Urushihara Hisashi, Murakami Yuka, Matsui Kenji, Tashiro Shimon
Division of Drug Development & Regulatory Science, Faculty of Pharmacy, Keio University.
Department of Research Ethics and Bioethics, Research and Development Initiative Center, National Cerebral and Cardiovascular Center.
Yakugaku Zasshi. 2018 Jan 1;138(1):63-71. doi: 10.1248/yakushi.17-00109. Epub 2017 Sep 25.
Under the Japanese drug regulatory system, post-marketing studies (PMS) must be in compliance with Good Post-marketing Study Practice (GPSP). The GPSP Ordinance lacks standards for the ethical conduct of PMSs; although only post-marketing clinical trials are subject to Good Clinical Practice. We conducted a web-based questionnaire survey on the ethical conduct of PMSs in collaboration with the Japanese Society of Hospital Pharmacists and pharmacists belonging to the Society. 1819 hospitals around Japan answered the questionnaire, of which 503 hospitals had conducted company-sponsored PMSs in 2015. 40.2% of the hospitals had obtained informed consent from participating patients in at least one PMS conducted in 2015, the majority of which was in written form. The first and second most frequent reasons for seeking informed consent in PMSs were to meet protocol requirements, followed by the requirement to meet institutional standard operational procedures and the request of the ethical review board of the hospital. Ethical review of PMSs was conducted in 251 hospitals. Despite a lack of standards for informed consent and ethical review in PMSs, a considerable number of study sites employed informed consent and ethical review for PMSs. While company policies and protocols are likely to be major determinants of the ethical conduct of PMSs, the governmental regulatory agency should also play a significant role in implementing a standardized ethical code for the conduct of PMSs.
在日本药品监管体系下,上市后研究(PMS)必须符合《上市后研究规范》(GPSP)。《GPSP条例》缺乏关于PMS伦理行为的标准;尽管只有上市后临床试验需遵循《药物临床试验质量管理规范》。我们与日本医院药剂师协会及协会所属药剂师合作,开展了一项关于PMS伦理行为的网络问卷调查。日本各地1819家医院回答了问卷,其中503家医院在2015年开展了企业资助的PMS。40.2%的医院在2015年开展的至少一项PMS中获得了参与患者的知情同意,其中大部分为书面形式。PMS中寻求知情同意最常见的第一和第二个原因是符合方案要求,其次是符合机构标准操作程序以及医院伦理审查委员会的要求。251家医院对PMS进行了伦理审查。尽管PMS缺乏知情同意和伦理审查的标准,但相当数量的研究场所对PMS采用了知情同意和伦理审查。虽然公司政策和方案可能是PMS伦理行为的主要决定因素,但政府监管机构在实施PMS标准化伦理规范方面也应发挥重要作用。