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Aliu P, Sarp S, Fitzsimmons P. Increasing Use of Compassionate Use/Managed Access Channels to Obtain Medicines for Use in COVID-19. Clin Pharmacol Ther 2021; 110:26-28. [PMID: 33326600 PMCID: PMC8359230 DOI: 10.1002/cpt.2140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 12/09/2020] [Indexed: 12/13/2022]
Affiliation(s)
- Paul Aliu
- Chief Medical OfficeNovartis Pharma AGBaselSwitzerland
| | - Séverine Sarp
- Chief Medical OfficeNovartis Pharma AGBaselSwitzerland
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Lim S, DeBruin DA, Leider JP, Sederstrom N, Lynfield R, Baker JV, Kline S, Kesler S, Rizza S, Wu J, Sharp RR, Wolf SM. Developing an Ethics Framework for Allocating Remdesivir in the COVID-19 Pandemic. Mayo Clin Proc 2020; 95:1946-1954. [PMID: 32861338 PMCID: PMC7305893 DOI: 10.1016/j.mayocp.2020.06.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 06/05/2020] [Accepted: 06/10/2020] [Indexed: 11/28/2022]
Abstract
On May 1, 2020, the US Food and Drug Administration (FDA) issued an Emergency Use Authorization (EUA) to allow use of the antiviral drug remdesivir to treat patients with severe coronavirus disease-2019 (COVID-19). Remdesivir is an investigational drug studied in clinical trials for COVID-19 and is available to children and pregnant women through compassionate-use access but is not yet FDA approved. In early May, the US Department of Health and Human Services began to distribute remdesivir, donated by Gilead Sciences, Inc., to hospitals and state health departments for emergency use; multiple shipments have since been distributed. This process has raised questions of how remdesivir should be allocated. The Minnesota Department of Health has collaborated with the Minnesota COVID Ethics Collaborative and multiple clinical experts to issue an Ethical Framework for May 2020 Allocation of Remdesivir in the COVID-19 Pandemic. The framework builds on extensive ethical guidance developed for public health emergencies in Minnesota before the COVID-19 crisis. The Minnesota remdesivir allocation framework specifies an ethical approach to distributing the drug to facilities across the state and then among COVID-19 patients within each facility. This article describes the process of developing the framework and adjustments in the framework over time with emergence of new data, analyzes key issues addressed, and suggests next steps. Sharing this framework and the development process can encourage transparency and may be useful to other states formulating and refining their approach to remdesivir EUA allocation.
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Key Words
- ecmo, extracorporeal membrane oxygenation
- ehr, electronic health record
- eua, emergency use authorization
- fda, food and drug administration
- hhs, department of health and human services
- mcec, minnesota covid ethics collaborative
- mdh, minnesota department of health
- niaid, national institute of allergy and infectious diseases
- sat, science advisory team
- shccc, state health care coordination center
- umn, university of minnesota
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Affiliation(s)
- Sarah Lim
- Minnesota Department of Health, St. Paul, MN
| | | | | | | | | | | | | | | | | | - Joel Wu
- University of Minnesota, Minneapolis
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Affiliation(s)
- Ameet Sarpatwari
- Program On Regulation, Therapeutics, And Law (PORTAL), Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Anna Kaltenboeck
- Drug Pricing Lab, Center for Health Policy and Outcomes, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Aaron S Kesselheim
- Program On Regulation, Therapeutics, And Law (PORTAL), Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
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Caplan AL, Teagarden JR, Kearns L, Bateman-House AS, Mitchell E, Arawi T, Upshur R, Singh I, Rozynska J, Cwik V, Gardner SL. Fair, just and compassionate: A pilot for making allocation decisions for patients requesting experimental drugs outside of clinical trials. J Med Ethics 2018; 44:761-767. [PMID: 29982174 DOI: 10.1136/medethics-2016-103917] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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: 03/15/2018] [Revised: 06/06/2018] [Accepted: 06/16/2018] [Indexed: 06/08/2023]
