own register of approved research ethics committees places them in Bogotá, Medellín, Cali, Floridablanca and Montería, attached to established IPS and medical foundations (INVIMA, CEI list to May 2025). Bogotá, Medellín and Cali are the tier-1 clusters — high-volume tertiary hospitals, certified pharmacy and clinical-laboratory services inside the same certified institution, and investigator populations that read English protocols without translation. Floridablanca (Santander) and Montería extend regional recruitment reach.

    Ethics committees

    A Colombian trial needs a CEI approved by INVIMA and a site holding a current BPC certificate. That certificate is issued to the IPS after INVIMA verifies compliance with Resolución 2378 de 2008 through inspection visits, runs for five years, and requires evidence that the institution is registered under the Sistema Único de Habilitación with authorized pharmaceutical service, clinical laboratory and sample-collection services (INVIMA, Certificaciones en BPC). Replacing a site’s ethics committee is a formal BPC modification requiring a new-conditions verification visit and a written transfer plan agreed with sponsor, CRO and both committees. Sponsors who treat CEI selection as an afterthought lose weeks here.

    Post-trial access in Colombia

    Colombia does not currently mandate post-trial access by statute. Resolución 2378 de 2008 and Resolución 8430 de 1993 were both read in full for post-trial supply language and neither contains it; Resolución 8430 allocates only harm-related costs (Arts. 13, 15(j)–(k), 58(c)). bioaccess® can operate voluntary continuity programs in Colombia on sponsor request. Statutory PTA mandates in Latin America currently apply to Argentina, Brazil, Panama, Chile, Peru, Ecuador, Costa Rica, Guatemala, Honduras and Nicaragua — not Colombia.

    What is coming, and why it favours moving now

    Three reform tracks are live. A draft unified sanitary regime would replace Decreto 4725 de 2005 and Decreto 3770 de 2004, adding conditional indefinite authorizations, international reliance mechanisms, mandatory UDI from first filing, four IVD risk classes on IMDRF parameters and an 18-month transition; it cleared national consultation and went to WTO public consultation (ConsultorSalud, June 2026). MinSalud has circulated a draft resolution on health research with human beings that would partially repeal Resolución 8430 de 1993 (ConsultorSalud, February 2026). And a clinical-research framework bill filed in the Cámara in August 2025 by Senator Fabián Díaz Plata and Representative Juan Daniel Peñuela Calvache would adopt ICH E6 and ISO 14155:2020 as the regulatory standard, create an INVIMA registry of authorized CROs and accredited investigators, and impose tacit approval — INVIMA objects within 7 calendar days for common-risk research and 30 for high-risk research, with ratification in a further 5 days (Cámara de Representantes, bill text). It classifies first-in-human studies and novel implantable devices as high-risk.

    None is law yet. All three point the same direction, and each rewards sponsors who already hold Colombian sites, a certified CEI relationship and an INVIMA filing history when a transition period starts.

    Registro Sanitario sits at the far end of the same pathway

    Registro Sanitario is the INVIMA marketing authorization that lets a device be sold in Colombia, granted under Decreto 4725 de 2005 with technical evaluation under Article 18 and legal evaluation under Article 19; INVIMA may issue one request for additional information, with 90 days to respond, and BPM and CCAA certificates run for five years (Decreto 4725 de 2005). bioaccess® already runs Registro Sanitario market access in Colombia, and the reason to place trial and registration with one operator is Article 18(k): the clinical evidence a class IIb or III sponsor generates in Colombia is the evidence its Colombian registration will later be judged on.

    Planning a first-in-human or pivotal trial in Colombia? bioaccess® is a US-headquartered, LATAM-native operator running regulatory submissions, importadora functions and 2–8 °C GDP cold chain across the region, and Colombia is now in scope for all phases, all indications, devices and drugs. To discuss INVIMA feasibility, site selection in Bogotá, Medellín or Cali, or a combined trial-plus-Registro-Sanitario pathway, 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 bioaccess® conduct clinical trials in Colombia?
    Yes. As of September 2026 Colombia is in scope for bioaccess® clinical-trial execution across all phases, from first-in-human through pivotal, in all indications, for both medical devices and drugs. This is a change from our earlier position. The reversal follows documented institutional improvement at INVIMA since 2022 — a dedicated device clinical-research group, a named specialized chamber for device protocols, published approval and non-approval registries, and a public study search — combined with our own operating capability in Bogotá, Medellín and Cali. bioaccess® also runs INVIMA Registro Sanitario market access in Colombia, so the trial and the eventual marketing authorization can be sequenced by one operator.

    What is INVIMA’s role in Colombian clinical trials?
    INVIMA authorizes, monitors and can halt clinical research in Colombia. It evaluates both clinical aspects and the quality of the investigational product, requires approval for Phase I, II and III protocols and for interventional Phase IV protocols, and requires submission of non-interventional Phase IV studies so it can determine whether formal approval applies. It may interrupt an investigation or require modifications at any time if authorization conditions change, Good Clinical Practice is not met, or participant or public-health protection requires it. Sponsor-to-CRO delegations must be reported to INVIMA and remain the sponsor’s responsibility.

    What is the INVIMA clinical-trial pathway for medical devices?
    Three instruments combine. Decreto 4725 de 2005 Article 36 authorizes prototype devices for research and experimentation only, against an INVIMA technical opinion; Article 48(b) permits exceptional importation without sanitary registration where the device is the subject of clinical research authorized in Colombia, following a prior opinion from the specialized chamber; Article 18(k) later requires clinical studies for class IIb and III Registro Sanitario. Resolución 8430 de 1993 supplies the human-subjects rules. The SEDMRDIV issues the technical and methodological opinion, supported since September 2022 by the GICASE group created under Resolución 2022035262.

    What is the INVIMA clinical-trial pathway for drugs?
    Resolución 2378 de 2008 adopted Good Clinical Practices with mandatory application for institutions researching medicines in humans, and is the basis of the site BPC certificate. Initial protocol evaluation is filed through INVIMA’s Protocolos en Línea platform, exclusive for that procedure since 2 January 2020, under tariff 4070 for protocols and 4083 for amendments. Adverse-event reporting content and periodicity follow Resolución 2011020764 de 2011, issued under Article 146 of Decreto 677 de 1995. Importation of unregistered investigational medicines runs under Article 96 of Decreto 677 de 1995 with a Comisión Revisora opinion. Controlled substances involve the Fondo Nacional de Estupefacientes, which administers that monopoly.

    What are typical INVIMA authorization timelines in 2026?
    There is no statutory day-count in force for protocol authorization. The measured figure is an average of 5.1 months from filing to a definitive INVIMA concept, approving or rejecting, against a stable volume of roughly 90 protocol-evaluation requests a year. Sponsors should plan the ethics-committee approval, the INVIMA concept and the import authorization as sequential rather than parallel steps. The clinical-research bill filed in August 2025 would replace the current position with tacit approval — 7 calendar days for common-risk and 30 for high-risk studies — but it is not law.

    Does Colombia require post-trial access?
    No. Colombia does not currently mandate post-trial access by statute. Resolución 2378 de 2008 and Resolución 8430 de 1993 contain no post-trial supply obligation; Resolución 8430 allocates only harm-related costs. bioaccess® can operate voluntary continuity programs in Colombia on sponsor request, governed by the protocol, the informed consent and the ethics committee’s expectations rather than by statute. Statutory PTA mandates in Latin America currently apply to Argentina, Brazil, Panama, Chile, Peru, Ecuador, Costa Rica, Guatemala, Honduras and Nicaragua.

    What is INVIMA Registro Sanitario?
    Registro Sanitario is the INVIMA authorization required to market a medical device in Colombia, granted under Decreto 4725 de 2005 following technical evaluation under Article 18 and legal evaluation under Article 19. INVIMA may issue one request for additional or clarifying information, and the applicant has 90 days to respond before the file is deemed abandoned. Manufacturing and storage certificates — BPM and CCAA — are valid for five years. For class IIb and III devices, Article 18(k) requires clinical studies demonstrating safety and effectiveness, which is why trial design and registration strategy belong in the same plan.

    Which Colombian cities have the best clinical-trial infrastructure?
    Bogotá, Medellín and Cali are the tier-1 clusters, and INVIMA’s own register of approved ethics committees places committees in those three cities plus Floridablanca and Montería, attached to established IPS and medical foundations. More than 160 centres held INVIMA Good Clinical Practice certification as of December 2024. The practical selection criterion is not city size but whether the certified institution holds authorized pharmaceutical service, clinical laboratory and sample-collection services inside the same habilitación, because a contracted service adds documentation to every BPC modification.

    How does Colombia compare to Argentina, Panama and Chile for early-phase device trials?
    On published regulatory clocks, three of the four disclose nothing binding. Argentina’s Disposición 7516/2025 Article 5 assigns protocol evaluation to ANMAT’s Dirección de Investigación Clínica without stating a day-count. Panama’s Decreto Ejecutivo 21 of 23 April 2026 regulates Títulos III and IV of Ley 84 de 2019 with no authorization day-count on the MINSA page. Chile’s ISP publishes 45 business days for the resolution authorizing import of unregistered pharmaceutical products for trial use. Colombia publishes no clock but has a measured 5.1-month average and, unlike the other three, publishes both its approvals and its refusals for device studies.

    What has changed at INVIMA since 2022?
    Resolución 2022035262 of 20 September 2022 created the GICASE group for device clinical research and support to the specialized chamber. The SEDMRDIV now carries an explicit mandate to evaluate device and IVD research protocols. INVIMA publishes registers of approved device studies, non-approved device studies with reasons, SEDMRDIV import authorizations for observational studies, and ethics-committee and site inspection status to November 2025. Its public study search reported 1,157 studies with a data date of 12 August 2026. INVIMA also remains one of eight PAHO Level IV Regional Reference Regulatory Authorities.

