Lexchin Joel
School of Health Policy and Management, York University, Toronto, ON M3J 1P3, Canada.
Ann Pharmacother. 2006 Dec;40(12):2216-22. doi: 10.1345/aph.1H117. Epub 2006 Nov 28.
Since the early- to mid-1990s, drug companies have paid fees for a variety of activities carried out by the Therapeutic Products Directorate in Canada and the Therapeutic Goods Administration in Australia.
To explore whether changes in approval times for new active substances and in the percentage of new drug submissions receiving positive decisions coincided with the level of user fees.
Data were collected from a range of Canadian and Australian government publications on the following topics: total funding for and workload of the regulatory agencies, the percentage of income that came from tax revenue and user fees, the percentage of new drug submissions that received a positive decision, and-for Canada only-the percent of submissions that were approved on first review.
In both countries, there was a moderate-to-strong positive association between the level of industry funding and the percent of submissions that received a positive decision and a moderate-to-strong (Canada) and moderate (Australia) negative association between the level of industry funding and approval times.
Changes observed in both countries are favorable to the pharmaceutical industry. Other than user fees leading to a pro-industry bias in the regulatory authorities, other possible explanations include a more efficient use of resources, a smaller workload (Canada), an improvement in the quality of drug submissions (Canada), and more resources (Australia). Further research strategies are needed to either confirm or refute the hypothesis that the level of industry funding affects decisions made in drug regulatory systems.
自20世纪90年代初至中期以来,制药公司为加拿大治疗产品管理局和澳大利亚治疗用品管理局开展的各种活动支付了费用。
探讨新活性物质审批时间的变化以及获得肯定性决定的新药申报百分比是否与用户费用水平相符。
从一系列加拿大和澳大利亚政府出版物中收集了以下主题的数据:监管机构的总资金和工作量、来自税收和用户费用的收入百分比、获得肯定性决定的新药申报百分比,以及(仅针对加拿大)首次审查时获批的申报百分比。
在这两个国家,行业资金水平与获得肯定性决定的申报百分比之间存在中度至强的正相关,而行业资金水平与审批时间之间在加拿大存在中度至强的负相关,在澳大利亚存在中度负相关。
在这两个国家观察到的变化对制药行业有利。除了用户费用导致监管机构出现有利于行业的偏差外,其他可能的解释包括资源利用效率提高、工作量减少(加拿大)、药品申报质量提高(加拿大)以及资源增加(澳大利亚)。需要进一步的研究策略来证实或反驳行业资金水平影响药品监管系统决策这一假设。