Abstract
Patients have received experimental pharmaceuticals outside of clinical trials for decades. There are no industry-wide best practices, and many companies that have granted compassionate use, or 'preapproval', access to their investigational products have done so without fanfare and without divulging the process or grounds on which decisions were made. The number of compassionate use requests has increased over time. Driving the demand are new treatments for serious unmet medical needs; patient advocacy groups pressing for access to emerging treatments; internet platforms enabling broad awareness of compelling cases or novel drugs and a lack of trust among some that the pharmaceutical industry and/or the FDA have patients' best interests in mind. High-profile cases in the media have highlighted the gap between patient expectations for compassionate use and company utilisation of fair processes to adjudicate requests. With many pharmaceutical manufacturers, patient groups, healthcare providers and policy analysts unhappy with the inequities of the status quo, fairer and more ethical management of compassionate use requests was needed. This paper reports on a novel collaboration between a pharmaceutical company and an academic medical ethics department that led to the formation of the Compassionate Use Advisory Committee (CompAC). Comprising medical experts, bioethicists and patient representatives, CompAC established an ethical framework for the allocation of a scarce investigational oncology agent to single patients requesting non-trial access. This is the first account of how the committee was formed and how it built an ethical framework and put it into practice.
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Affiliation(s)
- Arthur L Caplan
- Division of Medical Ethics, NYU School of Medicine, New York City, New York, USA
| | | | - Lisa Kearns
- Division of Medical Ethics, NYU School of Medicine, New York City, New York, USA
| | | | - Edith Mitchell
- Department of Medical Oncology, Sidney Kimmel Cancer Center, Jefferson University, Philadelphia, Pennsylvania, USA
| | - Thalia Arawi
- Salim El-Hoss Bioethics & Professionalism Program, Faculty of Medicine, American University of Beirut & Medical Center, Beirut, Lebanon
| | - Ross Upshur
- Dalla Lana Faculty of Public Health, University of Toronto, Toronto, Ontario, Canada
- Department of Family and Community Medicine, Sinai Health System, Toronto, Ontario, Canada
| | - Ilina Singh
- Department of Psychiatry, Wellcome Centre for Ethics and Humanities, University of Oxford, Oxford, UK
| | - Joanna Rozynska
- Center for Bioethics & Biolaw, Institute of Philosophy, University of Warsaw, Warsaw, Poland
| | - Valerie Cwik
- Muscular Dystrophy Association, Tucson, Arizona, USA
| | - Sharon L Gardner
- Department of Pediatrics, NYU Langone Health, New York City, New York, USA
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Kandolf Sekulovic L, Guo J, Agarwala S, Hauschild A, McArthur G, Cinat G, Wainstein A, Caglevic C, Lorigan P, Gogas H, Alvarez M, Duncombe R, Lebbe C, Peris K, Rutkowski P, Stratigos A, Forsea AM, De La Cruz Merino L, Kukushkina M, Dummer R, Hoeller C, Gorry C, Bastholt L, Herceg D, Neyns B, Vieira R, Arenberger P, Bylaite-Bucinskiene M, Babovic N, Banjin M, Putnik K, Todorovic V, Kirov K, Ocvirk J, Zhukavets A, Ymeri A, Stojkovski I, Garbe C. Access to innovative medicines for metastatic melanoma worldwide: Melanoma World Society and European Association of Dermato-oncology survey in 34 countries. Eur J Cancer 2018; 104:201-209. [PMID: 30388700 DOI: 10.1016/j.ejca.2018.09.013] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2018] [Accepted: 09/12/2018] [Indexed: 12/19/2022]
Abstract
