Accelerated review of Marketing Authorization Applications in the EU is reserved for products that are expected to be of major public health interest. While very valuable because it reduces EMA evaluation from 210 days to just 150 days, the status is not easy to get. Approximately half of all requests are rejected, and it’s not guaranteed to last. This Scrip story shows how Novartis recently lost accelerated status for Zolgensma, and how six other companies are now forced to slow development of their drugs as well. See the companies affected, what they are doing in response, and the competitive products that are benefitting.