    Sources

    • INVIMA — Cooperación internacional (PAHO Level IV ARNr status): https://www.invima.gov.co/el-instituto/cooperacion-internacional
    • PAHO/OPS — Autoridades Regulatorias de Referencia: https://www.paho.org/es/autoridades-regulatorias-referencia
    • INVIMA — Investigación Clínica, Dispositivos (GICASE, Resolución 2022035262 de 2022, forms ASS-RSA-FM085/169/170/171/172, published registers): https://www.invima.gov.co/productos-vigilados/dispositivos-medicos/investigacion-clinica
    • INVIMA — Sala especializada de dispositivos médicos y reactivos de diagnóstico in vitro: https://www.invima.gov.co/productos-vigilados/dispositivos-medicos/sala-especializada-dispositivos-reactivos
    • INVIMA — Registro de estudios clínicos con dispositivos médicos no aprobados 2021–2025: https://www.invima.gov.co/biblioteca/registro-estudios-clinicos-dispositivos-medicos-no-aprobados-invima-2021-2025
    • INVIMA — Lista de Estudios Clínicos (public study search, data date 12 August 2026): https://www.invima.gov.co/estudios
    • INVIMA — Fiscalización de Ensayos Clínicos, Medicamentos (Protocolos en Línea, tariffs 4070/4083, Resolución 2011020764 de 2011): https://www.invima.gov.co/productos-vigilados/medicamentos-y-productos-biologicos/medicamentos-de-sintesis-quimica-y-biologica/ensayos-clinicos
    • INVIMA — Procesos de certificación en Buenas Prácticas Clínicas (BPC certificate, 5-year validity): https://www.invima.gov.co/productos-vigilados/medicamentos-y-productos-biologicos/medicamentos-de-sintesis-quimica-y-biologica/licenciamiento-auditorias-y-certificaciones/certificaciones-en-buenas-practicas
    • INVIMA — Listado de Comités de Ética en Investigación aprobados a mayo 2025: https://www.invima.gov.co/biblioteca/comites-etica-investigacion-aprobados-invima-2025
    • Decreto 4725 de 2005 (Arts. 2, 18, 19, 21, 22, 36, 48, 89) — Función Pública, Gestor Normativo: https://www.funcionpublica.gov.co/eva/gestornormativo/norma.php?i=18697
    • Decreto 677 de 1995 (Art. 96 exceptional import; Arts. 145–146) — INVIMA normograma: https://normograma.invima.gov.co/compilacion/docs/decreto_0677_1995.htm
    • Resolución 2378 de 2008 (Buenas Prácticas Clínicas) — Instituto Nacional de Salud: https://www.ins.gov.co/Normatividad/Resoluciones/RESOLUCION%202378%20DE%202008.pdf
    • Resolución 8430 de 1993 — MinSalud: https://www.minsalud.gov.co/sites/rid/Lists/BibliotecaDigital/RIDE/de/dij/resolucion-8430-DE-1993.PDF
    • Resolución INVIMA 2025046281 de 19 de septiembre de 2025 (contingency plan; Fondo Nacional de Estupefacientes prioritization): http://normograma.invima.gov.co/normograma/compilacion/docs/resolucion_invima_46281_2025.htm
    • Resolución INVIMA 2025010547 de 19 de marzo de 2025 (Plan de Contingencia): https://normograma.invima.gov.co/compilacion/docs/resolucion_invima_10547_2025.htm
    • DANE — Nota Técnica, Proyecciones de Población, July 2025 (53 million in 2025): https://www.dane.gov.co/files/censo2018/proyecciones-de-poblacion/Nacional/NotaTecnica-PPED-jul2025.pdf
    • Cámara de Representantes — clinical-research framework bill, August 2025 (tacit approval 7/30 days, ICH E6, ISO 14155:2020): https://hcrpruebas.camara.gov.co/wp-content/uploads/2025/08/proyectos_ley/25082025_25082025_ver_documento_17.pdf
    • ConsultorSalud, 25 June 2025 — INVIMA average 5.1 months to definitive concept; ~90 protocols/year; 160+ BPC-certified centres: https://consultorsalud.com/colombia-reto-regulacion-estudios-clinicos/
    • ConsultorSalud, June 2026 — draft unified medical device sanitary regime replacing Decretos 4725/2005 and 3770/2004: https://consultorsalud.com/regimen-unico-dispositivos-medicos-impactos/
    • ConsultorSalud, February 2026 — MinSalud draft resolution partially repealing Resolución 8430 de 1993: https://consultorsalud.com/minsalud-investigacion-salud-seres-humanos-ips/
    • Disposición ANMAT 7516/2025, Art. 5 — Boletín Oficial de la República Argentina: https://www.boletinoficial.gob.ar/detalleAviso/primera/332695/20251009
    • Instituto de Salud Pública de Chile — 45 business days for trial import authorization: https://www.ispch.gob.cl/pregunta-frecuente/p-141/
    • MINSA Panamá — Decreto Ejecutivo N° 21 de 23 de abril de 2026: https://www.minsa.gob.pa/normatividad/decreto-ejecutivo-ndeg-21-jueves-23-de-abril-2026-que-reglamenta-los-titulos-iii-y-iv
    • bioaccess® — Colombia clinical trial regulatory guide: https://bioaccessla.com/regulatory-guide/colombia

  • Post-trial access in Peru under DS 021-2017-SA

    Peru obliges sponsors to keep supplying the investigational product, free of charge, to participants who are still benefiting after a trial ends. The duty lives in Título X (Arts. 115–118) of the Reglamento de Ensayos Clínicos approved by Decreto Supremo N.° 021-2017-SA, and it covers medical devices as well as drugs.

    What makes Peru different from the rest of Latin America is not the strength of the obligation but its drafting. Most regional PTA mandates state a duty and stop. Peru states the duty, names two authorization routes, lists the exact documents required for one of them, and assigns the post-access safety reporting. That specificity is why Peru is the most operationally tractable post-trial access market in the region.

    The obligation: Article 115 and Article 40(p)

    Article 115 defines post-study access as the free availability, to the research subject, of the investigational product studied in the trial — expressly including products that already hold a Peruvian sanitary registration — after the study closes or after that subject’s participation ends. It also requires that post-study access be anticipated before the study begins and disclosed during the informed consent process (DS 021-2017-SA, Art. 115).

    The same instrument places the duty on the sponsor directly. Article 40(p) makes the sponsor responsible for “asegurar el acceso de los sujetos de investigación, después de la culminación del ensayo clínico al producto de investigación” under the terms of Título X, and adds that this must be specified in the informed consent form. Article 40(s) separately requires free access to the investigational product, complementary products and trial procedures during participation — so the Peruvian scheme is continuous rather than a distinct post-close programme bolted on later.

    Article 115 sets conditions for when the duty is enforceable: the seriousness of the medical condition, the effect of withdrawing or modifying treatment, the absence of satisfactory therapeutic alternatives in Peru for that subject’s condition, sufficient efficacy and safety information, and a positive benefit-risk balance. The product must have proved beneficial to the subject in the principal investigator’s judgment, and “su uso se mantendrá en cuanto hubiere beneficio” — supply continues as long as benefit continues. There is no fixed end date.

    One clause matters in feasibility modelling. Where the pathology falls under the management of a MINSA General Directorate, the sponsor must maintain access “hasta que le sea accesible a través de dichas direcciones” — until the patient can obtain the product through the public system. For conditions inside a national programme, that converts an open-ended commitment into a handoff with a definable end state. For conditions outside one, it does not.

    Who pays

    The sponsor. Article 89 states that investigational products for use in clinical trials “serán financiados por el patrocinador y proporcionados gratuitamente al sujeto de investigación.” Read with Article 115’s “disponibilidad gratuita” and Article 40(p), there is no cost-sharing construct available in Peru — not co-payment, not reimbursement, not a named-patient sale. Budget the cost of goods, import, storage, dispensing and destruction as sponsor expense for the full benefit period.

    Devices are in scope

    Article 2, numeral 2.1, item 36 defines “producto en investigación” as “un producto farmacéutico o dispositivo médico” investigated or used as a comparator in a clinical trial, referring both terms back to Ley N.° 29459. Título X operates on “producto en investigación,” so the post-trial access duty applies textually to device trials, not only pharmaceutical ones.

    A device PTA commitment can mean continued supply of consumables, continued availability of an implanted system’s disposables, or continued technical support — and the Reglamento gives no device-specific carve-out. We treat device PTA exposure in Peru as live from protocol design onward.

    Two authorization routes under Article 116

    Article 116 provides that post-study access may be authorized through either of two mechanisms:

    Route 1 — an extension clinical trial authorized by OGITT. The Oficina General de Investigación y Transferencia Tecnológica of the Instituto Nacional de Salud grants authorization for a trial that constitutes an extension study, following the ordinary trial-authorization requirements in Article 67. Under Article 7, the INS is the national authority responsible for enforcing the Reglamento and for authorizing and overseeing clinical trials.

    Route 2 — case-by-case authorization by the ANM. The Reglamento’s abbreviation table defines ANM as the Autoridad Nacional de Productos Farmacéuticos, Dispositivos Médicos y Productos Sanitarios. In practice that authority is DIGEMID, which describes itself as “la Autoridad Nacional responsable de garantizar la eficacia, seguridad y calidad de los productos farmacéuticos, dispositivos médicos y productos sanitarios” and lists among its functions to “emitir opinión técnica vinculante y supervisar la autorización de los productos y dispositivos en investigación en el marco de lo dispuesto en el Reglamento de Ensayos Clínicos en el Perú” (DIGEMID, Institución).