According to data from recent studies from Europe, a large percentage of patients have restricted access to innovative medicines for metastatic melanoma. Melanoma World Society and European Association of Dermato-oncology conducted a Web-based survey on access to first-line recommended treatments for metastatic melanoma by current guidelines (National Comprehensive Center Network, European Society for Medical Oncology [ESMO] and European Organization for Research and Treatment of Cancer/European Association of Dermato-oncology/European dermatology Forum) among melanoma experts from 27 European countries, USA, China, Australia, Argentina, Brazil, Chile and Mexico from September 1st, 2017 to July 1st, 2018. Data on licencing and reimbursement of medicines and the number of patient treated were correlated with the data on health expenditure per capita (HEPC), Mackenbach score of health policy performance, health technology assessment (HTA), ASCO and ESMO Magnitude of clinical benefit scale (ESMO MCBS) scores of clinical benefit and market price of medicines. Regression analysis for evaluation of correlation between the parameters was carried out using SPSS software. The estimated number of patients without access in surveyed countries was 13768. The recommended BRAFi + MEKi combination and anti-PD1 immunotherapy were fully reimbursed/covered in 19 of 34 (55.8%) and 17 of 34 (50%) countries, and combination anti-CTLA4+anti-PD1 in was fully covered in 6 of 34 (17.6%) countries. Median delay in reimbursement was 991 days, and it was in significant correlation with ESMO MCBS (p = 0.02), median market price (p = 0.001), HEPC and Mackenbach scores (p < 0.01). Price negotiations or managed entry agreements (MEAs) with national authorities were necessary for reimbursement. In conclusion, great discrepancy exists in metastatic melanoma treatment globally. Access to innovative medicines is in correlation with economic parameters as well as with healthcare system performance parameters. Patient-oriented drug development, market access and reimbursement pathways must be urgently found.
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Affiliation(s)
- L Kandolf Sekulovic
- Department of Dermatology, Faculty of Medicine, Military Medical Academy, Belgrade, Serbia.
| | - J Guo
- Department of Urology and Melanoma, Peking University Cancer Hospital & Institute, Beijing, PR China
| | - S Agarwala
- St. Luke's University Hospital and Temple University, Bethlehem, USA
| | - A Hauschild
- Department of Dermatology, University Hospital Schleswig-Holstein (UKSH), Campus Kiel, Kiel, Germany
| | - G McArthur
- Divisions of Research and Cancer Medicine, Peter MacCallum Cancer Centre, Melbourne, VIC, 3000, Australia
| | - G Cinat
- Médica Oncóloga Instituto de Oncología Angel Roffo, Universidad de Buenos Aires Fundación CIDEA, Buenos Aires, Argentina
| | - A Wainstein
- Institute of Post-graduation, Faculdade de Ciências Médicas de Minas Gerais (FCM-MG) - Belo Horizonte (MG), Brazil
| | - C Caglevic
- Medical Oncology Service, Oncology Department, Clinica Alemana Santiago, Faculty of Medicine Clinica Alemana-Universidad Del Desarrollo, Santiago, Chile
| | - P Lorigan
- Institute of Cancer Sciences, University of Manchester, The Christie NHS Foundation Trust, Manchester, UK
| | - H Gogas
- 1(st)Department of Internal Medicine, Laiko Hospital and 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - M Alvarez
- Medico en Instituto Nacional de Cancerologia, Mexico City Area, Mexico
| | - R Duncombe
- Institute of Cancer Sciences, University of Manchester, The Christie NHS Foundation Trust, Manchester, UK
| | - C Lebbe
- APHP Dermatology Department, University Paris 7 Diderot, INSERM U976, PARIS, France
| | - K Peris
- Institute of Dermatology, Catholic University of the Sacred Heart, Rome, Italy
| | - P Rutkowski
- Maria Sklodowska-Curie Institute - Oncology Center, Warsaw, Poland
| | - A Stratigos
- 1(st)Department of Internal Medicine, Laiko Hospital and 1st Department of Dermatology-Venereology, Andreas Sygros Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - A-M Forsea
- Carol Davila University of Medicine and Pharmacy, Elias University Hospital Bucharest, Romania
| | - L De La Cruz Merino
- Department of Clinical Oncology, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | | | - R Dummer
- UniversitätsSpital Zürich-Skin Cancer Center, University Hospital, Zürich, Switzerland
| | - C Hoeller
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
| | - C Gorry
- National Centre for Pharmacoeconomics, Old Stone Building, Trinity Centre for Health Sciences, St. James's Hospital, Dublin 8, Ireland
| | - L Bastholt
- Department of Oncology, Odense University Hospital, Denmark
| | - D Herceg
- Department of Oncology, University Hospital Zagreb, Croatia
| | - B Neyns
