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延缓仿制药上市的策略。

Strategies That Delay Market Entry of Generic Drugs.

机构信息

The Program On Regulation, Therapeutics, and Law (PORTAL), Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts.

出版信息

JAMA Intern Med. 2017 Nov 1;177(11):1665-1669. doi: 10.1001/jamainternmed.2017.4650.

Abstract

Increasing prescription drug expenditures in the United States are primarily driven by high brand-name drug prices. Although generic competition helps lower drug prices, manufacturers of brand-name drugs often work to delay the availability of generic versions of their products. Strategies to forestall generic competition include patenting peripheral aspects of a drug or modified formulations that do not add clinical value, paying generic manufacturers to settle lawsuits challenging the validity of patents on brand-name drugs ("reverse payment" settlements), denying generic manufacturers access to drug samples necessary for bioequivalence testing, misusing risk evaluation and mitigation strategies, and filing citizen petitions with the US Food and Drug Administration (FDA). To address such tactics, the federal government can interpret existing patenting standards more strictly and promote certain types of patent challenges to ensure that patents are granted or upheld only for true innovations. Congress can enact pending legislation that would help discourage reverse payment settlements and compel brand-name manufacturers to share drug samples for bioequivalence testing. Finally, the FDA can provide earlier guidance on bioequivalence determinations for complex generic products and adopt the presumption that late-filed citizen petitions should be summarily rejected.

摘要

美国处方药支出的增加主要是由高价品牌药物驱动的。虽然仿制药竞争有助于降低药品价格,但品牌药物制造商经常采取策略延迟其产品的仿制药版本的上市。阻止仿制药竞争的策略包括为药物的外围方面或不增加临床价值的改良配方申请专利,向支付仿制药制造商以解决对品牌药物专利有效性的诉讼(“反向支付”和解),拒绝仿制药制造商获得用于生物等效性测试的药物样本,滥用风险评估和缓解策略,以及向美国食品和药物管理局(FDA)提交公民请愿书。为了解决这些策略,联邦政府可以更严格地解释现有专利标准,并促进某些类型的专利挑战,以确保仅为真正的创新授予或维持专利。国会可以颁布待决立法,以阻止反向支付和解,并迫使品牌药物制造商为生物等效性测试共享药物样本。最后,FDA 可以为复杂的仿制药产品提供更早的生物等效性确定指导,并采用推定,即应立即驳回迟交的公民请愿书。

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