MDR Annex XVI: Regulating Products Without an Intended Medical Purpose Under the MDR

How Are Medical Devices Regulated Under MDR Annex XVI?

How does MDR Annex XVI regulate products without an intended medical purpose that fall within the scope of the MDR? This question has become increasingly relevant for manufacturers seeking EU market access.

The Medical Devices Regulation (MDR) 2017/745 has transformed the European Union (EU) regulatory framework. It replaced the previous Medical Devices Directive (MDD) and introduced stricter requirements for manufacturers, notified bodies, and competent authorities.

One of the most significant changes is the expanded scope under MDR Annex XVI. The regulation now includes certain products that do not have a medical purpose but may still present similar safety risks. As a result, these products are subject to the MDR regulatory requirements, even though they are not medical devices by definition.

What Is New Under MDR Annex XVI in 2026?

Recent regulatory developments continue to clarify how MDR Annex XVI applies in practice. Authorities expect manufacturers to align with Common Specifications, updated classification rules, and strengthened clinical evaluation requirements.

This expanded scope marks a clear departure from traditional definitions of medical devices. Certain aesthetic or cosmetic products listed in Annex XVI now fall within the scope of the MDR and are subject to conformity assessment and post-market obligations.

What Products Fall Under MDR Annex XVI?

Under MDR Annex XVI, the following product groups are subject to the MDR, even though they do not have an intended medical purpose:

  • Contact lenses without vision correction (e.g., colored contact lenses)
  • Devices intended to modify the anatomy or fixation of body parts (e.g., subdermal implants without a medical purpose, such as aesthetic implants)
  • Facial and dermal fillers for aesthetic enhancement
  • Equipment for body shaping and fat reduction (e.g., liposuction devices)
  • High-intensity radiation devices for skin treatment, including IPL, lasers, infrared equipment, tattoo removal lasers, and hair removal systems
  • Equipment intended for transcranial brain stimulation without a medical purpose

Manufacturers of these products must comply with the applicable MDR safety, performance, and documentation requirements, subject to adaptations reflecting the absence of a medical purpose.

Classification of Devices Under MDR Annex XVI

How are devices classified under MDR Annex XVI?

Manufacturers must apply the relevant classification rules under Annex VIII, as modified or clarified by applicable Common Specifications and Commission Implementing Regulation (EU) 2022/2347. However, not all rules apply automatically. For example, Rules 9 and 10 address active therapeutic and diagnostic devices and assume a medical purpose. Because Annex XVI products lack a medical purpose, regulators apply specific Common Specifications and implementing regulations to determine the appropriate classification.

Understanding the correct classification is essential. It determines the conformity assessment route, the level of notified body involvement, and the overall regulatory strategy for EU market approval.

Important to note that not all rules can be applied. For instance, rules 9 and 10, which pertain to active therapeutic and diagnostic devices, assume a medical purpose.

To address this, a Commission Implementing Regulation (2022/2347) was introduced to reclassify relevant devices alongside the Common Specifications. Let’s take a closer look at the classification of specific product classes:

  1. Certain body shaping devices are classified as Class IIb under Commission Implementing Regulation (EU) 2022/2347, depending on their specific characteristics.
  2. Devices for skin rejuvenation, hair removal, and similar purposes may fall under Class IIa or IIb, depending on the application. This classification is explained in Section 5.
  3. Equipment for transcranial brain stimulation is classified as Class III and is covered in Section 6.

Annex XVI Medical Devices: Key Regulatory Requirements

MDR 2017/745 establishes clear and structured obligations for products covered under MDR Annex XVI, even when they do not have an intended medical purpose. Manufacturers must meet safety, documentation, and post-market requirements comparable to those applied to traditional medical devices.

Core Compliance Requirements Under MDR Annex XVI

Manufacturers must design and manufacture devices to ensure safety and performance. They must conduct a documented risk analysis and implement appropriate risk control measures in accordance with Annex I.

They must also complete a conformity assessment procedure to demonstrate compliance with the applicable regulatory requirements. Depending on the classification of the device, a notified body may need to be involved.

In addition, manufacturers must prepare and maintain comprehensive technical documentation. This documentation must clearly describe the device design, intended purpose, manufacturing processes, risk management activities, and evidence supporting conformity.

Manufacturers must assign a Unique Device Identification (UDI) to each device. They must ensure traceability by registering the required information in the relevant UDI database.

Clinical Evaluation and Post-Market Obligations

Under MDR Annex XVI, manufacturers must perform a clinical evaluation to demonstrate safety and performance in accordance with Article 61(9) and the applicable Common Specifications. They must base this evaluation on relevant clinical data. Clinical investigations may be required unless sufficient existing clinical data can adequately demonstrate safety and performance, in line with Article 61(9) and the Common Specifications.

