R. Noel, R. Hermann, B. Levitan, D. Watson, K. Van Goor
{"title":"Application of the Benefit-Risk Action Team (BRAT) Framework in Pharmaceutical R&D: Results From a Pilot Program","authors":"R. Noel, R. Hermann, B. Levitan, D. Watson, K. Van Goor","doi":"10.1177/0092861512458908","DOIUrl":"https://doi.org/10.1177/0092861512458908","url":null,"abstract":"Benefit-risk (B-R) assessments inform decisions regarding drug development and lifecycle management, serve as a basis for regulatory determinations, and help clinicians, patients, and payers make rational, value-based treatment decisions. Nevertheless, no widely accepted, systematic methods exist to guide, justify, and communicate benefit-risk decisions in a transparent and consistent manner. The B-R Action Team (BRAT), formed by the Pharmaceutical Research and Manufacturers of America (PhRMA), has developed a structured approach to B-R assessment—the “BRAT Framework”—that assists decision makers in selecting, organizing, summarizing, and communicating evidence relevant to B-R decisions. The BRAT Framework’s functionality has been demonstrated previously in a series of scenarios with hypothetical drugs as well as in a few real-world applications. Here we report results of a pilot program to assess the value of the Framework in pharmaceutical development and postmarketing settings, for the purpose of informing PhRMA’s regulatory advocacy. A third-party consultant conducted the assessment through a survey of pharmaceutical companies’ experiences using the Framework. We also identify aspects of the Framework that require further development.","PeriodicalId":391574,"journal":{"name":"Drug information journal : DIJ / Drug Information Association","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116591180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Are Pharmaceutical Market Withdrawals Preventable? A Preliminary Analysis","authors":"Jaya Sai V. Daggumalli, Irwin G. Martin","doi":"10.1177/0092861512458776","DOIUrl":"https://doi.org/10.1177/0092861512458776","url":null,"abstract":"Some drugs have been removed from the market once it had been determined that their risks outweighed their benefits. Withdrawals negatively impact patients using the drugs as well the pharmaceutical companies who devoted tremendous resources to research, development, and marketing. Therefore, there is a desire to minimize drug withdrawals by learning from previous incidents. Hints of the problems that lead to eventual market withdrawal might be found in the initial New Drug Application (NDA). If inappropriate approvals could be prevented, patients’ safety might be protected and withdrawals would not be necessary. Drugs withdrawn between 2001 and 2010 (n = 15) were considered for this investigation. The primary adverse events that led to the withdrawal of these 15 drugs were compared with the data available in the original NDA medical review. From the 15 drugs considered, sufficient information for analysis was available for only 7 drugs. Among the 7 drugs analyzed, the safety data found for 2 particular drugs suggested potential safety signals. Preliminary analyses suggest that the drug withdrawals could not have been predicted for the majority of drugs removed from the market.","PeriodicalId":391574,"journal":{"name":"Drug information journal : DIJ / Drug Information Association","volume":"30-31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133477362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Who Advises the Data Monitoring Committee (DMC)? A Review of Regulatory Guidance for Sponsors on DMCs After 5 Years and Advice for DMC Members","authors":"J. Glover, R. Kay","doi":"10.1177/0092861512452123","DOIUrl":"https://doi.org/10.1177/0092861512452123","url":null,"abstract":"Regulatory authorities in the US and EU recommend that pharmaceutical companies employ data monitoring committees (DMCs) to protect the safety of patients taking part in large randomized trials involving diseases with high morbidity or mortality and have provided guidance as to how such committees should be used. This article, whose authors have considerable experience in DMC membership, reviews the applicability of guidance to sponsors after 5 years and suggests that regulatory support for DMC members would be valuable. Advice is offered to members, often very experienced clinicians but inexperienced in pharmaceutical data review, as to how standard DMC data packages should be reviewed, which aspects of trial validity should be addressed, and how communication with the trial sponsor should be handled. It is suggested that DMCs could be supported by regulatory authorities in managing ethical and legal dilemmas to make DMC membership less exposed and more inviting.","PeriodicalId":391574,"journal":{"name":"Drug information journal : DIJ / Drug Information Association","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134256910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Mathematical Derivation of Therapeutic Index Based on hERG IC_50 Taking Into Account Fraction Unbound in Plasma and Clinical C_max\u0000","authors":"R. Fryer","doi":"10.1177/0092861512456285","DOIUrl":"https://doi.org/10.1177/0092861512456285","url":null,"abstract":"have offered some guidelines regarding what might bedeemed an appropriate therapeutic index (TI) to mitigate therisk of hERG-mediated arrhythmias for clinical candidates.Regardless of the actual TI desired, there is, at times, a degreeof confusion regarding how to calculate this value given the dif-ferent units oftentimes ascribed to an IC","PeriodicalId":391574,"journal":{"name":"Drug information journal : DIJ / Drug Information Association","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2012-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131718671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}