Kerr Kirk W, Glos Lukas J
Office of Strategic Programs, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, 10903 New Hampshire Avenue, Silver Spring, MD, 20993, USA.
Pharmaceut Med. 2020 Feb;34(1):19-29. doi: 10.1007/s40290-019-00317-9.
Growth in development, approvals, and revenue of drugs treating rare diseases (orphan drugs) has been increasing over the last four decades, which has drawn substantial attention to these products. Much of this growth has been attributed to the incentives created by the Orphan Drug Act, which includes a seven-year exclusivity period for the approval of rare disease indications.
This study aims to compare the effective market exclusivity period of small molecule new molecular entities (NMEs) for rare (orphan) and non-rare (non-orphan) diseases approved by the U.S. Food and Drug Administration (FDA) from 2001-2012. While the overall length of a drug's effective market exclusivity period has been explored previously, there is little empirical research evaluating the differences in its duration between drugs for rare and non-rare diseases.
Data sources utilized in this analysis included the NME Drug and New Biologic Approvals Reports, Orange Book, Orphan Drug Product Designation Database, Drugs@FDA and IQVIA's National Sales Perspective. We computed the effective market exclusivity period for each NME as the time from NME approval until approval of the first generic competitor. We then regressed the effective market exclusivity period for each NME, on orphan disease status, and other NME market factors using a Cox proportional hazards model. Subsequently, we calculated regression-adjusted median effective market exclusivity periods for both orphan and non-orphan NMEs to estimate effective exclusivity extensions from orphan status.
We find that only individual NMEs approved for the treatment of both orphan and non-orphan indications lower the hazard of generic entry (hazard ratio 0.464, p = 0.030) in comparison with non-orphan NMEs with a single indication. The associated additional median survival time for these NMEs is 1.9 years.
NMEs' orphan status per se is not associated with a reduction in the hazard of generic entry and longer effective market exclusivity periods in comparison with non-orphan NMEs. Only NMEs that were approved for the treatment of both orphan and non-orphan diseases experience lower hazard of generic entry and longer exclusivity periods compared with non-orphan drugs with a single indication.
在过去四十年中,治疗罕见病的药物(孤儿药)在研发、获批和收入方面的增长一直在增加,这引起了对这些产品的大量关注。这种增长很大程度上归因于《孤儿药法案》创造的激励措施,该法案包括为罕见病适应症的批准提供七年的独家期。
本研究旨在比较2001年至2012年美国食品药品监督管理局(FDA)批准的用于罕见(孤儿)病和非罕见(非孤儿)病的小分子新分子实体(NME)的有效市场独占期。虽然之前已经探讨了药物有效市场独占期的总体时长,但很少有实证研究评估罕见病药物和非罕见病药物在有效市场独占期时长上的差异。
本分析中使用的数据源包括NME药物和新生物制品批准报告、橙皮书、孤儿药产品指定数据库、FDA药品数据库以及IQVIA的全国销售视角。我们将每个NME的有效市场独占期计算为从NME获批到首个仿制药竞争对手获批的时间。然后,我们使用Cox比例风险模型,将每个NME的有效市场独占期与孤儿病状态以及其他NME市场因素进行回归分析。随后,我们计算了经回归调整后的孤儿和非孤儿NME的中位有效市场独占期,以估计因孤儿药身份而产生的有效独占期延长。
我们发现,与单一适应症的非孤儿NME相比,仅获批用于治疗孤儿和非孤儿适应症的个别NME会降低仿制药进入的风险(风险比0.464,p = 0.030)。这些NME的相关额外中位生存时间为1.9年。
与非孤儿NME相比,NME的孤儿药身份本身与仿制药进入风险的降低以及更长的有效市场独占期无关。与单一适应症的非孤儿药物相比,仅获批用于治疗孤儿和非孤儿疾病的NME经历更低的仿制药进入风险和更长的独占期。