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监管变革期间及之后的新药研发:1958年至1979年美国主要制药公司的临床研究活动

New drug development during and after a period of regulatory change: clinical research activity of major United States pharmaceutical firms, 1958 to 1979.

作者信息

May M S, Wardell W M, Lasagna L

出版信息

Clin Pharmacol Ther. 1983 Jun;33(6):691-700. doi: 10.1038/clpt.1983.95.

Abstract

The 1962 drug amendments fundamentally changed the way in which U.S. pharmaceutical firms could test new drugs in man and receive New Drug Application (NDA) approval. Although it is well known that the amendments and associated events caused a profound decline in the annual number of new drugs receiving NDA approval, the amendments' effects on clinical research into new chemical entities (NCEs) have not been investigated because data were unavailable. To study this we requested drug development information dating back to 1958 from most major United States-owned pharmaceutical firms and obtained complete responses from nine. The results showed that the introduction rate of NCEs into human testing dropped sharply in the early 1960s and declined substantially thereafter. The number of NCEs entering human testing fell from a mean of 89 a year in 1958-1962, to 35 a year in 1963-1972 (a reduction of 61%), and to 17 a year in the last 5 years of the survey, 1975-1979--an overall reduction of 81%. The number of NDA approvals received by these firms fell sharply by 49% in the early 1960s and more slowly for 10 years thereafter, from the mid-1960s to the mid-1970s. In the case of self-originated NCEs, the size of this later fall was 71%. Causes of these changes in NCE flow include the amendments and the events that prompted them; changes in scientific philosophy, standards, and state of the art; and economic factors.

摘要

1962年的药品修正案从根本上改变了美国制药公司在人体中测试新药并获得新药申请(NDA)批准的方式。尽管众所周知,这些修正案及相关事件导致每年获得NDA批准的新药数量大幅下降,但由于缺乏数据,尚未对这些修正案对新化学实体(NCE)临床研究的影响进行调查。为了研究这一问题,我们向美国大多数主要制药公司索取了可追溯至1958年的药物研发信息,并从九家公司获得了完整回复。结果显示,NCE进入人体试验的引入率在20世纪60年代初急剧下降,此后大幅下降。进入人体试验的NCE数量从1958 - 1962年的平均每年89种,降至1963 - 1972年的每年35种(减少了61%),在调查的最后五年,即1975 - 1979年,降至每年17种——总体减少了81%。这些公司获得的NDA批准数量在20世纪60年代初急剧下降了49%,此后十年下降速度较慢,从20世纪60年代中期到70年代中期。就自主研发的NCE而言,后期下降幅度为71%。NCE流动发生这些变化的原因包括修正案及其引发的事件;科学理念、标准和技术水平的变化;以及经济因素。

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