- Department of Medical Oncology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel (VUB), Brussels, Belgium
| | - R Vieira
- Department of Dermatology, Medical Faculty, University of Coimbra, Portugal
| | - P Arenberger
- Department of Dermatovenereology, Charles University 3rd Faculty of Medicine and University Hospital Kralovske Vinohrady, Prague, Czech Republic
| | | | - N Babovic
- Institute of Oncology and Radiology of Serbia, Belgrade, Serbia
| | - M Banjin
- Department of Oncology, University Hospital Sarajevo, Bosnia and Herzegovina
| | - K Putnik
- North Estonia Medical Centre, Tallinn, Estonia
| | - V Todorovic
- Clinic for Oncology and Radiotherapy, Podgorica, Montenegro
| | - K Kirov
- Clinic of Oncodermatology, National Cancer Center, Sofia, Bulgaria
| | - J Ocvirk
- Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - A Zhukavets
- Belarusian Medical Academy of Postgraduate Education (BelMAPE), Minsk, Belarus
| | - A Ymeri
- University Hospital Mother Theresa, Tirana, Albania
| | - I Stojkovski
- University Clinic of Radiotherapy and Oncology, Skopje, Macedonia
| | - C Garbe
- Centre for Dermatooncology, Department of Dermatology, Eberhard Karls University, Tuebingen, Germany
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Goozner M. History and the Ebola outbreak. Mod Healthc 2014; 44:24. [PMID: 25318255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
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10
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[New HIV drugs. Pipeline stays well filled]. MMW Fortschr Med 2014; 156 Suppl 1:6. [PMID: 25026840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Hawkes N. Seriously ill patients in UK will have access to unlicensed drugs. BMJ 2014; 348:g2161. [PMID: 24632993 DOI: 10.1136/bmj.g2161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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12
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In brief: miltefosine for amebic meningeoencephalitis available from CDC. Med Lett Drugs Ther 2013; 55:88. [PMID: 24165710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Darling MD, Reichenberg JS, Gavino ACP. New world cutaneous leishmaniasis: obstacles in initiating treatment with sodium stibogluconate in 2 travelers from Texas. J Drugs Dermatol 2013; 12:476-478. [PMID: 23652898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
New World cutaneous leishmaniasis (CL) is considered in the differential diagnosis for patients with nonhealing ulcers and a history of travel to high-risk areas. For patients at risk for progression to mucocutaneous leishmaniasis, first-line treatment in the United States entails the use of sodium stibogluconate (SSG), which is obtained from the Centers for Disease Control and Prevention (CDC) under an investigational drug protocol. We report 2 cases of New World CL in travelers to endemic areas who were diagnosed and treated with SSG. These cases demonstrate the logistics of coordinating with the CDC to definitively diagnose New World CL and initiate the necessary treatment.
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Affiliation(s)
- Melissa D Darling
- Department of Dermatology, Texas Tech University Health Sciences Center, Lubbock, TX, USA.
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14
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Sonderholm J. A theoretical flaw in the advance market commitment idea. J Med Ethics 2010; 36:339-343. [PMID: 20530089 DOI: 10.1136/jme.2009.033092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Infectious and parasitic diseases cause massive health problems in the developing world. Research and development of drugs for diseases that mainly affect poor people in developing countries is limited. The advance market commitment (AMC) idea is an incentivising mechanism for research and development of drugs for neglected diseases. Discussion of the AMC idea is of renewed interest given the launch in June 2009 of the first AMC. This pilot AMC is designed to, among other things, test the idea for potential future applications. This paper is a critique of the AMC idea. It seeks to show that the idea has a hitherto unrecognised theoretical flaw that should make policy-makers and donors hesitant to embrace future applications of the idea.
