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美国食品药品监督管理局(FDA)和欧洲药品管理局(EMA)批准的优先审评药物:是时候实现药品国际监管协调了吗?

Priority review drugs approved by the FDA and the EMA: time for international regulatory harmonization of pharmaceuticals?

作者信息

Alqahtani Saad, Seoane-Vazquez Enrique, Rodriguez-Monguio Rosa, Eguale Tewodros

机构信息

International Center for Pharmaceutical Economics and Policy, Massachusetts College of Pharmacy and Health Sciences (MCPHS University), Boston, MA, USA.

Division of General Medicine and Primary Care, Brigham and Women's Hospital, Boston, MA, USA.

出版信息

Pharmacoepidemiol Drug Saf. 2015 Jul;24(7):709-15. doi: 10.1002/pds.3793. Epub 2015 May 27.

DOI:10.1002/pds.3793
PMID:26013294
Abstract

INTRODUCTION

The US Food and Drug Administration (FDA) priority review process applies to a drug that is considered a significant improvement over the available alternatives. The European Medicines Agency (EMA) accelerated approval applies to a product that is of major public health interest. This study assessed differences in the characteristics of priority review new molecular entities and new therapeutic biologic products approved by the FDA and the EMA.

METHODS

This study includes regulatory information on drug applications, approvals, indications, and orphan designations of all priority review drugs approved by the FDA and the EMA in the period 1999-2011. Descriptive statistics, t-tests, and chi-squared and Wilcoxon tests were performed.

RESULTS

Overall, 100 FDA priority review new molecular entities and new therapeutic biologics were approved by both agencies; 87.0% of the products were first approved by the FDA. The average FDA review time (9.2 ± 8.4 months) was significantly lower than the EMA average review time (14.6 ± 4.0 months) (p < 0.0001). The FDA and the EMA granted orphan designation to 43.0% and 33.0%, respectively, of the applications. There were differences in the administration route (1.0% of all products), dosage (8.0%), strength (23%), posology (51.0%), indications (30.0%), restrictions of use (52.0%), limitations of use (19.0%), and outcomes limitations (28.0%) approved by both regulatory agencies.

CONCLUSION

Significant differences exist in the characteristics of the priority review drugs approved by the FDA and the EMA. Harmonization of the US and European regulatory frameworks may facilitate timely approval of pharmaceutical products.

摘要

引言

美国食品药品监督管理局(FDA)的优先审评程序适用于被认为相较于现有替代药物有显著改进的药物。欧洲药品管理局(EMA)的加速批准适用于具有重大公共卫生利益的产品。本研究评估了FDA和EMA批准的优先审评新分子实体及新治疗性生物制品在特性上的差异。

方法

本研究纳入了1999年至2011年期间FDA和EMA批准的所有优先审评药物的药物申请、批准、适应症及孤儿药指定的监管信息。进行了描述性统计、t检验、卡方检验和威尔科克森检验。

结果

总体而言,两个机构共批准了100个FDA优先审评新分子实体及新治疗性生物制品;87.0%的产品首先由FDA批准。FDA的平均审评时间(9.2±8.4个月)显著低于EMA的平均审评时间(14.6±4.0个月)(p<0.0001)。FDA和EMA分别对43.0%和33.0%的申请授予了孤儿药指定。两个监管机构批准的产品在给药途径(所有产品的1.0%)、剂量(8.0%)、规格(23%)、用药剂量(51.0%)、适应症(30.0%)、使用限制(52.0%)、使用局限性(19.0%)和疗效局限性(28.0%)方面存在差异。

结论

FDA和EMA批准的优先审评药物在特性上存在显著差异。美国和欧洲监管框架的协调一致可能有助于药品的及时批准。

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