2019年FDA批准新药中孤儿药分析

本文对2019年美国食品药品监督管理局（FDA）批准的新药进行了统计分析,通过对新药和孤儿药基本情况、获得优先审批权、临床病例数等进行对比分析,详细了解美国食品药品监督管理局对新药孤儿药的审批优惠政策,提出我国制定孤儿药相关政策的建议,为我国相关政策的制定和企业相关产品研发工作提供思路。     

2010-2015年美国FDA批准上市的孤儿药研究

目的:了解2010-2015年美国FDA批准的孤儿药的情况,为我国孤儿药的相关立法和新药研发提供参考。方法:查阅近年来国内外相关文献,对2010-2015年美国FDA批准的孤儿药进行统计和分析。结果与结论:2010-2015年美国FDA批准上市的孤儿药共77种,仅2015年就有21种,占该年获批新药的46.67%。获批孤儿药主要是治疗肿瘤、内分泌及代谢系统疾病、心血管疾病、感染性疾病、神经及精神疾病和血液系统疾病等全球高发疾病的药物,其中以抗肿瘤药物为主(38种,占49.35%),主要用于治疗黑色素瘤、非小细胞肺癌和白血病。美国FDA批准的孤儿药的研发企业以美国为主。我国尚无明确的罕见病和孤儿药的定义及相关立法,亟需加快相关立法进程,结合国情开展孤儿药的研发与审批。     

美国孤儿药资格认定及批准上市情况分析

目的： 系统了解美国孤儿药批准情况,分析资格认定和审批趋势。方法：以美国食品药品监督管理局(FDA)数据库Drugs@ FDA和孤儿药资格认定和批准在线数据库为主要数据来源,系统收集美国FDA自1983至2020年认定和批准的孤儿药信息,从审批数量、审批时间、治疗领域等方面进行统计分析。结果：1983-2020年FDA共认定孤儿药资格5757个,批准孤儿药适应症943个。从孤儿药认定身份到获批上市平均所需的时间为5.14年。批准的孤儿药适应症中抗肿瘤和免疫机能调节相关适应症最多,为 408个,占比为43.27%。结论：自1983年《孤儿药法案》实施以来,FDA授予的孤儿药资格数量和批准的孤儿药适应症数量呈现明显的增长趋势。     

从我国2016—2020年新药批准情况看新药研发及审批趋势

系统分析2016—2020年国家药品监督管理局(NMPA)新药审批情况,对比美国FDA同期获批新药,解析我国近5年的药物研发趋势,总结我国2016—2020年新药研发和审批趋势,并结合我国药品行政监督管理法规,分析我国在全球药物研发中的地位作用。研究发现,2016—2020年NMPA共批准新药申请(NDA)956个,其中化学药471个,中药235个,生物制药250个,5年间NMPA批准上市新药数量持续增加。与美国FDA申报审批情况相比,我国药品申报数量多,但通过比例较低,一类创新药申报数量较少,批准上市药物的适应证以抗肿瘤、消化系统和抗感染类为主,罕见病和孤儿药研发不足。中国新药批准数量逐年增加,但本土原研新药占比较小,基础研究及转化研究薄弱,新型靶点分子药物研发不够。     

2018年欧美批准新药情况分析

目的：分析2018年美国食品和药物管理局（FDA）和欧洲药品管理局（EMA）批准新药情况。方法：查询FDA和EMA网站数据信息,用Excel软件进行对比、分析。结果与结论：2018年FDA批准NMEs 59个,其中孤儿药34个,数量均创历史新高;FDA审批效率高,批准的新药质量好、治疗领域多样化,新药申请企业竞争激烈。EMA批准新药84个,批准新药的速度和质量低于FDA,但仍有部分新药早于FDA批准。     

再谈新药申报资料中存在的问题

《新药审批办法》颁布、实施后,卫生部又发布了《关于新药审批管理的若干补充规定》。在此期间,卫生部药政局和卫生部药品审评办公室(下称药审办)在一些地区举办了新药审评研讨班,因此,目前各初审单位和研制单位的新药申报资料已有较大改进。为了加强新药审批工作的管理,提高审批水平和工作效率,1989年卫生部对新药审批的机构和工作程序进行了调整和改革,由药审办归口负责办理新药审批的各项工作。将新药的审批分为初审和复审两个阶段,中、西新药的初审由省、自     

依法审批新药 促进新药研制开发

依法审批新药促进新药研制开发胡棠洪（江西省药政管理局３３００４６）新药审批是一项法规性、政策性和技术性很强的工作，完整地、准确地、严格地依法审药，是做好新药审批工作的关键。几年来，我省坚持依法审药，严把初审关，取得了一定成效。新药审批品种逐年上升，质...     

