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Hidaka M, Hanaoka H, Uyama Y. Different Development Strategies Affecting Japan's Drug lag between Japan-Based and Foreign-Based Companies. Ther Innov Regul Sci 2024; 58:714-720. [PMID: 38575785 DOI: 10.1007/s43441-024-00649-y] [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: 11/05/2023] [Accepted: 03/29/2024] [Indexed: 04/06/2024]
Abstract
We examined the development strategies of new molecular entities approved during a 10-year period (fiscal years of 2012-2021) in Japan to determine the differences in drug lag between Japan and foreign companies. The results demonstrated a clear difference in development strategies. For example, products were usually developed through a "only-Japan" strategy by Japan companies (51.1% of products), compared to a "MRCT (multi-regional clinical trials)" strategy by foreign companies (54.9% of products). Regarding types of licenses, for Japan companies, the percentage of original products was higher in the category of less drug lag, such as "no approval in the US and EU" (59.1%), whereas the percentage of "license-in" products was markedly higher in the "drug lag ≥ 5 years" category (52.5%). Such differences were not observed for products developed by foreign companies. Of 64 license-in products developed by Japan companies with a drug lag > 5 years, 51 (79.7%) had already been approved in the US or EU at initiation of clinical development in Japan. The origin of approximately half (34) of the products was from the emerging companies (non-member foreign companies of the Japan Pharmaceutical Manufacture Association). These results suggest that more global cooperation of Japan companies, particularly with emerging foreign companies, is necessary in terms of the earlier timing of license-in and development strategies of products to promote drug development without drug lag or drug loss in Japan.
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Affiliation(s)
- Masayasu Hidaka
- Department of Regulatory Science of Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
- Global Regulatory Sciences Japan, Bristol-Myers Squibb K.K., Tokyo, Japan
| | - Hideki Hanaoka
- Department of Regulatory Science of Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
- Division of Clinical Research Center, Chiba University Hospital, Chiba, Japan
| | - Yoshiaki Uyama
- Department of Regulatory Science of Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan.
- Regulatory Science Center, Pharmaceuticals and Medical Devices Agency, Shin‑Kasumigaseki Building, 3‑3‑2, Kasumigaseki, Chiyoda‑ku, Tokyo, 100‑0013, Japan.
- Graduate School of Medicine, Nagoya University, Nagoya, Japan.
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2
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Maeda H, Hara A, Ofuchi M, Shingai R, Misumi T, Murai Y. Trends in oncology drug lags in Japan from 2001 to 2020: A cross-sectional study. Clin Transl Sci 2023; 16:2665-2674. [PMID: 37815272 PMCID: PMC10719463 DOI: 10.1111/cts.13660] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2023] [Revised: 09/20/2023] [Accepted: 09/24/2023] [Indexed: 10/11/2023] Open
Abstract
Anticancer drugs are essential in the treatment of serious diseases, but their applications are limited by drug lags. This study investigated the characteristics of anticancer drugs approved in Japan over the past 20 years and compared the drug lag trends between Japan and the US. We assessed the changes in drug lag between Japan and the US and the factors affecting the drug lags using publicly available data for anticancer drugs approved in Japan from January 2001 to December 2020. A total of 299 anticancer drugs were approved in Japan in the last 20 years. The approval lag median between the US and Japan was 498 days (16.6 months), peaking in 2002, and decreasing annually thereafter. The minimum approval lag was 173.5 days (5.7 months) in 2018. Multivariate regression analysis revealed that "global simultaneous strategy," "catch-up strategy," and "immunotherapy" are major factors shortening the drug lag. In the past decade, 226 anticancer drugs were approved in Japan. The drug lag for anticancer drugs between Japan and the US peaked in 2002, after which it declined sharply to less than a year. However, the lag was shortest in 2018.
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Affiliation(s)
- Hideki Maeda
- Department of Regulatory ScienceFaculty of PharmacyMeiji Pharmaceutical UniversityKiyoseJapan
| | - Asuka Hara
- Department of Regulatory ScienceFaculty of PharmacyMeiji Pharmaceutical UniversityKiyoseJapan
| | - Momoka Ofuchi
- Department of Regulatory ScienceFaculty of PharmacyMeiji Pharmaceutical UniversityKiyoseJapan
| | - Riko Shingai
- Department of Regulatory ScienceFaculty of PharmacyMeiji Pharmaceutical UniversityKiyoseJapan
| | - Toshihiro Misumi
- Department of Data ScienceNational Cancer Center Hospital EastKashiwaJapan
| | - Yuna Murai
- Department of Regulatory ScienceFaculty of PharmacyMeiji Pharmaceutical UniversityKiyoseJapan
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3
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Tachibana Y, Narukawa M. Oncology drug lag in Japan: has it improved over the last decade? Int J Clin Oncol 2023; 28:1451-1460. [PMID: 37561368 DOI: 10.1007/s10147-023-02395-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Accepted: 07/28/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND Existing studies and statistics on the drug lag between Japan and the United States (US) for anti-cancer drugs indicate that it has decreased, whereas more drugs are left unapproved in Japan. This study aimed to quantify the impact of unapproved drugs on the drug lag. METHODS Information on 136 anti-cancer drugs approved in the US between 2011 and 2022 was collected. The approval lag, defined as the number of days from the date of approval in the US to the date of approval in Japan, was calculated for all selected drugs, and the median was calculated using the Kaplan-Meier method. The approval lag for drugs not approved in Japan was treated as censored data. Factors potentially associated with the approval lag were explored using Cox regression analysis. RESULTS The median approval lags for the first half-period (2011-2016) and the last half-period (2017-2022) were 961 days (2.6 years) and 1547 days (4.2 years), respectively (Log-rank test: p = 0.0687). The participation of Japan in the global pivotal trial was associated with a shorter approval lag, and new drug applications by non-Japanese companies that did not rank in the global sales top 20 were associated with a longer approval lag. CONCLUSIONS Drug lag has not decreased over the last decade. The percentage of pivotal trials for US approval that included Japan has increased but should be further increased in the future. Japan may require a scheme to encourage smaller non-Japanese companies to include Japan in their global clinical development plan.
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Affiliation(s)
- Yoshifumi Tachibana
- Department of Clinical Medicine (Pharmaceutical Medicine), Graduate School of Pharmaceutical Sciences, Kitasato University, 5-9-1 Shirokane, Minato-Ku, Tokyo, 108-8641, Japan.
- Nippon Boehringer Ingelheim Co. Ltd., Tokyo, Japan.
| | - Mamoru Narukawa
- Department of Clinical Medicine (Pharmaceutical Medicine), Graduate School of Pharmaceutical Sciences, Kitasato University, 5-9-1 Shirokane, Minato-Ku, Tokyo, 108-8641, Japan
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4
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Maki A, Narukawa M. Exploratory Analysis of Drug Lag in New Oncology Drugs Between Japan and the US. Ther Innov Regul Sci 2023; 57:671-677. [PMID: 36966205 DOI: 10.1007/s43441-023-00512-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 03/07/2023] [Indexed: 03/27/2023]
Abstract
BACKGROUND Drug lag in Japan has greatly decreased over the past decades; however, new instances of drug lag have appeared along with changes in the circumstances of oncology drug development. We aimed to investigate the factors associated with the approval lag for new oncology drugs between Japan and the United States (US) over the past decade by comparing approval dates and modalities, lead indications, approval types, and phase I strategies for earlier approval in Japan. METHOD We descriptively evaluated the characteristics of 117 new oncology drugs approved in either Japan or the US from January 1, 2011, to December 31, 2020. RESULTS Seventy-one drugs were approved in Japan, 112 in the US, five only in Japan, and 46 only in the US. Interestingly, new oncology drugs were predominantly developed by the top 20 pharmaceutical companies in Japan; however, the opposite was true for drugs that were not yet approved in Japan. However, no clear trend was observed in the relationship between drug lag and the studied factors, except for the phase I strategy. There was a numerical but clear trend in which a higher percentage of phase I multiregional clinical trials (MRCTs) in the drug development strategy was observed for drugs with earlier approval in Japan. CONCLUSION Participation in global drug development during the early stages, such as during phase I MRCTs, is one of the keys to successfully minimizing this new instance of drug lag in Japan.
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Affiliation(s)
- Akio Maki
- Department of Clinical Medicine (Pharmaceutical Medicine), Graduate School of Pharmaceutical Sciences, Kitasato University, 5-9-1 Shirokane, Minato-Ku, Tokyo, 108-8641, Japan.
| | - Mamoru Narukawa
- Department of Clinical Medicine (Pharmaceutical Medicine), Graduate School of Pharmaceutical Sciences, Kitasato University, 5-9-1 Shirokane, Minato-Ku, Tokyo, 108-8641, Japan
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Venkatakrishnan K, Gupta N, Smith PF, Lin T, Lineberry N, Ishida T, Wang L, Rogge M. Asia-Inclusive Clinical Research and Development Enabled by Translational Science and Quantitative Clinical Pharmacology: Toward a Culture That Challenges the Status Quo. Clin Pharmacol Ther 2023; 113:298-309. [PMID: 35342942 PMCID: PMC10083990 DOI: 10.1002/cpt.2591] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 03/17/2022] [Indexed: 01/27/2023]
Abstract
Access lag to innovative therapies in Asian populations continues to present a challenge to global health. Recent progressive changes in the global regulatory landscape, including newer guidelines, are enabling simultaneous global drug development and near-simultaneous global drug registration. The International Conference on Harmonization (ICH) E17 guideline outlines general principles for the design and analysis of multiregional clinical trials (MRCTs). We posit that translational research and quantitative clinical pharmacology tools are core enablers for Asia-inclusive global drug development aligned with ICH E17 principles. Assessment of ethnic sensitivity should be initiated early in the development lifecycle to inform the need for, and extent of, Asian phase I ethno-bridging data. Relevant ethno-bridging data may be generated as standalone Asian phase I trials, as part of Western First-In-Human trials, or under accelerated development settings as a lead-in phase in an MRCT. Quantitative understanding of human clearance mechanisms and pharmacogenetic factors is vital to forecasting ethnic sensitivity in drug exposure using physiologically-based pharmacokinetic models. Stratification factors to control heterogeneity in MRCTs can be identified by reverse translational research incorporating pharmacometric disease models and model-based meta-analyses. Because epidemiological variations can extend to the molecular level, quantitative systems pharmacology models may be useful in forecasting how molecular variation in therapeutic targets or pathway proteins across populations might impact treatment outcomes. Through prospective evaluation of conservation in drug- and disease-related intrinsic and extrinsic factors, a pooled East Asian region can be implemented in Asia-inclusive MRCTs to maximize efficiency in substantiating evidence of benefit-risk for the region at-large with a Totality of Evidence approach.
