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Scientific, Economic, Regulatory, and Ethical Challenges of Bringing Science‐Based Pediatric Nutrition Products to the U.S. Market and Ensuring Their Availability for Patients
Author(s) -
Merritt Russell J.,
Goldsmith Arthur H.
Publication year - 2014
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/0148607114549771
Subject(s) - product (mathematics) , context (archaeology) , business , reimbursement , new product development , economic shortage , scientific evidence , process (computing) , medicine , marketing , risk analysis (engineering) , economics , health care , computer science , government (linguistics) , economic growth , operating system , paleontology , linguistics , philosophy , geometry , mathematics , epistemology , biology
Many nutrition products and related drugs are unavailable or not consistently available to clinicians despite a body of clinical data and experience supporting their use. Many of these can be related to drug shortages that have increased since 2009. In addition, there are potentially useful products that are not approved for a specific use or are no longer being manufactured. This review broadly examines the product availability gap from the perspectives of a clinician/former nutrition industry medical director and an economist. The process of pediatric nutrition product and related drug innovation, as well as its drivers and the steps involved in bringing a product to market, is first described. This is followed by an assessment of factors influencing product availability beyond the innovation process, including regulatory issues, manufacturing compliance, purchasing practices, and other factors related to drug and nutrition product pricing and reimbursement. Three pediatric case examples are reviewed and placed in the context of the prior review. Last, recent and future possible steps toward closing the product availability gap are discussed.