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UK – NICE – RWE Framework

RWE 201 – UK – NICE – RWE Framework

 

NICE RWE Framework: https://www.nice.org.uk/corporate/ecd9/chapter/overview

Real-world data (RWD) encompasses various types of information on patient health, care delivery, and experiences collected outside traditional clinical trials. This data is crucial in forming National Institute for Health and Care Excellence (NICE) guidance.

NICE utilises RWD to:

  1. Characterise health conditions, care pathways, and patient outcomes.
  2. Design and validate economic models related to healthcare.
  3. Evaluate digital health technologies.
  4. Address health inequalities.
  5. Assess the safety of medical technologies.
  6. Examine the effects of interventions on care delivery.

While Randomised Controlled Trials (RCTs) are preferred for studying interventions, they may not always be available or applicable to real-world NHS settings for various reasons, including ethical constraints, technical challenges, or lack of funding. Sometimes, RCTs may also have limitations such as irrelevant comparators, exclusion of important population groups, or poor quality, making them insufficient for NHS decision-making.

NICE often resorts to non-randomised studies, particularly for medical devices, public health interventions, and assessments of medicines. Observational cohort studies and single-arm trials with real-world external control are commonly used non-randomised methods.

NICE aims to use RWD more consistently to fill evidence gaps and expedite patient access to innovations. For RWD to be trusted, it needs to be gathered and analysed transparently, utilising fit-for-purpose data while mitigating biases.

NICE has developed a real-world evidence framework to guide the generation of high-quality evidence. This framework is targeted primarily at those creating evidence to inform NICE guidance but is also relevant for patients, data collectors, and evidence reviewers. Core principles for generating trusted real-world evidence include ensuring data quality, transparency, and the use of analytical methods that minimise bias.

The framework consists of several sections:

  1. Introduction: Outlines the role and potential of RWD.
  2. Study Conduct: Describes expectations for planning and reporting RWD studies.
  3. Assessing Data Suitability: Provides guidelines for assessing the quality and relevance of RWD.
  4. Methods for Real-world Studies: Offers specific recommendations for conducting non-randomised studies.

Companies are encouraged to seek early advice from NICE on integrating RWD into their evidence-generation plans.

In summary, RWD has become an essential tool for improving healthcare outcomes and policy, fulfilling NICE’s strategic ambitions to drive innovation and resolve gaps in knowledge through robust, transparent, and high-quality evidence.

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UK – NICE – RWE Framework2023-10-14T08:35:21+00:00

Real World Evidence 201 – FDAs RWE Framework

RWE 201 – FDAs RWE Framework

Real World Evidence (RWE) 201 – FDAs RWE Framework

RWE 201: https://rwr-regs.com/rwe-201/

The FDA’s Real-World Evidence (RWE) Program framework, established under the 21st Century Cures Act, focuses on several key aspects:

[1] Scope of RWE Program Under 21st Century Cures Act: The program aims to evaluate the potential use of RWE to support the approval of a new indication for a drug already approved under section 505(c) of the FD&C Act or to help support or satisfy drug post-approval study requirements (e.g., FDAs Advancing RWE Program).

[2] Current Use of Real-World Data (RWD) for Evidence Generation: RWD sources, such as electronic health records, medical claims, and billing data, can be used for data collection and to develop analysis infrastructure to support various study designs, including randomized clinical trials and observational studies.

Current Uses of RWE:

  • Complementing traditional clinical trial data.
  • Supporting post-market commitments or requirements.
  • Label expansions (e.g., adding new indications for approved drugs).
  • Observational studies to understand product safety and effectiveness.

[3] Generating Evidence Regarding Safety and Effectiveness: Historically, there has been limited use of RWE to support effectiveness. Advances in the availability and analysis of RWD have increased the potential for generating robust RWE to support FDA regulatory decisions.  However, the value of using RWE to support regulatory decisions on drug efficacy and effectiveness has yet to be established.  To be explored further when we move to the EU and the EMAs RWE 2025 Vision.

[4] Framework for Evaluating RWD/RWE for Use in Regulatory Decisions: The FDA’s framework for evaluating RWD and RWE involves assessing the fitness of RWD (sources) for use in regulatory decisions, potential for study designs using RWD to support effectiveness, and regulatory considerations for study designs using RWD.

Data Quality and Reliability:

  • Not all RWD is fit for regulatory decisions. The FDA assesses the relevance and reliability of RWD.
  • Sources of RWD must be transparent, and any transformations to derive RWE must be robust and valid.

Methodological Challenges:

  • There are inherent biases in RWD because they are observational in nature
  • FDA focuses on minimising biases and promoting the use of appropriate statistical methods.

The framework aims to facilitate the acceleration of medical product development and the delivery of medical innovations for patients in need. It also distinguishes between the sources of RWD and the evidence derived from that data, as evaluating RWE in the context of regulatory decision-making depends on the evaluation of the methodologies used to generate the evidence and the reliability and relevance of the underlying RWD.

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Real World Evidence 201 – FDAs RWE Framework2023-08-16T15:06:53+00:00
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