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Phougat P, Beniwal M, Kapoor G, Aggarwal N, Kumari A, Sharma R, Chopra H, Sharma R, Kamal MA. Role and Responsibilities of Various Stakeholders in Pharmacovigilance (PV). Curr Drug Saf 2024; 19:CDS-EPUB-138291. [PMID: 38318830 DOI: 10.2174/0115748863277574240125045459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 12/14/2023] [Accepted: 12/26/2023] [Indexed: 02/07/2024]
Abstract
In this review paper, we have analyzed the potential and issues associated with Pharmacovigilance (PV). The analysis is divided into four sections: background, stakeholders, data sources, and medicinal chemistry. Each section discusses the current state, the future trends, and the best practices of Pharmacovigilance (PV). The main purpose, methods, results, and implications of our analysis are summarized. BACKGROUND Pharmacovigilance (PV) is the science and practice of monitoring, evaluating, understanding, and preventing adverse drug reactions. Pharmacovigilance (PV) was established by the World Health Organization in response to the thalidomide tragedy of 1961. The main purpose of Pharmacovigilance (PV) is to ensure the safety and efficacy of drugs in clinical practice. Stakeholders: Pharmacovigilance (PV) involves various stakeholders, such as patients, pharmacists, pharmaceutical companies, healthcare professionals, and regulatory authorities. Each stakeholder has a different role and responsibility in reporting, processing, analyzing, and communicating information about adverse drug reactions. Patient engagement is a key factor for enhancing Pharmacovigilance (PV) practices. DATA SOURCES Pharmacovigilance (PV) relies on data from various sources, such as clinical trials, spontaneous reports, electronic medical records, biomedical literature, and patient-reported data in online health forums. These data sources can provide valuable insights into the real-world use and safety of drugs, as well as the preferences and needs of patients. However, these data sources also pose challenges in terms of quality, validity, reliability, and accessibility. Medicinal Chemistry: Medicinal chemistry is the branch of chemistry that deals with the design, synthesis, and evaluation of new drugs and their biological effects. Medicinal chemistry can enhance Pharmacovigilance (PV) practices by finding new therapeutic indications for existing drugs or compounds that have already been tested for safety and efficacy. Medicinal chemistry also requires careful design and evaluation of covalent inhibitors, bi-substrate inhibitors, stabilizers of protein non-effective conformations, and hydrophobic pocket modifiers to ensure their safety and efficacy. IMPLICATIONS Pharmacovigilance (PV) is a dynamic and evolving discipline that requires collaboration, regulation, education, and innovation to improve patient safety and care. This review aims to provide a comprehensive overview of the potential and issues associated with Pharmacovigilance (PV) practices.
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Affiliation(s)
- Pinki Phougat
- Department of Pharmaceutical Education & Research, Bhagat Phool Singh Mahila Vishwavidyalaya, Khanpur Kalan, Sonipat, Haryana, India
| | - Meenu Beniwal
- Department of Pharmaceutical Education & Research, Bhagat Phool Singh Mahila Vishwavidyalaya, Khanpur Kalan, Sonipat, Haryana, India
| | - Garima Kapoor
- KIET School of Pharmacy, KIET Group of institution Delhi-NCR, Ghaziabad, India
| | - Navidha Aggarwal
- MM College of Pharmacy, Maharishi Markandeshwar (Deemed to be University), Mullana, India
| | - Aanchal Kumari
- Department of Pharmaceutical Education & Research, Bhagat Phool Singh Mahila Vishwavidyalaya, Khanpur Kalan, Sonipat, Haryana, India
| | - Rashmi Sharma
- Department of Pharmaceutical Education & Research, Bhagat Phool Singh Mahila Vishwavidyalaya, Khanpur Kalan, Sonipat, Haryana, India
| | - Hitesh Chopra
- Department of Biosciences, Saveetha School of Engineering, Saveetha Institute of Medical and Technical Sciences, Chennai - 602105, Tamil Nadu, India
| | - Rohit Sharma
- Department of Rasa Shastra and Bhaishajya Kalpana, Faculty of Ayurveda, Institute of Medical Sciences, Banaras Hindu University, Varanasi, 221005, Uttar Pradesh, India
| | - Mohammad Amjad Kamal
- Enzymoics, 7 Peterlee place, Hebersham, NSW 2770; Novel Global Community Educational Foundation, Australia
- Institutes for Systems Genetics, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, China
- King Fahd Medical Research Center, King Abdulaziz University, Saudi Arabia
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Bangladesh
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Kållberg C, Mathiesen L, Gopinathan U, Salvesen Blix H. The role of drug regulatory authorities and health technology assessment agencies in shaping incentives for antibiotic R&D: a qualitative study. J Pharm Policy Pract 2023; 16:53. [PMID: 36973761 PMCID: PMC10045501 DOI: 10.1186/s40545-023-00556-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Accepted: 03/13/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND Few antibiotics have entered the market in recent years despite the need for new treatment options. Some of the challenges of bringing new antibiotics to market are linked to the marketing authorization and health technology assessment (HTA) processes. Research shows great variation in geographic availability of new antibiotics, suggesting that market introduction of new antibiotics is unpredictable. We aimed to investigate regulatory authorities' and HTA agencies' role in developing non-financial incentives to stimulate antibiotic research and development (R&D). METHODS We conducted individual, semi-structured, stakeholder interviews. Participants were recruited from regulatory authorities (EMA and FDA) and HTA agencies in Europe. Participants had to be experienced with assessment of antibiotics. The data were analyzed using a deductive and inductive approach to develop codes and identify key themes. Data were analyzed using thematic analysis including the constant comparison method to define concepts, and rival thinking to identify alternative explanations. RESULTS We found that (1) interpretation of key concepts guiding the understanding of what type of antibiotics are needed vary (2) lack of a shared approach on how to deal with limited clinical data in the marketing authorization and HTA processes is causing barriers to getting new antibiotics to market (3) necessary adaptations to the marketing authorization process causes uncertainties that transmit to other key stakeholders involved in delivering antibiotics to patients. CONCLUSIONS A shared understanding of limited clinical data and how to deal with this issue is needed amongst stakeholders involved in antibiotic R&D, marketing authorization, and market introduction to ensure antibiotics reach the market before resistance levels are out of control. Regulatory authorities and HTA agencies could play an active role in aligning the view of what constitutes an unmet medical need, and direct new economic models towards stimulating greater diversity in the antibiotic armamentarium.