    Article 116 also fixes the trigger sequence: the principal investigator who considers post-study access appropriate for a subject communicates that to the sponsor, and the sponsor — not the investigator, not the site — files the application with the ANM.

    The routes are not interchangeable. An extension trial suits a defined cohort continuing on protocol with a data objective, and carries full trial-authorization machinery: ethics committee approval, insurance, reporting. The ANM route suits individual patients continuing after close, with no research objective. Choosing between them is the first decision in a Peru PTA plan.

    Article 117: the seven-document set

    The reason Peru is productizable is Article 117. For the ANM route, authorization is granted “para cada caso concreto,” on application by the sponsor that ran the trial, and the requirements are enumerated:

    # Article 117 requirement
    a Application for authorization addressed to the ANM
    b Written informed consent of the subject or legal representative, signed by the subject and the principal investigator
    c Clinical report in which the principal investigator justifies the need for the treatment
    d Duly completed official medical prescription (receta médica oficial)
    e Agreement of the person responsible for the institution or establishment where the treatment will be applied
    f Updated investigator’s brochure, as applicable
    g Copy of the resolución directoral authorizing the clinical trial from which the case derives

    Two of the seven are not sponsor-controlled — item (d) requires a Peruvian official prescription and item (e) requires institutional sign-off from the treating site. Those are the items that slip. Item (g) is why trial-close document retention matters: sponsors that archive the resolución directoral badly discover it when a case is already pending. Because the list is closed and enumerated, the scope of work is definable in advance: one dossier per patient, seven artifacts, two requiring site coordination. That is a service specification, not an open-ended regulatory exercise.

    Import, dispensing and product handling

    PTA supply still has to physically enter Peru and reach the patient under the Reglamento’s product rules. Article 94 provides that the ANM authorizes importation of the investigational product and complementary products by resolución directoral specifying the authorization’s validity period, and must issue it within three business days of application, against four documents: the import application, a copy of the OGITT trial authorization, a list of products and supplies, and proof of fee payment.

    Downstream, Article 92 requires dispensing through a Unidad de Dispensación para Ensayos Clínicos within the pharmacy service of the research institution, under Good Storage and Good Dispensing Practices. Article 91 requires investigational-product labelling to carry “Solo para uso en investigación” and “Prohibida su venta.” Article 96 requires that unused or returned product be destroyed in the presence of a notary public, with the knowledge of the ANM and OGITT. A PTA programme inherits all of it.

    Timelines that are actually in the regulation

    The Reglamento states review periods for the trial-authorization route but not for the Article 117 case authorization.

    Step Statutory period Source
    ANM technical opinion on safety and quality of the investigational product 30 business days (45 for biologics) Art. 69
    OGITT resolution authorizing a clinical trial, including the ANM opinion 40 business days (60 for biologics or where technical commissions are convened) Art. 70
    ANM import authorization by resolución directoral 3 business days Art. 94
    ANM case-by-case post-study access authorization (Art. 116–117) No period stated in the Reglamento —

    Article 70 also suspends the clock when the authority requests supplementary information, so the 40-business-day figure is a floor on a clean file rather than a service level. Sponsors planning a Peru PTA bridge should build the Route 1 schedule from Article 70 and treat Route 2 duration as an assumption to be confirmed with the ANM for the specific case, not a published commitment.

    Pharmacovigilance after access begins

    Article 118 does not release the sponsor at authorization. The sponsor must report treatment results to the ANM within the established period, along with suspected adverse drug reactions, without prejudice to reporting to the corresponding territorial health authority. Peru PTA is therefore a supervised supply arrangement with a continuing safety-reporting duty — which belongs in the pharmacovigilance agreement and the vendor scope, since trial safety infrastructure is often being wound down at exactly the point PTA begins.

    Stability of the pathway

    Título X has not been amended. Decreto Supremo N.° 028-2023-SA of 17 October 2023 modified numeral 2.1 item 10 of Article 2, Article 34(b), Article 40(b), Article 52(e), the heading of Chapter III of Título V, Anexo 1 and Anexo 4, and incorporated items 2.1.48 and 2.1.49, a third paragraph to Article 6, Article 60(i), and new Articles 85-A and 85-B. Articles 115 through 118 are not among them. The pathway a sponsor plans against today is the pathway approved in DS 021-2017-SA of 28 June 2017.

    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 Peru, 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 Peru require post-trial access?
    Yes. Título X of the Reglamento de Ensayos Clínicos, approved by Decreto Supremo N.° 021-2017-SA, creates a binding post-study access duty. Article 115 defines it as free availability of the investigational product to the research subject after the study closes or after that subject’s participation ends, and Article 40(p) assigns the duty to the sponsor. The obligation is conditional rather than automatic: Article 115 requires the principal investigator to find the product beneficial for that subject, and weighs the seriousness of the condition, the effect of withdrawal, the absence of satisfactory alternatives in Peru, the available efficacy and safety data, and the benefit-risk balance.

    What is Decreto Supremo 021-2017-SA?
    It is the Peruvian Reglamento de Ensayos Clínicos, dated 28 June 2017, the decree that governs authorization and conduct of clinical trials in Peru. It sets sponsor and investigator responsibilities, ethics committee accreditation, OGITT trial authorization, investigational product controls, import, pharmacovigilance and supervision. Título X (Articles 115–118) is its post-study access chapter. It was amended by Decreto Supremo N.° 028-2023-SA of 17 October 2023, which did not touch Articles 115–118.

    Who pays for post-trial supply in Peru?
    The sponsor, entirely. Article 89 requires that investigational products be financed by the sponsor and provided free of charge to the research subject, and Article 115 describes post-study access itself as “disponibilidad gratuita.” Article 40(p) puts the access obligation on the sponsor and requires that it be disclosed in the informed consent form. There is no cost-sharing, reimbursement or named-patient sale construct available. Sponsors should budget product cost, import, storage, dispensing and destruction for the entire period the principal investigator finds benefit continuing.

    What are the two authorization routes for PTA in Peru?
    Article 116 names them. The first is authorization of a clinical trial constituting an extension study, granted by OGITT at the Instituto Nacional de Salud under the ordinary trial-authorization requirements of Article 67. The second is a case-by-case authorization from the Autoridad Nacional de Productos Farmacéuticos, Dispositivos Médicos y Productos Sanitarios (ANM) for an investigational product that the principal investigator judges beneficial to the subject. Under Article 116, the investigator notifies the sponsor and the sponsor files the ANM application.

    What is the 7-document checklist under Article 117?
    For the ANM route, Article 117 requires: (a) an application addressed to the ANM; (b) written informed consent signed by the subject or legal representative and the principal investigator; (c) a clinical report in which the principal investigator justifies the need for treatment; (d) a duly completed official medical prescription; (e) agreement from the person responsible for the institution where treatment will be applied; (f) an updated investigator’s brochure as applicable; and (g) a copy of the resolución directoral authorizing the trial from which the case derives. Authorization is granted case by case.

    Does Peru PTA apply to medical devices?
    Yes, textually. Article 2, numeral 2.1, item 36 defines “producto en investigación” as a pharmaceutical product or medical device investigated or used as a comparator in a clinical trial, referencing Ley N.° 29459 for both terms. Título X operates on that same defined term, so the post-study access duty reaches device trials. The Reglamento contains no device-specific exemption from Articles 115–118, which means MedTech sponsors should model continued availability of the device system and its consumables in the same way drug sponsors model continued dosing.

    How long does OGITT authorization take?
    Article 70 gives OGITT a maximum of 40 business days to issue the resolution authorizing a clinical trial, inclusive of the 30 business days Article 69 allows the ANM for its binding technical opinion on the investigational product’s safety and quality. For biologic investigational products, or where the INS convenes technical commissions for controversial matters, the maximum is 60 business days, inclusive of a 45-business-day ANM opinion. The clock is suspended while the applicant responds to a request for supplementary information, so these are clean-file maxima rather than expected durations.

    How long does DIGEMID/ANM case-by-case authorization take?
    The Reglamento does not state a review period for the Article 116–117 case-by-case authorization. It does set an adjacent deadline that is often confused with it: under Article 94, the ANM must issue the investigational product import authorization by resolución directoral within three business days of application. Sponsors should confirm the expected case-review duration with the ANM for the specific product and patient rather than planning against a published figure, and should not assume the three-day import period applies to the Article 117 dossier.

    What is the difference between OGITT and DIGEMID in Peru PTA?
    OGITT — the Oficina General de Investigación y Transferencia Tecnológica of the Instituto Nacional de Salud — authorizes and supervises clinical trials, including the extension trial that constitutes Route 1 under Article 116. DIGEMID acts as the ANM: it issues binding technical opinions on investigational product safety and quality (Article 69), authorizes importation (Article 94), grants the case-by-case post-study access authorization (Articles 116–117), and receives the post-access safety reports (Article 118). Route 1 is an INS filing; Route 2 is a MINSA medicines-authority filing.

    What are the pharmacovigilance obligations during Peru PTA?
    Article 118 requires the sponsor to communicate the results of the treatment to the ANM within the established period, together with suspected adverse drug reactions attributable to the product, without prejudice to reporting adverse reactions to the corresponding territorial health authority. This duty runs for the life of the post-study access arrangement, which under Article 115 continues as long as the principal investigator finds benefit. Sponsors should ensure safety case processing, medical monitoring and the local reporting channel survive database lock rather than being decommissioned with the trial.

