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Argotti U, Leyens L, Lisbona C, López P, Alonso-Orgaz S, Nevado A, Cozzi V. Comparison of the Latin America Regulation Landscape and International Reference Health Authorities to Hasten Drug Registration and Clinical Research Applications. Ther Innov Regul Sci 2023; 57:1287-1297. [PMID: 37682461 PMCID: PMC10579156 DOI: 10.1007/s43441-023-00565-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 07/28/2023] [Indexed: 09/09/2023]
Abstract
INTRODUCTION Promptly providing new drugs to fulfill unmet medical needs requires changes in drug development and registration processes. Health Authorities (HAs) considered as reference due to their experience and acknowledgement (Food and Drug Administration [FDA] among others) already consider innovative clinical trial (CT) designs and flexible approval procedures, but Latin America (LATAM) regulations are still far. A comparison was performed to identify gaps. MATERIALS AND METHODS CT requirements for drug Marketing Authorization Application (MAA) and CT approval regulations were compared between LATAM and reference HAs (FDA/European Medicines Agency [EMA]/Health-Canada/Swissmedic/Therapeutic Goods Administration [TGA]/Pharmaceuticals and Medical Devices Agency [PMDA]), as of August 2022. Procedure included reference HAs regulations review, item selection, identification in LATAM regulations, and International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) guidelines (ICH-E6[R2]/ICH-E8[R1]) implementation revision. RESULTS For MAA, specific application requirements or ICH guideline M4(R4) on common technical document (CTD) adoption are generally stated, and phase-I/III performance is mandatory (explicitly/implicitly). Faster patient access procedures are infrequent: Priority-drug programs, conditional authorizations, or expedited procedures are scarce or non-existent. Regulatory reliance procedures are adopted through different pathways. Regarding CT approval, innovative/complex CT designs are not prohibited but usually omitted. Some countries implemented adapted CT conducting during the COVID-19 pandemic. Early scientific advice meetings (HA-sponsor) are occasionally considered. Most countries are not formally ICH-joined. CONCLUSIONS LATAM regulations must adapt to new regulatory standards (FDA/EMA/ICH) through implementation of frequent updates, reliance/expedited procedures, early HA-sponsor interactions, innovative/complex CTs, mandatory phase-III reaching elimination, and decentralized elements for CT conducting.
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Affiliation(s)
- Urimara Argotti
- International Regulatory Policy Department, Latin America Productos Roche, S.A. de C.V., Mexico City, Mexico
| | - Lada Leyens
- Product Development Regulatory, F. Hoffmann-La Roche AG, Basel, Switzerland
| | | | - Pilar López
- Medical Writing Department, LIDESEC S.L, Madrid, Spain
| | | | - Angel Nevado
- Medical Writing Department, LIDESEC S.L, Madrid, Spain
| | - Virginia Cozzi
- Medical Affairs Department, Roche Central America, Venezuela, and the Caribbean, Heredia, Costa Rica.
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Kim S, Lee JY, Cho SH, Shin EJ, Kim M, Lee JH. An Industry Survey on Unmet Needs in South Korea's New Drug Listing System. Ther Innov Regul Sci 2023; 57:759-768. [PMID: 37183236 DOI: 10.1007/s43441-023-00531-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 04/28/2023] [Indexed: 05/16/2023]
Abstract
INTRODUCTION Since introducing the positive listing system in 2007, the South Korean government has undergone multiple changes in its drug listing system. As there is a lack of studies that evaluate the system from an industry perspective, this paper examined South Korea's new drug listing system from the suppliers' perspective. METHODS We surveyed members of the three main pharmaceutical industry associations online. The survey (a 5-point Likert scale) covered their satisfactory levels, demands, and updates on the current new drug listing system, especially pharmacoeconomic evaluation, pharmacoeconomic evaluation exemption, and risk-sharing agreement. RESULTS A total of 56 respondents participated in the survey. The self-reported satisfaction level for value recognition of new drugs was 1.6 (± 0.7) points (5 points = very satisfied). The most highly demanded reforms for PE, RSA, and PEE were incremental cost-effectiveness ratio threshold (92.9%), reimbursement scope expansion (91.1%), and eligible disease (83.9%). Lastly, they also claimed that the indication-based pricing system must be introduced (83.9%). CONCLUSIONS Pricing and reimbursement policies need to improve in such a way that would enable better access to new drugs while still facilitating their development. Given the nature of the current system, some innovative rare disease treatments and anticancer drugs remain unreimbursed, resulting in low satisfaction levels across the pharmaceutical industry. Hence, pathways to speed up the reimbursement assessment process and expand the range of reimbursable diseases are required. Pharmaceutical companies are also important stakeholders, like in the case of clinicians and patients, and their opinions should also be considered in the process of pricing and reimbursement policy reforms.