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Affiliation(s)
- Karthik Venkatakrishnan
- Takeda Development Center Americas, Inc., Lexington, Massachusetts, USA.,EMD Serono Research & Development Institute, Inc., Billerica, Massachusetts, USA
| | - Neeraj Gupta
- Takeda Development Center Americas, Inc., Lexington, Massachusetts, USA
| | | | | | - Neil Lineberry
- Takeda Development Center Americas, Inc., Lexington, Massachusetts, USA
| | - Tatiana Ishida
- Takeda Development Center Americas, Inc., Lexington, Massachusetts, USA
| | - Lin Wang
- Takeda Development Center Asia, Shanghai, China
| | - Mark Rogge
- Takeda Development Center Americas, Inc., Lexington, Massachusetts, USA.,Center for Pharmacometrics and Systems Pharmacology, University of Florida, Orlando, Florida, USA
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Kohama M, Nonaka T, Uyama Y, Ishiguro C. Descriptive Analysis for the Trend of Pharmacovigilance Planning in Risk Management Plans on New Drugs Approved During 2016-2019. Ther Innov Regul Sci 2023; 57:37-47. [PMID: 35963930 DOI: 10.1007/s43441-022-00437-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 07/20/2022] [Indexed: 02/01/2023]
Abstract
BACKGROUND Japanese pharmaceutical authorities have conducted regulatory renovations of pharmacovigilance planning (PVP) since implementing new procedures for developing post-marketing study plans in 2018 in order to promote more focused and scientific approaches. This study aimed to descriptively assess the effects of those regulatory renovations on PVP for new drugs in Japan. METHODS We identified PVP information (drug characteristics, efficacy and safety issues, and additional activities) from the first version of risk management plans for new drugs approved between 2016 and 2019. The following indicators were analyzed: (1) proportion of the number of drugs with at least one efficacy issue among all the drugs, (2) proportion of the number of safety issues with additional activity among all the safety issues, and (3) proportion of database studies among all additional activities. RESULTS In total, 168 drugs, 1212 safety issues, and 301 additional activities were identified. The proportion of drugs with at least one efficacy issue decreased from 91.4% in 2016 to 27.3% in 2019, and the proportion of safety issues with additional activity also decreased from 93.9% in 2016 to 53.7% in 2019. In contrast, the proportion of database studies increased from 0 to 19.2%. The percentages of additional activities targeting important identified and potential risks also gradually decreased during the 4-year period. CONCLUSION Notable changes in the three indicators during 2016-2019 were observed, which suggests that regulatory renovation has affected PVP in Japan.
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Affiliation(s)
- Mei Kohama
- Office of Pharmacovigilance I, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Takahiro Nonaka
- Office of Medical Informatics and Epidemiology, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Yoshiaki Uyama
- Office of Medical Informatics and Epidemiology, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Chieko Ishiguro
- Section of Clinical Epidemiology, Department of Data Science, Center for Clinical Science, National Center for Global Health and Medicine, 1-21-1, Toyama Shinjuku-ku, Tokyo, 162-8655, Japan.
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7
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Luo X, Du X, Li Z, Qian F, Yang Y. Assessment of the Delay in Novel Anticancer Drugs between China and the United States: A Comparative Study of Drugs Approved between 2010 and 2021. Clin Pharmacol Ther 2023; 113:170-181. [PMID: 36151921 DOI: 10.1002/cpt.2755] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 09/16/2022] [Indexed: 12/24/2022]
Abstract
Access to anticancer drugs has been a critical health issue in China for many years. We retrospectively analyzed the novel anticancer drugs approved in the United States (US) between 2010 and 2021 to assess the evolving landscape of the drug lags in China by taking Japan and the European Union (EU) as comparisons. The absolute and relative lags of drug initial approval (DIA) and indication approval were calculated between China (or Japan/European Union) and the US based on the US approval date of novel agents, the duration was divided into 2010-2015 and 2016-2021. Overall, 123 (244 indications) new molecular entities (NMEs) approved in the United States were included, of which 58 (94 indications), 72 (128 indications), and 99 (170 indications) NMEs were also approved in China, Japan, and the European Union, respectively. The absolute lags of DIA and indications for approval in China improved dramatically in 2016-2021 compared with 2010-2015. Similarly, the relative DIA and indication approval lags in China decreased significantly in 2016-2021. The median review lags for DIA of China in 2016-2021 were comparable to Japan but dramatically lower than that of the European Union. Nevertheless, China had significantly longer median submission lags for DIA (28 months) in 2016-2021 than that of Japan (6 months) and the European Union (1 month). Although the absolute and relative lags of anticancer drugs in China had been initially addressed, 53% of NMEs and 61% of indications were still not approved for cancers in China compared with the United States. Therefore, China should adopt steps to further reduce drug lags.
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Affiliation(s)
- Xingxian Luo
- School of Pharmaceutical Sciences, Tsinghua University, Beijing, China.,Key Laboratory of Innovative Drug Research and Evaluation, National Medical Products Administration, Beijing, China.,Tsinghua-Peking Center for Life Sciences, Beijing, China
| | - Xin Du
- School of Pharmaceutical Sciences, Tsinghua University, Beijing, China.,Key Laboratory of Innovative Drug Research and Evaluation, National Medical Products Administration, Beijing, China
| | - Zhuangqi Li
- School of Pharmaceutical Sciences, Tsinghua University, Beijing, China.,Key Laboratory of Innovative Drug Research and Evaluation, National Medical Products Administration, Beijing, China
| | - Feng Qian
- School of Pharmaceutical Sciences, Tsinghua University, Beijing, China
| | - Yue Yang
- School of Pharmaceutical Sciences, Tsinghua University, Beijing, China.,Key Laboratory of Innovative Drug Research and Evaluation, National Medical Products Administration, Beijing, China
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8
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Miyazaki T, Komiyama M, Matsumaru N, Maeda H, Tsukamoto K. Lag Time for New Innovative, First-in-Class, Drug Approval in Japan. Biol Pharm Bull 2022; 45:477-482. [DOI: 10.1248/bpb.b21-00898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
| | | | | | - Hideki Maeda
- Department of Regulatory Science, Division of Clinical Pharmacy, Meiji Pharmaceutical University
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9
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Potential Future Drug Development Lag in Japan Based on an Analysis of Multiregional Clinical Trials in the US, Europe, and East Asia. Ther Innov Regul Sci 2022; 56:523-529. [PMID: 35181842 DOI: 10.1007/s43441-022-00381-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 01/20/2022] [Indexed: 10/19/2022]
Abstract
Although the "drug lag"-namely, the delay in drug approval time in Japan relative to the United States and/or European Union (US/EU)-has been shortened for drugs approved in Japan, there remain many new drugs that have been approved in the US/EU, but not in Japan. To assess the possibility of a future drug lag, this study has examined the current lag in drug development in Japan based on "ClinicalTrials.gov" data from multiregional clinical trials (MRCTs) conducted in the US/EU and East Asia. Among 828 MRCTs registered as of April 5th, 2021, the percentage of MRCTs in which Japan participated (jMRCTs) was 57.1%. jMRCTs were common for some diseases such as "nervous system" and "visual system" disorders, but less common for "neoplasm," infection," "mental," and "circulatory" disorders. Regarding the investigational drugs in non-jMRCTs (i.e., MRCTs without Japanese participation) in the latter four therapeutic areas (i.e., neoplasm, infection, mental and circulatory disorders), approximately 80% (313/399) of drugs were not being developed in Japan. Furthermore, many of these drugs were being developed by the top 50 pharmaceutical companies by sales, and the majority would be recognized as a new active ingredient with a new mode of action in Japan. This study has highlighted the possibility of a future drug lag in Japan, especially in the therapeutic areas of neoplasm, infection, mental, and circulatory disorders. Such a lag may arise not only between Japan and the US/EU, but also between Japan and other countries in the East Asian region.
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Nakamura H, Wakutsu N, Murayama S, Suzuki T. An Empirical Analysis of Japan's Drug Development Lag Behind the United States. J Clin Pharmacol 2021; 62:847-854. [PMID: 34970781 DOI: 10.1002/jcph.2023] [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: 09/15/2021] [Accepted: 12/28/2021] [Indexed: 11/06/2022]
Abstract
The "Drug lag" (i.e., the approval lag for new drugs) hinders patients' access to innovative, new medicines. The drug lag had been heavily debated in Japan from the late 2000s to the early 2010s. It consists of "development lag" (i.e., the submission date lag for new drug applications) and "review lag" (i.e., the difference in review periods). As the two lags have different causes and display significantly different recent trends in Japan, we focus on the development lag-in contrast with most previous literature-between Japan and the United States, based on a database we created for all new drugs from 2008 to 2018 using publicly available data sources. First, we found that Japan's development lag relative to the United States did not shrink in terms of the overall distribution rather than the median, which was the focus of most prior studies. Second, we examined the factors (product characteristics) that significantly affected the development lag and found that products that underwent multi-regional clinical trials and those that were certified as "breakthrough therapies" in the United States had significantly shorter development lags with high robustness, whereas products receiving price premiums did not. Finally, we discussed the policy implications of these results. For instance, innovative new drugs that are presumed to receive price premiums require enhanced policy support for early application from the initial stages of clinical trials. It is also essential to promote information-sharing regarding evaluations by foreign reviewing authorities for efficient utilization in the home country. This article is protected by copyright. All rights reserved.
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11
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Clinical Development and Regulatory Pathways of Monoclonal Antibodies in Japan. Ther Innov Regul Sci 2021; 56:173-183. [PMID: 34825323 DOI: 10.1007/s43441-021-00358-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 11/17/2021] [Indexed: 10/19/2022]
Abstract
The past two decades have seen rapid globalization in the development and distribution of pharmaceutical products. There has been an increasing demand to make innovative and life-saving medicines accessible to global populations promptly. However, regional regulatory requirements may slow drug development and approvals. Therapeutic monoclonal antibodies (mAbs) are among the fastest-growing therapeutics in oncology, immunology, and other disease areas. It has often been observed that, after a new therapeutic mAb is approved in the US and the EU, it takes several additional years before the mAb is approved in Japan. The delay in approval, or the drug approval lag, is primarily due to the delayed submission of new drug applications in Japan, which in turn is the result of regulatory requirements for ethnicity-specific clinical data. These regulatory requirements have been evolving for the last 20 plus years to accelerate new drug development and approval in Japan. This review is intended to examine the trend in drug approval lag for therapeutic mAbs in Japan between 2005 and 2020, review clinical data submissions used to support Japan New Drug Application (JNDA) approvals of mAbs, and discuss the implications of the regulatory environments in Japan in comparison with the US and the EU.
