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Real‐World Evidence, Public Participation, and the FDA
Author(s) -
Schwartz Jason L.
Publication year - 2017
Publication title -
hastings center report
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.515
H-Index - 63
eISSN - 1552-146X
pISSN - 0093-0334
DOI - 10.1002/hast.779
Subject(s) - agency (philosophy) , food and drug administration , enthusiasm , medicine , public relations , advisory committee , public health , scientific evidence , drug approval , political science , public administration , environmental health , psychology , pharmacology , drug , sociology , epistemology , social psychology , social science , philosophy , nursing
For observers of pharmaceutical regulation and the Food and Drug Administration, these are uncertain times. Events in late 2016 raised concerns that the FDA's evidentiary standards were being weakened, compromising the agency's ability to adequately perform its regulatory and public health responsibilities. Two developments most directly contributed to these fears—the approval of eteplirsen, a treatment for Duchenne muscular dystrophy, against the recommendations of both FDA staff and an advisory committee and the December 2016 signing of the 21st Century Cures Act, which encouraged greater use by the FDA of “real‐world” evidence not obtained through randomized controlled trials. The arrival of the Trump administration—with its deregulatory, industry‐friendly approach—has only amplified concerns over the future of the FDA. It is too early to know whether the recent developments are truly harbingers of an FDA less likely to prevent unsafe or ineffective products from reaching the market. But elements in the two events—the role of patient narratives in deliberations regarding eteplirsen and the enthusiasm for real‐world evidence in the 21st Century Cures Act—raise critical issues for the future of evidence in the FDA's work. The rigorous, inclusive approach under way to consider issues related to real‐world evidence provides a model for a similarly needed inquiry regarding public participation in FDA decision‐making .