Number of Patients Studied Prior to Approval of New Medicines: A Database Analysis

Ruben Duijnhoven, Sabine Straus, JM Raine, A den Boer, AW Hoes, ML (Marie) de Bruin

Research output: Contribution to journalArticleAcademicpeer-review

66 Citations (Scopus)
14 Downloads (Pure)

Abstract

Background: At the time of approval of a new medicine, there are few long-term data on the medicine's benefit-risk balance. Clinical trials are designed to demonstrate efficacy, but have major limitations with regard to safety in terms of patient exposure and length of follow-up. This study of the number of patients who had been administered medicines at the time of medicine approval by the European Medicines Agency aimed to determine the total number of patients studied, as well as the number of patients studied long term for chronic medication use, compared with the International Conference on Harmonisation's E1 guideline recommendations. Methods and Findings: All medicines containing new molecular entities approved between 2000 and 2010 were included in the study, including orphan medicines as a separate category. The total number of patients studied before approval was extracted (main outcome). In addition, the number of patients with long-term use (6 or 12 mo) was determined for chronic medication. 200 unique new medicines were identified: 161 standard and 39 orphan medicines. The median total number of patients studied before Conclusions: For medicines intended for chronic use, the number of patients studied before marketing is insufficient to evaluate safety and long-term efficacy. Both safety and efficacy require continued study after approval. New epidemiologic tools and legislative actions necessitate a review of the requirements for the number of patients studied prior to approval, particularly for chronic use, and adequate use of post-marketing studies.
Original languageUndefined/Unknown
JournalPLoS Medicine (print)
Volume10
Issue number3
DOIs
Publication statusPublished - 2013

Research programs

  • EMC NIHES-03-77-02

Cite this