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Affiliation(s)
- Sungju Kim
- Healthcare Group, Lee & Ko, Seoul, 04532, Republic of Korea
| | - Ji Yeon Lee
- Healthcare Group, Lee & Ko, Seoul, 04532, Republic of Korea
| | - Seong Ha Cho
- College of Pharmacy, Chung-Ang University, Seoul, 06974, Republic of Korea
| | - Eileen J Shin
- Healthcare Group, Lee & Ko, Seoul, 04532, Republic of Korea
| | - Minyoung Kim
- College of Pharmacy, Chung-Ang University, Seoul, 06974, Republic of Korea
| | - Jong Hyuk Lee
- College of Pharmacy, Chung-Ang University, Seoul, 06974, Republic of Korea.
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Kallio MJ, Starokozhko V, Agricola E, Burggraf M, Heß A, Ballensiefen W, Löbker W, Nuevo Y, Pasmooij AMG, Mol PGM. Translating Academic Drug Discovery Into Clinical Development: A Survey of the Awareness of Regulatory Support and Requirements Among Stakeholders in Europe. Clin Pharmacol Ther 2023; 113:349-359. [PMID: 36326573 PMCID: PMC10099080 DOI: 10.1002/cpt.2789] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 10/29/2022] [Indexed: 11/06/2022]
Abstract
Important discoveries by academic drug developers hold the promise of bringing innovative treatments that address unmet medical needs to the market. However, the drug development process has proved to be challenging and demanding for academic researchers, and regulatory challenges are an important barrier to implementing academic findings in clinical practice. European regulators offer varying degrees of support services to help drug developers meet regulatory standards and requirements. "Strengthening Training of Academia in Regulatory Sciences and Supporting Regulatory Scientific Advice" (STARS) is a European Commission-funded consortium aiming to strengthen the training of academics in regulatory science and requirements. Here, we report the results of four surveys that investigated the awareness and utilization of support tools offered by European regulators and identified the regulatory challenges and support needs of researchers. The surveys targeted four main European stakeholders in academic medicines research: academic research groups (706 respondents), academic research centers (99), funding organizations (49), and regulators (22). The results show that while European regulators provide various regulatory support tools, less than half of the responding academic researchers were aware of these tools and many experienced challenges in reaching a sufficient level of regulatory knowledge. There was a general lack of understanding of the regulatory environment that was aggravated by poor communication between stakeholders. The results of this study form a foundation for an improved European medicines regulatory network, in which regulatory challenges faced by academia are tackled.
