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Lopes LC, Salas M, Osorio-de-Castro CGS, Leal LF, Doubova SV, Cañás M, Dreser A, Acosta A, Baldoni AO, de Cássia Bergamaschi C, Mota DM, Gómez-Galicia DL, Sepúlveda-Viveros D, Delgado EN, da Costa Lima E, Chandia FV, Ferre F, Marin GH, Olmos I, Zimmermann IR, Fulone I, Roldán-Saelzer J, Sánchez-Salgado JC, Castro-Pastrana LI, de Souza LJC, Beltrán MM, Silva MT, Mena MB, de França Fonteles MM, Urtasun MA, Mónica Tarapués MD, Patricia Granja Hernández MD, Medero N, Comoglio RH, Barberato-Filho S, Galvão TF, Luiza VL, Santa-Ana-Tellez Y, Tanta YR, Elseviers M. Data Sources for Drug Utilization Research in Latin American countries - a cross-national study: DASDUR-LATAM Study. Pharmacoepidemiol Drug Saf 2021; 31:343-352. [PMID: 34957616 DOI: 10.1002/pds.5404] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2021] [Revised: 12/17/2021] [Accepted: 12/20/2021] [Indexed: 11/10/2022]
Abstract
PURPOSE Drug utilization research (DUR) contributes to inform policymaking and to strengthen health systems. The availability of data sources is the first step for conducting DUR. However, documents that systematize these data sources in Latin American (LatAm) countries are not known. We compiled the potential data sources for DUR in the LatAm region. METHODS A network of DUR experts from nine LatAm countries was assembled and experts conducted: (i) a website search of the government, academic, and private health institutions; (ii) screening of eligible data sources, and (iii) liaising with national experts in pharmacoepidemiology (via an on-line survey). The data sources were characterized by accessibility, geographic granularity, setting, sector of the data, sources and type of the data. Descriptive analyses were performed. RESULTS We identified 125 data sources for DUR in nine LatAm countries. Thirty-eight (30%) of them were publicly and conveniently available; 89 (71%) were accessible with limitations, and 18 (14%) were not accessible or lacked clear rules for data access. From the 125 data sources, 76 (61%) were from the public sector only; 46 (37%) were from pharmacy records; 43 (34%) came from ambulatory settings and; 85 (68%) gave access to individual patient-level data. CONCLUSIONS Although multiple sources for DUR are available in LatAm countries, the accessibility is a major challenge. The procedures for accessing DUR data should be transparent, feasible, affordable and protocol-driven. This inventory could permit a comparison of drug utilization between countries identifying potential medication-related problems that need further exploration.
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Affiliation(s)
- Luciane C Lopes
- Pharmaceutical Science Graduate Course, Universidade de Sorocaba UNISO, Sao Paulo, Brazil.,Rodovia Raposo Tavares, Km 92, 5, Sorocaba, Sao Paulo, Brazil
| | - Maribel Salas
- Daiichi Sankyo, Inc., Address: 211 Mount Airy Road, 1A-453, Basking Ridge, New Jersey, USA.,CCEB/CPeRT., University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States
| | - Claudia Garcia Serpa Osorio-de-Castro
- National School of Public Health, Oswaldo Cruz Foundation (Ministry of Health), Rio de Janeiro, Brazil.,Rua Leopoldo Bulhões, 1480, Manguinhos, Rio de Janeiro, RJ, Brazil
| | - Lisiane Freitas Leal
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University/Centre for Clinical Epidemiology - Lady Davis Institute, Montreal, Canada, 3755 Côte-Ste-Catherine Road, Pavillion H-485, Montreal, QC, Canada