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12
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Yu Y, Lin J, Muto C, Li Y, Mori Y, Mittapalli RK, Tse S, Liu J, Ge BK, Liu J. Assessment of the Utility of Physiologically-based Pharmacokinetic Model for prediction of Pharmacokinetics in Chinese and Japanese Populations. Int J Med Sci 2021; 18:3718-3727. [PMID: 34790045 PMCID: PMC8579302 DOI: 10.7150/ijms.65040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 09/20/2021] [Indexed: 11/05/2022] Open
Abstract
The objective for the present analyses was to evaluate the utility of physiologically-based pharmacokinetic (PBPK) modeling for prediction of the pharmacokinetics (PK) in Chinese and Japanese populations with a panel of Pfizer internal compounds. Twelve compounds from Pfizer internal development pipeline with available Westerner PK data and available PK data in at least one of the subpopulations of Japanese and Chinese populations were identified and included in the current analysis. These selected compounds represent various elimination pathways across different therapeutic areas. The Simcyp® PBPK simulator was used to develop and verify the PBPK models of individual compounds. The developed models for these compounds were verified by using the clinical PK data in Westerners. The verified PBPK models were further used to predict the PK of these compounds in Chinese and Japanese populations and the predicted PK parameters were compared with the observed PK parameters. Ten of the 12 compounds had PK data in Chinese, and all the 12 compounds had PK data in Japanese. In general, the PBPK models performed well in predicting PK in Chinese and Japanese, with 8 of 10 drugs in Chinese and 7 of 12 drugs in Japanese has AAFE values less than 1.25-fold. PBPK-guided predictions of the relative PK difference were successful for 75% and 50%, respectively, between Chinese and Western and between Japanese and Western of the tested drugs using 0.8-1.25 as criteria. In conclusion, well verified PBPK models developed using data from Westerners can be used to predict the PK in Chinese and Japanese populations.
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Affiliation(s)
| | | | | | | | | | | | | | - Jian Liu
- Pfizer Investment Co., LTD, China
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13
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Ushijima S, Matsumaru N, Tsukamoto K. Evaluation of Drug Lags in Development Initiation, New Drug Application and Approval Between Japan and the USA and the Impact of Local Versus Multi-regional Clinical Trials. Pharmaceut Med 2021; 35:253-260. [PMID: 34291425 DOI: 10.1007/s40290-021-00393-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/23/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Drug time lags occur between the date that new drugs are first approved, often in the USA, and approval is granted in other countries. Multi-regional clinical trials (MRCTs) are a key strategy for simultaneous global development and regulatory submission of new drugs. However, no studies have evaluated the impact of MRCT versus local development on key time points in the drug development lifecycle between the USA and Japan. It is important for pharmaceutical companies planning drug development in Japan to understand when they can start development, when they can catch up in case of development initiation delay, length of time the development period might take, and amount of time that market exclusivity is lost, if Japan does not participate in the MRCT. OBJECTIVE The aim of this study was to investigate differences in drug lag in development initiation, New Drug Application (NDA) submission and drug approval, as well as differences in the development and review periods, by local trials and MRCTs between Japan and the USA. We also assessed the advantages and disadvantages of MRCTs for these lags in Japan. METHODS We analyzed drug approvals in Japan between 2016 and 2020 and divided them into local and MRCT groups. Lags in development initiation, NDA submission, and approval of new drugs were calculated by subtracting each date in Japan from the corresponding date in the USA. Our study period was divided into three periods based on the International Conference on Harmonization (ICH) E17 guideline, published in 2017, and the guideline for the Phase I trials in the Japanese population prior to MRCTs, published in 2014. In addition, subgroup analyses by therapeutic area, regulatory background, modality, capital style, and sales ranking (2020) were conducted. RESULTS We analyzed 174 approvals in Japan and the USA. The differences in the drug lags for development initiation, NDA submission, and approval between the local and MRCT groups were 4.9, 3.5, and 3.2 years, respectively. All three lag times were shorter for the MRCT group than the local group. A development initiation lag in the local group has expanded since publication of the guidelines. CONCLUSIONS For the people of Japan, important drug lags were identified in development initiation, NDA submission, and drug approval dates between local trials and MRCTs that include Japan. It is difficult to recover fully from the delay caused by local development, and it is important to understand the further expansion of drug lags, in cases where Japan is not involved in the MRCT.
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Affiliation(s)
- Satoshi Ushijima
- Global Regulatory Science, Gifu Pharmaceutical University, Gifu, Japan. .,Astellas Pharma Inc., Tokyo, Japan.
| | - Naoki Matsumaru
- Global Regulatory Science, Gifu Pharmaceutical University, Gifu, Japan
| | - Katsura Tsukamoto
- Global Regulatory Science, Gifu Pharmaceutical University, Gifu, Japan
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14
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Asano K, Aoi Y, Kamada S, Uyama Y, Tohkin M. Points to Consider for Implementation of the ICH E17 Guideline: Learning from Past Multiregional Clinical Trials in Japan. Clin Pharmacol Ther 2021; 109:1555-1563. [PMID: 33245786 PMCID: PMC8246727 DOI: 10.1002/cpt.2121] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 11/05/2020] [Indexed: 11/16/2022]
Abstract
We identified the major points that are described in the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) E17 guideline but have not been considered in the past multiregional clinical trials (MRCTs) used for drug approval in Japan to elucidate potential challenges in the implementation of the ICH E17 guideline in Japan. Based on the analysis of 167 MRCTs of 130 drugs, several points, such as the same dose setting and consistency between the overall and Japanese populations, in addition to good clinical practice compliance, have been well considered in ≥ 75% of MRCTs. In contrast, the use of relevant guidelines for disease and primary end point definitions, standardization of efficacy/safety information, sample size allocation, as well as training/validation on subject selection and primary end point, have been addressed less adequately and may need to be considered when planning future MRCTs. This study provides useful information for the implementation of the ICH E17 guideline in Japan.
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Affiliation(s)
- Kunihito Asano
- Department of Regulatory ScienceGraduate School of Pharmaceutical SciencesNagoya City UniversityNagoyaJapan
- Office of New Drug IIIPharmaceuticals and Medical Devices Agency (PMDA)TokyoJapan
| | - Yoko Aoi
- Office of New Drug VPharmaceuticals and Medical Devices Agency (PMDA)TokyoJapan
| | - Shuji Kamada
- Office of New Drug VPharmaceuticals and Medical Devices Agency (PMDA)TokyoJapan
| | - Yoshiaki Uyama
- Office of Medical Informatics and EpidemiologyPharmaceuticals and Medical Devices Agency (PMDA)TokyoJapan
- Department of Regulatory Science of MedicineGraduate School of MedicineChiba UniversityChibaJapan
| | - Masahiro Tohkin
- Department of Regulatory ScienceGraduate School of Pharmaceutical SciencesNagoya City UniversityNagoyaJapan
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15
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Li X, Yang Y. The drug lag issue: a 20-year review of China. Invest New Drugs 2021; 39:1389-1398. [PMID: 33928468 DOI: 10.1007/s10637-021-01117-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 04/07/2021] [Indexed: 11/30/2022]
Abstract
China has been criticized for the long drug delay for a long time. There was little understanding of Chinese drug lag formation from the investigational new drug (IND) submission to the new drug application (NDA) approval. Therefore, we analyzed the problem of drug lag in China cumulating from the clinical trial starting lag to the lags formed during the regulatory process and discerned the key underlying factors. After investigating the availability in China of new molecular entities (NMEs) approved by the Food and Drug Administration (FDA) between 1999 and 2019, we find that even though cutting regulatory process could reduce the approval lag, the clinical trial starting time in China is more important in drug lag reduction than shortening development time and review time. The reduction of the regulatory process also needs continuous efforts by defining the clinical value based on the medical needs, regulatory procedure harmonization, and intensive discussions between applicants and regulators during the drug development process. Meanwhile, proactive approaches should be taken to encourage developing the first generics in China. More importantly, enhancing domestic research and development capabilities is still the key to cutting the drug lag. Moreover, the China National Medical Product Administration (NMPA) should attach importance to the accumulation of regulation experience on innovative drugs and transform the style of regulating generics to new drugs.
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Affiliation(s)
- Xiaoyu Li
- International Food & Drug Policy and Law Research Center, School of Business Administration, Shenyang Pharmaceutical University, Shenyang, China
| | - Yue Yang
- International Food & Drug Policy and Law Research Center, School of Business Administration, Shenyang Pharmaceutical University, Shenyang, China. .,Institute of Regulatory Science, Tsinghua University, Biomedicine Hall, Rm C104, Beijing, 100084, China.
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16
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Asada R, Shimizu S, Nakamura H, Ono S, Yamaguchi T. Comparison of Successful and Unsuccessful Cases of New Drug Approvals Based on the International Council on Harmonization E5 Guidelines in Japan. Clin Pharmacol Drug Dev 2021; 10:434-439. [PMID: 33787062 DOI: 10.1002/cpdd.942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 03/01/2021] [Indexed: 11/11/2022]
Affiliation(s)
- Ryuta Asada
- Innovative and Clinical Research Promotion Center, Gifu University Hospital, Gifu, Japan
| | - Shinobu Shimizu
- Department of Advanced Medicine, Nagoya University Hospital, Nagoya, Japan
| | - Harumasa Nakamura
- Translational Medical Center, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Shunsuke Ono
- Laboratory of Pharmaceutical Regulatory Science, Graduate School of Pharmaceutical Sciences, University of Tokyo, Tokyo, Japan
| | - Takuhiro Yamaguchi
- Department of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan
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17
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Tanaka M, Idei M, Sakaguchi H, Kato R, Sato D, Sawanobori K, Kawarasaki S, Hata T, Yoshizaki A, Nakamura M, Ikuma M. Achievements and challenges of the Sakigake designation system in Japan. Br J Clin Pharmacol 2021; 87:4027-4035. [PMID: 33694268 DOI: 10.1111/bcp.14807] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Revised: 02/15/2021] [Accepted: 02/25/2021] [Indexed: 12/25/2022] Open
Abstract
The Sakigake designation system (Sakigake) has been launched to encourage the pioneered development of innovative new medical products for the effective treatment of severe illness in Japan, which allows leveraging the several advantages in prioritized consultation, rapid review, premium drug pricing and extended data-protection period. We retrospectively analysed the Sakigake products including drugs and regenerative medical products to clarify the achievements and the future issues in this system. From April 2015 to August 2020 (the first 5-year trial period of Sakigake), 37 products were designated, and 10 of those were approved in Japan in which 7 new active substances achieved the first-in-world approvals. Oncology, neurology and cardiovascular disease were the major therapeutic areas, and those 3 accounted for 75.7% of all products. Sakigake achieved some first-in-world approvals by the Pharmaceuticals and Medical Devices Agency/the Ministry of Health, Labor and Welfare of innovative new medical products, although in some therapeutic areas, there remains room in stimulating drug development.