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Affiliation(s)
| | - Viktoriia Starokozhko
- Dutch Medicines Evaluation Board, Utrecht, The Netherlands.,Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | | | - Anne Heß
- Federal Institute for Drugs and Medical Devices, Bonn, Germany
| | - Wolfgang Ballensiefen
- German Aerospace Center, Project Management Agency, Health, Innovation for Disease Related Research and Personalised Medicine, Bonn, Germany
| | - Wiebke Löbker
- Federal Institute for Drugs and Medical Devices, Bonn, Germany
| | - Yoana Nuevo
- Spanish Agency of Medicines and Medical Devices, Madrid, Spain
| | | | - Peter G M Mol
- Dutch Medicines Evaluation Board, Utrecht, The Netherlands.,Department of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,European Medicines Agency, Amsterdam, The Netherlands
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Shi J, Chen X, Hu H, Ung COL. Application of implementation science framework to develop and adopt regulatory science in different national regulatory authorities. Front Public Health 2023; 11:1172557. [PMID: 37213606 PMCID: PMC10192700 DOI: 10.3389/fpubh.2023.1172557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 04/03/2023] [Indexed: 05/23/2023] Open
Abstract
Introduction The purpose of developing and adopting regulatory science (RS) for drug regulatory authorities (DRAs) is to enhance regulatory capacity by advancing the scientific approach for the evaluation of health-related products. While many DRAs around the world advocate the concept of RS, the implementation approaches of RS vary according to local needs and have not been systemically examined. This study aimed to systematically identify the evidence about how RS was developed, adopted, and advanced by the selected DRAs, and analyzed and compared the implementation experiences of RS development under the guidance of an implementation science framework. Methods Documentary analysis of government documents and a scoping literature review were conducted, and data analysis was performed under the guidance of the PRECEDE-PROCEED Model (PPM). DRAs in the United States, the European Union, Japan, and China had officially launched RS initiatives and were therefore selected as the target countries in this study. Results There is no common consensus on the definition of RS among the DRAs. However, these DRAs shared the same goal of developing and adopting RS, which was used to develop new tools, standards, and guidelines that could improve the effectiveness and efficiency of the risk and benefit assessment of the regulated products. Each DRA had decided its own priority areas for RS development and thus set specific objectives that might be technology-based (e.g., toxicology and clinical evaluation), process-based (e.g., partnership with healthcare systems and high-quality review/consultation services), or product-based (e.g., drug-device combination products and innovative emerging technologies). To advance RS, considerable resources had been allocated for staff training, advancing information technology and laboratory infrastructure, and funding research projects. DRAs also took multifaceted approaches to expand scientific collaborations through public-private partnerships, research funding mechanisms, and innovation networks. Cross-DRA communications were also reinforced through horizon scanning systems and consortiums to better inform and assist the regulatory decision-making process. The output measurements might be scientific publications, funded projects, DRAs interactions, and evaluation methods and guidelines. Improved regulatory efficiency and transparency leading to benefits to public health, patient outcomes, and translation of drug research and development as the key primary outcomes of RS development were anticipated but not yet clearly defined. Conclusion The application of the implementation science framework is useful for conceptualizing and planning the development and adoption of RS for evidence-based regulatory decision-making. Continuous commitment to the RS development and regular review of the RS goals by the decision-makers are important for DRAs to meet the ever-changing scientific challenges in their regulatory decision-making process.
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Affiliation(s)
- Junnan Shi
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macao SAR, China
| | - Xianwen Chen
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macao SAR, China
| | - Hao Hu
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macao SAR, China
- Centre for Pharmaceutical Regulatory Sciences, University of Macau, Taipa, Macao SAR, China
- Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Taipa, Macao SAR, China
| | - Carolina Oi Lam Ung
- State Key Laboratory of Quality Research in Chinese Medicine, Institute of Chinese Medical Sciences, University of Macau, Taipa, Macao SAR, China
- Centre for Pharmaceutical Regulatory Sciences, University of Macau, Taipa, Macao SAR, China
- Department of Public Health and Medicinal Administration, Faculty of Health Sciences, University of Macau, Taipa, Macao SAR, China
- *Correspondence: Carolina Oi Lam Ung
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Han JED, Ibrahim H, Aiyegbusi OL, Liu X, Marston E, Denniston AK, Calvert MJ. Opportunities and Risks of UK Medical Device Reform. Ther Innov Regul Sci 2022; 56:596-606. [PMID: 35416614 PMCID: PMC9007047 DOI: 10.1007/s43441-022-00394-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 03/14/2022] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To identify the potential opportunities and risks around future UK regulatory reform of medical devices. DESIGN A mixed methods approach, comprising a rapid literature review, one-to-one, semi-structured interviews with key stakeholders, a multidisciplinary stakeholder workshop, and a post-workshop survey. SETTING United Kingdom. PARTICIPANTS 32 key stakeholders across the medical device sector were identified both from the public and private sectors. RESULTS Opportunities relating to regulatory independence were identified, including the potential to create and implement a regulatory framework that ensures availability of medical devices; innovation and investment potential; and safety to the citizens of the UK. The most significant risks identified included threats to the safety of individual patients and the wider health system arising from the delay in awaiting regulatory approval due to the shortage of approved bodies; and reduced competitiveness of UK market and device manufacturers. Recommendations were identified to mitigate risks, centred on harnessing broader cross-sector collaborations, promoting patient and public partnership, and maximizing international engagement. CONCLUSIONS The UK's medical device sector is at a time-critical juncture to construct a regulatory framework to navigate its exit of Europe and respond to Europe's transition to new medical device regulations whilst also addressing the ongoing demand for rapid approval for new devices in response to the global pandemic. Investment, capacity-building, and international engagement will play a central role in mitigating risks and maximizing opportunities for medical device regulation.