| | - Svetlana V Doubova
- National Medical Center Siglo XXI, Mexico, Mexican Institute of Social Security, Mexico City (IMSS), Av Cuahutemos 330. México City, Mexico
| | - Martín Cañás
- Federación Médica de la Provincia de Buenos Aires (FEMEBA), Argentina, Calle 5 N° 473, La Plata, Argentina
| | - Anahi Dreser
- Centre for Health Systems Research, National Institute of Public Health, Mexico, Av. Universidad 655, Cuernavaca, Morelos, Mexico
| | - Angela Acosta
- University of Sao Paulo Department of Public Health, São Paulo, SP, Brazil
| | - Andre Oliveira Baldoni
- Universidade Federal de São João Del-Rei (UFSJ), Dvinópolis, Brazil, R. Sebastião Gonçalves Coelho, 400 - Chanadour, Divinópolis, MG, Brazil
| | - Cristiane de Cássia Bergamaschi
- Pharmaceutical Science Graduate Course, Universidade de Sorocaba UNISO, Sao Paulo, Brazil.,Rodovia Raposo Tavares, Km 92, 5, Sorocaba, Sao Paulo, Brazil
| | - Daniel Marques Mota
- Brazilian Health Regulatory Agency, Brasilia, Brazil.,Setor de Indústria e Abastecimento (SIA) - Trecho 5, Área Especial 57, Brasília, DF, Brazil
| | - Diana L Gómez-Galicia
- Facultad de Farmacia, Universidad Autónoma del Estado de Morelos, Mexico, Cuernavaca, Mexico
| | | | | | - Elisangela da Costa Lima
- School of Pharmacy, Universidade Federal do Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil.,Avenida Carlos Chagas Filho, 373, Cidade Universitária, Rio de Janeiro, RJ, Brazil
| | - Felipe Vera Chandia
- Unidad de Evaluación de Tecnologías en Salud, Centro de Investigación Clínica, Pontificia Universidad Católica de Chile., Chile, Avda. Libertador Bernando O'Higgins 340, Santiago, Chile
| | - Felipe Ferre
- Federal University of Minas Gerais - School of Medicine, Minas Gerais, Brazil, Av. Prof. Alfredo Balena, 190 - sala 503 / Belo Horizonte - MG zip 30130-100
| | - Gustavo H Marin
- Faculty of Medicine, National University of La Plata - CONICET, Argentina, Calle 60 y 120 (1900) La Plata, Argentina
| | - Ismael Olmos
- Servicios de Salud del Estado, Uruguay / Milán, Uruguay
| | - Ivan R Zimmermann
- Department of Public Health, University of Brasilia, Campus Darcy Ribeiro, Asa Norte, Brasilia, DF, Brazil
| | - Izabela Fulone
- Pharmaceutical Science Graduate Course, Universidade de Sorocaba UNISO, Sao Paulo, Brazil.,Rodovia Raposo Tavares, Km 92, 5, Sorocaba, Sao Paulo, Brazil
| | - Juan Roldán-Saelzer
- Instituto de Salud Publica de Chile, Santiago, Chile, Marathon 1000, Nunoa, Santiago, Chile
| | | | - Lucila I Castro-Pastrana
- Department of Chemical and Biological Sciences, Universidad de las Américas Puebla, Mexico.,ExHacienda de Santa Catarina Mártir s/n, 72810, San Andrés Cholula, Puebla, Mexico
| | - Luiz Jupiter Carneiro de Souza
- Oswaldo Cruz Foundation (Ministry of Health), Brasilia, Brazil.,Avenida L3 Norte, no number, Darcy Ribeiro University Campus (University of Brasília - UNB), Gleba A -ZIP Code: 70.904-130 - Brasília - DF, Brazil
| | | | - Marcus Tolentino Silva
- Pharmaceutical Science Graduate Course, Universidade de Sorocaba UNISO, Sao Paulo, Brazil.,Rodovia Raposo Tavares, Km 92, 5, Sorocaba, Sao Paulo, Brazil
| | - María Belén Mena
- Facultad de Ciencias Médicas, Universidad Central del Ecuador, Quito, Ecuador, Calle Sodiro e Iquique Quito-Ecuador
| | - Marta Maria de França Fonteles
