估计加速批准药物确认试验的潜在好处:信息框架的综合价值
1Harvard T.H. Chan School of Public Health, 90 Smith St, Boston, MA, 02120, USA. bjiao@hsph.harvard.edu.
PharmacoEconomics
|July 25, 2023
概括
新的信息价值框架有助于评估通过美国食品和药物管理局的加速批准 (AA) 政策批准的药物的确认试验. 一个设计良好的试验提供了显著的价值,而低于最佳的设计大大减少了潜在的好处.
科学领域:
- 卫生经济学 卫生经济学
- 生物统计学 生物统计学
- 药物开发 药物开发
背景情况:
- 美国食品和药物管理局的加速批准 (AA) 政策使患者能够快速获得新疗法.
- 支持AA的初步试验通常使用代用终点和小型单臂设计,从而对临床益处产生不确定性.
- 需要一个强大的框架来评估进一步的确认性试验的价值.
研究的目的:
- 开发一个全面的信息价值 (VOI) 框架来评估确认性试验.
- 量化从初步AA试验中减少不确定性的潜在好处.
- 为了指导最佳的试验设计和政策决策对AA药物.
主要方法:
- 制定了来自确认性试验 (EVICT) 信息的预期值指标.
- EVICT使用临床上有意义的终点,随机对照和更大的样本大小来量化试验的好处.
- 以转移性乳腺癌的假设AA药物为例说明了框架.
主要成果:
- 一个高度不确定的AA药物的初步试验显示了大量的EVICT.
- 一个经过精心设计的证实性试验得出了1260万美元的人口水平的EVICT.
- 使用替代终点和单臂设计可以减少60%的EVICT.
结论:
- 开发的VOI框架为决策提供了准确的估计.
- 这一框架可以为AA药物提供覆盖政策和基于价值的定价.
- 它指导了更具信息性的确认性试验的设计.
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