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Affiliation(s)
- Cecilia Kållberg
- Institute of Health and Society, Faculty of Medicine, University of Oslo, Forskningsveien 3A, 0373, Oslo, Norway.
- Norwegian Institute of Public Health, Lovisenberggata 8, 0456, Oslo, Norway.
| | - Liv Mathiesen
- School of Pharmacy, University of Oslo, Sem Sælands Vei 3, 0371, Oslo, Norway
| | - Unni Gopinathan
- Norwegian Institute of Public Health, Lovisenberggata 8, 0456, Oslo, Norway
| | - Hege Salvesen Blix
- Norwegian Institute of Public Health, Lovisenberggata 8, 0456, Oslo, Norway
- School of Pharmacy, University of Oslo, Sem Sælands Vei 3, 0371, Oslo, Norway
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Nævestad TO, Storesund Hesjevoll I, Elvik R. How can regulatory authorities improve safety in organizations by influencing safety culture? A conceptual model of the relationships and a discussion of implications. Accid Anal Prev 2021; 159:106228. [PMID: 34147704 DOI: 10.1016/j.aap.2021.106228] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 04/16/2021] [Accepted: 05/27/2021] [Indexed: 06/12/2023]
Abstract
Regulators have increasingly started to focus on safety culture. The causal link between regulatory initiatives to improve safety culture and a potential decline in accidents may, however, appear like a "black box", involving social processes that seem hard to foresee and influence. We need a better conceptual understanding of this. The aims of our study are to: 1) Map studies of regulatory efforts to influence safety culture in companies, 2) Use the identified studies to develop a conceptual model of the analytical relationships between regulatory initiatives to improve safety culture and accidents in these studies, including the factors influencing these analytical relationships and 3) discuss practical implications. The review is reported according to PRISMA-guidelines, and focuses on professional transport (aviation, sea, rail, road) and the Norwegian petroleum sector. Our review indicates at least six analytical relationships, mediating between regulatory attempts to influence organizational safety culture and accidents. These are between: 1) Rules and regulators, 2) Regulators and companies, 3) Managers and employees in the companies, 4) Organizational members' shared ways of thinking and acting, which are the two key elements of safety culture, 5) Safety culture and safety behaviour, and between 6) Safety behaviour and accidents. Regulatory attempts to influence safety culture may fail or succeed at each level, through factors involved in the different relationships.
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Affiliation(s)
- Tor-Olav Nævestad
- Institute of Transport Economics, Gaustadalléen 21, NO-0349 Oslo, Norway.
| | | | - Rune Elvik
- Institute of Transport Economics, Gaustadalléen 21, NO-0349 Oslo, Norway
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Safroneeva E, Straumann A, Schoepfer AM. Latest Insights on the Relationship Between Symptoms and Biologic Findings in Adults with Eosinophilic Esophagitis. Gastrointest Endosc Clin N Am 2018; 28:35-45. [PMID: 29129298 PMCID: PMC8237235 DOI: 10.1016/j.giec.2017.08.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Patients with eosinophilic esophagitis (EoE) present with symptoms accompanied by behavioral adaptions to living with this condition. These include swallowing- and nonswallowing-associated pain in adulthood. In children, EoE symptoms vary with age and include vomiting, abdominal pain, and dysphagia. Studies using validated patient-reported outcome measures have demonstrated that symptoms in EoE are associated with severe biologic alterations and that patients on the low biologic severity spectrum have few symptoms. This nonlinear nature of the relationship between symptoms and biologic findings has important implications for among other things the length of diagnostic delay, selection of patients for clinical trials, trial duration, and long-term management of EoE patients.
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Affiliation(s)
- Ekaterina Safroneeva
- Institute of Social and Preventive Medicine, University of Bern, Finkenhubelweg 11, Bern, 3012, Switzerland.
| | - Alex Straumann
- EoE Center, Praxis Römerhof, Römerstrasse 7, Olten, 4600, Switzerland; Division of Gastroenterology and Hepatology, University Hospital Zurich, Rämistrasse 100, Zurich, 8006, Switzerland
| | - Alain M Schoepfer
- Division of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois, Rue du Bugnon 44, Lausanne, 1011, Switzerland
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Abstract
In the month of June 2013 the Government of India suddenly suspended three drugs for use. The suspension of the anti-diabetic agent came as a rude shock to the medical community who has been utilizing this insulin sensitizer for more than a decade. We took a close look at the controversies surrounding this agent, the current state in the global scenario and how India has reacted in this mini review. Like most of the drugs utilized in the management of medical disorders pioglitazone also has been under the scanner for quite some time. However no definitive cause and effect association with any of the adverse events namely bladder cancer, anemia, fractures and heart failure was found. The international community responded with caution and refrained from banning the drug outright except for France. The ban in India in the absence of incriminating data on the Indian population seems out of place.
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Affiliation(s)
- S M Sadikot
- Jaslok Hospital and Research Centre, Mumbai 400026, India.
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