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Analysis of Labeling Decisions Regarding Therapeutic Indications During New Drug Application Reviews in Japan
Author(s) -
Yokota M,
Kusama M,
Sugiyama Y,
Ono S
Publication year - 2011
Publication title -
clinical pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.941
H-Index - 188
eISSN - 1532-6535
pISSN - 0009-9236
DOI - 10.1038/clpt.2011.134
Subject(s) - clinical pharmacology , medicine , drug , multinomial logistic regression , pharmacology , actuarial science , business , computer science , machine learning
We analyzed regulatory reviews in Japan to study the modifications made in drug labeling with respect to proposed therapeutic indications, and investigated factors associated with these changes so as to gain insight into the reasons behind the decisions. Of 220 new molecular entities (NMEs) approved in Japan from 2000 to 2009, 70 received more restricted indications and 14 received more expanded indications than those proposed by the applicants. Multinomial regression analysis suggested that the presence of competitive drugs in the market, higher estimated peak sales, and higher complexity of the proposed indication were factors that significantly increased the likelihood of the indications being restricted on review, in addition to factors related to adequacy of efficacy data. Our results give us a clue to how the approved therapeutic indications reflect the characteristics of the applicants, drugs, review areas (RAs), and clinical evidence in the submitted data package, as well as to the principle behind the decisions. Clinical Pharmacology & Therapeutics (2011) 90 3, 432–441. doi: 10.1038/clpt.2011.134