Tags

Type your tag names separated by a space and hit enter

Postmarket safety in Canada: are significant therapeutic advances and biologics less safe than other drugs? A cohort study.
BMJ Open. 2014 Feb 18; 4(2):e004289.BO

Abstract

OBJECTIVES

Examine the probability of new active substances (NASs) approved in Canada between 1 January 1997 and 31 March 2012 acquiring a serious postmarket safety warning.

DESIGN

Cohort study.

DATA SOURCES

Annual reports of the Therapeutic Products Directorate and the Biologic and Genetic Therapies Directorate; evaluations of therapeutic innovation from the Patented Medicine Prices Review Board and Prescrire International; MedEffect Canada website.

INTERVENTIONS

Postmarket regulatory safety warning or withdrawal from market due to safety reasons.

PRIMARY AND SECONDARY OUTCOME MEASURES

Compare the probability of acquiring a postmarket safety warning in Canada in four different groups of drugs: (1) traditional medications versus biologics; (2) medications that offer significant new therapeutic benefits versus those that do not. Determine how well the type of review that an NAS received from Health Canada predicted the product's postmarket therapeutic value.

RESULTS

The probability of a traditional NAS acquiring a serious safety warning and/or being withdrawn was 29.9% (95% CI 21.8% to 40.2%) vs 27.3% (95% CI 18.2% to 39.7%) for an NAS of biological origin (p=0.47, log-rank test). For medications that were significant therapeutic advances the probability was 40.2% (95% CI 24.5% to 60.9%) vs 33.9% (95% CI 26.4% to 42.7%) for those that were not (p=0.18, log-rank test). Health Canada was 77.4% accurate in predicting the therapeutic importance of an NAS.

CONCLUSIONS

There was no difference in postmarket regulatory safety action between traditional medications and biologics and no difference between drugs with significant therapeutic benefits and those without. Although these results draw on Canadian data, they are likely to be relevant internationally. Further research should assess whether the current level of premarket safety evaluation is acceptable.

Authors+Show Affiliations

School of Health Policy and Management, York University, Toronto, Ontario, Canada.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24549164

Citation

Lexchin, Joel. "Postmarket Safety in Canada: Are Significant Therapeutic Advances and Biologics Less Safe Than Other Drugs? a Cohort Study." BMJ Open, vol. 4, no. 2, 2014, pp. e004289.
Lexchin J. Postmarket safety in Canada: are significant therapeutic advances and biologics less safe than other drugs? A cohort study. BMJ Open. 2014;4(2):e004289.
Lexchin, J. (2014). Postmarket safety in Canada: are significant therapeutic advances and biologics less safe than other drugs? A cohort study. BMJ Open, 4(2), e004289. https://doi.org/10.1136/bmjopen-2013-004289
Lexchin J. Postmarket Safety in Canada: Are Significant Therapeutic Advances and Biologics Less Safe Than Other Drugs? a Cohort Study. BMJ Open. 2014 Feb 18;4(2):e004289. PubMed PMID: 24549164.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Postmarket safety in Canada: are significant therapeutic advances and biologics less safe than other drugs? A cohort study. A1 - Lexchin,Joel, Y1 - 2014/02/18/ PY - 2014/2/20/entrez PY - 2014/2/20/pubmed PY - 2014/2/20/medline KW - CLINICAL PHARMACOLOGY SP - e004289 EP - e004289 JF - BMJ open JO - BMJ Open VL - 4 IS - 2 N2 - OBJECTIVES: Examine the probability of new active substances (NASs) approved in Canada between 1 January 1997 and 31 March 2012 acquiring a serious postmarket safety warning. DESIGN: Cohort study. DATA SOURCES: Annual reports of the Therapeutic Products Directorate and the Biologic and Genetic Therapies Directorate; evaluations of therapeutic innovation from the Patented Medicine Prices Review Board and Prescrire International; MedEffect Canada website. INTERVENTIONS: Postmarket regulatory safety warning or withdrawal from market due to safety reasons. PRIMARY AND SECONDARY OUTCOME MEASURES: Compare the probability of acquiring a postmarket safety warning in Canada in four different groups of drugs: (1) traditional medications versus biologics; (2) medications that offer significant new therapeutic benefits versus those that do not. Determine how well the type of review that an NAS received from Health Canada predicted the product's postmarket therapeutic value. RESULTS: The probability of a traditional NAS acquiring a serious safety warning and/or being withdrawn was 29.9% (95% CI 21.8% to 40.2%) vs 27.3% (95% CI 18.2% to 39.7%) for an NAS of biological origin (p=0.47, log-rank test). For medications that were significant therapeutic advances the probability was 40.2% (95% CI 24.5% to 60.9%) vs 33.9% (95% CI 26.4% to 42.7%) for those that were not (p=0.18, log-rank test). Health Canada was 77.4% accurate in predicting the therapeutic importance of an NAS. CONCLUSIONS: There was no difference in postmarket regulatory safety action between traditional medications and biologics and no difference between drugs with significant therapeutic benefits and those without. Although these results draw on Canadian data, they are likely to be relevant internationally. Further research should assess whether the current level of premarket safety evaluation is acceptable. SN - 2044-6055 UR - https://www.unboundmedicine.com/medline/citation/24549164/Postmarket_safety_in_Canada:_are_significant_therapeutic_advances_and_biologics_less_safe_than_other_drugs_A_cohort_study_ L2 - http://bmjopen.bmj.com/cgi/pmidlookup?view=long&pmid=24549164 DB - PRIME DP - Unbound Medicine ER -