我国新药管理存在的问题与整治建议

通过分析SFDA数据库及福建省4批药品招标目录的药品实例,发现我国新药研究创新能力低,仿制药申报呈现"井喷"之势;目前我国市场上的新药绝大多数不是实质意义上的新药,而是按新药管理的老药。"新药"审批泛滥是药价虚高的根源所在。     

2016年美国FDA批准的新药分析

目的：对2016年美国FDA批准的新药进行分析,供医药界和相关管理部门参考。方法：通过FDA官网的药物创新专栏与Drugs@FDA数据库查阅、收集FDA批准新药的信息,进行统计分析。结果与结论：2016年,FDA共批准22个新药,比2015年大幅减少,也低于1997-2016年的年均新药数量（28个/年）,其中新药申请15个,生物制品许可申请7个。批准新药中获得优先审查、快速通道、突破性治疗和加速审批资格的分别为15个、8个、7个和6个,批准孤儿药9个。批准新药的治疗领域以抗感染药、抗肿瘤药和神经系统用药为主,剂型以注射剂、片剂为主。     

2017年10月FDA批准新药概况

2017年10月,FDA批出 1 个新分子实体药品(表 1),为治疗淋巴瘤药品 Calquence(acalabrutinib). Calquence 获"突破性治疗药物"和"孤儿药"指定以及"优先审评"地位,通过加速审批程序被批准用于既往接受过至少一次治疗的的套细胞淋巴瘤(mantle cell lymphoma, MCL)成年患者的治疗.     

Predictors of orphan drug approval in the European Union

Objective To encourage the development of drugs for rare diseases, orphan drug legislation has been introduced in the USA (1983) and in the EU (2000). Recent literature discusses factors that may influence the development of new orphan medicinal products in the EU. This study aims to identify predictors for successful marketing authorisation of potential orphan drugs in the EU. Methods A comparison between randomly selected authorised and a matched sample of not-yet-authorised orphan drug designations has been performed. Determinants in the study included characteristics of the indication, of the product and of the sponsor. Data were collected from the public domain only. Results Orphan drug approval was strongly associated with previous experience of the sponsor in obtaining approval for another orphan drug (OR = 17.3, 95% CI = 5.6–53.1). Furthermore, existing synthetic entities compared to biotechnology products tended to have a higher likelihood of reaching approval status (OR = 3.9, 95% CI = 0.9–16.6). Conclusion This study showed that experience of a company in developing orphan drugs is an important predictor for subsequent authorisation of other orphan drugs. The same applies for existing (synthetic) molecules, for which much knowledge is available. Further research should be directed towards studying the quality of the clinical development program of those designated orphan medicinal products not reaching approval status.     

欧盟罕用药管理的成就与经验及其对中国的启示

目的提出我国罕用药制度的建议。方法制度比较分析。结果欧盟通过颁布《罕用药管理规定》以促进罕用药的研发、投产和上市,取得了较为显著的成绩。这得益于欧盟在管理罕用药领域内采取各项行之有效的政策措施,主要体现在夯实主要立法基础、增强制度可操作性、完善特别审批程序以及大力资助研发投入等方面。这些举措给中国未来罕用药管理政策的制定和完善提供了丰富而又宝贵的经验。结论我国需要建立罕用药管理制度、完善特殊审批制度、促进罕用药基础研究的成果向应用领域转化。     

Past,Present, and Future of Antibacterial Economics: Increasing Bacterial Resistance,Limited Antibiotic Pipeline,and Societal Implications

Growing antimicrobial resistance and a dwindling antibiotic pipeline have resulted in an emerging postantibiotic era, as patients are now dying from bacterial infections that were once treatable. The fast‐paced “Golden Age” of antibiotic development that started in the 1940s has lost momentum; from the 1980s to the early 2000s, there was a 90% decline in the approval of new antibiotics as well as the discovery of few new novel classes. Many companies have shifted away from development due to scientific, regulatory, and economic hurdles that proved antibiotic development to be less attractive compared with more lucrative therapeutic areas. National and global efforts are focusing attention toward potential solutions for reinvigorating the antibiotic pipeline and include “push” incentives such as public–private partnerships and “pull” incentives such as reimbursement reform and market exclusivity. Hybrid models of incentives, global coordination among stakeholders, and the appropriate balance of antibiotic pricing, volume of drug used, and proper antimicrobial stewardship are key to maximizing efforts toward drug development to ensure access to patients in need of these therapies.     

精准药学:从转化医学到精准医学探讨新药发展

自1960年以来,美国FDA推出的基础研究-发现-设计-临床前开发-临床研究等过程的新药研发的转化研究,这种"转化研究"的"万里挑一"的模式,可以说是最早的"转化研究",对近50年的新药发展起了积极作用。随着生命科学研究的发展及成果的应用,转化研究得到快速发展,转换医学模式成为国际医学健康领域的新概念和研究模式。在美国2010年提出"精准医学"概念之后,奥巴马在他的国情咨文中提出了"精确医学"计划,希望更接近治愈癌症和糖尿病等疾病,希望将以基因为特点的大数据信息用于精准个体化药物治疗。"精准医学"作为医学的未来是人类医学的变革,长期目标是为实现多种疾病的治愈提供有价值的信息。基于精准医疗四要素中"精确、准时、共享、个体化",笔者提出"精准药学"的概念,希望它在实现"精准医疗"中发挥重要的作用,而且具有不同于"精准医学"的研究目标和研究特征。"精准药物"治疗只有实现"精准诊断"的基础上,医疗应用相关的"精准药物"才能提出"精准治疗方案",才能实现精准的个体化治疗。在"大数据"时代,基因组学是精准医学和精准药学的共同基础。但药物研发中可以认为与健康人和病人的基因有关,更与疾病的病因有关,但有些功能性疾病和病毒、细菌、寄生虫等感染性疾病的治疗还与它们的感染、复制及其酶和蛋白等生化过程有关,也与药物的制剂技术和组合有关。因此需要更广阔的知识和视野去认识研发的难度和治疗的精准性,才能开发出疗效更好、更安全、更便利、更经济的新药。     