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Affiliation(s)
- Ji Eun Diana Han
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK.,Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - Hussein Ibrahim
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK.,Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - Olalekan Lee Aiyegbusi
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK.,Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, UK.,Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.,National Institute for Health Research (NIHR) Birmingham Biomedical Research Centre, University of Birmingham, Birmingham, UK.,National Institute for Health Research (NIHR) Applied Research Collaborative West Midlands, University of Birmingham, Birmingham, UK
| | - Xiaoxuan Liu
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK.,Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, UK.,Health Data Research UK, London, UK.,University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - Eliot Marston
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
| | - Alastair K Denniston
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK.,Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.,Health Data Research UK, London, UK.,University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.,Regulatory Horizons Council, London, UK
| | - Melanie J Calvert
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK. .,Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, UK. .,Centre for Patient Reported Outcomes Research, Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK. .,National Institute for Health Research (NIHR) Birmingham Biomedical Research Centre, University of Birmingham, Birmingham, UK. .,NIHR Surgical Reconstruction and Microbiology Research Centre University Hospitals Birmingham NHS Foundation Trust, University of Birmingham, Birmingham, UK. .,National Institute for Health Research (NIHR) Applied Research Collaborative West Midlands, University of Birmingham, Birmingham, UK.
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Hassan S, Dhali M, Zaman F, Tanveer M. Big data and predictive analytics in healthcare in Bangladesh: regulatory challenges. Heliyon 2021; 7:e07179. [PMID: 34141936 PMCID: PMC8188364 DOI: 10.1016/j.heliyon.2021.e07179] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 03/20/2021] [Accepted: 05/27/2021] [Indexed: 12/23/2022] Open
Abstract
Big data analytics and artificial intelligence are revolutionizing the global healthcare industry. As the world accumulates unfathomable volumes of data and health technology grows more and more critical to the advancement of medicine, policymakers and regulators are faced with tough challenges around data security and data privacy. This paper reviews existing regulatory frameworks for artificial intelligence-based medical devices and health data privacy in Bangladesh. The study is legal research employing a comparative approach where data is collected from primary and secondary legal materials and filtered based on policies relating to medical data privacy and medical device regulation of Bangladesh. Such policies are then compared with benchmark policies of the European Union and the USA to test the adequacy of the present regulatory framework of Bangladesh and identify the gaps in the current regulation. The study highlights the gaps in policy and regulation in Bangladesh that are hampering the widespread adoption of big data analytics and artificial intelligence in the industry. Despite the vast benefits that big data would bring to Bangladesh's healthcare industry, it lacks the proper data governance and legal framework necessary to gain consumer trust and move forward. Policymakers and regulators must work collaboratively with clinicians, patients and industry to adopt a new regulatory framework that harnesses the potential of big data but ensures adequate privacy and security of personal data. The article opens valuable insight to regulators, academicians, researchers and legal practitioners regarding the present regulatory loopholes in Bangladesh involving exploiting the promise of big data in the medical field. The study concludes with the recommendation for future research into the area of privacy as it relates to artificial intelligence-based medical devices should consult the patients' perspective by employing quantitative analysis research methodology.
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Affiliation(s)
- Shafiqul Hassan
- College of Law, Prince Sultan University, Prince Nasser Bin Farhan St, Salah Ad Din, Riyadh 12435, Saudi Arabia
| | - Mohsin Dhali
- College of Law, Prince Sultan University, Prince Nasser Bin Farhan St, Salah Ad Din, Riyadh 12435, Saudi Arabia
| | - Fazluz Zaman
- Department of Business and Law, Federation University Australia, 154-158 Sussex St, Sydney NSW 2000, Australia
| | - Muhammad Tanveer
- Prince Sultan University, Prince Nasser Bin Farhan St, Salah Ad Din, Riyadh 12435, Saudi Arabia
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