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Abstract
On May 2, 2006, a divided panel of the U.S. Court of Appeals for the District of Columbia, in a startling opinion, Abigail Alliance for Better Access to Developmental Drugs v. Eschenbach, held that terminally ill patients who have exhausted all other available options have a constitutional right to experimental treatment that FDA has not yet approved. Although ultimately overturned by the full court, Abigail Alliance generated considerable interest from various constituencies. Meanwhile, FDA proposed similar regulatory amendments, as have lawmakers on both sides of the aisle in Congress. But proponents of expanded access fail to consider public health and consumer safety concerns. In particular, allowing patients to try unproven treatments, outside of controlled clinical trials risks both the study's outcome and the health of patients who might benefit from the deliberate, careful process of new drug approval as it currently operates under FDA's auspices.
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Singh HH, Rapaka RS, Shurtleff D, De La Garza R. NIDA drug supply and analytical services program: providing research resources and tools to the scientific community. Drug Alcohol Depend 2008; 95:182-6. [PMID: 18484110 DOI: 10.1016/j.drugalcdep.2008.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Silverman E. Drugs to plan for in 2008. Manag Care 2007; 16:43-45. [PMID: 18198729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
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Meron D. Balancing government regulation against access to drugs: address to Seton Hall University School of Law, February 16, 2007. Seton Hall Law Rev 2007; 37:929-939. [PMID: 18363219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Affiliation(s)
- Daniel Meron
- United States Department of Health and Human Services, USA
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20
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Abstract
In this paper, I support the claim that placing certain restrictions on public access to possible new treatments is morally problematic under some exceptional circumstances. Very ill patients may find that all available standard treatments are unacceptable, either because they are ineffective or have serious adverse effects, and these patients may understandably be desperate to try something new even if this means stepping into the unknown. Faced with certain death, it is rational to want to try something new and to chance a dire outcome. Restricting possible new treatments to research trials may put these treatments scientifically, geographically or economically out of reach of these patients. For those who can get access, research restrictions could weaken, though not necessarily eliminate, the value of consent participants of such trials are able to give. Some participants may therefore be exploited for scientific purposes in the name of public interest. There are nonetheless compelling reasons for keeping some restrictive regulation in this area.
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Affiliation(s)
- Sarah J L Edwards
- Centre for Bioethics and Philosophy of Medicine UCL, Research & Development Directorate, University College London Hospitals NHS Trust, London W1P 9LL, UK.
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Abstract
We examined trends in the introduction of new chemical entities (NCEs) worldwide from 1982 through 2003. Although annual introductions of NCEs decreased over time, introductions of high-quality NCEs (that is, global and first-in-class NCEs) increased moderately. Both biotech and orphan products enjoyed tremendous growth, especially for cancer treatment. Country-level analyses for 1993-2003 indicate that U.S. firms overtook their European counterparts in innovative performance or the introduction of first-in-class, biotech, and orphan products. The United States also became the leading market for first launch.
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Affiliation(s)
- Henry G Grabowski
- Department of Economics, Duke University, Durham, North Carolina, USA.
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22
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Freire MC. Opportunities for overcoming tuberculosis: new treatment regimens. World Hosp Health Serv 2006; 42:34-7. [PMID: 16669375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
TB is mainly concentrated in developing countries and global control efforts have been hampered by the deficiencies of diagnostic, prophylactic and therapeutic tools. This article looks at the need for new TB therapies and how the Stop TB Partnership's Working Group on New TB Drugs has positively influenced the TB drugs pipeline. This has involved developing a revolutionary concept for TB drug development and leveraging the potential of the existing drugs pipeline. As part of the process, there is also a need for broader collaboration to identify new candidate compounds, expand clinical trial capacity, advance new technologies and ensure regulatory harmonization.
