Hoos Anton, Anderson James, Boutin Marc, Dewulf Lode, Geissler Jan, Johnston Graeme, Joos Angelika, Metcalf Marilyn, Regnante Jeanne, Sargeant Ifeanyi, Schneider Roslyn F, Todaro Veronica, Tougas Gervais
M4P (Medicines 4 Patients) Consulting, London, UK.
GlaxoSmithKline, Brentford, Middlesex, UK.
Ther Innov Regul Sci. 2015 Nov;49(6):929-939. doi: 10.1177/2168479015580384.
The purpose of medicines is to improve patients' lives. Stakeholders involved in the development and lifecycle management of medicines agree that more effective patient involvement is needed to ensure that patient needs and priorities are identified and met. Despite the increasing number and scope of patient involvement initiatives, there is no accepted master framework for systematic patient involvement in industry-led medicines research and development, regulatory review, or market access decisions. Patient engagement is very productive in some indications, but inconsistent and fragmentary on a broader level. This often results in inefficient drug development, increasing evidence requirements, lack of patient-centered outcomes that address unmet medical needs and facilitate adherence, and consequently, lack of required therapeutic options and high costs to society and involved parties. Improved patient involvement can drive the development of innovative medicines that deliver more relevant and impactful patient outcomes and make medicine development faster, more efficient, and more productive. It can lead to better prioritization of early research; improved resource allocation; improved trial protocol designs that better reflect patient needs; and, by addressing potential barriers to patient participation, enhanced recruitment and retention. It may also improve trial conduct and lead to more focused, economically viable clinical trials. At launch and beyond, systematic patient involvement can also improve the ongoing benefit-risk assessment, ensure that public funds prioritize medicines of value to patients, and further the development of the medicine. Progress toward a universal framework for patient involvement requires a joint, precompetitive, and international approach by all stakeholders, working in true partnership to consolidate outputs from existing initiatives, identify gaps, and develop a comprehensive framework. It is essential that all stakeholders participate to drive adoption and implementation of the framework and to ensure that patients and their needs are embedded at the heart of medicines development and lifecycle management.
药物的目的是改善患者生活。参与药物研发及生命周期管理的利益相关者一致认为,需要更有效地让患者参与进来,以确保识别并满足患者的需求和优先事项。尽管患者参与举措的数量和范围不断增加,但在由行业主导的药物研发、监管审查或市场准入决策中,尚无公认的系统性患者参与总体框架。患者参与在某些适应症方面成效显著,但在更广泛层面上却不一致且零碎。这往往导致药物研发效率低下、证据要求增加、缺乏以患者为中心的结果来满足未满足的医疗需求并促进依从性,进而导致缺乏所需的治疗选择以及给社会和相关各方带来高昂成本。改善患者参与能够推动创新药物的研发,带来更具相关性和影响力的患者结果,并使药物研发更快、更高效且更有成效。它可以使早期研究的优先级更高;改善资源分配;改进试验方案设计以更好地反映患者需求;并且,通过消除患者参与的潜在障碍,提高招募和留存率。它还可能改善试验实施情况,并带来更具针对性、经济上可行的临床试验。在药物上市及之后,系统性的患者参与还可以改善持续的获益 - 风险评估,确保公共资金优先用于对患者有价值的药物,并推动药物的进一步研发。朝着建立患者参与通用框架取得进展需要所有利益相关者采取联合、非竞争性的国际方法,真正携手合作以整合现有举措的成果、识别差距并制定一个全面的框架。所有利益相关者都必须参与进来,以推动该框架的采用和实施,并确保患者及其需求贯穿于药物研发和生命周期管理的核心。