在批准后对新药和新器械产生比较证据
Andrea Cipriani1, John P A Ioannidis2, Peter M Rothwell3
1Department of Psychiatry, University of Oxford, Oxford, UK; Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK.
Lancet (London, England)
|March 23, 2020
概括
药物和设备的营销后研究往往缺乏可靠的比较数据. 实施指导原则可以激励制造商及时生成与患者相关的证据,以改善利益风险评估.
科学领域:
- 药品和医疗器械
- 监管科学
- 临床研究
背景情况:
- 药物和设备的证据缺口经常在市场批准后继续存在.
- 目前的营销后研究往往是零碎的,研究缺乏活跃的比较对象,患者相关的结果或及时完成.
- 市场投入后研究的监管要求可能无法充分解决市场进入时存在的局限性.
研究的目的:
- 为制药和医疗器械制造商提出七项指导原则,以生成市场推广后的比较数据.
- 鼓励及时解决有关药物和器械效益风险概况的关键问题.
- 提高营销后证据的质量和相关性.
主要方法:
- 开发一套七个关键指导原则,用于营销后的证据生成.
- 强调监管机构,卫生技术评估组织和付款人制定定制的证据计划.
- 建议分层研究设计,优先考虑使用活跃比较器的随机试验.
主要成果:
- 原则主张定制的证据生成计划解决事先批准的数据限制.
- 使用活性对照剂的随机试验优先评估净临床益处.
- 通过创新设计限制非随机研究和提高试验效率的建议.
- 呼吁政府投资研究网络和数据系统.
- 倡导经济激励和处罚以确保数据的产生.
结论:
- 实施拟议的原则可以激励制造商提供高质量的,比较的营销后数据.
- 在营销后阶段解决证据缺陷对于药物和设备的利益风险准确评估至关重要.
- 监管机构,行业和患者之间的协作努力对于及时和相关的批准后研究至关重要.
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