--- name: reg-strategy description: "Build a precedent-grounded regulatory strategy for a new product — so you know exactly what the agency will ask before they ask it." --- # /reg-strategy Regulatory naivety delays products by years. Not because companies skip steps — but because they submit with evidence gaps they didn't know were gaps, or chose a pathway without benchmarking the actual precedent, or waited for a Complete Response Letter to learn what a Type C meeting would have told them for free. This skill forces a systematic review of analogous submissions, maps your evidence gaps against regulatory expectations, and produces a strategy that survives the agency's first response. **Product Definition** - Exact product description — mechanism of action, indication, patient population, route of administration - Proposed regulatory pathway (510(k), PMA, NDA, BLA, De Novo, EUA — or equivalent in EU/other jurisdictions) - What makes this product different from what already exists? (This is the agency's first question) - What is the risk profile — and what is the worst-case failure mode for a patient? - Any combination product or software component (SaMD) that triggers additional regulatory frameworks? **Precedent Analysis — 4-5 analogous submissions:** For each precedent: - Submission ID, product, indication, applicant, submission date, outcome - Pathway chosen and why it was appropriate - Study types and sample sizes accepted - What the agency required that was non-obvious from guidance documents? - Any Complete Response Letters or additional information requests — what triggered them? - Time from submission to clearance/approval **Evidence Gap Analysis** - What does the agency's guidance document say is required vs what your current data package contains? - What do the precedent submissions suggest is required beyond the guidance? (Guidance documents are always behind current agency practice) - For each gap: what study/test closes it, estimated timeline, estimated cost, and can it be done in parallel with other activities? - Which gaps require novel study designs (no established protocol)? **The Critical Path** - Submission sequence — pre-submission meeting → study execution → IND/IDE if applicable → final submission - Early engagement opportunities: Pre-Sub (FDA), Scientific Advice (EMA), Type B/C meeting requests - What specific questions to bring to the pre-submission meeting — vague questions get vague answers - Timeline from today to submission, realistic vs optimistic scenario **The One Gap That Could Delay 12+ Months** - Which evidence gap, if not addressed early, becomes a Complete Response Letter 9 months after submission? - What is the study type that takes longest to execute? - What is the agency's track record on this evidence type — have they recently raised the bar? **Risk Register** - What is the agency most likely to disagree with in your proposed indication? - Are there any pending guidance documents or recent Advisory Committee discussions that could shift requirements? - Competitive submissions that might set a new precedent before yours arrives? ## Rules 1. Precedent analysis is mandatory. Guidance documents describe the floor, not the ceiling — recent precedents describe the actual expectation. 2. Every evidence gap must have a named owner and a timeline. "We'll figure it out later" is how delays happen. 3. Pre-submission meetings are almost always worth requesting. Document the specific questions you will ask. 4. Combination products and SaMD components must be flagged immediately — they add 6-18 months minimum. 5. Distinguish between what the agency requires and what they prefer. Both matter, but they're different risks. 6. Strategy documents must be updated after every agency interaction. A static strategy is a stale strategy. The output of this skill is a regulatory strategy brief: pathway rationale, evidence package status, gap closure plan, submission timeline, and the one risk that could delay approval by a year if not addressed in the next 90 days.