- Universidade Federal do Ceará (UFC), Fortaleza, Ceará, Brazil, Rua Pastor Samuel Munguba, 1210, Rodolfo Teófilo, Fortaleza- Ceará, 60430-372, Brazil
| | - Martín A Urtasun
- Federación Médica de la Provincia de Buenos Aires (FEMEBA), Argentina, Calle 5 N° 473, La Plata, Argentina
| | - M D Mónica Tarapués
- Facultad de Ciencias Médicas, Universidad Central del Ecuador, Quito, Ecuador, Calle Sodiro e Iquique Quito-Ecuador
| | - M D Patricia Granja Hernández
- Hivos - Humanistic Organization for Social Change, Quito, Ecuador, Av. Amazonas 239 (entre 18 de septiembre y Jorge Washington) Quito - Ecuador
| | - Natalia Medero
- Servicios de Salud del Estado (ASSE), Montevedeo, Uruguay, Luis Alberto de Herrera 3326, Montevideo, Uruguay
| | - Raquel Herrera Comoglio
- Hospital Nacional de Clínicas, Pharmacovigilance Service, Buenos Aires, Argentina, Santa Rosa 1564, X5000 ETF, Córdoba, Argentina
| | - Silvio Barberato-Filho
- Pharmaceutical Science Graduate Course, University of Sorocaba, São Paulo, Brazil, Rodovia Raposo Tavares, Km 92,5, Sorocaba, São Paulo, Brazil
| | - Taís Freire Galvão
- Universidade Estadual de Campinas, Faculdade de Ciências Farmacêuticas, Campinas, Brazil, R. Cândido Portinari, 200 - Cidade Universitária Zeferino Vaz Campinas/SP 13083-871
| | - Vera Lucia Luiza
- National School of Public Health, Oswaldo Cruz Foundation (Ministry of Health), Rio de Janeiro, Brazil.,Rua Leopoldo Bulhões, 1480, Manguinhos, Rio de Janeiro, RJ, Brazil
| | - Yared Santa-Ana-Tellez
- Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht Institute of Pharmaceutical Sciences, Netherlands, David de Wiedgebouw, Universiteitsweg 99, Utrecht, Netherlands
| | - Yesenia Rodríguez Tanta
- Institute of Health and Technology Assessment and Research - Social Security of Peru (ESSALUD), Lima, Peru, Jirón Domingo Cueto 109, Jesús María 15072 - Lima, Peru
| | - Monique Elseviers
- Department of Clinical Pharmacology, University of Ghent, Belgium, Centre for Research and Innovation in Care, University of Antwerp, Belgium, Campus Drie Eiken, Building R - Office R. 214 Universiteitsplein 1 2610 WILRIJK (Antwerpen), Belgium
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Poswar FDO, da Silva LP, Zambrano MB, Pedrini DB, Saute JAM, Giugliani R. Clinical trials for genetic diseases in Latin America. AMERICAN JOURNAL OF MEDICAL GENETICS PART C-SEMINARS IN MEDICAL GENETICS 2021; 187:381-387. [PMID: 34480410 DOI: 10.1002/ajmg.c.31934] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 03/25/2021] [Accepted: 08/17/2021] [Indexed: 11/09/2022]
Abstract
Latin American geneticists have been contributing to the scientific development of Human and Medical Genetics fields since the early 1950s. In the last decades, as Medical Genetics is moving toward a new era of innovative therapies for previously untreatable conditions, the participation of Latin America in clinical trials is also increasing. This review discusses the particularities regarding funding, regulatory, and ethical aspects of conducting clinical trials for genetic diseases in Latin America, with an especial focus on Brazil, the largest country with the highest number of studies. Although there are still several barriers to overcome, the recent development of orphan drug legislation and policies for rare diseases in many Latin American countries indicates a growing opportunity for the participation of the region in international efforts for the development of new therapies for genetic diseases.
