Illuminating FDA's 2023 BLA Approvals: A Comparative Analysis

January 26, 2024

Woman typing on a laptop next to a microscope in a medical laboratory.

The FDA's Biologics License Application (BLA) approvals in 2023 have marked a significant chapter in medical innovation, embodying precision and transformative therapies. A closer examination of the approvals, their numbers, and the trends they reveal unveils a dynamic landscape in biologics.

Some of the most Influential BLA Approvals in 2023 include

  1. Gene Therapies for Sickle Cell Disease: Lyfgenia and Casgevy™ represent pioneering gene therapies, a hallmark in addressing genetic diseases with precision medicine.
  2. Breakthrough Vaccines: Notably, the newly approved MenB vaccine extend vital protection against life-threatening strains of meningitis, particularly crucial for vulnerable demographics like young children.
  3. Biosimilars Gaining Ground: Alvotech's Humira biosimilar, Hyrimoz, embodies the growing affordability and accessibility of impactful treatments through market competition. 

Quantitative Analysis: 2023 vs. 2020-2023 BLA Approvals

  • 2023 BLA Approvals: FDA approved 59 biologics (including BLAs, sBLAs, and biological device approvals) in 2023 compared to 76 in 2020, 65 in 2021, and 61 in 2022. 
  • BLAs with RMAT Designation: 
    • FDA approved two BLAs in 2023 that had received a regenerative medicine advanced therapy (RMAT) designation. The new program saw its first three BLA approvals in 2021 with no approvals in 2022. 

Commentary on 2023 Biologics Approvals

  • Accelerated Approval: The pathway expedites access to promising drugs. However, concerns regarding post-approval data collection and safety risks necessitate continued scrutiny.
  • Orphan Drugs: The upward trend in orphan drug approvals reflects the FDA's dedication to addressing unmet medical needs, albeit the ongoing challenge of balancing innovation with equitable access. 2023 saw 12 BLA approvals for orphan drugs.
  • Novel Biologics: Progress in antibody-drug conjugates and bispecific antibodies highlights ongoing advancements in biological drug design, promising enhanced therapeutic options.
  • Gene and Cell Therapies: Approval of gene therapies for sickle cell disease underscores their immense potential but warrants diligent long-term safety monitoring and equitable access.
  • Gene Editing: FDA’s first approval of a CRISPR-based therapy underscores promising potential across various diseases.
  • Biosimilars: Increased approvals signify cost-saving avenues and expanded access to essential therapies, emphasizing the importance of fostering competitive markets. In 2023, FDA approved 8 biosimilars, compared to 3 in 2020, 4 in 2021, and 7 in 2022.
  • Expedited Programs for Regenerative Medicine Therapies: The pathway expedites access to promising therapies for serious conditions.

Emerging Trends in FDA's Biologics Approval Decisions

  • Patient-Centered Drug Development: The FDA's focus on patient input and real-world evidence underscores the evolving approach to ensure treatment relevance and value. Interactive and patient-led listening sessions in collaboration with patient advocacy groups allow for educating FDA on specific diseases and unmet medical needs.
  • Pilot Program for Rare Disease Approvals: An initiative aiming to streamline orphan drug approvals stands to expedite access for patients with limited treatment options. 

FDA Trends in Recent Years

  • Shifting Priorities: Rigorous evaluations and confirmatory data are gaining prominence, potentially leading to a decline in overall approvals while fortifying confidence in endorsed treatments.
  • Targeted Regulatory Pathways: Specialized pathways like Breakthrough Therapy and RMAT exemplify the FDA's dedication to fostering innovation while catering to unique regulatory needs.
  • Promotion of CATT Program: CBER Advanced Technologies Team (CATT) is a means for prospective innovators/developers of advanced manufacturing technology to engage in questions/dialogue with CBER staff related to implementing advanced manufacturing technology in the development of CBER-regulated products.

CBER Super Office Established

  • Office of Therapeutic Products (OTP): Established within CBER due to the increase in development of novel products. Re-organization of CBER’s Office of Tissues and Advanced Therapies into the super office (OTP) will allow for better alignment of disciplines, increase review capacity, and will strength the expertise in Cell and Gene Therapies.


In summary, 2023 showcases significant strides in biologics, offering groundbreaking solutions for complex diseases. While safety, accessibility, and ethical considerations remain paramount, the FDA's dynamic approach and commitment to innovation set the stage for a promising future in shaping healthier lives. 

Seeking FDA Approval for Your BLA? Partner with ProPharma for Expert Guidance

Navigating the FDA approval process can be complex. If you are aiming for biologics approval, ProPharma's expertise can be your guiding light.

Contact ProPharma's team of seasoned professionals specializing in regulatory affairs, compliance, and strategy. Let us help you navigate the intricate landscape of BLA approvals, ensuring compliance, and success for your innovative solutions.


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