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Affiliation(s)
- Mototsugu Tanaka
- Office of New Drug 1, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Mayumi Idei
- Office of New Drug 1, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Hiroshi Sakaguchi
- Office of New Drug 1, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Ryosuke Kato
- Office of New Drug 1, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Daisuke Sato
- Office of New Drug 1, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Kenji Sawanobori
- Office of New Drug 1, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Shuichi Kawarasaki
- Office of New Drug 2, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Toshiyuki Hata
- Office of New Drug 3, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Asako Yoshizaki
- Office of New Drug 4, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Miki Nakamura
- Office of New Drug 5, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Mutsuhiro Ikuma
- Office of New Drug 1, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
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18
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Tanaka M, Idei M, Sakaguchi H, Kato R, Sato D, Sawanobori K, Kawarasaki S, Hata T, Yoshizaki A, Nakamura M, Ikuma M. Rationales of delay and difference in regulatory review by Japan, the USA and Europe among new drugs first approved in Japan. Br J Clin Pharmacol 2021; 87:3279-3291. [PMID: 33511674 DOI: 10.1111/bcp.14749] [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: 10/13/2020] [Revised: 12/28/2020] [Accepted: 01/18/2021] [Indexed: 01/04/2023] Open
Abstract
AIMS To clarify the rationales of delay or difference in the review of new drug applications among regulatory authorities for new drugs, those first approved in the world being in Japan. METHODS Among 80 new drugs first approved in Japan from 2008 to 2019, we identified those subsequently approved in the USA or Europe. Significant delays in approval time (boxplot outliers) and the rationales for the delays were assessed among the Pharmaceuticals and Medical Devices Agency (PMDA), the US Food and Drug Administration (FDA) and the European Medicines Agency (EMA). RESULTS Of the 80 Japan-first approvals, 25 and 24 were approved in the USA and Europe, respectively, and their median approval times in Japan, the USA and Europe were 285, 334 and 477 days, respectively. Significant delays were identified for pirfenidone (1806 days, FDA), alogliptin benzoate (1856 days, FDA), insulin degludec (1457 days, FDA) and romosozumab (750 days, PMDA; 994 days, FDA; 748 days, EMA). Due to concerns about cardiovascular risk, alogliptin benzoate and insulin degludec were requested for additional clinical trials by the FDA, and romosozumab required a much longer review period than the standard approval time in all three regions. CONCLUSIONS Among the new drugs significantly delayed in approval time in Japan, the USA or Europe, there were some differences in the requirements, the participating regions and the assessment of clinical trials. The regulatory views on the cardiovascular risk also differed among the three regions. These divergences may be associated with the differences in approval histories.
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Affiliation(s)
- Mototsugu Tanaka
- Office of New Drug 1, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Mayumi Idei
- Office of New Drug 1, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Hiroshi Sakaguchi
- Office of New Drug 1, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Ryosuke Kato
- Office of New Drug 1, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Daisuke Sato
- Office of New Drug 1, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Kenji Sawanobori
- Office of New Drug 1, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Shuichi Kawarasaki
- Office of New Drug 2, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Toshiyuki Hata
- Office of New Drug 3, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Asako Yoshizaki
- Office of New Drug 4, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Miki Nakamura
- Office of New Drug 5, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Mutsuhiro Ikuma
- Office of New Drug 1, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
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19
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Zheng H, Hampson LV, Jaki T. Bridging across patient subgroups in phase I oncology trials that incorporate animal data. Stat Methods Med Res 2021; 30:1057-1071. [PMID: 33501882 PMCID: PMC8129464 DOI: 10.1177/0962280220986580] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In this paper, we develop a general Bayesian hierarchical model for bridging across patient subgroups in phase I oncology trials, for which preliminary information about the dose-toxicity relationship can be drawn from animal studies. Parameters that re-scale the doses to adjust for intrinsic differences in toxicity, either between animals and humans or between human subgroups, are introduced to each dose-toxicity model. Appropriate priors are specified for these scaling parameters, which capture the magnitude of uncertainty surrounding the animal-to-human translation and bridging assumption. After mapping data onto a common, 'average' human dosing scale, human dose-toxicity parameters are assumed to be exchangeable either with the standardised, animal study-specific parameters, or between themselves across human subgroups. Random-effects distributions are distinguished by different covariance matrices that reflect the between-study heterogeneity in animals and humans. Possibility of non-exchangeability is allowed to avoid inferences for extreme subgroups being overly influenced by their complementary data. We illustrate the proposed approach with hypothetical examples, and use simulation to compare the operating characteristics of trials analysed using our Bayesian model with several alternatives. Numerical results show that the proposed approach yields robust inferences, even when data from multiple sources are inconsistent and/or the bridging assumptions are incorrect.
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Affiliation(s)
- Haiyan Zheng
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK.,Department of Mathematics and Statistics, Lancaster University, Lancashire, UK
| | - Lisa V Hampson
- Advanced Methodology and Data Science, Novartis Pharma AG, Basel, Switzerland
| | - Thomas Jaki
- Department of Mathematics and Statistics, Lancaster University, Lancashire, UK.,MRC Biostatistics Unit, University of Cambridge, Cambridge, UK
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20
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Efficacy Comparison for a Schizophrenia and a Dysuria Drug Among East Asian Populations: A Retrospective Analysis Using Multi-regional Clinical Trial Data. Ther Innov Regul Sci 2021; 55:523-538. [PMID: 33393013 DOI: 10.1007/s43441-020-00246-9] [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: 09/30/2020] [Accepted: 11/18/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND AND OBJECTIVES Multi-regional clinical trials (MRCTs) are an efficient drug development strategy for eliminating drug lag in East Asian countries. In planning MRCTs according to the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use E17 guideline, it is expected that East Asian populations with relatively similar ethnicity can be pooled as one population. However, evidence supporting this assumption is limited. This study aimed to investigate population/regional differences considering influencing factors among East Asian regions using MRCT data as a research model. METHODS A retrospective analysis was conducted to determine the efficacy of two drugs, asenapine, a schizophrenia drug, and tadalafil, a dysuria drug for benign prostatic hyperplasia, using MRCT data from Japan, Korea, and Taiwan. First, predictive factors and effect modifiers were evaluated. Then, population/regional differences were evaluated using multivariate regression models, with the interaction term Region-by-Treatment group and adjustment for influencing intrinsic/extrinsic factors. RESULTS Among the 4 outcomes for the two drugs, no significant population/regional differences were detected (P > 0.05) by the adjusted regression models. The effect modifiers, such as pretreatment drug status or concurrent diseases, were common among countries. CONCLUSIONS No significant population/regional efficacy differences were found for the two drugs among the three regions. This finding supported the possible applicability of the region pooling strategy for MRCTs in East Asia, emphasizing the benefits of exploring ethnic difference/influencing factors at an early stage to design further confirmatory studies. However, further evidence for various drugs should be accumulated.
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21
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Tanaka M, Idei M, Sakaguchi H, Kato R, Sato D, Sawanobori K, Kawarasaki S, Hata T, Yoshizaki A, Nakamura M, Ikuma M. Evolving Landscape of New Drug Approval in Japan and Lags from International Birth Dates: Retrospective Regulatory Analysis. Clin Pharmacol Ther 2020; 109:1265-1273. [PMID: 33048367 PMCID: PMC8246743 DOI: 10.1002/cpt.2080] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 10/05/2020] [Indexed: 12/26/2022]
Abstract
The Pharmaceuticals and Medical Devices Agency (PMDA) has approved hundreds of new drugs in recent years. We retrospectively analyzed the new drugs approved in Japan from 2008 to 2019, and identify the first-in-world approvals and clarify the current drug lag. The new drug and the drug lag were defined as a drug with a new active substance and a difference between the approval date in Japan and the international birth date, respectively. Among 400 new drugs approved in Japan during the last 12 years, 80 (20.0%) were first approved in Japan, and 320 were outside Japan (the United States: 202, 50.5%; Europe: 82, 20.5%; other regions: 36, 9.0%). Of these, 45 new drugs have not yet been approved outside Japan, and the remaining 355 have been globally approved in Japan and overseas. The number of new drug approvals were the largest in oncology followed by metabolic/endocrine and infectious diseases. The median drug lags (year) among all 400 new drugs and 355 new drugs with global approvals were 4.3 and 4.7 in the first tertile (2008-2011), 1.5 and 2.6 in the second tertile (2012-2015), and reduced to 1.3 and 2.2 in the third tertile (2016-2019), respectively. Substantial drug lag remains in neurology, psychiatry, and therapeutic areas where the number of new drug approvals was relatively small. Collectively, one-fifth of the new drugs approved in Japan are first-in-world approvals. Drug lag has been greatly decreased, although it still exists.
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Affiliation(s)
- Mototsugu Tanaka
- Office of New Drug 1, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Mayumi Idei
- Office of New Drug 1, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Hiroshi Sakaguchi
- Office of New Drug 1, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Ryosuke Kato
- Office of New Drug 1, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Daisuke Sato
- Office of New Drug 1, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Kenji Sawanobori
- Office of New Drug 1, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Shuichi Kawarasaki
- Office of New Drug 2, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Toshiyuki Hata
- Office of New Drug 3, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Asako Yoshizaki
- Office of New Drug 4, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Miki Nakamura
- Office of New Drug 5, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
| | - Mutsuhiro Ikuma
- Office of New Drug 1, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
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22
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Nakamura H, Wakutsu N. Reducing Reimbursement Drug Price Risk to Enhance R&D Incentives without Raising Drug Prices/Expenditures: Implications of Simulations Based on Questionnaire Survey of Pharmaceutical Companies in Japan. Health Policy 2020; 124:714-720. [PMID: 32475740 DOI: 10.1016/j.healthpol.2020.03.010] [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: 06/11/2019] [Revised: 03/04/2020] [Accepted: 03/31/2020] [Indexed: 10/24/2022]
Abstract
Due to severe financial conditions and unmet medical needs, the Japanese government must prioritize both R&D incentives and drug prices/expenditures. However, increasing reimbursement drug prices to strengthen R&D incentives also increases the financial burden on patients and the National Health Insurance, wherein virtually all prescription drugs are reimbursed, with prices determined and controlled by the government. Hence, it is important to find ways to achieve higher R&D incentives without raising drug prices/expenditures. To seek such policies, we focus on the reimbursement drug price risk of pharmaceutical firms. An original questionnaire survey is used to collect data on the price-risk attitudes of R&D-oriented pharmaceutical firms in Japan. With this data, we conduct numerical simulations to quantify the effect of reducing the reimbursement drug price risk on firms' R&D incentives. Then, we check the robustness of our results. We find that many R&D-oriented pharmaceutical firms in Japan are risk averse. Thus, to enhance R&D incentives, reducing price risk is effective. The simulated impact of removing a ±10% price risk is equivalent to winning a 5% premium, which is substantial. These results are robust to changes in utility form, price/sales patterns and market size, while increased price risk enhances the simulated impact.
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Affiliation(s)
- Hiroshi Nakamura
- Keio University, 4-1-1 Hiyoshi, Kohoku-ku, Yokohama, Kanagawa 223-8526, Japan.
| | - Naohiko Wakutsu
- Nagoya City University, 1 Yamanohata, Mizuho-cho, Mizuho-ku, Nagoya, Aichi 467-8501, Japan.
