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Deadline for Abstract Submissions: 15 April, 2025

Please note that all entries will be fully editable on this platform until the final submission deadline.
As of the deadline, submissions can no longer be edited or retracted.

2025 Prix Galien UK Awards Ceremony
05 June, 2025 / 7:30 pm
Natural History Museum
Cromwell Road, South Kensington London

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You are submitting to the Prix Galien UK Awards. If you are interested in submitting in another country, kindly make your choice in the selection drop-down from the login screen.

Thank you for applying for a Prix Galien Award. We urge you to provide the most accurate and up-to-date information possible for your product/candidate submission. The following aspects are particularly important:

Please address the specific question in the each section – be as specific as possible
Please be aware of the word limits in each section
All sections are mandatory (except where indicated)
The judging committee will only take into account information you provide on the form, and will not conduct wider searches
Any references you provide should be specific to the product/solution

Select a category of submission *

Prix Galien StartUp 2023 Application Form

GENERAL INFORMATION

Company Name *

Product/Solution Name *

Generic Name

Date of MHRA Approval in the UK
(if not licensed please provide details of when the license is expected you can also provide details of approvals in other countries)

Date of Approval in the UK, including the name of approving body(ies)
(including CE/UK CA marking. If not approved, please provide details of when this is expected (you can also provide details of approvals in other countries (100 words maximum)*

Details of MHRA Approvals (100 words maximum)

words remaining :

Therapeutic Indications
(if appropriate, otherwise add N/A):

Please provide details of public sector funding, and public sector involvement, that has made this innovation possible
(250 words maximum)

words remaining :

Licensed Therapeutic Indications
(please include the therapeutic indication from the SmPC)

Indications for the product
(please be as specific as possible):

Has the product been approved by NICE or any other body in the UK
(for NICE approval, please provide date. If not approved by NICE, or approval is pending, please provide details).

Has the product been approved by NICE or any other Governmental body in the UK
(if this does not require such approval, please state reasons why).

Has this product / Innovation previously received a Prix Galien award in the UK or in any other country
(please provide details including dates)

Has the product received any other award in the UK or in any other country?

BACKGROUND

Background information and need
(please be as specific as possible in your description; limit 500 words)

words remaining :

Development & Clinical Or Preclinical Evidence (500 words)

History and timeline for the development of the product including preclinical and clinical evidence
(please be as specific as possible in your description; 500 words)

words remaining :

Provide technical details where appropriate
(for example, interoperability, data security, etc; 250 words maximum)

INNOVATION

Why is this drug or device innovative, and/or how it will improve the human condition, and/or why is it better than competitor products
(500 words)

words remaining :

REFERENCES

Please provide references specific for your product
(ideally this should be from peer-reviewed literature, or papers in press, but if this is not possible, please provide other sources and justify their inclusion)

Upload a maximum of two other documents specific for your product (if necessary).

Gold Contributor
Package

Product Entry

Dedicated Table of 10 at the Awards Ceremony

5 Tickets to the Galien Forum

£23,500

Silver Contributor
Package

Product Entry

5 Tickets to the Awards Ceremony

3 Tickets to the Galien Forum

£15,000

Bronze Contributor
Package

Product Entry

2 Tickets to the Awards Ceremony

2 Tickets to the Galien Forum

£9,000

	10 additional tickets to the Awards Ceremony		£13,500
	Individual combo ticket to the Awards Ceremony and Forum		£1,450
	Individual Award Ceremony ticket		£1,450
	Individual Forum ticket		£550

Proceed to Payment

You have chosen to settle your fees through Business France. Please contact Roxane: roxane.valfort@businessfrance.fr to complete your submission

Bank Name:	JP Morgan Chase Bank
Branch Name:	Broadway Morris Exchange 294
Address:	42 Broadway, New York, NY 10004
ABA/routing number:	021000021
Account number:	515907223
Account name:	The Galien Foundation

Account information for payment by wire transfer

Please be sure to upload your transaction receipt to complete your submission

Important – Difference between buttons:

SAVE PROGRESS:

Save your work in progress
Allows you to return later to continue
Does not perform validation
Ideal if you need to temporarily interrupt your application

VALIDATE:

Checks that your form is properly filled out
Verifies all required information is present on each page
Upon successful validation, the Final Submission page will appear
Only by accessing the Final Submission page will you be able to complete your application to the Prix Galien and be considered a candidate

Please ensure that you have not exceeded the word count.

Final Submission

IMPORTANT

By clicking ‘Submit Final Application’ below, you confirm that:

Your application is complete
You want to be officially considered as a candidate
You understand this is your final submission
You can still edit your form if you want to make some last-minute changes

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