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Tarricone R, Ciani O, Torbica A, Brouwer W, Chaloutsos G, Drummond MF, Martelli N, Persson U, Leidl R, Levin L, Sampietro-Colom L, Taylor RS. Lifecycle evidence requirements for high-risk implantable medical devices: a European perspective. Expert Rev Med Devices 2020; 17:993-1006. [PMID: 32975149 DOI: 10.1080/17434440.2020.1825074] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
INTRODUCTION The new European Union (EU) Regulations on medical devices and on in vitro diagnostics provide manufacturers and Notified Bodies with new tools to improve pre-market and post-market clinical evidence generation especially for high-risk products but fail to indicate what type of clinical evidence is appropriate at each stage of the whole lifecycle of medical devices. In this paper we address: i) the appropriate level and timing of clinical evidence throughout the lifecycle of high-risk implantable medical devices; and ii) how the clinical evidence generation ecosystem could be adapted to optimize patient access. AREAS COVERED The European regulatory and health technology assessment (HTA) contexts are reviewed, in relation to the lifecycle of high-risk medical devices and clinical evidence generation recommended by international network or endorsed by regulatory and HTA agencies in different jurisdictions. EXPERT OPINION Four stages are relevant for clinical evidence generation: i) pre-clinical, pre-market; ii) clinical, pre-market; iii) diffusion, post-market; and iv) obsolescence & replacement, post-market. Each stage has its own evaluation needs and specific studies are recommended to generate the appropriate evidence. Effective lifecycle planning requires anticipation of what evidence will be needed at each stage.
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Affiliation(s)
- Rosanna Tarricone
- Department of Social and Political Science, Bocconi University , Milan, Italy.,SDA Bocconi School of Management , Milan, Italy.,SDA Bocconi School of Management, Centre for Research on Health and Social Care Management (CERGAS) , Milan, Italy
| | - Oriana Ciani
- SDA Bocconi School of Management, Centre for Research on Health and Social Care Management (CERGAS) , Milan, Italy.,Institute of College and Medicine, University of Exeter, South Cloisters, St Luke's Campus , Exeter, UK
| | - Aleksandra Torbica
- Department of Social and Political Science, Bocconi University , Milan, Italy.,SDA Bocconi School of Management , Milan, Italy
| | - Werner Brouwer
- Erasmus School of Health Policy & Management (ESHPM), Erasmus University Rotterdam , Rotterdam, PA, The Netherlands
| | - Georges Chaloutsos
- Biomedical Engineering Department, Onassis Cardiac Surgery Centre & Director , Athens, Greece
| | - Michael F Drummond
- Professor of Health Economics, Centre for Health Economics, University of York , York, UK
| | - Nicolas Martelli
- Associate Clinical Professor, Hôpital Européen Georges Pompidou , Paris, France
| | - Ulf Persson
- IHE, Swedish Institute for Health Economics , Lund, Sweden
| | - Reiner Leidl
- Institute of Health Economics and Healthcare Management, Helmholtz Zentrum München - German Research Center for Environmental Health (Gmbh) , Neuherberg, Germany
| | - Les Levin
- Chief Executive Officer & Scientific Officer, EXCITE International , Canada
| | - Laura Sampietro-Colom
- Deputy Director of Innovation, Head of Health Technology Assessment Unit at Hospital Clinic Barcelona , Spain
| | - Rod S Taylor
- Institute of Health and Wellbeing, University of Glasgow , Glasgow, UK
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Cha JJ, Hong SJ, Kim JS, Seo J, Lee SH, Lee S, Shim CY, Hong GR. A Case of Successful MitraClip for Severe Mitral Regurgitation with Left Ventricular Dysfunction in Korea. Korean Circ J 2020; 50:836-838. [PMID: 32281326 PMCID: PMC7440995 DOI: 10.4070/kcj.2020.0062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 03/06/2020] [Accepted: 03/17/2020] [Indexed: 11/29/2022] Open
Affiliation(s)
- Jung Joon Cha
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea
| | - Sung Jin Hong
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea
| | - Jung Sun Kim
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea.
| | - Jiwon Seo
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea
| | - Seung Hyun Lee
- Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea
| | - Sak Lee
- Division of Cardiovascular Surgery, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea
| | - Chi Young Shim
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea
| | - Geu Ru Hong
- Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Yonsei University Health System, Seoul, Korea
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