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23
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Hiramatsu A, Hanaoka H, Uyama Y. Characteristics on Drug Safety Measures in Japan Stratified by System Organ Classes and Therapeutic Categories in Relation to the Approval Date. Ther Innov Regul Sci 2020; 54:1534-1540. [PMID: 32524501 DOI: 10.1007/s43441-020-00180-w] [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: 03/11/2020] [Accepted: 06/03/2020] [Indexed: 11/26/2022]
Abstract
Revisions of drug package inserts (PIs) may be made immediately after approval or after considerable clinical experience; however, it is unclear whether there is a relationship between the characteristics of these safety measures and the period since drug approval. Here, we analyzed 209 cases of safety measures (revisions of the PIs) taken in Japan over 5 years (FY2014 to FY2018). The median, minimum, and maximum period from approval date in Japan to PI revision date was 6.29 years (interquartile range 2.68-15.53 years), 0.16 years, and 59.69 years, respectively. The cases were classified into four groups depending on types of adverse reaction and therapeutic category in relation to the national approval date and international birth date, resulting in the grouping together of particular adverse reactions and therapeutic drugs. For example, "Hepatobiliary disorders", "Blood and lymphatic system disorders", "Respiratory, thoracic and mediastinal disorders", "Antineoplastics", "Chemotherapeutics", and "Other agents affecting metabolism" were associated with the group of safety measures taken early after approval of a drug soon after the international birth date, suggesting that careful attention at an earlier stage after approval is necessary for these adverse reactions and drugs. Understanding such features of PI revisions makes pharmacovigilance planning more appropriate, contributing to the implementation of rapid and proper safety measures after drug approval.
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Affiliation(s)
- Ayaka Hiramatsu
- Office of New Drug II, Pharmaceuticals and Medical Devices Agency, Tokyo, Japan
- Department of Regulatory Science of Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Hideki Hanaoka
- Division of Clinical Research Center, Chiba University Hospital, Chiba, Japan
- Department of Regulatory Science of Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Yoshiaki Uyama
- Office of Medical Informatics and Epidemiology, Pharmaceuticals and Medical Devices Agency, Shin-Kasumigaseki Building, 3-3-2 Kasumigaseki, Chiyodaku, Tokyo, 100-0013, Japan.
- Department of Regulatory Science of Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan.
- Graduate School of Medicine, Nagoya University, Nagoya, Japan.
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24
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Nakayama H, Matsumaru N, Tsukamoto K. Safety-Related Regulatory Actions and Risk Factors for Anticancer Drugs in Japan. Pharmaceut Med 2020; 33:45-52. [PMID: 31933266 DOI: 10.1007/s40290-018-0260-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The approval of anticancer drugs in Japan has increased to meet high medical demand. To maximize the benefits of anticancer drugs, adverse drug reactions (ADRs) must be properly managed. However, in some cases, clinically significant safety issues are detected after launch, and safety-related regulatory actions (SRRAs) are implemented. OBJECTIVES We aimed to determine the characteristics of SRRAs for anticancer drugs approved in Japan and to identify factors related to the drug development and regulatory approval process associated with the occurrence of an SRRA. METHODS We defined an SRRA as the issuance of a 'Yellow Letter', 'Blue Letter', or an official notification by the Ministry of Health, Labor and Welfare. Anticancer drugs approved in Japan as new active ingredients from April 2004 to July 2016 were analyzed using publicly available information. The Kaplan-Meier survival curve was plotted to estimate the probability of the occurrence of an SRRA, and the Cox proportional hazards model was used to identify risk factors associated with the occurrence of an SRRA. Independent variables were selected using backward/forward stepwise selection according to Akaike's Information Criterion. RESULTS An SRRA was implemented for 38 of 63 anticancer drugs. Approximately 70% of SRRAs occurred within 2 years after approval, and the median time between approval and the occurrence of an SRRA was 1.6 years (interquartile range 0.94-2.4). No Yellow Letter was issued during the follow-up period; however, one Blue Letter was issued for 'acute lung injury and interstitial pneumonia' for sorafenib. According to official notifications, 'clinically significant adverse reactions' was the most revised section of package inserts (62%). The probability of an SRRA at the 1-, 2- and 3-year follow-up was 15.9% (95% confidence interval [CI] 6.4-24.4%), 41.3% (95% CI 27.8-52.3%), and 56.8% (95% CI 41.8-68.0%), respectively. Monoclonal antibodies were associated with a low risk of occurrence of an SRRA (hazard ratio [HR] 0.29, p = 0.019), while the large number of patients in pivotal studies (per 100 patients) was associated with a high risk of occurrence (HR 1.07, p = 0.012). CONCLUSIONS The high-risk period for the occurrence of an SRRA for anticancer drugs in Japan was within 2 years after approval. Among the factors related to the drug development and regulatory approval process, anticancer drugs in the form of non-monoclonal antibodies, and whose pivotal studies included a large number of patients, were more likely to be associated with an SRRA. Postmarketing follow-up should therefore be carefully performed, especially in the first 2 years after approval and for non-monoclonal antibody anticancer drugs. Moreover, postmarketing follow-up is crucial, even if large-scale pivotal studies for regulatory approval have already been performed.
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Affiliation(s)
- Hiroki Nakayama
- Healthcare Policy and CSR, Astellas Pharma Inc., 2-5-1, Nihonbashi-Honcho, Chuo-ku, Tokyo, 103-8411, Japan.
| | - Naoki Matsumaru
- Global Regulatory Science, Gifu Pharmaceutical University, 1-25-4, Daigakunishi, Gifu, 501-1196, Japan
| | - Katsura Tsukamoto
- Global Regulatory Science, Gifu Pharmaceutical University, 1-25-4, Daigakunishi, Gifu, 501-1196, Japan
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25
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New paradigm for expediting drug development in Asia. Drug Discov Today 2020; 25:491-496. [PMID: 31926136 DOI: 10.1016/j.drudis.2019.12.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 12/20/2019] [Accepted: 12/30/2019] [Indexed: 12/21/2022]
Abstract
Some Asian regulators currently require Phase I data in Asians before joining global Phase II/III trials. Here, we discuss inherent limitations of Phase I ethnic sensitivity studies (ESS) to identify potential interethnic differences. We review recent new drug applications (NDAs) for Japan and China to critically assess the value of separate ESSs in Asian populations. Given that the observed value of ESS was limited, we propose a new global drug development paradigm: if relevant safety, pharmacokinetic (PK), and pharmacogenetic (PG) data are available from the original Phase I study population, it might be possible to extrapolate those data to Asian populations for their inclusion in Phase II/III trials, without an ESS. This could help to streamline drug development in Asia while still addressing regulatory requirements.
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26
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Hirota S, Yamaguchi T. Timing of Pediatric Drug Approval and Clinical Evidence Submitted to Regulatory Authorities: International Comparison Among Japan, the United States, and the European Union. Clin Pharmacol Ther 2019; 108:985-994. [PMID: 31869436 DOI: 10.1002/cpt.1757] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 11/13/2019] [Indexed: 11/08/2022]
Abstract
Many prescription drugs approved for adult use lack pediatric labeling information, resulting in their off-label use in children. Drug regulatory authorities have developed legal and regulatory frameworks to promote pediatric drug development. However, the current state of pediatric indication approval and quality of efficacy evidence, which forms the basis of regulatory approvals, is unknown. Here, we analyzed novel therapeutics approved in Japan, the United States, and the European Union during 2005-2014 to investigate the timing and frequency of pediatric indication approval, and characterized the design of pediatric studies supporting regulatory approval. We found that the United States and European Union experienced a higher frequency of supplemental indication approval in pediatrics based on better-designed studies than Japan. The speed and efficiency of pediatric drug development will improve by coordinating pediatric studies on an international basis. The results also implied the necessity for a robust system of postmarketing monitoring of pediatric efficacy and safety.
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Affiliation(s)
- Saeko Hirota
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Takuhiro Yamaguchi
- Division of Biostatistics, Tohoku University Graduate School of Medicine, Sendai, Japan
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27
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Lee SW, Park SH, Song I, Noh Y, Park H, Ha D, Shin JY. Notable Differences in Drug Lag Between Korea and Japan of New Drugs Between 2009 and 2017. Ther Innov Regul Sci 2019. [DOI: 10.1177/2168479019838468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Sang-Won Lee
- Sungkyunkwan University, School of Pharmacy, Suwon, Korea
| | - So-Hee Park
- Sungkyunkwan University, School of Pharmacy, Suwon, Korea
| | - Inmyung Song
- Sungkyunkwan University, School of Pharmacy, Suwon, Korea
| | - Yunha Noh
- Sungkyunkwan University, School of Pharmacy, Suwon, Korea
| | - Hyekyung Park
- Sungkyunkwan University, School of Pharmacy, Suwon, Korea
| | - Dongmun Ha
- Sungkyunkwan University, School of Pharmacy, Suwon, Korea
| | - Ju-Young Shin
- Sungkyunkwan University, School of Pharmacy, Suwon, Korea
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28
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Sai K, Yoshida A, Hanatani T, Imatoh T, Takeuchi M, Narukawa M, Watanabe H, Uyama Y, Saito Y. Population/regional differences in efficacy of 3 drug categories (antidiabetic, respiratory and psychotropic agents) among East Asians: A retrospective study based on multiregional clinical trials. Br J Clin Pharmacol 2019; 85:1270-1282. [PMID: 30735569 DOI: 10.1111/bcp.13893] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 01/25/2019] [Accepted: 02/04/2019] [Indexed: 01/18/2023] Open
Abstract
AIMS This study aimed to identify population/regional differences in drug efficacy and the influencing factors among East Asians to be considered when planning multiregional clinical trials (MRCTs) to facilitate rapid drug approval in Asians. METHODS A retrospective analysis of efficacy (intergroup difference in endpoint between control and study drug treatment) among East Asian populations for 3 drug categories, antidiabetic, respiratory and psychotropic agents, was conducted in collaboration with pharmaceutical companies using their MRCT data. Common endpoints by drug category were selected; background factors that commonly affected the endpoints among regions were analysed first; then the population/regional differences were evaluated by the interaction term region-by-treatment using an analysis of covariance model after adjusting for background factors. RESULTS Among 17 endpoints for eight pharmaceutical products from 3 drug categories, no substantial population/regional differences were detected in the 3 drug categories examined (P > .05), except for haemoglobin A1c change between Japan and Korea for an antidiabetic drug, insulin glulisine (P = .0068). However, no such regional differences were evident in patients with clinically important higher haemoglobin A1c baseline values (majority subgroup). Variability in disease severity at baseline and concomitant drugs were determined to be potential influencing factors for regional differences. CONCLUSIONS This study suggests that the regional variability in efficacy of these 3 drug categories is not large among East Asians, and reveals the importance of considering background factors when planning MRCTs. Further studies are needed to evaluate regional variability in the efficacy of other drug categories and clarify the factors leading to regional differences in East Asians.