    Sources

  • Post-trial access in Chile under Ley 20.850 and Código Sanitario Art. 111 C

    Chile obliges the holder of a clinical trial’s provisional-use authorization — and, later, whoever holds the product’s sanitary registration — to keep supplying the trial treatment free of charge for as long as it retains therapeutic usefulness. The rule is Article 111 C of the Código Sanitario, inserted by Ley 20.850, and it is written in a way that binds an acquirer who was never involved in the trial.

    That last clause is why Chile belongs on a deal checklist rather than only on a clinical operations checklist. A US sponsor can sell or out-license a Chilean-registered product and hand the buyer an open-ended, free-of-charge supply duty that appears nowhere in the trial budget, the product P&L, or most representations and warranties.

    What Ley 20.850 actually did

    Ley Núm. 20.850, “Crea un sistema de protección financiera para diagnósticos y tratamientos de alto costo y rinde homenaje póstumo a don Luis Ricarte Soto Gallegos,” was promulgated on 1 June 2015 by the Ministerio de Salud (BCN Ley Chile) and published in the Diario Oficial on 6 June 2015, a date recited in later ministerial decrees (Decreto 11 Exento, 30 April 2025).

    The statute is best known for the high-cost treatment fund it created. But Article 34 of the same law added two new Titles to Book Four of the Código Sanitario: Title V on clinical trials of pharmaceutical products and elements of medical use (Arts. 111 A to 111 G), and Title VI on defective health-product liability (Arts. 111 H to 111 N). Chile’s trial authorization regime, its post-trial access duty, its strict-liability rule for trial injury and its ten-year limitation period all arrived in one act (Código Sanitario, DFL 725). Ley 20.850 restates the same right in Article 17: trial patients “tendrán derecho… a la continuidad gratuita de los tratamientos recibidos conforme al protocolo de estudio, aun cuando éste haya finalizado y mientras subsista su utilidad terapéutica” (Ley 20.850, Art. 17).

    What Article 111 C requires

    The operative text is short. Article 111 C, first paragraph:

    “El paciente sujeto de ensayo clínico tendrá derecho a que, una vez terminado éste, el titular de la autorización especial para uso provisional con fines de investigación y, con posterioridad en su caso, el titular del registro sanitario del producto sanitario de que se trate, le otorgue sin costo para el paciente la continuidad del tratamiento por todo el tiempo que persista su utilidad terapéutica, conforme al protocolo de investigación respectivo.” (Código Sanitario Art. 111 C)

    Four things follow. It is a patient right, not a sponsor best-effort. It is free to the patient, with no cost-sharing carve-out. It has no calendar end point: termination turns on loss of therapeutic usefulness, not commercial launch, not reimbursement listing, not a fixed number of years. And it is anchored to the study protocol, so the protocol’s definition of continued benefit stays load-bearing years after database lock. Brazil caps the equivalent duty at five years from commercial availability; Chile has a named obligor and no clock.

    Breach is sanctioned under Article 111 G, which routes Title V infractions to Book Ten of the Código Sanitario and to Ley 20.120. Book Ten’s general penalty article allows fines from one-tenth of a UTM up to 1,000 UTM, doubled on recidivism, plus suspension of distribution and use of the products concerned (Código Sanitario, Art. 174).

    Devices are expressly in scope

    Most Latin American post-trial provisions are drafted around medicines and leave device sponsors to argue about scope. Chile does not. Article 111 A states that the special provisional-use authorization “se requerirá para todo producto farmacéutico o dispositivo médico,” and Title V is titled for “productos farmacéuticos y elementos de uso médico” (Código Sanitario Art. 111 A). Because Article 111 C attaches to the holder of that same authorization, the post-trial duty reaches device sponsors on the face of the text. The Ministerio de Salud may exempt, by supreme decree, device categories whose use “no conlleve un riesgo relevante para las personas” — that is an exemption from the authorization requirement, and a sponsor relying on it should confirm the specific decree rather than assume one exists for its class.

    For an implantable or capital-equipment device, continuity “for as long as therapeutic usefulness persists” raises questions the statute does not answer: replacement units, consumables, explant and revision, software maintenance, end of product life. Those gaps close in the protocol and the informed consent, because Article 111 C points back to the protocol for its content.

    The obligation follows the registration, not the sponsor

    The second paragraph of Article 111 C is the one that changes deal economics:

    “Esta obligación 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.” (Código Sanitario Art. 111 C)

    Read that literally. The duty binds the sanitary-registration holder even where that party never held the provisional-use authorization, and even where it acquired the registration afterwards. It travels with the asset by operation of law. An asset purchase that transfers only the Chilean registration — no trial contracts, no site agreements, no sponsor entity — still carries the tail. A licensing deal in which the licensee becomes the Chilean registration holder does the same.

    Four diligence questions follow for anyone buying a product with Chilean clinical history. Was any Chilean trial run under an ISP provisional-use authorization for this product, per the public research register the ISP must keep under Article 111 A? How many participants remain on treatment, under what protocol definition of continued benefit? Who has supplied them since study close, under what import authorization? And is there seller indemnity for a duty Chilean law places on the registration holder directly — noting that allocation between the parties does not extinguish the duty toward the patient.

    The exposure is unbounded in duration by design, which makes it hard to reserve for and easy to miss. We identified no published Chilean enforcement decision quantifying the tail, so today’s practical risk is less about fines than about inheriting an undisclosed supply commitment and finding it after closing.

    Where the ISP fits

    The Instituto de Salud Pública is the regulator on both ends of this obligation. It grants the provisional-use authorization under Article 111 A — valid for no more than one year, renewable for equal successive periods — accredits research centers under Article 111 D, and fiscalizes protocols, informed consents, good clinical practice and adverse-event reporting (Código Sanitario Arts. 111 A and 111 D). Article 111 D also makes any confidentiality obligation in a protocol or agreement unenforceable against the ISP. The authorization is a paid service: prestación 4111035 is listed at CLP $1,129,893 plus IVA (ISP). Article 99 separately lets the ISP provisionally authorize unregistered pharmaceutical products for trials and for urgent medicinal uses arising from shortage or inaccessibility (Código Sanitario Art. 99; ISP guidance).

    What the ISP has not published is Article 111 C guidance. Its “Guía de consideraciones generales para estudios clínicos” (Res. Ex. N° 173, 29 January 2024 — BCN) and its first-edition “Guía de investigación clínica de dispositivos médicos en humanos. Buenas prácticas clínicas” (Res. Ex. N° 341, 7 April 2026, recorded as Res. Ex. 2.050 — BCN; ISP) were both reviewed for post-trial content. The device guide cites Article 111 A and covers post-participation care for adverse events and post-market clinical follow-up, but not Article 111 C or continued supply. Chile’s newest device GCP guidance is silent on the obligation its own statute imposes on device sponsors.

    CENABAST and the exceptional-import backstop

    CENABAST is Chile’s public procurement and supply agency, and Ley 20.850 gave it powers that matter when a supply chain breaks. Under Article 15, where a product covered by the high-cost system has its registration suspended, cancelled or lapsed, CENABAST may — with prior Ministry of Health authorization, and only where no alternative exists at the maximum industrial price — exceptionally import and distribute it “independientemente si cuentan o no con autorización o registro sanitarios.” The same article deems those circumstances public-health grounds under Chile’s industrial property law and closes with a liability rule: “Los titulares de los registros o autorizaciones sanitarias, los productores o los importadores serán responsables civilmente por la falta de continuidad de los tratamientos” (Ley 20.850, Art. 15). Article 31 adds the procurement side: contracting one product with more than one supplier where continuity requires it, direct contracting where CENABAST holds the registration itself, and requesting a provisional sanitary registration in shortage situations (Ley 20.850, Art. 31; CENABAST).

    This is a state backstop for continuity of covered treatments, with civil liability pointed back at the registration holder. It is not a route to hand off an Article 111 C duty.

    The Ricarte Soto Fund as the exit ramp, and its limits

    Ley 20.850’s financial protection system is insured by FONASA for beneficiaries of every Chilean health system — FONASA, isapres, CAPREDENA and DIPRECA — regardless of socioeconomic status, and covers 100% of the cost of the medicines, medical devices or foods expressly guaranteed for each defined health problem (Superintendencia de Salud). ChileAtiende describes it as guaranteeing diagnosis and treatment for 27 high-cost conditions (ChileAtiende). Inclusion runs through a supreme decree under Article 5, subject to a cost threshold, favourable scientific evaluation, recommendation and an incorporation decision (Ley 20.850, Art. 5).

    Getting a product into that decree is the cleanest way for Article 111 C exposure to become a state-funded treatment rather than a private supply obligation. It is also slow, competitive and outside the sponsor’s control — and nothing in Article 111 C ends the duty on listing. Treat it as practical mitigation, not a legal termination event.

    What the statute leaves open

    First, Title V repeatedly refers to a reglamento — adverse-event reporting under Article 111 B, center accreditation under Article 111 D, insurance under Article 111 F. We identified no ISP or MINSAL instrument in this review that operationalizes Article 111 C specifically. The obligation is statutory and self-executing on its face; the mechanics are not written down.

    Second, entry into force. The first transitory article provides that “las normas de esta ley regirán a contar de la entrada en vigencia del decreto a que se refiere el artículo 5º” (Ley 20.850, disposiciones transitorias). The Article 34 amendments sit in the consolidated Código Sanitario text and the ISP has operated the Article 111 A authorization since, but how that clause interacts with the Title V insertions is a question for Chilean counsel, not for a CRO.

    Third, “utilidad terapéutica” is undefined. Chile’s medical academy, writing on Title V and its draft reglamento in Revista Médica de Chile, argued that continuation should be decided case by case once final results including safety are known, by the patient and treating physician, and that “se necesita una definición de utilidad más objetiva y fácil de determinar” (Rev Med Chile). Until that definition exists, the protocol is the only instrument that sets the endpoint — an argument for drafting it at protocol design, not at study close.

