---
type: source
title: "Compass Pathways Receives FDA Rolling NDA Review and Commissioner's National Priority Voucher for COMP360 Psilocybin in TRD"
author: "Compass Pathways (BusinessWire press release)"
url: https://ir.compasspathways.com/News--Events-/news/news-details/2026/Compass-Pathways-Announces-FDA-Granted-NDA-Rolling-Review-Request-and-Awarded-Commissioners-National-Priority-Voucher/default.aspx
date: 2026-04-24
domain: health
secondary_domains: []
format: press-release
status: processed
processed_by: vida
processed_date: 2026-05-11
priority: high
tags: [psilocybin, Compass-Pathways, FDA, NDA, COMP360, TRD, regulatory, psychedelic, approval-timeline]
intake_tier: research-task
extraction_model: "anthropic/claude-sonnet-4.5"
---

## Content

**Announcement:** FDA granted Compass Pathways' rolling NDA review request for COMP360 (synthetic psilocybin) in treatment-resistant depression (TRD). Simultaneously, FDA selected COMP360 for the Commissioner's National Priority Voucher (CNPV) program.

**COMP360 clinical evidence basis:**
- COMP005 (June 2025, n=258): Single dose COMP360 25mg vs. placebo. MADRS change -3.6 (p<0.001). 25% response rate at week 6, maintained through week 26.
- COMP006 (February 2026, n=568): 25mg vs. 10mg vs. 1mg placebo-like, 2 doses 3 weeks apart. MADRS change -3.8 (p<0.001). 39% response rate vs. 23% control. Rapid onset from next day. 40%+ non-remitters achieved remission after second dose.
- Two consecutive positive Phase 3 trials — first psychedelic to achieve this milestone.

**Rolling NDA details:**
- Compass can submit NDA modules as they are completed (rather than all at once)
- 26-week durability data from COMP006 (Part B) expected early Q3 2026 — the final required dataset
- Rolling NDA submission completion: Q4 2026

**Priority Voucher benefits:**
- Enhanced FDA communications during review
- Shortened review time: 1-2 months from NDA filing (vs. standard 6-12 months)
- Maintains FDA's full safety/efficacy review standards
- Priority Vouchers are part of Trump EO on psychedelics (April 18, 2026) — FDA Commissioner directed to issue to compounds with Breakthrough Therapy designations

**Revised FDA approval timeline:**
- Rolling submission complete: Q4 2026
- With 1-2 month review: potential FDA approval decision as early as Q4 2026 — Q1 2027
- Previous guidance was 2027; priority voucher may pull this forward

**Additional FDA action (same day):**
- FDA also accepted IND application for COMP360 in PTSD — opens Phase 3 for a second indication
- PTSD Phase 3 could begin enrollment 2026-2027 if protocol finalized

**Session 42 update:** The Session 42 musing noted "probable FDA approval 2027" — the priority voucher with 1-2 month review shortens this to potentially Q4 2026-Q1 2027.

## Agent Notes
**Why this matters:** Rolling NDA review + Priority Voucher means COMP360 could receive FDA approval faster than any prior psychedelic. The review timeline could be as short as 1-2 months post-filing (Q4 2026), meaning FDA approval is possible before end of 2026 — earlier than the "2027" framing from prior sessions. After approval: DEA must reschedule within 90 days → commercial launch possible 2027.

**What surprised me:** The simultaneous PTSD IND acceptance. This expands Compass's potential market dramatically — PTSD affects ~12M Americans vs. ~7M TRD. If PTSD Phase 3 succeeds, COMP360 becomes a multi-indication psychedelic drug with broader commercial reach. This also means the access/reimbursement problem scales: 19M potential patients, but the insurance bottleneck remains identical.

**What I expected but didn't find:** Any statement on pricing or insurance strategy. Compass has not publicly stated COMP360 pricing or payer engagement strategy. The access problem (who can pay for this?) is entirely unaddressed in the press release.

**KB connections:**
- [[healthcare AI regulation needs blank-sheet redesign because the FDA drug-and-device model built for static products cannot govern continuously learning software]] — a different regulatory design problem, but both reflect FDA's adaptation challenges to novel therapeutic modalities
- [[CMS is creating AI-specific reimbursement codes which will formalize a two-speed adoption system]] — the same two-speed pattern will apply to psilocybin: proven indication gets reimbursement, newer indications remain cash-pay

**Extraction hints:**
- Update Session 42's psilocybin regulatory claim with the new timeline: "FDA approval possible Q4 2026-Q1 2027 (not 2027)" following priority voucher
- New claim candidate: "COMP360 psilocybin therapy faces a two-step access bottleneck — FDA approval (Q4 2026-Q1 2027) unlocks legal availability, but CMS reimbursement (2029-2030 at earliest) determines whether it reaches the 7M Americans with treatment-resistant depression or remains a cash-pay option for the insured and affluent"
- The PTSD IND acceptance deserves tracking — 12M PTSD sufferers is a much larger market than TRD

**Context:** Compass Pathways is publicly traded (NASDAQ: CMPS). This is an official investor relations announcement. The clinical data (COMP005, COMP006) has been peer-reviewed and published/presented. The Priority Voucher is a federal program under Trump's psychedelics EO, confirmed by FDA Commissioner announcement. High-confidence source.

## Curator Notes (structured handoff for extractor)
PRIMARY CONNECTION: [[the mental health supply gap is widening not closing because demand outpaces workforce growth and technology primarily serves the already-served rather than expanding access]]
WHY ARCHIVED: COMP360's accelerated FDA timeline (Q4 2026-Q1 2027 possible) is the most important update to the psilocybin regulatory picture. The two-step bottleneck claim (FDA approval ≠ access; CMS reimbursement is the real gate) is the key extraction target.
EXTRACTION HINT: Focus on the gap between FDA approval (necessary) and CMS reimbursement (sufficient for access). The priority voucher accelerates the first step; nothing accelerates the second. An FDA-approved but uninsured therapy reproduces the Oregon access pattern nationally.