Manufacturers must also implement a post-market surveillance (PMS) system. This system must monitor device performance, analyze safety data, investigate complaints and adverse events, and trigger corrective actions when necessary.

Clear and accurate labeling remains essential. Manufacturers must provide instructions for use that specify the intended purpose, handling conditions, storage requirements, and relevant warnings or contraindications.

MDR 2017/745 significantly expands the regulatory scope by including devices without an intended medical purpose under MDR Annex XVI. This expansion ensures a high level of protection for users and strengthens oversight of aesthetic and non-therapeutic technologies entering the EU market.

By working with MDx CRO, manufacturers can navigate MDR Annex XVI requirements efficiently and position their products for successful EU market access.

From Annex XVI Compliance to Scientific validity reports for EU IVDR Submissions

Although Annex XVI devices do not have an intended medical purpose, they are still required to demonstrate safety and performance through robust evidence. This shift reflects a broader regulatory principle also seen under the In Vitro Diagnostic Regulation (IVDR): claims must be supported by structured, scientifically sound documentation.

Under the MDR, manufacturers of Annex XVI products must:

  • Conduct a clinical evaluation based on available clinical data
  • Justify safety and performance claims through documented evidence
  • Align with Common Specifications and applicable classification rules
  • Maintain technical documentation that withstands notified body scrutiny

This evidence-based mindset closely mirrors what is required for Scientific Validity Reports under the IVDR.

The Regulatory Convergence: MDR Annex XVI & IVDR Scientific Validity

While MDR Annex XVI focuses on devices without an intended medical purpose and IVDR governs in vitro diagnostic devices, both frameworks demand:

  • A clear definition of claims
  • Scientific substantiation of those claims
  • Transparent literature review methodologies
  • Structured documentation aligned with regulatory expectations

In IVDR submissions, the Scientific Validity Report is a foundational document demonstrating the association between an analyte and a clinical condition. Similarly, Annex XVI devices must justify safety and performance through documented clinical evaluation and risk analysis — even when no therapeutic or diagnostic purpose exists.

In both cases, regulatory authorities expect:

  • Systematic literature review strategies
  • Critical appraisal of available data
  • Traceable evidence linking claims to supporting documentation
  • Ongoing updates through post-market surveillance

The common denominator is simple: no claims without evidence.

Why This Matters for Manufacturers

Manufacturers working across MDR and IVDR portfolios increasingly face overlapping regulatory expectations. A strong internal capability to develop:

  • Clinical Evaluation Reports (CERs)
  • Scientific Validity Reports
  • Performance Evaluation documentation
  • Post-market evidence strategies

creates operational efficiency and reduces regulatory risk.

At MDx CRO, we support manufacturers not only in MDR Annex XVI compliance, but also in preparing scientifically robust documentation for EU IVDR submissions — including comprehensive Scientific Validity Reports aligned with notified body expectations.

Explore how Scientific Validity Reports are structured and what notified bodies look for under the IVDR. You can read our detailed guide on Scientific Validity Reports for EU IVDR Submissions.

FAQs

How does MDR define “intended medical purpose” for medical devices?

The MDR 2017/745 places strong emphasis on the concept of intended purpose. Manufacturers define the intended purpose through the information they provide on labeling, in the instructions for use (IFU), and in promotional materials.
The MDR defines “intended purpose” in Article 2(12). Whether a product has a medical purpose depends on the manufacturer’s intended use as reflected in labeling, instructions for use, and promotional materials.Manufacturers must clearly state whether the device supports diagnosis, treatment, monitoring, prevention, or alleviation of a disease or injury.
Under MDR Annex XVI, this distinction becomes particularly important, as certain products without a traditional medical purpose still fall within the scope of the regulation and must meet defined safety and performance requirements.

Are there any exemptions or special considerations for medical devices without an intended medical purpose?

Yes. MDR 2017/745 establishes specific requirements for products covered under MDR Annex XVI, even though they do not have an intended medical purpose.
First, manufacturers must comply with the relevant Common Specifications adopted under Article 9(4). These specifications require manufacturers to apply risk management in line with Annex I and, where necessary, conduct a clinical evaluation focused on safety and performance.
For clinical evaluation, manufacturers do not need to demonstrate a clinical benefit in the traditional medical sense. Instead, under Article 61(9), they must demonstrate the performance and safety of the product.

Are there any specific labeling or instructions for use (IFU) requirements for medical devices without an intended medical purpose under MDR 2017/745?

Yes, devices without an intended medical purpose have specific information requirements that affect both labeling and the instructions for use (IFU).According to Annex I, Section 23 of MDR 2017/745 and the applicable Common Specifications, the instructions for use must clearly state that the device has no intended medical purpose and must describe the associated risks and any limitations of use.