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Affiliation(s)
- Kimie Sai
- Division of Medicinal Safety Science, National Institute of Health Sciences, Kawasaki, Japan
| | - Akiomi Yoshida
- Department of Clinical Medicine (Biostatistics), School of Pharmacy, Kitasato University, Tokyo, Japan
| | - Tadaaki Hanatani
- Division of Medicinal Safety Science, National Institute of Health Sciences, Kawasaki, Japan
| | - Takuya Imatoh
- Division of Medicinal Safety Science, National Institute of Health Sciences, Kawasaki, Japan
| | - Masahiro Takeuchi
- Department of Clinical Medicine (Biostatistics), School of Pharmacy, Kitasato University, Tokyo, Japan
| | - Mamoru Narukawa
- Department of Clinical Medicine (Pharmaceutical Medicine), School of Pharmacy, Kitasato University, Tokyo, Japan
| | - Hiroshi Watanabe
- Department of Clinical Pharmacology and Therapeutics, Hamamatsu University School of Medicine, Hamamatsu, Japan.,Center of Clinical Sciences, National Center for Global Health and Medicine, Tokyo, Japan
| | - Yoshiaki Uyama
- Office of Medical Informatics and Epidemiology, Pharmaceuticals & Medical Devices Agency, Tokyo, Japan
| | - Yoshiro Saito
- Division of Medicinal Safety Science, National Institute of Health Sciences, Kawasaki, Japan
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Sun IC. Significant differences on submission lag following regulation reform for registration of novel therapeutic drugs in Taiwan. Invest New Drugs 2019; 37:1094-1106. [PMID: 30612310 DOI: 10.1007/s10637-018-00715-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Accepted: 12/12/2018] [Indexed: 11/24/2022]
Abstract
Drug lag, which delays patients' access to medicinal products, is typically associated with pharmaceutical regulations. To shorten drug lag, health authorities may establish new policies to liberalize the regulations, a step that is important in countries, such as Taiwan, with consumer demand for imported novel therapeutic agents. Taiwan's government enacted Articles 38-1 and 38-2 of Regulations for Registration of Medicinal Products to relax the regulatory barriers for new drug submission, thus conditionally exempting the requirement for the Certificate of Pharmaceutical Product (CPP). This study examined whether the enacted regulations reduce submission lag by analyzing the time gap of submission between Taiwan and the United States during 2014-2017. The results indicated that the enacted regulations substantially affected submission lag. Submission lag was significantly shorter for applications not requiring a CPP than those requiring one CPP, which in turn was significantly shorter than those requiring two CPPs. This conclusion can be applied to biological, chemical, non-orphan, and oncology drugs and also applications filed by subsidiary companies, but not orphan drugs and applications filed by contract agents. Among applications requiring one CPP, oncology drugs showed the shortest submission lag. Certain factors, such as clinical studies recruiting over-threshold Taiwanese participants and those performed before the submission of new drug application in the United States, may shorten submission lag. In summary, this study justifies the policy of the exemption from CPP requirements, which supports the hypothesis that relaxing regulatory barriers can reduce submission lag in Taiwan.
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Affiliation(s)
- I-Chen Sun
- Division of Pharmaceutical Science, Center for Drug Evaluation, Taipei, Taiwan, Republic of China. .,School of Pharmacy, National Defense Medical Center, Taipei, Taiwan, Republic of China.
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30
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Tan-Koi WC, Limenta M, Mohamed EHM, Lee EJD. The Importance of Ethnicity Definitions and Pharmacogenomics in Ethnobridging and Pharmacovigilance. Pharmacogenomics 2019. [DOI: 10.1016/b978-0-12-812626-4.00011-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Matsumoto Y, Cabalu T, Sandhu P, Hartmann G, Iwasa T, Yoshitsugu H, Gibson C, Uemura N. Application of Physiologically Based Pharmacokinetic Modeling to Predict Pharmacokinetics in Healthy Japanese Subjects. Clin Pharmacol Ther 2018; 105:1018-1030. [PMID: 30252941 PMCID: PMC6587435 DOI: 10.1002/cpt.1240] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 09/15/2018] [Indexed: 11/25/2022]
Abstract
Pharmacokinetics (PKs) in Japanese healthy subjects were simulated for nine compounds using physiologically based PK (PBPK) models parameterized with physicochemical properties, preclinical absorption, distribution, metabolism, and excretion (ADME) data, and clinical PK data from non‐Japanese subjects. For each dosing regimen, 100 virtual trials were simulated and predicted/observed ratios for peak plasma concentration (Cmax) and area under the curve (AUC) were calculated. As qualification criteria, it was prespecified that >80% of simulated trials should demonstrate ratios to observed data ranging from 0.5–2.0. Across all compounds and dose regimens studied, 93% of simulated Cmax values in Japanese subjects fulfilled the criteria. Similarly, for AUC, 77% of single‐dosing regimens and 100% of multiple‐dosing regimens fulfilled the criteria. In summary, mechanistically incorporating the appropriate ADME properties into PBPK models, followed by qualification using non‐Japanese clinical data, can predict PKs in the Japanese population and lead to efficient trial design and conduct of Japanese phase I studies.
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Affiliation(s)
- Yuki Matsumoto
- Clinical Pharmacokinetics and Pharmacometrics Group, Clinical Pharmacology, Clinical Research Division, Japan Development, MSD K.K., Tokyo, Japan.,Faculty of Medicine, Graduate School of Medicine, Oita University, Oita, Japan
| | - Tamara Cabalu
- Department of Pharmacokinetics, Pharmacodynamics, and Drug Metabolism, Merck & Co., Inc., Kenilworth, New Jersey, USA
| | - Punam Sandhu
- Department of Pharmacokinetics, Pharmacodynamics, and Drug Metabolism, Merck & Co., Inc., Kenilworth, New Jersey, USA
| | - Georgy Hartmann
- Department of Pharmacokinetics, Pharmacodynamics, and Drug Metabolism, Merck & Co., Inc., Kenilworth, New Jersey, USA
| | - Takashi Iwasa
- Clinical Pharmacokinetics and Pharmacometrics Group, Clinical Pharmacology, Clinical Research Division, Japan Development, MSD K.K., Tokyo, Japan
| | - Hiroyuki Yoshitsugu
- Clinical Pharmacokinetics and Pharmacometrics Group, Clinical Pharmacology, Clinical Research Division, Japan Development, MSD K.K., Tokyo, Japan
| | - Christopher Gibson
- Department of Pharmacokinetics, Pharmacodynamics, and Drug Metabolism, Merck & Co., Inc., Kenilworth, New Jersey, USA
| | - Naoto Uemura
- Faculty of Medicine, Graduate School of Medicine, Oita University, Oita, Japan
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Delays in New Drug Applications and Associated Factors for Orphan Anticancer Drugs in Japan Compared with the USA. Pharmaceut Med 2018. [DOI: 10.1007/s40290-018-0257-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Okabayashi S, Kobayashi T, Hibi T. Drug Lag for Inflammatory Bowel Disease Treatments in the East and West. Inflamm Intest Dis 2018; 3:25-31. [PMID: 30505839 DOI: 10.1159/000491878] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 07/03/2018] [Indexed: 12/12/2022] Open
Abstract
Background Inflammatory bowel disease (IBD), though historically common in the West, is now increasingly prevalent in industrializing countries. A simultaneous dramatic increase in IBD drug options has enabled most patients to achieve remission. Nevertheless, worldwide disparities in the approval of IBD drugs, or "drug lag", remain problematic. Summary Drug lag for major IBD drugs before March 31, 2018 (12 for Crohn's disease [CD] and 13 for ulcerative colitis [UC]) was compared between that of the United States (US), European Union (EU), and Asia (Japan, China, South Korea, Taiwan, and the Philippines) to assess current trends. In the US, unapproved IBD drugs accounted for 16.7% (2/12) for CD and 23.1% (3/13) for UC; approval lag was 3.8 (0-80.5) months for CD and 3.6 (0-88) months for UC. In the EU, unapproved drugs accounted for 16.7% (2/12) for CD and 15.4% (2/13) for UC; approval lag was 0.03 (0-13.9) months for CD and 0 (0-13.9) months for UC. This demonstrates the short drug lag in both regions, although one drug developed in a joint US/EU clinical trial had around a 350-day approval lag. In Asia, the proportion of unapproved IBD drugs was the lowest in Japan at 33.3% (4/12) for CD and 23.1% (3/13) for UC; South Korea had the shortest lag for CD at 13.2 (0-133.1) months and the Philippines had the shortest lag for UC at 9.9 (0.6-176.2) months, but these countries still had longer lag periods than the West. However, a proportion of unapproved drugs and approval lag has decreased considerably in Asia since the start of the biologics era. Key Messages Despite the recent shortening drug lag between different countries and regions, this study shows that disparities persist. With globalization, eliminating these disparate drug lags is necessary to manage IBD and may require efforts toward international adoption of a more standardized approval process.
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Affiliation(s)
- Shinji Okabayashi
- Center for Advanced IBD Research and Treatment, Kitasato University Kitasato Institute Hospital, Tokyo, Japan
| | - Taku Kobayashi
- Center for Advanced IBD Research and Treatment, Kitasato University Kitasato Institute Hospital, Tokyo, Japan
| | - Toshifumi Hibi
- Center for Advanced IBD Research and Treatment, Kitasato University Kitasato Institute Hospital, Tokyo, Japan
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35
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Serrano P, Hartmann M, Schmitt E, Franco P, Amexis G, Gross J, Mayer-Nicolai C. Clinical Development and Initial Approval of Novel Immune Checkpoint Inhibitors in Oncology: Insights From a Global Regulatory Perspective. Clin Pharmacol Ther 2018; 105:582-597. [PMID: 29923615 DOI: 10.1002/cpt.1123] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Accepted: 05/18/2018] [Indexed: 12/28/2022]
Abstract
Immune checkpoint inhibitors (ICI) have demonstrated meaningful patterns of clinical efficacy across various cancers. During their development, novel regulatory strategies and clinical design approaches were explored. This metrics-based narrative review examines submission strategies and clinical evidence expectations of the US, European, and Japanese drug agencies, as well as their impact on approval and overall development times. Also discussed is the role of emerging clinical science and biomarker evaluation to get the first six ICI initially approved.
