Rawlins M D, Jefferys D B
Department of Pharmacological Sciences, Wolfson Unit of Clinical Pharmacology, The University, Newcastle, upon Tyne.
BMJ. 1991 Jan 26;302(6770):223-5. doi: 10.1136/bmj.302.6770.223.
To investigate the fate of product licence applications containing new active substances in relation to their degree of innovation and therapeutic category. To assess the numbers of volunteers and patients exposed to a new active substance when marketing autorisation is first sought.
Observational study of records for each licence application submitted to the United Kingdom licensing authority for marketing authorisation from 1987 to 1989.
118 product licence applications containing one or more new active substances.
Success of application for product licence as assessed by the decision of the Committee on Safety of Medicines to advise the granting of a licence (with or without conditions) or provisionally advise its refusal on the grounds of quality, safety, or efficacy. Assessment of numbers of volunteers and patients exposed to each substance during premarketing studies and clinical trials, and the numbers of treated patients available for an assessment of safety.
118 relevant product licence applications were submitted during the review. Although 60% (52/86) of semi-innovative products fell into one of three therapeutic categories (cardiovascular, central nervous system, or anti-infective agents), only 41% (13/32) of fully innovative products fell into these categories. 47 applications were granted (conditionally or unconditionally) but the success rate for fully innovative products (56%, 18/32) was greater than that for semi-innovative products (34%, 29/86). The number of volunteers and patients exposed to a new product at submission varied widely and tended to be greater for successful applications.
The results suggest a broadening of the pharmaceutical industry's research and development programmes and that a more liberal licensing policy exists for fully innovative products than for semi-innovative products. The relatively limited exposure of patients to new active substances at licensing underlines the importance of rigorous postmarketing surveillance.
调查含有新活性物质的产品许可申请的命运与其创新程度和治疗类别之间的关系。评估首次寻求上市许可时接触新活性物质的志愿者和患者数量。
对1987年至1989年提交给英国许可当局以获取上市许可的每份许可申请记录进行观察性研究。
118份含有一种或多种新活性物质的产品许可申请。
药品安全委员会就是否建议授予许可(有条件或无条件)或因质量、安全性或有效性原因临时建议拒绝许可所做决定来评估产品许可申请的成功率。评估上市前研究和临床试验期间接触每种物质的志愿者和患者数量,以及可用于安全性评估的接受治疗患者数量。
审查期间提交了118份相关产品许可申请。尽管60%(52/86)的半创新产品属于三个治疗类别之一(心血管、中枢神经系统或抗感染药物),但只有41%(13/32)的完全创新产品属于这些类别。47份申请获得(有条件或无条件)批准,但完全创新产品的成功率(56%,18/32)高于半创新产品(34%,29/86)。提交申请时接触新产品的志愿者和患者数量差异很大,成功申请的数量往往更多。
结果表明制药行业的研发计划有所拓宽,并且对于完全创新产品存在比对半创新产品更宽松的许可政策。在许可时患者接触新活性物质的情况相对有限,这凸显了严格的上市后监测的重要性。