In 2015, Japan's Minister of Health, Labour and Welfare established an expert advisory panel to focus on Japan Vision: Healthcare 2035 and plan ways to meet the challenges facing the country’s healthcare system over the next two decades. “Japan has been facing an unprecedented situation with fewer children and our aging society. The Japan policy of Healthcare 2035 actually focuses on this problem,” explains Kanmuri Kazuhiro, Ascent Development Services. “The balance of demand and supply will become a serious problem in the near future in Japan. The real question is: How do we manage financing and make the quality of the healthcare system good?”
The HMA-EMA Big Data Task Force has proposed ten priority actions to help the EU’s medicines regulatory network make best use of big data to support public health. “The first one we mention is the establishment of a Data Analytics Real-World Interrogation Network, also called DARWIN EU, which we see as a natural evolution of what regulators have been doing for decades now,” explains Nikolai Brun, Co-Chair, HMA-EMA Steering Group on Big Data, in this conversation with Thomas Kühler, Head of Regulatory Science & Policy, EU/AMESA, Sanofi, and Global Forum Regional Editor for Europe. “Technological advances have enabled us to query data remotely and preserving patient privacy and anonymity. We can query data remotely in European databases with an intelligent probe, and this probe can ask a question to the database and return with the answer. That is the vision behind DARWIN EU.”
“How can we find drugs to treat COVID as fast as possible? The master protocol is to me the obvious example,” suggests Lisa LaVange, Professor and Chair of the Department of Biostatistics at UNC Chapel Hill and former Director of the Office of Biostatistics at CDER, FDA. “They do require quite a bit more upfront planning but those that are launched and have been running for a while have been able to study a large number of drugs in a really smart way.” Lisa serves on the Therapeutics Clinical Committee and as Co-Chair of the Master Protocol Subcommittee for Accelerating COVID-19 Therapeutic Innovations & Vaccines (ACTIV) and was interviewed by Richard Zink, Vice President, Data Management, Biostatistics, Statistical Programming at Lexitas and Associate Editor of Therapeutic Innovation and Regulatory Science.
Global Forum Translational Science Co-Editors Gary Kelloff and David Parkinson look back at 2020 and discuss milestones in the early detection and targeted therapy of cancer and other diseases as well as the impact of the coronavirus pandemic on clinical research.
“As biosimilars receive FDA approval and more and more become available to patients, we're beginning to see a greater understanding and appreciation for these medicines as lower cost options,” explains Dr. Hillel Cohen, executive director of scientific affairs in the Sandoz division of Novartis and Sandoz representative to the education committee of the US Biosimilars Council. “You are not being switched to a new medication. You're being kept on the same medication that's being made by a different manufacturer.”
In 2017, Health Canada launched the Regulatory Review of Drugs and Devices (R2D2) initiative with the goal of creating a regulatory system that provides greater and faster access to therapeutic products aligned with Canada's healthcare system needs. “One of our greatest achievements was setting up an aligned review process where a manufacturer can make a drug submission to the regulator and make a submission to health technology assessment at about the same time,” explains Megan Bettle, Director General, COVID-19 Regulatory Response Team at Health Canada. “By doing this, we're still making independent decisions but it's allowed those two separate processes to be brought together so you no longer have a prolonged regulatory review, HTA review, you have decisions being made much closer in time. It's making it more efficient for drugs to actually get to patients who need them.”
For racial and ethnic minorities in the United States, health disparities take on many forms, including higher rates of chronic disease and premature death. Gaps persist even after differences in health insurance, socioeconomic status, state and severity of the disease, comorbidities, and medical facility are taken into account, says Michelle Durham, Director, Psychiatry Residency Training at Boston Medical Center (BMC). The COVID-19 pandemic has highlighted, and in many cases widened, the gap in both health outcomes and access to quality care, unmasking long-standing inequities that pervade the healthcare system and society at large.
David Mukanga, Senior Program Officer Regulatory Affairs, Africa Systems, Bill & Melinda Gates Foundation (and Africa Regional Editor for DIA Global Forum) explores the East African Community’s Medicines Regulatory Harmonization (EAC MRH) initiative with Margareth Sigonda, Head of Health Programs for The New Partnership for Africa's Development, the African Union development agency. “Before this initiative was launched in the EAC, each country had different requirements, different formats for dossier submission,” Margareth explains. “Therefore, adopting the CTD was really a game changer in terms of how now the countries were in a position to receive applications that were kind of in a similar format.”
2020 marks the tenth anniversary of the FDA’s Biosimilars Price Competition & Innovation Act, which created a regulatory approval pathway in the US for biosimilars designed to increase access to safe, effective and cost-effective biological treatment options for patients. “I have absolute confidence in these products as a scientist and seeing them work clinically, but we've got to make it work commercially,” explains Gillian Woollett (Avalere Health) in this interview with Anna Rose Welch (Chief Editor, Biosimilar Development, Life Science Connect). “I always say biosimilars offer savings–but be careful with that statement. That means somebody is not receiving the money they were previously receiving, and they don't want to forego that money.” Anna Rose will moderate the Short Course on Current Biosimilars Policy at DIA’s 2020 Biosimilars Conference.
“How do you do the process of regulation? Not the science of regulation, but how do you do the process of regulation more flexibly and agilely?” asks Murray Lumpkin, Deputy Director Integrated Development and Lead for Global Regulatory Systems Initiatives, Bill & Melinda Gates Foundation. “We certainly hope that the openness that regulators around the world have to this concept of reliance, of referencing, will evolve and strengthen because of what we're all going through now,” says John Lim, founding Executive Director of the Center of Regulatory Excellence at Duke-NUS Medical School in Singapore. (Listen to our previous Pandemic Vaccine Preparedness podcast with Dr. Lumpkin.)