Industry Insights & Regulatory Updates

FDA Laboratory Developed Tests (LDTs) Regulation

The FDA Laboratory Developed Tests regulation marks one of the most significant shifts in U.S. diagnostic oversight in decades. The FDA’s new rule phases in full regulation of LDTs over four years, with no grandfathering. This change elevates the importance of IVD CROs, whose regulatory and clinical expertise will be critical as laboratories adapt to stringent new requirements. The rule represents a major transformation in the U.S. IVD landscape and will reshape how laboratories develop, validate, and maintain LDTs.

Introduction

On September 29, 2023, the FDA released a groundbreaking proposed rule that fundamentally redefines how the agency regulates Laboratory‑Developed Tests (LDTs). This proposal shifts LDTs out of decades of enforcement discretion and brings them fully under the FDA’s medical device framework.

Because LDTs are a subset of in vitro diagnostic products (IVDs), the new rule has sweeping implications for clinical laboratories, manufacturers, and the broader diagnostics industry. Under the FDA Laboratory Developed Tests regulation, LDTs will now be treated like other medical devices—requiring quality systems, medical device reporting, registration, listing, and in many cases, premarket review.

For stakeholders across the IVD sector, this change is significant.

Key Points to Consider as the FDA regulates LDTs

  1. Expanded Definition of IVDs
    The FDA proposes to explicitly classify LDTs as IVDs under 21 CFR 809.3.
    This means LDTs will now fall under the same requirements as traditional IVD medical devices.
  2. Phased, Four‑Year Implementation
    The FDA will remove enforcement discretion in five stages over a four‑year timeline.
    Each stage introduces new regulatory obligations for laboratories.
  3. No Grandfather Clause
    The proposal does not exempt existing LDTs. All LDTs (old and new) must eventually comply.
  4. Test Categories Exempt from Enhanced Oversight
    Certain test types, including forensic tests and HLA assays, are proposed for exemption.
  5. Public Comment Period
    Stakeholders were invited to submit comments through December 4, 2023.

Background on FDA Regulation for LDTs and IVDs

IVDs have traditionally been subject to rigorous regulatory scrutiny under various heads:

  • 510(k) premarket notification or premarket approval (PMA)
  • Quality system regulation
  • Medical device reporting
  • Registration and listing
  • Labeling

LDTs, however, historically operated under enforcement discretion, receiving minimal oversight. This approach was based on the assumption that LDTs were low risk and used primarily within single laboratories.

That landscape has changed.

The Evolving Landscape of LDTs

Over the last 50 years, LDTs have become increasingly complex, widely used, and technically sophisticated. This evolution has driven demand for stronger oversight in areas such as:

  • Clinical validity
  • Analytical performance
  • Manufacturing consistency
  • Patient safety

The new FDA Laboratory Developed Tests regulation directly responds to these gaps. By redefining LDTs and removing enforcement discretion, the FDA aims to strengthen public health protections.

The Road Ahead: Key Regulatory Impacts

The phased implementation timeline will introduce major compliance requirements:

Medical Device Reporting

The first enforcement area to take effect.

Quality Systems Regulation

Expected three years after publication of the final rule.

Premarket Review

Introduced 3.5 to four years after the final rule, starting with high‑risk LDTs and expanding to moderate-and-low risk tests.

Labs performing LDTs must begin planning now. Clinical and analytical validation, documentation systems, and regulatory processes will all require upgrades.

Alignment With Europe’s IVDR Rollout

The FDA’s new approach mirrors developments in Europe under the In Vitro Diagnostic Regulation (IVDR). The IVDR already applies strict rules to in‑house tests and LDTs, requiring:

  • Complete Technical Documentation
  • A compliant Quality Management System
  • Performance evaluation and validation
  • Adherence to Article 5.5 requirements for in‑house devices

çUnder IVDR, an LDT cannot be used if an equivalent CE‑marked test exists. This forces laboratories to justify in‑house development and meet near‑manufacturer‑level standards.

Conclusion: An Industry in Transition

As experts in IVD quality, regulatory, and clinical operations, MDx CRO encourages laboratories and manufacturers to prepare now for the FDA Laboratory Developed Tests regulation. Although legal challenges may influence the timeline, increased oversight is inevitable, and already fully established within Europe under the IVDR.

Stakeholders should submit comments to the FDA by December 4, 2023, and begin strengthening their regulatory systems immediately.

Written by:
Carlos Galamba

Carlos Galamba

CEO

Senior regulatory leader and former BSI IVDR reviewer with deep experience in CE marking high-risk IVDs, companion diagnostics, and IVDR implementation.
Industry Insights & Regulatory Updates