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Martin D. NICE appeals to DoH for faster referral of new drugs. Health Serv J 2005; 115:8. [PMID: 16250126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
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Centers for Disease Control and Prevention (CDC), Department of Health and Human Services (HHS). Establishment of vaccination clinics; user fees for investigational new drug (IND) influenza vaccine services and vaccines. Interim final rule and request for comments. Fed Regist 2005; 70:3490-3. [PMID: 15669145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
We are amending 42 CFR part 70 to establish vaccination clinics and a user fee in connection with the administration of vaccination services and vaccine. On December 7, 2004, HHS Secretary Tommy G. Thompson announced the purchase of 1.2 million doses of GlaxoSmithKline (GSK) influenza vaccine, Fluarix, for distribution to areas most in need as determined by State public health authorities. The Fluarix vaccine has been approved in seventy-eight foreign countries, and FDA has recently reviewed extensive manufacturing and summary clinical information and conducted an inspection of the GSK manufacturing facility in Germany to determine that this vaccine, although not licensed in the United States, is suitable for use under an Investigational New Drug application (IND). The Food and Drug Administration (FDA) reviewed GSK's IND application as well as the clinical protocol and manufacturing data. CDC and CDC's Institutional Review Board approved the GSK flu vaccine response protocol including the informed consent document. To ensure that the vaccine is properly administered to individuals identified to be most at risk and facilitate compliance with IND requirements, CDC is establishing vaccination clinics. CDC is proceeding without delay because of the unprecedented nature of this season's influenza vaccine shortage caused by contamination problems with Chiron Corporation's production facility in the United Kingdom, which effectively cut in half the expected United States supply of inactivated influenza vaccine. A user fee is being established in order to recoup the costs associated with administering the vaccine and for the vaccine itself. All individuals, other than those who are enrolled in Medicare Part B, will be required to pay the user fee.
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Grady C. The challenge of assuring continued post-trial access to beneficial treatment. Yale J Health Policy Law Ethics 2005; 5:425-35. [PMID: 15742586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Affiliation(s)
- Christine Grady
- Department of Clinical Bioethics, National Institutes of Health, USA
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Hale V. Creating more paths to hope. Newsweek 2004; 144:80. [PMID: 15605728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
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Memantine for Alzheimer's disease. Med Lett Drugs Ther 2003; 45:73-4. [PMID: 12968123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
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Hillson G. Regulators deny access to experimental hepatitis C drug. Can HIV AIDS Policy Law Rev 2002; 7:31-2. [PMID: 14719494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
An application for access to an experimental hepatitis C drug under Canada's Special Access Programme has been turned down. In the process, Canada's drug regulators have created discomfort and uncertainty about how the Special Access Programme is managed.
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Porter R, Mulder RT. PHARMAC and availability of pharmaceuticals. N Z Med J 2002; 115:274; author reply 274-5. [PMID: 12117167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
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Open letter to scientific journals, the pharmaceutical industry and drugs approval authorities. ESPE Drugs and Therapeutics Committee. European Society of Paediatric Endocrinology. Clin Endocrinol (Oxf) 1997; 47:501. [PMID: 9404450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
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Vazquez E. DMP 266 on the horizon. Posit Aware 1997; 8:25. [PMID: 11364636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
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From the Centers for Disease Control and Prevention. Availability of diphtheria antitoxin through an investigational new drug protocol. JAMA 1997; 277:1665. [PMID: 9169880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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Centers for Disease Control and Prevention (CDC). Availability of diphtheria antitoxin through an investigational new drug protocol. MMWR Morb Mortal Wkly Rep 1997; 46:380. [PMID: 9148144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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34
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Affiliation(s)
- P E Cleaton-Jones
- Committee for Research on Human Subjects (Medical), University of the Witwaterstand, Johannesburg, South Africa
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35
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Affiliation(s)
- P Busse
- NAPWA South Africa, Western Cape
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36
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Affiliation(s)
- S Emery
- National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Sydney, Australia
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37
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Affiliation(s)
- P King
- Roche Products, Wetwyn Garden City
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38
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Affiliation(s)
- G R McLean