    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 or acquisition exposure in Chile, 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 Chile require post-trial access?
    Yes. Article 111 C of the Código Sanitario gives clinical trial participants a right to continued treatment after the trial ends, free of charge, for as long as the treatment retains therapeutic usefulness. The duty falls first on the holder of the ISP special provisional-use authorization and then on the holder of the product’s sanitary registration. The same right is restated in Article 17 of Ley 20.850. This is a statutory patient right, not an ethics-committee expectation or a best-efforts commitment, and breach is sanctionable under Article 111 G through Book Ten of the Código Sanitario.

    What is Ley 20.850 (Ley Ricarte Soto)?
    Ley 20.850 is the Chilean statute that created a universal financial protection system for high-cost diagnoses and treatments, promulgated 1 June 2015 and published 6 June 2015. It is named in posthumous tribute to journalist Luis Ricarte Soto Gallegos. Beyond the fund, its Article 34 inserted Titles V and VI into Book Four of the Código Sanitario, creating Chile’s clinical trial authorization regime (Arts. 111 A to 111 G) and its defective health-product liability regime (Arts. 111 H to 111 N). Most sponsors know the fund and miss the clinical trial chapter.

    What does Código Sanitario Art. 111 C require?
    It requires that, once a clinical trial ends, the holder of the special provisional-use authorization — and afterwards, where applicable, the holder of the product’s sanitary registration — provide the participant with continuity of treatment “sin costo para el paciente,” for the whole time that its therapeutic usefulness persists, in accordance with the study protocol. A second paragraph extends the duty to a registration holder that never held the provisional authorization or that acquired the registration later. There is no calendar limit and no cost-sharing exception in the text.

    Does Chile PTA apply to medical devices?
    Yes, on the face of the statute. Article 111 A states that the special provisional-use authorization is required for “todo producto farmacéutico o dispositivo médico,” and Title V is titled for pharmaceutical products and elements of medical use. Because Article 111 C attaches to the holder of that authorization, device sponsors are captured. The Ministry of Health may exempt low-risk device categories from the authorization requirement by supreme decree, so confirm the applicable decree for your class rather than assuming an exemption applies.

    Who pays for post-trial supply in Chile?
    The obligated party pays. Article 111 C says the treatment is provided “sin costo para el paciente,” and names the provisional-use authorization holder and then the sanitary-registration holder as the parties who must provide it. There is no provision allowing the cost to be shifted to the patient, the treating institution, FONASA or an isapre. Sponsors may allocate the economics contractually between themselves, a licensee or an acquirer, but that allocation does not change who Chilean law holds responsible to the patient.

    How long must sponsors provide post-trial access in Chile?
    For as long as therapeutic usefulness persists — “por todo el tiempo que persista su utilidad terapéutica.” Chile sets no fixed term, no five-year cap, and no automatic termination at commercial launch or reimbursement listing. That makes it materially more open-ended than Brazil, where Lei 14.874/2024 permits interruption five years after commercial availability. Because “utilidad terapéutica” is undefined in the statute, the study protocol referenced by Article 111 C becomes the practical instrument that defines when the obligation ends.

    What is the M&A diligence trap in Chile PTA?
    The second paragraph of Article 111 C binds the sanitary-registration holder “aun cuando no haya sido el titular de la autorización provisional o haya adquirido con posterioridad el registro sanitario.” The supply duty travels with the registration by operation of law. A buyer acquiring only a Chilean marketing authorization — with no trial contracts, no sponsor entity, no site agreements — can inherit an open-ended, free-of-charge obligation to patients it has never seen, arising from a trial it never ran. Standard reps and warranties rarely surface it, and standard product P&Ls never price it.

    What is ISP’s role in Chile PTA?
    The Instituto de Salud Pública grants the Article 111 A special provisional-use authorization (maximum one year, renewable for equal successive periods), maintains the public register of authorized human research, accredits research centers under Article 111 D, and fiscalizes protocols, informed consents, GCP and adverse-event notification. Its listed fee for prestación 4111035 is CLP $1,129,893 plus IVA. The ISP’s public register is the practical starting point for confirming whether a Chilean-registered product has a trial history that could trigger an Article 111 C tail.

    What is CENABAST and how does its exceptional-import route work?
    CENABAST is Chile’s Central de Abastecimiento, the public health supply and procurement agency. Under Article 15 of Ley 20.850, where a covered product’s registration is suspended, cancelled or lapsed, CENABAST may — with prior Ministry of Health authorization and where no priced alternative exists — exceptionally import and distribute it regardless of whether it holds sanitary registration, to guarantee treatment continuity. Article 31 lets it contract with multiple suppliers and request a provisional sanitary registration in shortage situations. Article 15 also makes registration holders, producers and importers civilly liable for failures of treatment continuity.

    Does the PTA obligation transfer with the marketing authorization?
    Yes. That is the explicit effect of Article 111 C’s second paragraph, and it is the single most commercially consequential sentence in Chile’s post-trial regime. Acquirers and in-licensees should treat the Chilean registration as carrying a potential supply liability, diligence the ISP research register and the seller’s Chilean trial history, quantify the number of patients still on treatment, and negotiate indemnities knowing that the statutory duty to the patient sits with whoever holds the registration.

    Sources

    • Ley Núm. 20.850, Ministerio de Salud, promulgated 1 June 2015 — Arts. 5, 15, 17, 31, 34, disposiciones transitorias: https://www.bcn.cl/leychile/navegar?idNorma=1078148
    • Código Sanitario (DFL 725), consolidated text — Arts. 99, 111 A, 111 B, 111 C, 111 D, 111 E, 111 F, 111 G, 111 H–111 N, 174: https://www.bcn.cl/leychile/navegar?idNorma=5595
    • Decreto 11 Exento, M. de Salud, 30 April 2025 (recital confirming Ley 20.850 published 6 June 2015): https://www.bcn.cl/leychile/navegar?idNorma=1212845
    • ISP prestación 4111035, provisional-use authorization for clinical study products: https://www.ispch.gob.cl/prestacion/4111035/
    • ISP, autorización excepcional sin registro sanitario (Art. 99 / D.S. 3/2010 Art. 21, prestación 4111036, SAFIS): https://www.ispch.gob.cl/anamed/medicamentos/autorizacion-excepcional-sin-registro-sanitario/
    • ISP, Estudios Clínicos: https://www.ispch.gob.cl/anamed/estudios-clinicos/
    • Resolución Exenta N° 173, 29 January 2024, “Guía de consideraciones generales para estudios clínicos” (ISP): https://www.bcn.cl/leychile/navegar?idNorma=1201301
    • Resolución Exenta N° 341, 7 April 2026 / Res. Ex. 2.050, “Guía de investigación clínica de dispositivos médicos en humanos. Buenas prácticas clínicas” (ISP): https://www.bcn.cl/leychile/navegar?idNorma=1223885 and https://www.ispch.gob.cl/wp-content/uploads/resoluciones/36444_2050-2026.pdf
    • CENABAST, “Ley Ricarte Soto: con nuevas facultades, CENABAST asegura disponibilidad de medicamentos”: https://www.cenabast.cl/ley-ricarte-soto-con-nuevas-facultades-cenabast-asegura-disponibilidad-de-medicamentos/
    • Superintendencia de Salud, Ley Ricarte Soto orientation page: https://www.superdesalud.gob.cl/tax-temas-de-orientacion/ley-ricarte-soto-6088/
    • ChileAtiende, Ley Ricarte Soto: https://www.chileatiende.gob.cl/fichas/38873-ley-ricarte-soto
    • Academia Chilena de Medicina, declaration on Title V of Ley 20.850 and its draft reglamento, Revista Médica de Chile: https://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872017000300013

  • 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

  • Post-trial access in Panama under Decreto Ejecutivo 21/2026 Article 68

    Panama now imposes a binding post-trial access obligation. Article 68 of Decreto Ejecutivo No. 21 de 23 de abril de 2026 requires investigators and sponsors to ensure that every participant who demonstrated clinical or public-health benefit keeps access to the investigational product until that product is commercialized in Panama.

    The instrument is four months old. It was published in Gaceta Oficial Digital No. 30510-C on 23 April 2026 and entered into force on promulgation under Article 105. Most post-trial access (PTA) guidance in circulation still describes Panama as having an import mechanism but no obligation, or cites instruments that no longer govern health research. Sponsors closing studies in Panama in 2026 and 2027 are exposed to a requirement their vendors have not read.

    What Decreto Ejecutivo 21/2026 actually is

    Decreto 21/2026 is the implementing regulation for Titles III and IV of Ley 84 de 14 de mayo de 2019, the statute that regulates and promotes health research in Panama and establishes its governance. Per the Infojurídica record for the decree, Title III of Ley 84/2019 covers the Comité Nacional de Bioética de la Investigación (CNBI) and Title IV covers the management of health research projects. Ley 84/2019 was published in Gaceta Oficial 28775-A on 16 May 2019.

    The decree runs 105 articles across fifteen chapters, is signed by President José Raúl Mulino Quintero and Minister of Health Fernando Boyd Galindo, and rests on the Constitution, Ley 66 de 10 de noviembre de 1947 (Código Sanitario) and Ley 84 de 2019. The CNBI hosts its own copy, a practical signal that the bioethics system treats it as the operative reference.

    Article 68 verbatim

    Article 68 is titled “Acceso a productos por parte de los participantes.” The operative first paragraph 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, de conformidad con criterios especificados en la reglamentación y en cumplimiento de la normativa correspondiente a la importación de estos productos. Para tales efectos, solicitará ante la autoridad competente, una extensión del permiso de importación del producto utilizado durante la investigación para uso exclusivo de los participantes de dicho estudio hasta cumplir la fase post investigación.”