罕见病用药现状分析

罕见病用药指用于治疗、诊断和预防罕见病或罕见症状的药物。近年来罕见病用药的研发逐渐成为一个可获利的研发策略,受到高度关注和重视。从目前国外罕见病药品市场情况、参与罕见病药物研发的公司和重点品种、美国和欧盟等发达国家和地区罕见病药物的指定和批准情况等方面对罕见病用药的现状及发展趋势进行简述。通过借鉴这些国家和地区罕见病药物发展的成功经验,为制定中国罕见病药物开发的刺激措施提出建议,为相关研发人员提供参考。     

Cross-national comparative study of orphan drug policies in Saudi Arabia,the United States,and the European Union

BackgroundRare diseases are chronic, serious, and life-threatening conditions that have not received sufficient attention from drug developers due to their rarity. Policies have been implemented to encourage research and incentivize the development of orphan drugs. However, the implementation of these policies has been inconsistent worldwide.ObjectiveThe primary aim of this study was to compare orphan drug policies in the United States, Europe, and Saudi Arabia (SA) and assess their impact on the number of approved indications.MethodLists of all drugs granted orphan designations and authorized for marketing in the United States, European Union, and SA were extracted using orphan drug lists available in regulatory body databases. The availability of these drugs, regarding their approval for orphan indication and designation, was assessed and classified using Anatomical Therapeutic Chemical codes.ResultA total of 792 orphan drug designations with at least one authorized indication were identified in this study. Of these, 92% were designated by the Food and Drug Administration (FDA), and 27% were designated by the European Medicine Agency (EMA). The FDA, EMA, and Saudi Food and Drug Authority approved 753, 435, and 253 orphan drugs, respectively.ConclusionFewer orphan drug approvals were found in SA than in the United States and Europe. This highlights the need to focus on rare diseases and orphan drugs and for policies to be created in SA to attract pharmaceutical markets and fulfill unmet orphan drug approval needs.     

美国与欧盟孤儿药研发上市管理制度及对我国的启示

目的通过对美国与欧盟对孤儿药研发上市相关管理政策的分析,为我国孤儿药研发上市管理提供借鉴。方法分析美国和欧盟药政管理部门公开的法规文献和数据库检索数据,总结其对孤儿药的激励政策,分析获得孤儿药资格认定和批准上市的药物特点。结果美国和欧盟对孤儿药研发均颁布实施了诸如市场独占期、政府资助、审评专家对研究方案的指导等相应的激励政策。研发机构应采取及早申请孤儿药认定、多途径发现孤儿药及孤儿药的再开发等研发策略。结论美国和欧盟对孤儿药的研发与上市激励政策,刺激了制药企业对罕见病治疗药物的研发热情,有效缓解了罕见病无药可治的现状,对我国制定相关孤儿药政策提供了有益的借鉴。国内创新型制药企业应尽早布局孤儿药的研发,应重点关注国内已经被大众接受的罕见病和治疗,以及超说明书使用的问题;重点关注生物仿制药如单克隆抗体的研发动态;重点关注国际孤儿药专业公司的研发动态,使孤儿药在国内相关法律法规建立健全后,立即有所响应,尽早抢占孤儿药研发的领先地位和市场地位。     

The new drug approvals of 1987, 1988, and 1989: trends in drug development

The new drug approvals of 1987, 1988, and 1989 were analyzed to determine whether there are any emerging trends in the US drug development and review processes. Sixty-four new drugs were approved by the FDA during this period, of which 55 met the Center for the Study of Drug Development's definition of a new chemical entity (NEC). For the 55 NCEs, the mean length of the investigational new drug application (IND) phase (IND filing to NDA submission) was 5.2 years, the new drug application (NDA) phase (NDA submission to approval) was 2.9 years, and the total phase (IND filing to NDA approval) was 8.1 years. Nine of the 55 NCEs were classified by the FDA as 1A (important therapeutic gain), 15 were classified as 1B (modest gain), 29 were classified as 1C (little or no gain), and 2 were classified as 1AA (drugs to treat AIDS and AIDS-related conditions); 10 drugs were granted orphan status. The mean NDA phase for 1A drugs was 2.4 years; 1B drugs, 2.9 years; 1C drugs, 3.1 years; 1AA drugs, 1.4 years; and orphan drugs, 2.5 years. Forty-four of the 55 NCEs (80%) were available in foreign markets before US approval was given, with a mean of 6.5 years of prior marketing. These data are consistent with figures for previous years and suggest little change in the rate of new drug development and review in the United States.