- Department of Philosophy, University of the Witwaterstand, Johannesburg, South Africa
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39
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Expanded access and patient assistance programs for other experimental drugs from their manufacturers. Crit Path AIDS Proj 1997;:44-64. [PMID: 11364445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
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40
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Nightingale SL, Kimbrough CA, Rheinstein PH. Access to investigational drugs for treatment purposes. Am Fam Physician 1994; 50:845-7. [PMID: 8079913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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41
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From the Centers for Disease Control and Prevention. Change in source of information: availability of varicella vaccine for children with acute lymphocytic leukemia. JAMA 1993; 270:308. [PMID: 8315766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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42
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Centers for Disease Control and Prevention (CDC). Change in source of information: availability of Varicella vaccine for children with acute lymphocytic leukemia. MMWR Morb Mortal Wkly Rep 1993; 42:499. [PMID: 8510637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Secola R. PIXY 321 (GM-CSF/IL-3 fusion protein). J Pediatr Oncol Nurs 1993; 10:117-8. [PMID: 8397971 DOI: 10.1177/104345429301000309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Affiliation(s)
- R Secola
- Children's Hospital of Orange County, CA 92668
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44
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Skolnick AA. Obtaining drug for AIDS-related toxoplasmosis. JAMA 1993; 269:1086. [PMID: 8433446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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45
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Centers for Disease Control and Prevention (CDC). Update: availability of sulfadiazine--United States. MMWR Morb Mortal Wkly Rep 1993; 42:105. [PMID: 8429812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Sulfadiazine is a sulfa drug commonly used in combination with pyrimethamine to treat toxoplasmosis in patients with acquired immunodeficiency syndrome (AIDS) and newborns with congenital infections. In December 1992, CDC reported that the domestic manufacturer of sulfadiazine had ceased production in October 1992 and that no large inventories of the drug were available from major distributors (1). On February 8, CDC obtained permission from the Food and Drug Administration (FDA) to proceed with an "Investigational New Drug" (IND) application protocol under which sulfadiazine may be imported and made available to physicians until a domestic commercial source is re-established.
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Lord M, Arrarte A, Dean J, Boram J. Underground medicine. A quest for state-of-the-art treatments is turning thousands of ordinary Americans into activists--and sometimes outlaws. US News World Rep 1992; 112:62-71. [PMID: 10170976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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47
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Investigational new drug, antibiotic, and biological product applications; clinical hold and termination--FDA. Final rule. Fed Regist 1992; 57:13244-9. [PMID: 10118458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
The Food and Drug Administration (FDA) is issuing a final regulation that provides additional grounds for placing an investigation on "clinical hold" and for terminating an investigational new drug application (IND). Under this rule, FDA may require sponsors to cease distributing an experimental drug in an open, nonconcurrently controlled investigation if any of several specified conditions exist. This final rule is part of the Public Health Service's(PHS's) efforts to make promising drugs widely available to people with acquired immunodeficiency syndrome (AIDS) or human immunodeficiency virus (HIV)-related disease who lack satisfactory alternative therapies, while simultaneously ensuring that the adequate and well-controlled clinical trials essential to establishing a new drug's safety and effectiveness are expeditiously conducted.
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Expanded availability of investigational new drugs through a parallel track mechanism for people with AIDS and other HIV-related disease--PHS. Notice final policy statement. Fed Regist 1992; 57:13250-9. [PMID: 10118459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
Abstract
The Public Health Service (PHS) is announcing a final policy to make promising investigational drugs for AIDS and other HIV-related diseases more widely available under "parallel track" protocols while the controlled clinical trials essential to establish the safety and effectiveness of new drugs are carried out. The "parallel track" initiative establishes an administrative system designed to expand the availability of promising investigational agents and to make these agents more widely available to people with AIDS and other HIV-related diseases who have no therapeutic alternatives and who cannot participate in the controlled clinical trials.
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Nightingale SL. From the Food and Drug Administration. JAMA 1992; 267:339. [PMID: 1727943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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50
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Parallel track expedites access to anti-AIDS drugs. Am Fam Physician 1990; 42:18. [PMID: 2368655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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