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Affiliation(s)
- Philippe Serrano
- R&D Regulatory Oncology, EMD Serono Research & Development Institute, Billerica, Massachusetts, USA
| | | | - Elmar Schmitt
- R&D Regulatory Oncology, Merck KGaA, Darmstadt, Germany
| | - Pedro Franco
- Global Regulatory & Scientific Policy, Merck Serono Europe Ltd, London, UK
| | | | - Jan Gross
- R&D Regulatory Oncology, Merck KGaA, Darmstadt, Germany
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Yamashita K, Kaneko M, Narukawa M. A Significant Anticancer Drug Approval Lag Between Japan and the United States Still Exists for Minor Cancers. Clin Pharmacol Ther 2018; 105:153-160. [PMID: 29882302 DOI: 10.1002/cpt.1136] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 05/30/2018] [Indexed: 11/08/2022]
Abstract
Reports have indicated that approval lag for anticancer drugs between Japan and the United States has decreased. However, if this is also true for drugs used to treat minor cancers remains unknown. We analyzed the anticancer drugs approved in Japan from 2006 to 2016 to compare the drug approval lag based on cancer incidence (major vs. minor cancers) between Japan and the United States. The lag of anticancer drugs for minor cancers had not decreased relative to that a decade ago. Recently, development strategies resulting in longer approval lag were used by pharmaceutical companies more often for the development of drugs used to treat minor cancers than for drugs targeting major cancers, leading to significant differences in the approval lag time between drugs for major and minor cancers. Effective measures that expedite the development of drugs targeting minor cancers in Japan should, therefore, be implemented to shorten lag time.
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Affiliation(s)
- Kenji Yamashita
- Department of Clinical Medicine (Pharmaceutical Medicine), Graduate School of Pharmaceutical Sciences, Kitasato University, Tokyo, Japan.,MSD K.K. (a subsidiary of Merck, Kenilworth, NJ, USA), Tokyo, Japan
| | - Masayuki Kaneko
- Department of Clinical Medicine (Pharmaceutical Medicine), Graduate School of Pharmaceutical Sciences, Kitasato University, Tokyo, Japan
| | - Mamoru Narukawa
- Department of Clinical Medicine (Pharmaceutical Medicine), Graduate School of Pharmaceutical Sciences, Kitasato University, Tokyo, Japan
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Nakayama H, Matsumaru N, Tsukamoto K. The drug lag and associated factors for orphan anticancer drugs in Japan compared to the United States. Invest New Drugs 2018; 37:1086-1093. [PMID: 29855823 DOI: 10.1007/s10637-018-0612-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Accepted: 05/24/2018] [Indexed: 11/24/2022]
Abstract
The approval of orphan anticancer drugs in Japan has increased to meet high social demand. Drug lag, namely the approval lag of new drugs, is recognized as a social issue in Japan. We investigated the approval lag and its components, submission lag and review-time lag, between Japan and the United States (US) to reveal whether an approval lag still exists, and to identify potential factors that may contribute to reducing the approval lag. Anticancer drugs approved in Japan between April 2004 and November 2017 were investigated using publicly available information. Results showed that the median approval lag of orphan anticancer drugs in 2016-2017 was 727.0 days (interquartile range, IQR, 310.0-1054.3). The approval lag was significantly correlated with the submission lag (correlation coefficient = 1.00, P < 0.001) but not with the review-time lag (correlation coefficient = -0.16, P = 0.22). The submission lag was significantly longer for orphan anticancer drugs than non-orphan drugs (median, 712.5 days [IQR, 186.0-1448.3] vs. 387.0 days [92.8-1096.0], P = 0.023). External collaboration in drug development was associated with a longer submission lag (coefficient = 762.1, P = 0.017), while breakthrough therapy designation in the US was associated with a shorter submission lag (coefficient = -832.8, P = 0.035). In conclusion, we revealed that an approval lag for orphan anticancer drugs still existed in 2016-2017. A submission lag for orphan anticancer drugs was the main component affecting the approval lag, and was longer than that for non-orphan drugs. External collaboration in drug development may be a potential factor in reducing the submission lag for orphan anticancer drugs.
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Affiliation(s)
- Hiroki Nakayama
- Healthcare Policy & CSR, Astellas Pharma Inc., 2-5-1, Nihonbashi-Honcho, Chuo-ku, Tokyo, 103-8411, Japan.
| | - Naoki Matsumaru
- Global Regulatory Science, Gifu Pharmaceutical University, 1-25-4, Daigakunishi, Gifu, 501-1196, Japan
| | - Katsura Tsukamoto
- Global Regulatory Science, Gifu Pharmaceutical University, 1-25-4, Daigakunishi, Gifu, 501-1196, Japan
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Kikuchi C, Murakami M, Shimomura H, Shimada S, Aoyama T. Influence of Drug Lag on New Drug Label Revisions. Ther Innov Regul Sci 2018; 53:138-145. [PMID: 29714601 DOI: 10.1177/2168479018769294] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND Drug lag (DL) in Japan has decreased in the last few years as a result of the globalization of drug development in the past decade, and new molecule entities (NMEs) with short DL are on the rise. The purpose of this study was to investigate the influence of DL on postmarketing safety of NMEs, by comparing the length of DL and the chronological trend of package insert revisions. METHODS The number of label revisions occurring during 6 years after approval was investigated for 142 NMEs approved between 2000 and 2006. The NMEs were classified by the length of DL (2 years and 4 years), and the label revision trends by each label section and therapeutic categories were analyzed. RESULTS The cumulative number of level revisions in the "Drug Interactions" and "Clinically Significant Adverse Reactions" sections in the first year after approval in the DL <2 years group was significantly greater than in the DL ≥2 years group. In the chemotherapeutic category that showed the shortest DL, the first label revision occurred in 33.3% within the first year and in 66.7% by the second year, and label revisions were performed earlier than in any other therapeutic categories. CONCLUSIONS These results suggest that the package inserts of NMEs with a shorter DL tend to be revised earlier and more frequently, and it requires more careful monitoring of safety information after product launch.
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Affiliation(s)
- Chikara Kikuchi
- 1 Faculty of Pharmaceutical Sciences, Tokyo University of Science, Chiba, Japan
| | - Miyako Murakami
- 1 Faculty of Pharmaceutical Sciences, Tokyo University of Science, Chiba, Japan
| | - Hitoshi Shimomura
- 1 Faculty of Pharmaceutical Sciences, Tokyo University of Science, Chiba, Japan.,2 Department of Pharmacy, International University of Health and Welfare Ichikawa Hospital, Chiba, Japan
| | - Shuji Shimada
- 1 Faculty of Pharmaceutical Sciences, Tokyo University of Science, Chiba, Japan
| | - Takao Aoyama
- 1 Faculty of Pharmaceutical Sciences, Tokyo University of Science, Chiba, Japan
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Rokuda M, Matsumaru N, Tsukamoto K. Identification of Drug Characteristics for Implementing Multiregional Clinical Trials Including Japan. Clin Ther 2018; 40:284-295. [DOI: 10.1016/j.clinthera.2017.12.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Revised: 12/12/2017] [Accepted: 12/15/2017] [Indexed: 12/01/2022]
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Murakami M, Suzuki Y, Tominaga T. Rapid Globalization of Medical Device Clinical Development Programs in Japan ― The Case of Drug-Eluting Stents ―. Circ J 2018; 82:636-643. [DOI: 10.1253/circj.cj-17-0533] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | - Yuka Suzuki
- Pharmaceuticals and Medical Devices Agency (PMDA)
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Pharmacy Students' Knowledge and Attitude toward Registration Trials and Clinical Research: A Survey in a Japanese University Hospital. PHARMACY 2017; 5:pharmacy5040067. [PMID: 29232893 PMCID: PMC5748548 DOI: 10.3390/pharmacy5040067] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 12/06/2017] [Accepted: 12/06/2017] [Indexed: 11/30/2022] Open
Abstract
Clinical research plays a fundamental role in establishing new treatments. Clinical research coordinators are considered essential in clinical research, and medical professionals such as pharmacists often take on this role. Pharmacy students can be considered future candidates for this task. We used questionnaires to survey the knowledge of and attitudes toward registration trials and clinical research of pharmacy students at Tokushima University Hospital. All pharmacy students (103) to whom questionnaires were sent responded. Almost all respondents were aware of registration trials and clinical research. More than 90% were aware of the existence of clinical research coordinators, and about half (48.6%) understood their role. In clinical research terminology, most respondents were aware of informed consent and related issues, but fewer than 20% were aware of more practical things. In total, 29.1% and 40.8% of the respondents were willing to carry out and coordinate research. These findings suggest that pharmacy students have basic knowledge of clinical research and that many students are willing to carry out and coordinate clinical research. More practical exposure to clinical research may help to strengthen their future contribution. Further studies may help to determine how to provide education on registration trials and clinical research to pharmacy students.
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Todaka K, Kishimoto J, Ikeda M, Ikeda K, Yamamoto H. Impact of Risk-Benefit Perception and Trust on Medical Technology Acceptance in Relation to Drug and Device Lag: A Tripartite Cross-Sectional Survey. Ther Innov Regul Sci 2017; 52:629-640. [PMID: 29714546 DOI: 10.1177/2168479017739267] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND New drug and medical device introduction in Japan usually lags behind that in the West. Many reports indicate that in Japan, the associated risks are considered greater than the benefits recognized in other countries. This study aimed to compare the relationship between risk-benefit perception and acceptance of medical technologies in 3 leading markets. METHODS A tripartite cross-sectional survey of the general public was used. In total, 3345 adults in the United Kingdom, the United States, and Japan participated, and sexes and age groups were equally represented. Questions about the perception of risk, benefit, and acceptance of medical and other scientific technologies, and trust of medical product providers or regulatory authorities were included. RESULTS Five-step Likert coding for risk/benefit/acceptance of 4 medical items (x-rays, antibiotics, vaccines, and cardiac pacemakers) and 6 general items (such as automobiles and airplanes) were collected. Relationships between benefit perception and acceptance were linear for 4 medical technologies. The relationship had a similar slope but was shifted downward in Japan compared with the UK and US ( P < .01), suggesting a lower acceptance in Japan for all benefit perceptions. The trend was the same between risk perception and acceptance, except for slopes that were negative. Correspondence analysis showed a strong correlation among acceptance of medical technologies, benefits of medical technologies, trust in doctors, and trust in the Department of Health. The UK and US attributes were clustered with positive responses such as "useful," "acceptable," and "trustworthy," whereas Japan was clustered with intermediate to negative responses such as "neither" and "untrustworthy." CONCLUSIONS Acceptance of medical technologies was low in Japan because of significant differences in trust for doctors and authorities compared with that in the UK and US. This is a possible basis for delays of 24 to 60 months for medical product approval in Japan.