    Our English translation: “Investigators and sponsors must ensure access to the product for all participants, provided the clinical or public-health benefit of the intervention was demonstrated during the study; until its commercialization in the country, in accordance with criteria specified in the regulations and in compliance with the rules governing importation of these products. For such purposes, they shall request from the competent authority an extension of the import permit for the product used during the research, for the exclusive use of the participants in that study, until the post-research phase is complete.”

    The second paragraph assigns exceptional cases to the research bioethics committee. The third requires “acuerdos, convenios u otras figuras” reflecting the sponsor’s intent to commercialize the product in Panama, modelled on the CIOMS guidelines, so the sponsor can offer access once study participation ends — expressly “a fin de evitar que la descontinuación de una intervención prive a los participantes de la investigación de capacidades básicas o reduzca considerablemente la calidad de vida que habían logrado durante el estudio.”

    Investigators and sponsors are co-obligated

    The subject of Article 68 is plural: “los investigadores y patrocinadores.” That is unusual in the region, where most PTA provisions name the sponsor alone. Panama makes the local principal investigator jointly responsible.

    The investigator therefore carries a personal regulatory duty to escalate if the sponsor does not fund continued supply, and Article 69 requires the sponsor to secure at least one principal investigator resident in Panama answering scientific, ethical and legal questions — so there is always an identifiable domestic co-obligor the CNBI and the accredited Comité de Bioética de la Investigación (CBI) can hold to account.

    Article 68 does not use the word gratuito, so cost allocation is not stated verbatim. It is reached indirectly: Article 71 num. 2 makes the CIOMS international ethical guidelines for health-related research involving humans a fundamental document governing approval, execution and follow-up of research, and Article 66 requires the CBI to apply CIOMS in vulnerability analysis. CIOMS Guideline 6 states that “the obligation to care for participants’ health needs rests with the researcher and the sponsor” and requires plans for “providing continued access to study interventions that have demonstrated significant benefit.” Read with Article 61, under which participants “no deben incurrir en ningún gasto por participar en un estudio de investigación,” the practical outcome is sponsor-funded supply — inferred from Articles 61, 66 and 71, not quoted from Article 68.

    Duration: until commercialization in Panama

    The end point in Article 68 is “hasta su comercialización en el país” — until the product is commercialized in Panama. There is no fixed month count and no cap. For a device or drug with no Panamanian registration plan that phrasing is open-ended, which is why the third paragraph of Article 68 demands agreements documenting the sponsor’s commercialization intent. A sponsor not planning to commercialize must either negotiate a defined exit with the CBI under the exceptional-cases paragraph or plan for a long tail.

    CIOMS supplies the standard the CBI will most likely apply: provision “may end as soon as the study intervention is made available through the local public health-care system or after a predetermined period of time that the sponsors, researchers and community members have agreed before the start of a trial.” A sponsor that has not defined the PTA exit at protocol stage has weaker footing at study close.

    The extension of the import permit

    Article 68 names a specific filing: an extensión del permiso de importación covering the investigational product for the exclusive use of that study’s participants, through the post-research phase. It is not a compassionate-use application — it is an extension of the existing research import permit, scoped to a closed cohort.

    The surrounding machinery sits in Chapter XIII. Under Article 95, where a high-risk study uses medicines or products for human health, product evaluation before the trial starts belongs to the Dirección Nacional de Farmacia y Drogas (DNFD), filed through the RESEGIS platform of the Dirección General de Salud Pública with GMP certification, certificate of analysis, investigator’s brochure and product manuals; the DNFD answers within fifteen working days. Article 99 states plainly that “la importación de los productos de investigación se hará en base al registro del proyecto de investigación en la plataforma RESEGIS, la aprobación ética y su autorización por la Dirección Nacional de Farmacia y Drogas.” Article 100 makes the investigator or tramitante responsible for evidencing all approval and importation documentation in RESEGIS.

    Three approvals therefore gate every post-trial shipment: an active RESEGIS project record, CBI ethical approval covering the post-trial phase, and DNFD authorization. Article 97 adds labelling minimums — identification or code, lot, expiry, storage conditions, special warnings — with Spanish required except where the DNFD accepts English on prior justification. For a 2–8 °C product that chain must hold through a supply period that may run years past the last patient visit.

    RESEGIS, the DNFD and the CBI

    RESEGIS is the Registro y Seguimiento de la Investigación para la Salud, established under Article 79 in the Dirección General de Salud Pública. The MINSA introductory guide confirms that the principal investigator registers the project and that a third party or tramitante may file on the investigator’s behalf provided the investigator is already enrolled. That tramitante route is how a sponsor without a Panamanian legal entity gets filings made locally.

    The CBI’s role in PTA is decision-making, not advisory. Article 68 paragraph 2 gives the accredited committee authority over exceptional cases and requires it to determine the applicable mechanisms against previously defined criteria; Article 66 requires the CNBI and accredited CBIs to hold a standard operating procedure for these situations. The CBI that approved the protocol is the body that will approve, condition or reject a proposed PTA arrangement, and Article 91 requires the investigator to load approval certifications into RESEGIS.

    What Article 104 repealed — and what it did not

    Article 104 repeals Decreto Ejecutivo No. 1843 de 16 de diciembre de 2014, Decreto Ejecutivo No. 6 de 3 de febrero de 2015 (the prior bioethics regulation) and Resolución No. 390 de 6 de noviembre de 2003. Any PTA position built on the pre-2026 bioethics-committee framework rests on repealed instruments.

    Article 104 does not repeal Decreto Ejecutivo No. 27 de 10 de mayo de 2024, published in Gaceta 30028-C. That decree implements Ley 419 de 1 de febrero de 2024, the commercial medicines and public-procurement statute, and defines “acceso a medicamento post-estudio clínico” in Article 2 num. 3 as a pharmaceutical product used in a clinical study in Panama, supplied on the treating investigator’s justification of continued benefit “hasta que este esté comercialmente disponible en el país o según lo determine el Comité de Bioética en Investigación.” It stays part of the medicines regime. What changed on 23 April 2026 is that the obligation now lives in Article 68 of the health-research decree. Decreto 27/2024 describes an available route; Article 68 imposes a must.

    Misconceptions worth correcting

    “Panama has a mechanism but no mandate.” Accurate before 23 April 2026, wrong now. Article 68 uses deben asegurar.

    “Ley 419/2023 is the Panamanian PTA law.” The number is right, the year is wrong, and the statute is the wrong one. It is Ley 419 of 1 February 2024, and it regulates commercial medicines and public procurement, not health research. The health-research statute is Ley 84 de 14 de mayo de 2019.

    “Decreto Ejecutivo 27/2024 is the operative PTA instrument.” It is the operative instrument for the medicines regime and it still contains the definition, but the binding continued-supply obligation for study participants now sits in Decreto 21/2026 Article 68.

    “PTA in Panama is a compassionate-use filing.” Article 68 instead routes it through an extension of the research import permit for a defined cohort, evidenced in RESEGIS under Articles 99 and 100.

    What sponsors should do before database lock

    Define the PTA exit in the protocol and informed consent, not at close-out. Get the CBI to approve the arrangement and the acuerdos o convenios required by Article 68 paragraph 3 while the study is still open. Keep the RESEGIS record live through the post-research phase. Budget the import-permit extension, DNFD interaction and Spanish labelling as a workstream distinct from the trial, with a named local filer able to act as tramitante. And confirm which accredited CBI holds the file — that committee, not MINSA centrally, decides the exceptional-case mechanism.

    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 Panama 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

    What does Panama require for post-trial access?
    Panama requires investigators and sponsors to ensure that every trial participant who demonstrated clinical or public-health benefit continues to receive the investigational product until it is commercialized in Panama. The requirement is Article 68 of Decreto Ejecutivo No. 21 de 23 de abril de 2026. Operationally the sponsor must request an extension of the research import permit covering only that study’s participants, keep the project record active in the RESEGIS platform, obtain Dirección Nacional de Farmacia y Drogas authorization for importation under Article 99, and document the arrangement with the accredited research bioethics committee that approved the protocol.

    Is post-trial access mandatory in Panama?
    Yes, since 23 April 2026. Article 68 of Decreto Ejecutivo 21/2026 uses the mandatory verb deben asegurar (“must ensure”) and names both investigators and sponsors as obligors. The decree entered into force on promulgation under Article 105 and was published in Gaceta Oficial Digital No. 30510-C. Before that date, Panama had a definitional and import route for post-study medicine access under Decreto Ejecutivo 27/2024 but no clearly worded affirmative duty on the sponsor. Guidance describing Panama as a mechanism-only jurisdiction is out of date.

    Who pays for post-trial access in Panama?
    In practice the sponsor. Article 68 does not use the word gratuito, so cost allocation is not stated verbatim in that article. It arrives through three linked provisions: Article 61 states that participants must not incur any expense for participating in a research study; Article 71 num. 2 makes the CIOMS international ethical guidelines a fundamental governing document; and CIOMS Guideline 6 places the obligation to meet participants’ health needs on the researcher and the sponsor. Sponsors should budget product, importation, labelling, cold-chain and local filing costs.

    How long must sponsors provide post-trial access in Panama?
    Until the product is commercialized in Panama — “hasta su comercialización en el país” in Article 68. There is no fixed duration and no statutory cap. Where the sponsor does not intend to register and commercialize in Panama, the obligation is open-ended on its face, and the exit must be negotiated with the research bioethics committee under the exceptional-cases paragraph of Article 68. CIOMS Guideline 6 supports ending provision once the intervention is available through the local public health system or after a period agreed before the trial started, which is why the exit should be defined in the protocol.

