Warner Kay, See Wolf, Haerry David, Klingmann Ingrid, Hunter Amy, May Matthew
GlaxoSmithKline, Brentford, United Kingdom.
BAYER, Berlin, Germany.
Front Med (Lausanne). 2018 Oct 9;5:270. doi: 10.3389/fmed.2018.00270. eCollection 2018.
The importance and merits of greater patient involvement in medicines research and development (R&D) are commonly acknowledged and are thought to offer benefits for all involved parties. It helps to improve discovery, development, and evaluation of new effective medicines, based on the collaborative identification and understanding of unmet needs, research priorities, optimization of clinical study design, outcome measures, and endpoint development. It can result in increased transparency, trust and mutual respect between patients and other stakeholders. This applies to all stages of medicines R&D, from industry-led research, to regulation and licensing of medicines, to appraisal by health technology assessment (HTA) bodies. Integration of patients into the medicines development process needs to be structured and governed by clear rules and modes of operation to be effective and yield the best results for all stakeholders. Existing codes of practice for patient involvement with various stakeholders do not comprehensively cover the full scope of R&D, with the exception of more general statements applicable to interaction. Overarching guidance on meaningful and ethical interaction is missing. One specific aim of the European Patients' Academy on Therapeutic Innovation (EUPATI) was to close this gap through the development of guidance documents for selected stakeholders. Four separate guidance documents were developed, incorporating the results from comprehensive internal and external consultation. They cover patient involvement in: pharmaceutical industry-led medicines R&D; ethics committees; regulatory authorities; HTA. Each guidance suggests where patient involvement could be adopted or strengthened. The EUPATI guidance document for patient involvement in industry-led medicines research and development covers the interaction between patients and the pharmaceutical industry within all functions throughout the medicines R&D lifecycle in relation to medicines for human use. It relates to activities pre-approval and post approval, involving individuals and groups of patients. The guideline distinguishes between the level of expertise in a disease area that is required and the different areas where patient involvement can take place; however, this is not meant to limit involvement, and these opportunities may change and increase over time. This EUPATI guidance document is aimed at the pharmaceutical industry who want to engage patients in R&D activities, however all stakeholders involving patients in pharmaceutical-led medicines R&D should understand and use this EUPATI guidance document.
患者更多地参与药物研发(R&D)的重要性和优点已得到普遍认可,并且被认为能为所有相关方带来益处。基于对未满足需求的共同识别与理解、研究重点、临床研究设计的优化、结果测量以及终点指标的制定,这有助于改进新的有效药物的发现、研发和评估。它能够提高患者与其他利益相关者之间的透明度、信任和相互尊重。这适用于药物研发的所有阶段,从行业主导的研究,到药物的监管和许可,再到卫生技术评估(HTA)机构的评估。要使患者融入药物研发过程并取得成效,为所有利益相关者带来最佳结果,就需要构建相应的体系,并由明确的规则和运作模式来管理。现有的患者与各利益相关者的实践准则并未全面涵盖研发的所有方面,除了一些适用于互动的一般性表述外。关于有意义且符合伦理的互动的总体指导意见缺失。欧洲治疗创新患者学会(EUPATI)的一个具体目标就是通过为选定的利益相关者制定指导文件来填补这一空白。为此制定了四份单独的指导文件,纳入了全面的内部和外部咨询结果。它们涵盖了患者在以下方面的参与:制药行业主导的药物研发;伦理委员会;监管机构;卫生技术评估。每份指导意见都指出了可以采用或加强患者参与的领域。EUPATI关于患者参与行业主导的药物研发的指导文件涵盖了在人类用药的药物研发生命周期的所有职能中患者与制药行业之间的互动。它涉及批准前和批准后的活动,包括个体患者和患者群体。该指南区分了所需疾病领域的专业知识水平以及患者可以参与的不同领域;然而,这并非旨在限制参与,而且这些机会可能会随着时间而变化和增加。这份EUPATI指导文件针对的是希望让患者参与研发活动的制药行业,不过所有在制药行业主导的药物研发中涉及患者的利益相关者都应理解并使用这份EUPATI指导文件。