After a shove from European Parliament, EU member states, and industry stakeholders, the European Commission (EC) issued proposed amendments to streamline its medical device and in vitro diagnostic regulations, MDR and IVDR. While the proposal moves through the legislative process, industry leaders have voiced support, resistance, and confusion.
“I don't think anybody would dispute that MDR and IVDR needed updating,” said Elisabethann Wright, a lawyer who has focused her practice on EU law and regulation of medical devices and pharmaceuticals for the past 40 years. “Some argue that the amendments undermine the ongoing safety and performance of devices. Apart from some nebulous statements, I don’t see them as diminishing that protection. I see them as clarifying.”
Because of their rigor, MDR and IVDR created
serious compliance burdens
for
medical device manufacturers — enough to prompt some companies to withdraw devices from the EU market or postpone CE Marking. According to industry organization Medtech Europe’s 2024 administrative burden report, more than 70% of manufacturers have had to allocate more resources to comply with MDR/IVDR. Its 2022 industry survey found that about half the respondents had planned portfolio reductions due to the cost of compliance.
The EC drafted the amendments to potentially reverse this trend. Its aims were to reduce administrative burden, to give manufacturers more flexibility on evidence, and to better align with the AI Act and the Clinical Trials Regulation, among other regulations. The EC also said it intended to bring “legal clarity and certainty” to notified bodies — a definite win if it happens.
“Manufacturers are concerned whether the revision will leave them with more case-by-case uncertainty, especially regarding certificate validity, evidence expectations, and review timelines,” said Attrayee Chakraborty, quality systems engineer for Analog Devices. “The Commission’s proposal is explicitly framed as a simplification package, but only time will tell if manufacturers and notified bodies debate feasibility, resourcing, and the practical amount of evidence required.”
Coming soon: an end to the five-year recertification
One of the more notable proposed changes is the end of the five-year certificate validity period. If the amendment holds, recertification will shift to ongoing periodic reviews proportionate to device risk class, except in “exceptional cases” where a notified body opts to limit the validity period. The risk-based approach more closely aligns with FDA’s Total Product Life Cycle regulatory framework.
“Both the proposal and FDA are moving toward a lifecycle, risk-based model that relies more on ongoing evidence, post-market monitoring, and tailored oversight rather than rigid one-time checkpoints,” said Chakraborty. “The point is that market entry is no longer a barrier; rather, sustaining a presence in the market with a truly quality product is what matters.”
EU-based manufacturers may see this as an ongoing burden, however, due to the perceived pressure to stay continually “inspection ready,” said Geethapriya Setty, global regulatory affairs manager for Hologic. “It introduces a different layer of complexity, especially for AI-enabled devices that are continually learning,” she said. “FDA is addressing this through lifecycle approaches and the Predetermined Change Control Plans. The EU appears to be moving in that direction, even if it is not fully articulated yet.”
Notified body involvement moves to a more risk-based cadence
The proposed amendments reduce notified body involvement for lower- and medium-risk devices. For class IIa and IIb devices, they may assess technical documentation for one representative device in a generic device group, category, or even a portfolio, rather than repeatedly reviewing multiple similar files. It also puts an end to systematic technical-documentation assessment of representative devices during surveillance activities.
Notified bodies can, however, conduct unannounced audits on a “for-cause” basis. They may also conduct remote audits when needed.
While the EC intended to reduce the burden on notified bodies with these changes, the risk-based approach, as written, sends mixed messages. “Notified bodies are expected to maintain strong continuous oversight because certificates would no longer expire,” said Wright. “But the commission is also relaxing oversight with less-frequent audits, more reliance on remote assessments, and fewer surprise inspections. That raises a question for me: Can oversight really become stronger, or at least maintain equivalence to the existing level?”
Team NB, the organization that represents more than 85%
of currently designated notified bodies, believes the amendments “would lower oversight below the standards applied even prior to the MDR/IVDR,” according to its position statement. They argue the changes would limit their ability to detect safety and performance issues early in a product’s lifecycle, “shifting the EU regulatory model from a proactive, preventive framework to a predominantly reactive one,” the statement said.
As an alternative, the organization proposes a performance-based structure: once a manufacturer completes two periodic reviews without issue, it would be rewarded with reduced surveillance intensity. This approach, the organization argues, would enable the notified bodies to have closer involvement early in a product’s life cycle, when a device is more prone to design issues and subject to user feedback. Team NB says the approach would incentivize manufacturers to maintain high compliance standards while reducing administrative burden for established devices.
Whatever the approach to oversight, notified bodies will likely need guidance on how to implement a risk-based framework to create the consistency the EC hopes to achieve. “They’re going to need direction from either the MDCG or Team NB on what risk-based review is going to mean in practice and procedures for risk-based surveillance,” said Wright. “A consistent approach would be welcomed, but without instruction or guidance, I don’t know how they’re going to achieve it.”
Clinical evidence expectations loosen
The proposed amendments loosen the clinical evidence requirements in a few ways. Manufacturers can use clinical data from equivalent devices without needing access to the equivalent manufacturer’s technical documentation, provided they can prove equivalence using available data and state-of-the-art knowledge. This change removes an administrative hurdle that made it next to impossible to use equivalence data.
“The amendment applies to established technologies which are considered lower risk than other devices in the same class,” said Wright. “This is a welcome change to get high-volume devices on the market quickly.”
If the amendments become law, manufacturers would have a broader scope to justify demonstrating safety and performance with non-clinical data alone, including methods such as in silico testing, where that approach is adequate. Reliance on non-clinical data alone could be particularly relevant for some legacy devices, while use of alternative methods aligns with broader policy goals around scientific innovation. Team NB requests clarification on both, arguing in its position statement that the new language introduces unneeded ambiguity.
Follow the course
It will take time for any amendments to MDR or IVDR to become finalized. In the meantime, Setty, who recently co-authored, with Chakraborty, two papers on the intersection of MDR and the AI Act for the
Journal of Regulatory Affairs
, advises her colleagues to stay informed and stay the course.
“Stay actively engaged, keep monitoring the developments, and contribute feedback when the EC asks for it,” she said. “The current regulations and timelines remain intact,” adds Chakraborty. “Until the proposals are accepted, we can only remain as prepared as possible for either outcome.”