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Affiliation(s)
- Fabiano de Oliveira Poswar
- Clinical Research Group in Medical Genetics, Medical Genetics Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.,Medical Genetics Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Larissa Pozzebon da Silva
- Clinical Research Group in Medical Genetics, Medical Genetics Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.,Medical Genetics Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Marina Bauer Zambrano
- Clinical Research Group in Medical Genetics, Medical Genetics Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.,Medical Genetics Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Diane Bressan Pedrini
- Clinical Research Group in Medical Genetics, Medical Genetics Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.,Medical Genetics Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Jonas Alex Morales Saute
- Medical Genetics Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.,Department of Internal Medicine, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Roberto Giugliani
- Clinical Research Group in Medical Genetics, Medical Genetics Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.,Medical Genetics Service, Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil.,Department of Genetics, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Lara Gongora AB, Werutsky G, Jardim DL, Nogueira-Rodrigues A, Barrios CH, Mathias C, Maluf F, Riechelmann R, Fraga M, Gomes H, William WN, Yamada CAF, de Castro Jr G, Rosa DD, de Melo AC, Sala R, Bustamante E, Bretel D, Arrieta O, Cardona AF, Bastos DA. Impact of the COVID-19 Pandemic on Oncology Clinical Research in Latin America (LACOG 0420). JCO Glob Oncol 2021; 7:649-658. [PMID: 33956499 PMCID: PMC8162498 DOI: 10.1200/go.20.00663] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 03/01/2021] [Accepted: 04/06/2021] [Indexed: 01/08/2023] Open
Abstract
PURPOSE COVID-19 has affected cancer care worldwide. Clinical trials are an important alternative for the treatment of oncologic patients, especially in Latin America, where trials can be the only opportunity for some of them to access novel and, sometimes, standard treatments. METHODS This was a cross-sectional study, in which a 22-question survey regarding the impact of the COVID-19 pandemic on oncology clinical trials was sent to 350 representatives of research programs in selected Latin American institutions, members of the Latin American Cooperative Oncology Group. RESULTS There were 90 research centers participating in the survey, with 70 of them from Brazil. The majority were partly private or fully private (n = 77; 85.6%) and had confirmed COVID-19 cases at the institution (n = 57; 63.3%). Accruals were suspended at least for some studies in 80% (n = 72) of the responses, mostly because of sponsors' decision. Clinical trials' routine was affected by medical visits cancelation, reduction of patients' attendance, reduction of other specialties' availability, and/or alterations on follow-up processes. Formal COVID-19 mitigation policies were adopted in 96.7% of the centers, including remote monitoring and remote site initiation visits, telemedicine visits, reduction of research team workdays or home office, special consent procedures, shipment of oral drugs directly to patients' home, and increase in outpatient diagnostic studies. Importantly, some of these changes were suggested to be part of future oncology clinical trials' routine, particularly the ones regarding remote methods, such as telemedicine. CONCLUSION To our knowledge, this was the first survey to evaluate the impact of COVID-19 on Latin American oncology clinical trials. The results are consistent with surveys from other world regions. These findings may endorse improvements in clinical trials' processes and management in the postpandemic period.
