Moseley Jane, Vamvakas Spiros, Berntgen Michael, Cave Alison, Kurz Xavier, Arlett Peter, Acha Virginia, Bennett Simon, Cohet Catherine, Corriol-Rohou Solange, Du Four Emma, Lamoril Christelle, Langeneckert Anja, Koban Maren, Pasté Muriel, Sandler Susan, Van Baelen Karin, Cangini Agnese, García Sonia, Obach Mercè, Gimenez Garcia Emmanuel, Varela Lema Leonor, Jauhonen Hanna-Mari, Rannanheimo Piia, Morrison Deborah, Van De Casteele Marc, Strömgren Anna, Viberg Anders, Makady Amr, Guilhaume Chantal
European Medicines Agency (EMA), The Netherlands.
MSD, UK.
Br J Clin Pharmacol. 2020 Jun;86(6):1034-1051. doi: 10.1111/bcp.14279. Epub 2020 Apr 24.
The understanding of the benefit risk profile, and relative effectiveness of a new medicinal product, are initially established in a circumscribed patient population through clinical trials. There may be uncertainties associated with the new medicinal product that cannot be, or do not need to be resolved before launch. Postlicensing or postlaunch evidence generation (PLEG) is a term for evidence generated after the licensure or launch of a medicinal product to address these remaining uncertainties. PLEG is thus part of the continuum of evidence development for a medicinal product, complementing earlier evidence, facilitating further elucidation of a product's benefit/risk profile, value proposition, and/or exploring broader aspects of disease management and provision of healthcare. PLEG plays a role in regulatory decision making, not only in the European Union but also in other jurisdictions including the USA and Japan. PLEG is also relevant for downstream decision-making by health technology assessment bodies and payers. PLEG comprises studies of different designs, based on data collected in observational or experimental settings. Experience to date in the European Union has indicated a need for improvements in PLEG. Improvements in design and research efficiency of PLEG could be addressed through more systematic pursuance of Scientific Advice on PLEG with single or multiple decision makers. To date, limited information has been available on the rationale, process or timing for seeking PLEG advice from regulators or health technology assessment bodies. This article sets out to address these issues and to encourage further uptake of PLEG advice.
对一种新药品的获益风险概况及相对有效性的理解,最初是通过临床试验在特定患者群体中确立的。新药品可能存在一些不确定性,这些不确定性在上市前无法或无需解决。上市后或上市后证据生成(PLEG)是指在药品获得许可或上市后生成证据,以解决这些剩余的不确定性。因此,PLEG是药品证据开发连续过程的一部分,它补充早期证据,有助于进一步阐明产品的获益/风险概况、价值主张,和/或探索疾病管理及医疗保健提供的更广泛方面。PLEG不仅在欧盟,而且在美国、日本等其他司法管辖区的监管决策中都发挥着作用。PLEG对卫生技术评估机构和支付方的下游决策也具有相关性。PLEG包括基于在观察性或实验性环境中收集的数据进行的不同设计的研究。欧盟目前的经验表明,PLEG需要改进。通过更系统地向单个或多个决策者寻求关于PLEG的科学建议,可以解决PLEG设计和研究效率方面的改进问题。迄今为止,关于向监管机构或卫生技术评估机构寻求PLEG建议的基本原理、流程或时机的信息有限。本文旨在解决这些问题,并鼓励更多地采用PLEG建议。