Braithwaite R Scott
Section of Value and Comparative Effectiveness, Division of General Internal Medicine, New York University School of Medicine, New York, NY, USA.
Drug Healthc Patient Saf. 2011;3:37-41. doi: 10.2147/DHPS.S21927. Epub 2011 Aug 3.
Many consumers and clinicians incorrectly believe that the Food and Drug Administration (FDA) approval of a new therapeutic implies that its benefits have been proven to exceed its harms. While the FDA could require proof that benefits exceed harms prior to approval, it has been argued that this approach would be infeasible because of prohibitively large sample sizes. One possible alternative would be for the FDA to supplement its standard "label" denoting "safe and effective" with a secondary "label" denoting benefits have been demonstrated to exceed harms, which would be granted only after sufficient post-marketing data had accumulated to prove that its benefits exceeded its harms. This secondary label would not necessarily be linked to marketing restrictions or other commercial prohibitions but, rather, would be only information for consumers and clinicians. Strengths, weaknesses, and feasibility challenges of this approach are discussed.
许多消费者和临床医生错误地认为,美国食品药品监督管理局(FDA)批准一种新疗法意味着其益处已被证明超过了危害。虽然FDA在批准之前可以要求证明益处超过危害,但有人认为这种方法不可行,因为所需样本量过大。一种可能的替代方法是,FDA在其表示“安全有效”的标准“标签”之外,再补充一个二级“标签”,表明已证明益处超过危害,该二级标签只有在积累了足够的上市后数据以证明其益处超过危害之后才会授予。这个二级标签不一定与营销限制或其他商业禁令相关联,而仅仅是为消费者和临床医生提供的信息。本文讨论了这种方法的优点、缺点和可行性挑战。