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Affiliation(s)
- Aline B. Lara Gongora
- Latin American Cooperative Oncology Group (LACOG), Porto Alegre, Brazil
- Hospital Sírio-Libanês, São Paulo, Brazil
| | - Gustavo Werutsky
- Latin American Cooperative Oncology Group (LACOG), Porto Alegre, Brazil
| | - Denis L. Jardim
- Latin American Cooperative Oncology Group (LACOG), Porto Alegre, Brazil
- Hospital Sírio-Libanês, São Paulo, Brazil
| | - Angelica Nogueira-Rodrigues
- Latin American Cooperative Oncology Group (LACOG), Porto Alegre, Brazil
- Brazilian Group of Gynecologic Oncology (EVA), Belo Horizonte, Brazil
- Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Carlos H. Barrios
- Latin American Cooperative Oncology Group (LACOG), Porto Alegre, Brazil
| | - Clarissa Mathias
- Latin American Cooperative Oncology Group (LACOG), Porto Alegre, Brazil
- Núcleo de Oncologia da Bahia (NOB)/Oncoclínicas, Salvador, Brazil
- Sociedade Brasileira de Oncologia Clínica (SBOC), São Paulo, Brazil
| | - Fernando Maluf
- Hospital Sírio-Libanês, São Paulo, Brazil
- Beneficência Portuguesa de São Paulo, São Paulo, Brazil
- Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Rachel Riechelmann
- A.C. Camargo Cancer Center, São Paulo, Brazil
- Brazilian Gastrointestinal Tumors Group (GTG), Porto Alegre, Brazil
| | - Maurício Fraga
- Latin American Cooperative Oncology Group (LACOG), Porto Alegre, Brazil
- Universidade Federal de Santa Maria (UFSM), Santa Maria, Brazil
| | - Henry Gomes
- Latin American Cooperative Oncology Group (LACOG), Porto Alegre, Brazil
- Instituto Nacional de Enfermedades Neoplasicas (INEN), Lima, Peru
| | - William N. William
- Latin American Cooperative Oncology Group (LACOG), Porto Alegre, Brazil
- Beneficência Portuguesa de São Paulo, São Paulo, Brazil
- Brazilian Group of Thoracic Oncology (GBOT), Porto Alegre, Brazil
| | - Camilla A. F. Yamada
- Latin American Cooperative Oncology Group (LACOG), Porto Alegre, Brazil
- Beneficência Portuguesa de São Paulo, São Paulo, Brazil
| | - Gilberto de Castro Jr
- Latin American Cooperative Oncology Group (LACOG), Porto Alegre, Brazil
- Hospital Sírio-Libanês, São Paulo, Brazil
- Brazilian Group of Thoracic Oncology (GBOT), Porto Alegre, Brazil
- Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, Brazil
| | - Daniela D. Rosa
- Latin American Cooperative Oncology Group (LACOG), Porto Alegre, Brazil
- Brazilian Group of Breast Cancer Studies (GBECAM), Porto Alegre, Brazil
- Hospital Moinhos de Vento, Porto Alegre, Brazil
| | - Andreia C. de Melo
- Latin American Cooperative Oncology Group (LACOG), Porto Alegre, Brazil
- Brazilian Group of Gynecologic Oncology (EVA), Belo Horizonte, Brazil
- Instituto Nacional de Câncer (INCA), Rio de Janeiro, Brazil
| | - Raul Sala
- Latin American Cooperative Oncology Group (LACOG), Porto Alegre, Brazil
- Grupo Argentino de Investigación Clínica en Oncología, Rosario, Argentina
| | - Eva Bustamante
- Latin American Cooperative Oncology Group (LACOG), Porto Alegre, Brazil
- Chilean Cooperative Group for Oncologic Research (GOCCHI), Santiago, Chile
| | - Denisse Bretel
- Latin American Cooperative Oncology Group (LACOG), Porto Alegre, Brazil
- Grupo de Estudios Clínicos Oncológicos Peruano (GECOPERU), Lima, Peru
| | - Oscar Arrieta
- Latin American Cooperative Oncology Group (LACOG), Porto Alegre, Brazil
- Instituto Nacional de Cancerología, Ciudad del México, México City, México
| | - Andrés F. Cardona
- Latin American Cooperative Oncology Group (LACOG), Porto Alegre, Brazil
- Clinical and Translational Oncology Group, Clínica del Country, Bogotá, Colombia
| | - Diogo A. Bastos
- Latin American Cooperative Oncology Group (LACOG), Porto Alegre, Brazil
- Hospital Sírio-Libanês, São Paulo, Brazil
- Instituto do Câncer do Estado de São Paulo (ICESP), São Paulo, Brazil
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