Studying the Impact of European Union Regulatory Interventions for Minimising Risks From Medicines: Lessons Learnt and Recommendations

Author:

Goedecke Thomas1ORCID,Martirosyan Liana2ORCID,Gault Nathalie3ORCID,Seifert Karin4ORCID,Morales Daniel R.1ORCID,Bahri Priya1ORCID,Strassmann Valerie1ORCID,Huber Martin4ORCID,Straus Sabine25ORCID

Affiliation:

1. European Medicines Agency Amsterdam The Netherlands

2. Medicines Evaluation Board Utrecht The Netherlands

3. French National Agency for Medicines and Health Products Safety (ANSM) Saint‐Denis France

4. Federal Institute for Drugs and Medical Devices Bonn Germany

5. Department of Medical Informatics Erasmus Medical Centre Rotterdam The Netherlands

Abstract

ABSTRACTPurposeThe European Medicines Agency's (EMA) Pharmacovigilance Risk Assessment Committee (PRAC) launched a strategy to examine the public health impact of major regulatory interventions aimed at minimising risks of medicinal products. We conducted a lessons learnt analysis of impact studies completed between 2015 and 2023.MethodsWe surveyed PRAC Sponsors and (Co‐)Rapporteurs involved in the evaluation of 12 impact studies (10 commissioned by EMA and 2 conducted collaboratively by Member States) to explore how these support regulatory decision‐making. Questions covered achievement of study objectives, risk minimisation effectiveness, added value for regulatory decision‐making, and recommendations for future impact studies. Themes were generated using thematic content analysis.ResultsSurvey responses from 15 PRAC Sponsors and (Co‐)Rapporteurs from 10 European Union Member States were included in the analysis. Among four cross‐sectional surveys and eight drug utilisation studies, 50% achieved all objectives, the other studies partially due to limitations. Two studies concluded that risk minimisation measures were overall effective, two were effective with variation across countries, two were partially effective and four studies showed limited effectiveness. Two studies were deemed inconclusive due to limitations. The reasons for the limited effectiveness of risk minimisation may be explored using mixed‐method approaches. Assessment of study feasibility and a priori discussion of effectiveness measurements is important.ConclusionDespite limitations, impact research adds value to regulatory decision‐making by addressing knowledge gaps and providing additional information on unintended consequences of regulatory interventions. Our recommendations will help to improve planning, conducting and interpretating future impact studies.

Publisher

Wiley

Reference18 articles.

1. Heads of Medicines Agencies and European Medicines Agency “European Medicines Agencies Network Strategy to 2025 ” Protecting Public Health at a Time of Rapid Change (EMA/85501/2020) 2020 https://www.ema.europa.eu/en/documents/report/european‐union‐medicines‐agencies‐network‐strategy‐2025‐protecting‐public‐health‐time‐rapid‐change_en.pdf.

2. European Medicines Agency (EMA) “Pharmacovigilance Risk Assessment Committee Rules of Procedure (EMA/PRAC/567515/2012) ”2021 https://www.ema.europa.eu/en/documents/other/prac‐rules‐procedure_en.pdf.

3. Pharmacovigilance Risk Assessment Committee (PRAC) “Guideline on Good Pharmacovigilance Practices (GVP) ” Module XVI—Risk Minimisation Measures: Selection of Tools and Effectiveness Indicators (Rev 3)—Draft for Public Consultation (EMA/204715/2012 Rev 3) 2021 https://www.ema.europa.eu/en/documents/regulatory‐procedural‐guideline/guideline‐good‐pharmacovigilance‐practices‐gvp‐module‐xvi‐risk‐minimisation‐measures‐selection‐tools_en.pdf.

4. Comprehensive evaluation of post-approval regulatory actions during the drug lifecycle – a focus on benefits and risks

5. Regulation (EC) No 726/2004 of the European Parliament and of the Council of 31 March 2004 Laying Down Community Procedures for the Authorisation and Supervision of Medicinal Products for Human and Veterinary Use and Establishing a European Medicines Agency;European Union;Official Journal of the European Communities,2004

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