    What is Decreto Ejecutivo 21/2026?
    Decreto Ejecutivo No. 21 de 23 de abril de 2026 is the Panamanian regulation implementing Titles III and IV of Ley 84 de 14 de mayo de 2019 on health research. It has 105 articles across fifteen chapters covering the CNBI, accredited bioethics committees, participant rights, the RESEGIS registration platform, the administrative review procedure, and Chapter XIII on research using medicines and other products for human health. It was published in Gaceta Oficial Digital No. 30510-C and entered into force on promulgation.

    What happened to Decreto Ejecutivo 27/2024?
    It is still in force as the implementing regulation for Ley 419 de 1 de febrero de 2024, the commercial medicines and public-procurement statute, and it still defines acceso a medicamento post-estudio clínico in Article 2 num. 3. Article 104 of Decreto 21/2026 repeals Decreto Ejecutivo 1843/2014, Decreto Ejecutivo 6/2015 and Resolución 390/2003 — not Decreto 27/2024. What changed is authority: the binding post-trial obligation on investigators and sponsors now comes from Article 68 of Decreto 21/2026, so citing Decreto 27/2024 as the whole picture understates the duty.

    Does Panama post-trial access apply to medical devices?
    Article 68 refers to “el producto” without limiting it to medicines, and Chapter XIII is titled “De la investigación para la salud donde se utilizan medicamentos y otros productos para la salud humana.” Article 95 covers “medicamentos o productos para la salud humana,” and the glossary in Article 2 num. 8 defines high-risk intervention technology as a medical or health technology used to intervene in diagnosis, treatment, prevention or rehabilitation. On that reading device studies are within scope. Sponsors of device trials should confirm the specific import pathway with the Dirección Nacional de Farmacia y Drogas rather than assume the medicine route applies unchanged.

    What is the difference between Ley 84/2019 and Ley 419/2024?
    Ley 84 de 14 de mayo de 2019 regulates and promotes health research and establishes its governance; its Title III creates the Comité Nacional de Bioética de la Investigación and its Title IV governs management of health research projects. Ley 419 de 1 de febrero de 2024 regulates medicines and other products for human health and their public procurement. Post-trial access as an obligation flows from Ley 84/2019 through Decreto 21/2026 Article 68. Note also that the frequently seen citation “Ley 419/2023” is wrong on the year.

    Who reviews and approves post-trial access requests in Panama?
    Three bodies, in sequence. The accredited Comité de Bioética de la Investigación that approved the protocol reviews the post-trial arrangement and, under Article 68 paragraph 2, decides exceptional cases against previously defined criteria. The Dirección Nacional de Farmacia y Drogas evaluates the product and authorizes importation under Articles 95 and 99. The Dirección General de Salud Pública operates the RESEGIS platform under Article 79, where the investigator or tramitante must evidence all approval and importation documentation under Article 100.

    Sources

  • First-in-Human Trial Readiness in Latin America: The Cross-Functional Gate Before Submission

    First-in-Human Trial Readiness in Latin America: The Cross-Functional Gate Before Submission

    A first-in-human (FIH) study in Latin America can move quickly only when the sponsor’s evidence tells one consistent story. The protocol, risk analysis, investigator brochure or device dossier, informed-consent materials, ethics package, and import plan must describe the same intended use, population, procedure, and safeguards. If those documents drift apart, a fast regulatory pathway can turn into a long clarification cycle.

    Internal experience across early-stage programs shows that readiness is less about producing more pages and more about closing the handoffs between regulatory, clinical, quality, site, and supply-chain teams. This practical gate helps MedTech founders and regulatory directors test whether a study is ready for country submissions without relying on a single calendar estimate.

    1. Start with one study story

    Before country tailoring begins, write a concise study narrative that every contributor can use. State what the investigational device is, who will use it, for which patients, in what setting, and what the FIH study is designed to learn. Separate proof-of-principle or early-feasibility questions from claims that will require a later pivotal study or market authorization.

    Then link each major claim to evidence. A risk control in the technical file should appear in the protocol’s monitoring plan and, where relevant, in the training and consent materials. The primary endpoint should match the feasibility objective. The procedure described for the investigator should match the version assessed by the ethics committee. This simple traceability exercise exposes contradictions before an authority or committee has to ask about them.

    • Intended use: define the population, setting, operator, procedure, and boundaries of use.
    • Risk controls: show foreseeable hazards, mitigations, stopping rules, and escalation contacts.
    • Clinical objective: use a focused endpoint set that answers the early-stage question without promising more than the study can demonstrate.
    • Participant protection: connect eligibility, follow-up, adverse-event handling, and consent language to the risk profile.
    • Version control: maintain one controlled source for device specifications, protocol revisions, and country annexes.

    2. Map the regulatory and ethics lanes before filing

    Latin America is not one regulatory pathway. A country matrix should identify the competent authority, ethics route, submission format, required translations, import documentation, responsible local party, and the definition of a complete submission. It should also distinguish a statutory or published review period from a practical activation forecast that includes clarifications, contracts, training, and shipment.

    Brazil illustrates why this distinction matters. Law No. 14.874/2024 establishes a 30-business-day period for an ethics committee to issue its opinion after accepting a complete document set, and a 90-business-day ceiling for the health analysis of primary clinical-trial petitions covered by the law. Those provisions are useful planning inputs, but they do not eliminate sponsor work before acceptance or operational work after authorization. The official English translation of Law No. 14.874/2024 should be checked for scope and the current implementation context.

    Colombia requires a different document conversation. INVIMA’s clinical-investigation materials identify the technical and ethical information needed for medical-device studies and publish current forms for protocol evaluation, ethics-committee assessment, notifications, and periodic reports. The sponsor should confirm the latest checklist rather than reusing a prior country’s format. The INVIMA clinical-investigation page is the appropriate starting point for current requirements.

    3. Treat site and import readiness as submission evidence

    An approved protocol cannot enroll if the site cannot perform the procedure, protect participants, or receive the investigational product. Site feasibility should therefore be documented before submission, not treated as a post-approval procurement task. Confirm investigator experience, procedure volume, equipment, imaging or laboratory support, emergency coverage, data systems, and the site’s ability to meet the visit schedule.

    For an investigational device, also map the physical journey into the country. Identify the importer of record or other responsible local party, customs broker, shipping documents, product description, packaging, storage conditions, and receipt inspection. The receiving site should know who can release a shipment, where it will be stored, how it will be labeled, and how deviations will be documented. If those answers are missing, the regulatory package is operationally incomplete even when the PDF set looks finished.

    Use an owner-and-dependency map for each handoff. Regulatory owns the submission matrix; clinical owns protocol and endpoint consistency; quality owns controlled versions and deviation pathways; the site owns readiness evidence; and logistics owns import and delivery controls. A single accountable person should resolve conflicts rather than allowing parallel teams to submit different answers.

    4. Run a documented readiness gate

    Two weeks before the planned filing, hold a cross-functional gate with the country team and proposed site. The objective is not to read every page aloud. It is to test the few dependencies that can stop the study.

    • Traceability check: reconcile intended use, device configuration, endpoints, risks, and consent language across all core documents.
    • Completeness check: confirm forms, translations, signatures, fees, certificates, and local representative details for the target country.
    • Site check: verify staff training, equipment, standard operating procedures, safety escalation, and recruitment assumptions.
    • Import check: test the shipment dossier with the broker and receiving site before the first dispatch.
    • Clarification check: prepare an evidence map showing who will answer likely questions and how quickly.

    Record open items with an owner, due date, and submission impact. If a high-risk item is unresolved, move the filing date rather than hiding the issue inside an optimistic timeline. A short, coherent dossier usually creates more speed than a large dossier assembled in parallel without a common source of truth.

    Frequently asked questions

    What is the most common FIH readiness failure?
    Document inconsistency is a frequent failure: the protocol, device description, risk controls, and consent materials describe different versions of the study. A traceability matrix finds this before submission.

    Can a sponsor use the same dossier in every Latin American country?
    The scientific core can be reused, but country forms, translations, ethics routes, local responsibilities, and import rules require tailored annexes. Reuse controlled content; do not assume identical filing requirements.

    When should import planning begin?
    Begin during site selection and protocol planning. Shipment classification, local responsibility, customs documents, storage, and receipt procedures can affect the activation sequence and should be tested before authorization.

    For sponsors planning an early-stage MedTech study, the practical goal is a submission that regulators, ethics committees, investigators, and logistics partners can all execute from the same study story. That is the readiness gate that turns a promising FIH concept into a controllable Latin America launch plan.

  • 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.

  • $8 Billion Of Pharma Capital Just Pointed At Argentina. What Medtech Founders Should Take From The May 29 CAEME Announcement.

    On May 29, 2026, the Cámara Argentina de Especialidades Medicinales (CAEME) announced jointly with President Javier Milei a six-year clinical research investment commitment from seven multinational pharmaceutical companies: Pfizer, Merck, Roche, Novartis, BMS, GSK, and Sanofi. The total commitment is USD 8 billion through 2032. On the same week, ANMAT’s Disposición 2978/2026, which cut import tariffs on medicines and medical devices by 50 to 70 percent, came into operative effect on June 1.

    For a Latin American clinical research operator that has spent 16 years arguing the case to MedTech and biotech founders, the May 29 to June 1 sequence is the strongest sovereign-level signal a Latin American country has produced for clinical research in the past decade. The data and the policy arrived in the same week. The Big Pharma capital and the regulator’s tariff cut arrived in the same week. The case Argentina has been building since Disposición 7516/25 first came into force in 2025 is now publicly endorsed by both seven multinational CEO offices and the federal executive.