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Affiliation(s)
- Koji Todaka
- 1 Center for Clinical and Translational Research, Kyushu University Hospital, Fukuoka, Japan
| | - Junji Kishimoto
- 2 Department of Research and Development of Next Generation Medicine, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masayuki Ikeda
- 3 Department of Medical Informatics, Kagawa University Hospital, Miki-cho, Kagawa, Japan
| | - Koji Ikeda
- 4 Clinical Research, Innovation and Education Center, Tohoku University Hospital, Sendai, Miyagi, Japan
| | - Haruko Yamamoto
- 5 Center for Advancing Clinical and Translational Sciences, National Cerebral and Cardiovascular Center, Suita, Osaka, Japan
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Kogure S, Koyama N, Hidaka S. Utilization of the Bridging Strategy for the Development of New Drugs in Oncology to Avoid Drug Lag. J Clin Pharmacol 2017. [DOI: 10.1002/jcph.951] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- Seiji Kogure
- Department of Pharmaceutical Regulatory Science; School of Pharmacy; Nihon University; Chiba Japan
- Oncology Clinical Development Department; Daiichi Sankyo Co. Ltd.; Tokyo Japan
| | - Nobuyuki Koyama
- Clinical Data and Biostatistics Department; Daiichi Sankyo Co. Ltd.; Tokyo Japan
| | - Shinji Hidaka
- Department of Pharmaceutical Regulatory Science; School of Pharmacy; Nihon University; Chiba Japan
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Abstract
The delays in the approval and development of neurological drugs between Japan and other countries have been a major issue for patients with neurological diseases. The objective of this study was to analyze factors contributing to the delay in the launching of neurological drugs in Japan. We analyzed data from Japan and the US for the approval of 42 neurological drugs, all of which were approved earlier in the US than in Japan, and examined the potential factors that may cause the delay of their launch. Introductions of the 42 drugs in Japan occurred at a median of 87 months after introductions in the US. The mean review time of new drug applications for the 20 drugs introduced in Japan in January 2011 or later (15 months) was significantly shorter than that for the other 22 drugs introduced in Japan in December 2010 or earlier (24 months). The lag in the Japan's review time behind the US could not explain the approval delays. In the 31 of the 42 drugs, the application data package included overseas data. The mean review time of these 31 drugs (17 months) was significantly shorter than that of the other 11 drugs without overseas data (26 months). The mean approval lag behind the US of the 31 drugs (78 months) was also significantly shorter than that of the other 11 drugs (134 months). These results show that several important reforms in the Japanese drug development and approval system (e.g., inclusion of global clinical trial data) have reduced the delays in the clinical development of neurological drugs.
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Affiliation(s)
- Masayuki Ikeda
- Department Medical Informatics, Kagawa University Hospital
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Takayama A, Narukawa M. Pharmaceutical Pricing and Reimbursement in Japan: For Faster, More Complete Access to New Drugs. Ther Innov Regul Sci 2016; 50:361-367. [PMID: 30227073 DOI: 10.1177/2168479015619202] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND In Japan, National Health Insurance (NHI) has ensured that all Japanese citizens can use the health services they need for more than 50 years. This paper gives an overview of the Japanese NHI drug price listing scheme and practice, and it also discusses the issue of drug price setting and health insurance system from the viewpoint of better patient access to new drugs as well as the environment for innovative new drug development. METHODS For each New Molecular Entity (NME) approved between October 2004 and December 2014, we checked its presence in the list of NHI drug prices as of January 31, 2015, to calculate the NHI coverage rate and the average time between marketing approval and the date of NHI listing. RESULTS A total of 304 NMEs were listed in the NHI price list during the study period, and the NHI coverage rate (excepting preventive vaccines) was 97.4%. The average time between marketing authorization and the initiation of reimbursement was 66 days. There were 88 drugs that gained premiums for innovativeness/usefulness. CONCLUSIONS From the view of NHI coverage scope and speed, the hurdle to access new drugs in Japan is shown to be lower than in other countries that also set public prices for reimbursement. Although the difficulty of controlling health expenditures increases, drug pricing that properly reflects the drug's clinical value is important in that it also furthers the development of medical technology. Better price setting can also facilitate patient access to innovative drugs.
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Affiliation(s)
- Akane Takayama
- 1 Department of Clinical Medicine (Pharmaceutical Medicine), Kitasato University School of Pharmacy, Tokyo, Japan
| | - Mamoru Narukawa
- 1 Department of Clinical Medicine (Pharmaceutical Medicine), Kitasato University School of Pharmacy, Tokyo, Japan
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Uyama Y. [Challenges on drug evaluation in the globalization of drug development from the viewpoint of regulatory science]. Nihon Yakurigaku Zasshi 2016; 148:14-17. [PMID: 27430673 DOI: 10.1254/fpj.148.14] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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Venkatakrishnan K, Burgess C, Gupta N, Suri A, Takubo T, Zhou X, DeMuria D, Lehnert M, Takeyama K, Singhvi S, Milton A. Toward Optimum Benefit-Risk and Reduced Access Lag For Cancer Drugs in Asia: A Global Development Framework Guided by Clinical Pharmacology Principles. Clin Transl Sci 2016; 9:9-22. [PMID: 26836226 PMCID: PMC5351319 DOI: 10.1111/cts.12386] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Revised: 12/22/2015] [Accepted: 01/05/2016] [Indexed: 12/13/2022] Open
Affiliation(s)
- K Venkatakrishnan
- Millennium Pharmaceuticals Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited), Cambridge, Massachusetts, USA
| | - C Burgess
- Millennium Pharmaceuticals Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited), Cambridge, Massachusetts, USA
| | - N Gupta
- Millennium Pharmaceuticals Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited), Cambridge, Massachusetts, USA
| | - A Suri
- Millennium Pharmaceuticals Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited), Cambridge, Massachusetts, USA
| | - T Takubo
- Takeda Pharmaceutical Company Limited, Tokyo, Japan
| | - X Zhou
- Millennium Pharmaceuticals Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited), Cambridge, Massachusetts, USA
| | - D DeMuria
- Millennium Pharmaceuticals Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited), Cambridge, Massachusetts, USA
| | - M Lehnert
- Millennium Pharmaceuticals Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited), Cambridge, Massachusetts, USA
| | - K Takeyama
- Takeda Pharmaceutical Company Limited, Tokyo, Japan
| | - S Singhvi
- Millennium Pharmaceuticals Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited), Cambridge, Massachusetts, USA
| | - A Milton
- Millennium Pharmaceuticals Inc., a wholly owned subsidiary of Takeda Pharmaceutical Company Limited), Cambridge, Massachusetts, USA
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Nakajima K, Dagher R, Strawn L, Urushidani J, Kurokawa T, Chiba K. The Relationship Between Development Start Lag and Approval Lag in Oncology Drug Development in Japan. Ther Innov Regul Sci 2015; 49:911-919. [PMID: 30222391 DOI: 10.1177/2168479015579518] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The delay of initiation of clinical development is considered a causes of delay of approval of drugs (drug lag) in Japan. METHODS For oncology drugs newly approved between 2000 and 2012 in Japan, a possible impact of delay of initiation of clinical development (development start lag [DSL]) on delay of approval (approval lag [AL]) was investigated, focusing on the delay from the US timelines. The equation defining the relationship between the DSL and AL of 33 oncology drugs was calculated by using simulation models, then the Pearson coefficient of correlation between parameters was calculated. RESULTS From the analysis of all drugs investigated, a positive relationship between the DSL and AL was suggested. However, the relationship seemed to have 2 phases, including a flat phase, followed by a linearly increased phase with a breakpoint at 2340 DSL days (approximately 6.4 DSL years). CONCLUSIONS Shortening the DSL is important for reducing large AL, but it is not necessary to eliminate the DSL completely for the purpose of minimizing the AL.
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Affiliation(s)
- Keitaro Nakajima
- 1 Department of Drug Development & Regulatory Science, Keio University of Pharmacy, Tokyo, Japan.,2 Regulatory Affairs Division, Development Japan, Pfizer Japan Inc, Tokyo, Japan
| | - Ramzi Dagher
- 3 Worldwide Safety and Regulatory, Pfizer Inc, Groton, CT, USA
| | - Laurie Strawn
- 4 Worldwide Safety and Regulatory, Pfizer Inc, San Diego, CA, USA
| | - Jun Urushidani
- 1 Department of Drug Development & Regulatory Science, Keio University of Pharmacy, Tokyo, Japan
| | - Tatsuo Kurokawa
- 1 Department of Drug Development & Regulatory Science, Keio University of Pharmacy, Tokyo, Japan
| | - Koji Chiba
- 1 Department of Drug Development & Regulatory Science, Keio University of Pharmacy, Tokyo, Japan.,5 Laboratory of Clinical Pharmacology, Yokohama University of Pharmacy, Yokohama, Japan
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Maeda K, Katashima R, Ishizawa K, Yanagawa H. Japanese Physicians' Views on Drug Post-Marketing Surveillance. J Clin Med Res 2015; 7:956-60. [PMID: 26566409 PMCID: PMC4625816 DOI: 10.14740/jocmr2328w] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2015] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Registration trials leading to the approval of drugs are paramount in drug development. After approval, continuous efforts are necessary to ensure proper use of the approved drugs. In Japan, post-marketing surveillance (PMS) by drug companies is conducted in accordance with good post-marketing study practice (GPSP). Although the global standard for pharmacovigilance is incorporated into GPSP, attention has recently been focused on disassociating them. In this study, we examined physicians' views on PMS with the aim of conducting PMS more effectively. METHODS We retrospectively reviewed records between 2009 and 2013 from the institutional review board of Tokushima University Hospital, an academic hospital in rural Japan. The annual number of times PMS was performed was then determined. Next, we assessed physicians' attitudes toward drug PMS, including ethical issues, in a cross-sectional study using a questionnaire designed for this study. Five- and two-point scales were used. The questionnaire was distributed in 2014 to 221 physicians listed as investigators in PMS contracts. RESULTS Of the 221 physicians, 103 (46.6%) responded to the questionnaire. About 50% of the respondents had experience writing PMS reports. Many of the physicians considered PMS to be important but burdensome. Furthermore, from the viewpoint of research ethics, many physicians considered it improper within the present PMS framework to collect and provide data beyond the scope of routine clinical practice without obtaining informed consent in the case of extra blood sampling, provision of images, monitoring and controlled studies. CONCLUSIONS Beyond practical factors such as workload, attention should be given to establishing an ethical infrastructure and globally harmonized system with regard to the Japanese PMS system. Given the limitations of this single-institution study, further research is needed to collect information for developing a suitable infrastructure.
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Affiliation(s)
- Kazuki Maeda
- Clinical Trial Center for Developmental Therapeutics, Tokushima University Hospital, Tokushima, Japan
| | - Rumi Katashima
- Clinical Trial Center for Developmental Therapeutics, Tokushima University Hospital, Tokushima, Japan
| | - Keisuke Ishizawa
- Institutional Review Board, Tokushima University Hospital, Tokushima, Japan
| | - Hiroaki Yanagawa
- Clinical Trial Center for Developmental Therapeutics, Tokushima University Hospital, Tokushima, Japan
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50
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Poirier AF. Closing the drug lag for new drug submission and review in Japan: An industry perspective. Clin Pharmacol Ther 2015; 98:486-8. [DOI: 10.1002/cpt.192] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 07/26/2015] [Indexed: 11/10/2022]
Affiliation(s)
- AF Poirier
- Pfizer U.S. Regulatory Policy and Global Intelligence; Groton Connecticut USA
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