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利用真实世界证据进行药物警戒和资源有限卫生机构的药物安全相关决策:台湾的 10 年经验。

Using real-world evidence for pharmacovigilance and drug safety-related decision making by a resource-limited health authority: 10 years of experience in Taiwan.

机构信息

Taiwan Drug Relief Foundation, Taipei, Taiwan.

Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, Taiwan.

出版信息

Pharmacoepidemiol Drug Saf. 2020 Nov;29(11):1402-1413. doi: 10.1002/pds.5084. Epub 2020 Sep 7.

Abstract

PURPOSE

Real-world evidence has become increasingly relevant in regulatory decision making. Compared to large regulatory bodies, the national pharmacovigilance system in Taiwan is still under development, and the aim of this study is to demonstrate how a resource-limited health authority utilizes real-world evidence in decision making.

METHODS

We described different sources of real-world data available in Taiwan and illustrated the structural framework that integrates real-world evidence into Taiwan's national pharmacovigilance system. Additionally, we reviewed real-world studies conducted in the past 10 years and provided examples to show how these studies influenced drug safety-related decision making in Taiwan.

RESULTS

During the past 10 years, real-world evidence used when making drug safety-related regulatory decisions in Taiwan was mainly generated from nationwide claims databases, but other sources of real-world data, such as national registries and large electronic hospital databases, also became available recently. Different types of real-world evidence, including drug utilization studies, risk evaluation studies, and risk minimization measure evaluation studies, have been used to support regulatory decisions in Taiwan.

CONCLUSIONS

Through collaborations between the government and academics, Taiwan has started to integrate real-world evidence into the national pharmacovigilance system. However, future efforts, including linkages between different sources of real-world data and improvements in procedural and methodological practices, are needed to generate more regulatory-quality real-world evidence.

摘要

目的

真实世界证据在监管决策中的作用日益重要。相较于大型监管机构,台湾的国家药物警戒体系仍在发展之中,本研究旨在展示资源有限的卫生当局如何在决策中利用真实世界证据。

方法

我们描述了台湾现有的各种真实世界数据来源,并阐述了将真实世界证据整合到台湾国家药物警戒体系中的结构框架。此外,我们还回顾了过去 10 年中开展的真实世界研究,并提供了一些示例,说明这些研究如何影响台湾的药物安全相关决策。

结果

在过去 10 年中,台湾在药物安全相关监管决策中使用的真实世界证据主要来自全国性索赔数据库,但最近也有其他来源的真实世界数据,如国家登记处和大型电子医院数据库可用。不同类型的真实世界证据,包括药物利用研究、风险评估研究和风险最小化措施评估研究,已被用于支持台湾的监管决策。

结论

通过政府和学术界之间的合作,台湾已开始将真实世界证据纳入国家药物警戒体系。然而,未来仍需要做出努力,包括整合不同来源的真实世界数据,并改进程序和方法学实践,以生成更多具有监管质量的真实世界证据。

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