    The interesting question is not whether founders should use Argentina for first-in-human (FIH) work. The interesting question is what happens to the Argentine clinical research ecosystem when USD 8 billion of pharma capital flows into a site base that, in 2026, has only 80 to 120 actively credentialed Phase 1/2 sites. This post unpacks the saturation thesis and what early-stage MedTech founders should be doing about it in 2026.

    The Site Saturation Math

    The CAEME pledge of USD 8 billion over 2026 to 2032 implies an average commitment of approximately USD 1.33 billion per year. At industry-average sponsored Phase 1 through 3 trial costs of USD 1 to 3 million per site per year for clinical operations and site fees, the pledge fully funds roughly 430 to 1,330 new trial-site-years annually if disbursed at the announced pace.

    Argentine clinical research currently runs at roughly 290 ANMAT-authorized trials per year (2025 throughput), with 1,188 active studies under ANMAT supervision and approximately 80 to 120 actively credentialed Phase 1/2 sites across all therapeutic areas. The pledge contemplates a 2.5x step-up in trial inflows against approximately the same site base.

    The implication is straightforward. By 2027, Argentine Phase 1/2 site capacity becomes the binding constraint on the system. Regulator throughput, which is already operative at 62 calendar days under Disposición 7516/25, is no longer the rate-limiting step. Site availability is. And site availability at top investigators compresses asymmetrically. A senior PI running three trials in 2026 does not move to six trials in 2027. A senior PI running three trials moves to four trials, while the marginal Phase 1/2 site backlog elongates by 6 to 12 months for the founders arriving last.

    Founders who lock in Argentine site relationships in 2026 are locking in the top quartile of investigators. Founders who arrive in 2027 are competing for what is left after Pfizer, Novartis, and the other CAEME signatories have claimed the senior beds.

    Why the Argentine Government Did This Now

    Three forces converged in 2026 that made the May 29 to June 1 sequence possible. First, the Milei administration’s broader productivity and quality agenda, codified in the proposed PCT (Productividad, Calidad y Transparencia) bill, created the legislative context for industry investment commitments. Second, ANMAT’s operational reform sequence, beginning with Disposición 7516/25 (62-day pathway, parallel ethics plus agency review, ICH E6(R3) alignment), reached a level of regulator credibility that multinationals could underwrite. Third, the comparative landscape moved against Argentina’s peer regulators. Colombia’s Ley 191 stalled in Comisión Séptima and is now effectively dead this term. Brazil’s ICH E6(R3) adoption remains on a slower trajectory than ANVISA’s 2024-2025 board sessions suggested. Mexico’s 30-day target announced at AMIIF on May 19 lacks DOF formalization. Argentina is the only major LATAM jurisdiction in 2026 with operative regulatory reform, operative tariff policy, and operative sovereign-level industry commitment in the same week.

    The PCT bill is the only caveat that matters. The CAEME pledge is contingent on PCT passage. As of June 1, the bill remains stalled. Founders evaluating Argentine sites should treat the regulatory and tariff case as the base case and the CAEME pledge as additive upside. Disposición 7516/25 and Disposición 2978/2026 are in force regardless.

    How to Sequence Argentina in 2026

    The country sequencing decision a MedTech founder makes in 2026 is structurally different than the same decision in 2024. Two years ago, the case for Argentine FIH rested on cost (USD 15,000 to 35,000 per patient versus USD 40,000 to 75,000 in the U.S. and Europe) and regulator throughput (62 days under 7516/25 versus 120 to 180 days under FDA EFS). Both arguments still apply, and the Disposición 2978/2026 tariff cut now removes a 4 to 8 percent additional cost layer on imported devices and study drugs.

    What is new in 2026 is the time pressure. The CAEME pledge does not change the operational case. It changes the urgency of the operational case. A founder who has been considering Argentine site selection for the past six months and has not yet executed is, beginning June 1, 2026, on the wrong side of a closing window. By Q4 2026, the same site relationships will be visibly competitive. By Q2 2027, the top-quartile PI list will be substantively claimed.

    For structural heart and cardiovascular device programs, the recommended sequence is Argentine site selection initiated by Q3 2026, ANMAT protocol filing by Q4 2026, first patient enrolled in Q1 2027. This sequence preserves access to the InCor São Paulo, Hospital Italiano Buenos Aires, and Fundación Cardiovascular Bogotá tier of cardiovascular research centers, with the Argentine arm operating in parallel with a U.S. EFS submission.

    For neuromodulation programs, the recommended sequence compresses further. Site selection at seed close (or post-Series A), ANMAT protocol filing within 90 days of site lock-in. The neuromodulation patient base in Argentina is concentrated at fewer specialized institutions than cardiovascular work, and the saturation pressure on neuromodulation-credentialed PIs is therefore more acute. Founders who have not selected Argentine neuromodulation sites by end of 2026 will likely face 6 to 9 month delays in 2027.

    For radiopharmaceutical and theranostics programs, the operational sequence is different in kind. Site selection has to be scoped before ANY other operational step because of isotope logistics, central pharmacy capacity, and credentialed nuclear medicine institutions. Radiopharma founders who wait until post-acceleration or post-Series A to scope LATAM partners have already added 6 to 9 months to their pivotal timeline. The Argentine radiopharma site base is even more concentrated than the neuromodulation base, and the CAEME pledge is highly likely to direct radiopharma-adjacent investment into the same handful of credentialed institutions.

    What This Means for the Colombia Case

    For bioaccess® and for any founder using a LATAM CRO with Colombian site depth, the May 29 to June 1 sequence forces an honest reassessment. Colombia in 2026 holds the following: established U.S.-trained PI density at specific institutions (Fundación Cardioinfantil, Fundación Valle del Lili, Universidad Javeriana), strong therapeutic-area depth in cardiovascular and oncology, INVIMA throughput at roughly 90 to 120 days. Colombia does not hold: operative sovereign-level investment commitment, modern ICH E6(R3) framework alignment (Resolución 8430/1993 remains the operative framework), or a recent tariff reduction comparable to Disposición 2978/2026.

    The Colombia case for 2026 is no longer “cheaper and faster.” The Colombia case is “specific therapeutic-area depth, U.S.-trained PI networks, and complementarity to an Argentine arm.” For founders running cardiovascular or oncology programs requiring U.S. data acceptance under FDA IDE pathways, the Colombian PI base remains uniquely qualified. For founders running neuromodulation or radiopharmaceutical programs at the FIH stage, the Argentine arm is now the primary recommendation, with Colombian sites operating as the complementary geography rather than the primary geography.

    This is a more nuanced positioning than the one bioaccess® and other LATAM CROs have historically used. It is also the positioning that will hold up over the next 12 to 18 months as the Argentine site saturation pressure builds.

    What Founders Should Do Before End of Q3 2026

    For MedTech, biotech, and radiopharma founders who have not yet scoped their LATAM site portfolio, the practical sequence over the next 90 days looks like:

    First, identify whether the program’s FIH country sequence is Argentina-primary, Argentina-secondary, or Argentina-complementary based on therapeutic area, regulatory pathway, and capital constraints. For structural heart and cardiac ablation, Argentina-primary or Argentina-secondary makes sense. For neuromodulation, Argentina-primary. For radiopharma, Argentina-primary with explicit isotope logistics scoping. For oncology devices with U.S. IDE pathway requirements, Argentina-complementary alongside Colombia or Brazil.

    Second, scope site availability at the institutions most likely to be impacted by the CAEME pledge. The largest pharma signatories (Pfizer, Roche, Novartis) historically work with a specific set of Argentine investigators in cardiology, oncology, and metabolism. Site availability at those investigators will compress first.

    Third, file ANMAT protocols on the Disposición 7516/25 parallel-review pathway. The 62-day timeline allows a 2026 Q3 site selection to produce first-patient-in by year-end. Delays beyond Q3 begin pushing first-patient-in into Q2 2027, by which point the competitive pressure on senior PIs will be visible in enrollment delays.

    Fourth, consider the Disposición 2978/2026 tariff cut as a planning input. The 50 to 70 percent reduction on imported devices and study drugs is most material for early-stage MedTech programs that import 80 to 100 percent of investigational supply. Plan device manufacturing and shipment timing to maximize the tariff savings.

    The Bottom Line

    Argentina did not become a clinical research hub on May 29, 2026. Argentina has been a clinical research hub for 30 years. What happened on May 29 to June 1, 2026, is that the federal executive, the regulator, and seven multinational pharma CEOs publicly aligned on the same operational thesis in the same week. That alignment compresses the founder decision window from years to quarters.

    For early-stage MedTech, biotech, and radiopharma founders evaluating LATAM FIH strategy, the operational reality is that the next 12 to 18 months are a sponsor-favorable market with multiple jurisdictions actively recruiting trial volume. Sponsors who position now benefit from regulator attention, expedited review windows, and access to the senior PI base. Sponsors who delay lose that window.

    The most expensive FIH decision a founder makes is not the per-patient cost of a single study. It is the calendar cost of choosing the wrong country sequence for their specific program. Argentina’s May 29 to June 1 sequence makes the calendar argument harder to ignore.

    If you are evaluating a 2026 LATAM FIH country sequencing decision and want a tailored proposal that incorporates the new ANMAT regulatory and tariff environment alongside Colombian and Brazilian complementary site options, the team at bioaccess® can produce a country-level model within two weeks. We have run FIH trials across Argentina, Colombia, Brazil, and Mexico since 2010, and our U.S. EFS plus LATAM FIH practice is the only one in Latin America structured to deliver both pathways under a single operational team.

    Citations: