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以患者为中心的药物研发:合作的新方向。

Patient-Focused Drug Development: A New Direction for Collaboration.

作者信息

Perfetto Eleanor M, Burke Laurie, Oehrlein Elisabeth M, Epstein Robert S

机构信息

*Department of Pharmaceutical Health Services Research, University of Maryland School of Pharmacy, Baltimore, MD †LORA Group LLC, Royal Oak, MD ‡Epstein Health LLC, Woodcliff Lake, NJ.

出版信息

Med Care. 2015 Jan;53(1):9-17. doi: 10.1097/MLR.0000000000000273.

Abstract

CONTEXT

Patient-Focused Drug Development (PFDD) is a new initiative from the Food and Drug Administration (FDA) intended to bring patient perspectives into an earlier stage of product development. The goal is that patients will be able to provide context for benefit-risk assessments and input to review divisions, and also aid in the development of new assessment tools, study endpoints, and risk communications. This paper provides a summary on what is known to date about FDA's PFDD initiative and describes implications for patients, researchers, payers, and the biopharmaceutical industry. It also provides a roadmap for stakeholders to consider in defining their role in and in shaping PFDD's direction, and for expanding PFDD principles to conditions beyond the current 20 under FDA consideration.

METHODS

A search was conducted of the peer-reviewed and gray literature using PubMed and Google. This included laws, FDA guidance documents, the peer-reviewed literature, and FDA presentations for content relevant to the search term "patient-focused drug development."

FINDINGS

Currently, FDA activities within PFDD are limited to gaining patient insights through 20 disease-specific meetings. However, many stakeholders see the initiative much more generally as representing a broad shift toward patient centeredness in biopharmaceutical product development.

CONCLUSIONS

Depending upon the trajectory taken and whether or not all PFDD aims are eventually addressed, the initiative has the potential to change product development in fundamental ways. Further research should explore how patient input on disease manifestation and treatment options is best ascertained from patients and documented before initiating and during drug development.

摘要

背景

以患者为中心的药物研发(PFDD)是美国食品药品监督管理局(FDA)发起的一项新举措,旨在将患者的观点纳入产品研发的早期阶段。目标是让患者能够为获益-风险评估提供背景信息,并为审评部门提供意见,同时也有助于开发新的评估工具、研究终点和风险沟通方式。本文总结了迄今为止关于FDA的PFDD举措的已知情况,并描述了其对患者、研究人员、支付方和生物制药行业的影响。它还为利益相关者提供了一个路线图,供其在确定自身在PFDD中的角色以及塑造其方向时加以考虑,以及将PFDD原则扩展到FDA目前正在考虑的20种疾病以外的其他疾病。

方法

使用PubMed和谷歌对同行评审文献和灰色文献进行检索。这包括法律、FDA指南文件、同行评审文献以及FDA关于与搜索词“以患者为中心的药物研发”相关内容的报告。

研究结果

目前,FDA在PFDD范围内的活动仅限于通过20场特定疾病会议获取患者的见解。然而,许多利益相关者普遍认为该举措代表了生物制药产品研发向以患者为中心的广泛转变。

结论

根据所采取的轨迹以及是否最终实现PFDD的所有目标,该举措有可能从根本上改变产品研发。进一步的研究应探索如何在药物研发启动前和过程中,最好地从患者那里获取有关疾病表现和治疗选择的患者意见并进行记录。

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