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·药事管理·
患者偏好信息在美国医疗产品上市前决策中的应用及启示
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任晓悦 ,颜建周,丁瑞琳,邵 蓉(中国药科大学国家药物政策与医药产业经济研究中心,南京 211198)
中图分类号 R95 文献标志码 A 文章编号 1001-0408(2024)19-2321-07
DOI 10.6039/j.issn.1001-0408.2024.19.01
摘 要 目的 通过研究患者偏好信息在美国医疗产品上市前决策中的应用,为我国患者偏好信息的应用提供借鉴。方法 采用
文献研究法探究美国患者偏好信息收集与应用的概况、法律依据和参与主体,详细分析患者偏好信息在医疗产品上市前决策中的
应用情况,分析我国患者偏好信息的应用现状与挑战,并提出建议。结果与结论 美国通过开展多项患者参与项目以及立法推动
多主体进行患者偏好信息的收集和应用,将患者偏好信息用于为医疗产品上市前决策提供参考:在研发环节为医疗产品研发和设
计提供信息、辅助临床试验设计;在上市审批环节作为FDA上市审批决策的证据之一,用于识别获益大于风险的患者群体,并纳
入医疗产品说明书。我国患者偏好信息的应用缺乏更高层级法律文件的指导,尚无针对性的指南文件。建议我国借鉴美国经验,
在更高层级的法律文件中明确鼓励患者偏好的研究与应用;针对患者偏好信息的收集与应用制定专门的指导文件;根据我国国情
确定监管决策中患者偏好信息纳入的权重和形式。
关键词 患者偏好;药品;医疗器械;上市前决策
Application of patient preference information in premarketing decision of medical products in the United
States and its implications
REN Xiaoyue,YAN Jianzhou,DING Ruilin,SHAO Rong(Research Center of National Drug Policy &
Ecosystem, China Pharmaceutical University, Nanjing 211198, China)
ABSTRACT OBJECTIVE To provide reference for the application of patient preference information in China by studying the
application of patient preference information in the premarketing decision-making of medical products in the United States.
METHODS The literature research method was used to explore the general situation, legal basis, and participants of the collection
and application of patient preference information in the United States, analyze the application of patient preference information in
premarketing decision-making of medical products in detail, and analyze the application status and challenges of patient preference
information in China, so as to put forward suggestions. RESULTS & CONCLUSIONS United States has promoted the collection
and application of patient preference information through several patient participation projects and legislation. The patient preference
information is used to support premarketing decision-making of medical products: providing information for medical product
development and design, and assisting clinical trial design in the research and development process; helping to support FDA’s
marketing approval decisions, identifying patient groups whose benefits outweigh risks, and included in medical product
descriptions in the marketing approval process. The application of patient preference information in China lacks the guidance of
higher-level legal documents, and there are no targeted guidance documents. It is suggested that China should learn from the
experience of the United States and clearly encourage the research and application of patient preference in higher-level legal
documents; develop specific guidance documents for the collection and application of patient preference information; determine the
weight and form of patient preference information to be considered in regulatory decision-making according to national conditions.
KEYWORDS patient preference; drug; medical device; premarketing decision
近年来,患者参与药品和医疗器械(以下统称为“医 学者的广泛关注。患者对疾病和相关治疗的经验、观
疗产品”)的全生命周期决策受到各国医疗卫生机构和 点、需求和偏好等信息统称为患者体验数据(patient ex‐
[1]
perience data,PED) ,是患者参与决策的重要载体。其
Δ 基金项目 教 育 部 人 文 社 会 科 学 研 究 规 划 基 金 项 目(No.
22YJAZH126) 中,患者偏好信息(patient preference information,PPI)是
*第一作者 硕士研究生。研究方向:医药政策与法规。E-mail: 指患者针对特定治疗的不同临床结局或其他特性的选
18852079330@163.com
择意愿和接受程度的定性或定量评估结果,是对治疗方
# 通信作者 教授,博士生导师,博士。研究方向:医药政策与法
规。电话:025-86185193。E-mail:shaorong118@163.com 案的获益和风险权衡结果的表现 [1―2] 。具体而言,不同
中国药房 2024年第35卷第19期 China Pharmacy 2024 Vol. 35 No. 19 · 2321 ·