Table 2.

Aggregate ranking of Core Recommendations (question 5, Human).

Number	Core Recommendations	Totala
9	Foster innovation in clinical trials	35
18	Promote use of high-quality real-world data (RWD) in decision making	30
17	Reinforce patient relevance in evidence generation	26
15	Contribute to HTAs' preparedness and downstream decision making for innovative medicines	25
1	Support developments in precision medicine, biomarkers, and “omics”	23
11	Expand benefit-risk assessment and communication	22
2	Support translation of Advanced Therapy Medicinal Products cell, genes, and tissue-based products into patient treatments	17
5	Create an integrated evaluation pathway for the assessment of medical devices, in vitro diagnostics, and borderline products	16
7	Diversify and integrate the provision of regulatory advice along the development continuum	16
29	Leverage collaborations between academia and network scientists to address rapidly emerging regulatory science research questions	16
13	Optimize capabilities in modeling and simulation and extrapolation	15
16	Bridge from evaluation to access through collaboration with Payers	13
10	Develop the regulatory framework for emerging digital clinical data generation	13
31	Disseminate and share knowledge, expertise, and innovation across the regulatory network and to its stakeholders	12
4	Facilitate the implementation of novel manufacturing technologies	12
28	Develop network-led partnerships with academia to undertake fundamental research in strategic areas of regulatory science	11
12	Invest in special population initiatives	10
25	Promote global cooperation to anticipate and address supply challenges	10
19	Develop network competence and specialist collaborations to engage with big data	10
14	Exploit digital technology and artificial intelligence in decision making	10
3	Promote and invest in the Priority Medicines scheme (PRIME)	9
6	Develop understanding of and regulatory response to nanotechnology and new materials' utilization in pharmaceuticals	6
24	Continue to support development of new antimicrobials and their alternatives	6
30	Identify and enable access to the best expertise across Europe and internationally	5
8	Leverage novel non-clinical models and 3Rs	5
22	Further develop external communications to promote trust and confidence in the EU regulatory system	4
26	Support innovative approaches to the development and post-authorization monitoring of vaccines	4
20	Deliver real-time electronic Product Information (ePI)	3
21	Promote the availability and uptake of biosimilars in health care systems	2
27	Support the development and implementation of a repurposing framework	0
23	Implement EMA's health threats plan, ring-fence resources and refine preparedness approaches	0

^aTotal times chosen as first, second, or third most important.