Salvatore_Alesci

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Expert
 Conference
 on
 the
 Revision
 of
 
the
 Declara5on
 of
 Helsinki
 
March
 1st,
 2013
 
 
Tokyo,
 Japan
 
 
2
•  Introduc5on
 
•  General
 Posi5on
 Statements
 on
 the
 Revision
 
of
 the
 Declara5on
 of
 Helsinki
 
•  Posi5on
 Statements
 on
 Post-­‐study
 Access
 
– Comments
 on
 Sponsor’s
 Role
 and
 Responsibili3es
 
in
 Post-­‐Study
 Access
 

 
Outline
 
3
Introduc5on
 
•  Biopharmaceu5cal
 companies
 are
 commiLed
 to
 high-­‐quality
 clinical
 
research
 that
 is
 both
 scien5fically
 and
 ethically
 rigorous
 

 
•  Biopharmaceu5cal
 companies
 are
 commiLed
 to
 sponsoring
 clinical
 trials
 
that
 fully
 comply
 with
 all
 legal
 and
 regulatory
 requirements
 
 

 
•  PhRMA
 highly
 values
 the
 fundamental
 principles
 of
 the
 Declara5on
 of
 
Helsinki
 and
 has
 incorporated
 them
 into
 its
 own
 voluntary
 principles
 
•  Principles
 on
 Conduct
 of
 Clinical
 Trials
 and
 Communica3on
 of
 Clinical
 
Trials
 Results
 (PhRMA,
 2009)
 
“In
 sponsoring
 and
 conduc9ng
 clinical
 research,
 PhRMA
 members
 place
 
great
 importance
 on
 respec9ng
 and
 protec9ng
 the
 safety
 of
 research
 
par9cipants.
 Principles
 for
 the
 conduct
 of
 clinical
 research
 are
 set
 forth
 in
 
interna9onally
 recognized
 documents,
 such
 as
 the
 Declara9on
 of
 Helsinki
 
and
 the
 Guideline
 for
 Good
 Clinical
 Prac9ce
 of
 the
 Interna9onal
 Conference
 
on
 Harmoniza9on.”
 

 
General
 Posi5on
 Statements
 on
 the
 
Revision
 of
 the
 Declara5on
 of
 Helsinki
 
•  PhRMA
 recognizes
 the
 importance
 of
 preserving
 the
 original
 
intent
 of
 the
 Declara3on
 of
 Helsinki
 as
 a
 concise
 set
 of
 guiding
 
principles
 addressing
 ethical
 responsibili3es
 of
 physicians
 and
 
physician-­‐inves3gators
 

 
•  Biopharmaceu3cal
 companies
 remain
 suppor3ve
 of
 the
 basic
 
principles
 of
 the
 Declara3on
 of
 Helsinki
 and
 other
 global
 ethical
 
guidance
 documents,
 in
 alignment
 with
 their
 obliga3on
 to
 
comply
 with
 the
 legal
 and
 regulatory
 requirements
 of
 clinical
 
trials
 

 
•  PhRMA
 welcomes
 the
 opportunity
 to
 contribute
 expert
 input
 
and
 support
 the
 WMA
 with
 any
 future
 revision
 of
 the
 Declara3on
 
of
 Helsinki
 
4
•  PhRMA
 recognizes
 the
 value
 of
 providing
 addi5onal
 clarity
 on
 post-­‐
study
 access
 in
 the
 Declara5on
 of
 Helsinki,
 without
 altering
 its
 original
 
intent
 of
 a
 set
 of
 guiding
 principles:
 
–  Clearly
 define
 what
 cons3tutes
 post-­‐study
 access
 
 
–  Make
 explicit
 reference
 to
 roles
 and
 responsibili3es
 in
 providing
 
 post-­‐
study
 access,
 including
 :
 
–  Primary
 responsibility
 of
 host-­‐country
 
 governments
 to
 provide
 access
 to
 
medical
 care
 (including
 approved
 medicines)
 through
 their
 healthcare
 systems
 
–  Role
 and
 responsibility
 of
 local
 Na3onal
 Regulatory
 Authori3es
 (NRAs)
 and
 Ethic
 
Review
 CommiSees
 (ERCs)
 in
 determining
 whether
 a
 proposed
 research
 study
 is
 
suitable
 for
 the
 host-­‐country
 
–  Strengthen
 the
 concept
 that
 post-­‐study
 benefits
 to
 study
 par3cipants
 
and
 host
 communi3es
 can
 take
 many
 forms,
 and
 are
 not
 limited
 to
 the
 
poten3al
 iden3fica3on
 of
 a
 beneficial
 interven3on
 in
 the
 study
 
 

 

  5
Posi5on
 Statements
 on
 Post-­‐study
 Access
 
Comments
 on
 Sponsor’s
 Role
 and
 Responsibili5es
 
in
 Post-­‐Study
 Access
 

 
•  Comments
 are
 specific
 for
 post-­‐study
 access
 to
 study
 medica5ons
 by
 pa5ents
 who
 
par5cipated
 in
 a
 clinical
 trial
 

 
•  The
 sponsor
 may
 offer
 post-­‐study
 access
 to
 study
 medica5ons
 in
 specific
 circumstances
 
 
(for
 example,
 life-­‐threatening
 diseases,
 severe
 debilita6ng
 medical
 condi6ons,
 or
 clinical
 
emergencies
 for
 which
 no
 appropriate
 alterna6ve
 therapies
 are
 locally
 available):
 
–  Subject
 to
 local
 legal
 and
 regulatory
 requirements
 
–  Guided
 by
 the
 best
 available
 evidence
 for
 a
 favorable
 benefit/risk
 profile
 

 
•  Plans
 for
 post-­‐study
 access
 (including
 discon5nua5on)
 should
 be
 guided
 by
 the
 
documented
 pre-­‐trial
 agreement
 and
 any
 poten5al
 modifica5ons
 

 
•  In
 cases
 where
 the
 sponsor
 plans
 to
 provide
 post-­‐study
 access
 to
 the
 study
 
medica5on,
 supply
 may
 be
 discon5nued
 if:
 
–  In
 the
 sponsor’s
 opinion,
 new
 informa3on
 becomes
 available
 that
 affects
 nega3vely
 
 
 
 
 
the
 previous
 benefit/risk
 assessment
 of
 the
 medica3on
 
–  The
 reviewing
 agency
 rejects
 the
 request
 for
 marke3ng
 authoriza3on
 based
 upon
 an
 
assessment
 of
 benefit/risk
 and
 there
 are
 no
 further
 plans
 to
 seek
 authoriza3on
 
•  In
 all
 circumstances,
 the
 sponsor
 will
 work
 with
 relevant
 local
 healthcare
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
authori5es
 and
 services
 in
 the
 best
 interest
 of
 the
 study
 par5cipants
 

 
6