在批准之前对新药和新器械产生比较证据
Huseyin Naci1, Maximilian Salcher-Konrad1, Aaron S Kesselheim2
1Department of Health Policy, London School of Economics and Political Science, London, UK.
Lancet (London, England)
|March 23, 2020
概括
监管部门的批准往往缺乏对新药和新设备的比较数据. 我们为机构和支付者提出五项原则,
科学领域:
- 健康经济学
- 制药政策
- 医疗器械法规
背景情况:
- 在欧洲和美国获得监管批准时,新药和医疗器械的比较数据有限.
- 现有的活性比较试验可能不会产生临床或政策相关的数据.
- 欧洲和美国的加速审批途径可以进一步减少证据的产生.
研究的目的:
- 为监管机构和付款人提出五项关键原则,鼓励制药和设备公司产生可靠的比较数据.
- 确保及时提供支持患者,临床医生和付款人的知情决策的证据.
- 解决药物和医疗器械的比较证据不足的问题.
主要方法:
- 为监管机构 (例如欧洲药物署,美国食品和药物管理局) 和付款人提出五项关键原则.
- 建议加强标签,以提供可比数据.
- 建议更有选择性地使用不完整数据的加速审批计划.
- 提倡更多地使用随机试验和网络元分析.
- 通过基于已证明的附加效益的定价和支付决定,提出由付款人主导的激励措施.
主要成果:
- 拟议的原则旨在为制造药物和设备的比较数据提供激励.
- 实施可能会为临床实践和卫生政策带来更有意义的证据.
- 为决策提供有用的比较证据.
结论:
- 一种涉及监管机构,付款人和明确标签的多方面的方法对于改善比较证据的产生至关重要.
- 监管机构应该更谨慎地加快审批, 并推广可靠的试验设计.
- 付款人在通过经济政策激励证据生成方面发挥着重要作用.
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