Is there a need for a universal benefit-risk assessment framework for medicines? Regulatory and industry perspectives

Pharmacoepidemiol Drug Saf. 2013 Sep;22(9):1004-12. doi: 10.1002/pds.3464. Epub 2013 Jun 5.

Abstract

Purpose: To explore the current status and need for a universal benefit-risk framework for medicines in regulatory agencies and pharmaceutical companies.

Methods: A questionnaire was developed and sent to 14 mature regulatory agencies and 24 major companies. The data were analysed using descriptive statistics, for a minority of questions preceded by manual grouping of the responses.

Results: Overall response rate was 82%, and study participants included key decision makers from agencies and companies. None used a fully quantitative system, most companies preferring a qualitative method. The major reasons for this group not using semi-quantitative or quantitative systems were lack of a universal and scientifically validated framework. The main advantages of a benefit-risk framework were that it provided a systematic standardised approach to decision-making and that it acted as a tool to enhance quality of communication. It was also reported that a framework should be of value to both agencies and companies throughout the life cycle of a product. They believed that it is possible to develop an overarching benefit-risk framework that should involve relevant stakeholders in the development, validation and application of a universal framework. The entire cohort indicated common barriers to implementing a framework were resource limitations, a lack of knowledge and a scientifically validated and acceptable framework.

Conclusions: Stakeholders prefer a semi-quantitative, overarching framework that incorporates a toolbox of different methodologies. A coordinating committee of relevant stakeholders should be formed to guide its development and implementation. Through engaging the stakeholders, these outcomes confirm sentiments and need for developing a universal benefit-risk assessment framework.

Keywords: benefit-risk assessment; benefit-risk methodologies; framework; pharmaceutical industry; pharmacoepidemiology; regulatory agency; universal.

MeSH terms

  • Decision Support Techniques
  • Decision Trees
  • Drug Industry / economics
  • Drug Industry / legislation & jurisprudence*
  • Drug Industry / trends
  • Drug-Related Side Effects and Adverse Reactions
  • Evidence-Based Medicine / methods
  • Evidence-Based Medicine / trends
  • Government Regulation*
  • Legislation, Drug
  • Models, Theoretical
  • National Health Programs / economics
  • National Health Programs / organization & administration*
  • National Health Programs / trends
  • Pharmaceutical Preparations* / economics
  • Product Surveillance, Postmarketing / methods*
  • Product Surveillance, Postmarketing / standards
  • Product Surveillance, Postmarketing / trends
  • Risk Assessment

Substances

  • Pharmaceutical Preparations