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      Expert survey on real‐world data utilization and real‐world evidence generation for regulatory decision‐making in drug lifecycle in Korea

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          Abstract

          As the importance of utilizing real‐world data (RWD)/real‐world evidence (RWE) for supporting regulatory scientific decision‐making continues to grow, experiences and inputs from experts become crucial for developing a systematic and practice‐oriented plan for the use of fit‐for‐purpose RWD/RWE. This study aimed to survey relevant experts from government agencies, industries, and academia to identify prerequisites for the drug life cycle in Korea. The questionnaire comprised the following: (A) the definition and categories of RWD/RWE, (B) the suitability and feasibility of using RWD/RWE at each authorization stage by the types of RWD, and (C) the challenges and solutions for the use of RWD/RWE. A total of 46 respondents completed the online survey, with 89.1% of them having prior experience with RWD/RWE usage. A majority of respondents agreed that RWD can be obtained from various sources. Among these sources, the registry was the most suitable source. It is suitable to compensate for the limitations of randomized control trials and ensure quality in data collection. Though there was consensus among the respondents for the use of RWD/RWE in post‐marketing surveillance, the use of such data in new drug application (NDA) was disagreeable. Respondents considered it necessary to write a protocol in advance for RWD collection and RWE generation, for all RWD types. In conclusion, this study examined the perceptions of experts for RWD/RWE use at each approval stage of drugs. The results suggest that guidelines for the fit‐for‐purpose use of RWD/RWE should be developed via careful deliberation among experts in the future.

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          Most cited references19

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          Real-World Evidence and Real-World Data for Evaluating Drug Safety and Effectiveness

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            What Is Real-World Data? A Review of Definitions Based on Literature and Stakeholder Interviews.

            Despite increasing recognition of the value of real-world data (RWD), consensus on the definition of RWD is lacking.
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              Emulating Randomized Clinical Trials with Nonrandomized Real-World Evidence Studies: First Results from the RCT DUPLICATE Initiative

              Background: Regulators are evaluating the use of non-interventional real-world evidence (RWE) studies to assess the effectiveness of medical products. The RCT-DUPLICATE initiative uses a structured process to design RWE studies emulating randomized controlled trials (RCTs) and compare results. Here, we report findings of the first 10 trial emulations, evaluating cardiovascular outcomes of antidiabetic or antiplatelet medications. Methods: We selected 3 active-controlled and 7 placebo-controlled RCTs for replication. Using patient-level claims data from US commercial and Medicare payers, we implemented inclusion/exclusion criteria, selected primary endpoints, and comparator populations to emulate those of each corresponding RCT. Within the trial-mimicking populations, we conducted propensity score matching to control for >120 pre-exposure confounders. All study parameters were prospectively defined and protocols registered before hazard ratios (HRs) and 95% confidence intervals (CIs) were computed. Success criteria for the primary analysis were pre-specified for each replication. Results: Despite attempts to emulate RCT design as closely as possible, differences between the RCT and corresponding RWE study populations remained. The regulatory conclusions were equivalent in 6 of 10. The RWE emulations achieved a HR estimate that was within the 95% CI from the corresponding RCT in 8 of 10 studies. In 9 of 10, either the regulatory or estimate agreement success criteria were fulfilled. The largest differences in effect estimates were found for RCTs where second-generation sulfonylureas were used as a proxy for placebo regarding cardiovascular effects. Nine of 10 replications had a standardized difference between effect estimates of <2, which suggests differences within expected random variation. Conclusions: Agreement between RCT and RWE findings varies depending on which agreement metric is used. Interim findings indicate that selection of active comparator therapies with similar indications and use patterns enhances the validity of RWE. Even in the context of active comparators, concordance between RCT and RWE findings is not guaranteed, partially because trials are not emulated exactly. More trial emulations are needed to understand how often and in what contexts RWE findings match RCTs. Clinical Trial Registration: URL: https://clinicaltrials.gov Unique Identifiers: NCT03936049, NCT04215523, NCT04215536, NCT03936010, NCT03936036, NCT03936062, NCT03936023, NCT03648424, NCT04237935, NCT04237922
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                Author and article information

                Contributors
                eunahan@yonsei.ac.kr
                Journal
                Clin Transl Sci
                Clin Transl Sci
                10.1111/(ISSN)1752-8062
                CTS
                Clinical and Translational Science
                John Wiley and Sons Inc. (Hoboken )
                1752-8054
                1752-8062
                17 April 2024
                April 2024
                : 17
                : 4 ( doiID: 10.1111/cts.v17.4 )
                : e13801
                Affiliations
                [ 1 ] College of Pharmacy, Ajou University Suwon Gyeonggi‐do South Korea
                [ 2 ] Department of BioHealth Regulatory Science Graduate School of Ajou University Suwon Gyeonggi‐do South Korea
                [ 3 ] College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Yonsei University Incheon South Korea
                [ 4 ] Department of Pharmaceutical Medicine & Regulatory Sciences College of Medicine and Pharmacy, Yonsei University Incheon South Korea
                Author notes
                [*] [* ] Correspondence

                Euna Han, College of Pharmacy, Yonsei Institute of Pharmaceutical Sciences, Yonsei University, 85 Songdogwahak‐ro, Incheon 21983, South Korea.

                Email: eunahan@ 123456yonsei.ac.kr

                Author information
                https://orcid.org/0000-0002-7780-159X
                https://orcid.org/0000-0003-1224-9746
                https://orcid.org/0000-0001-6086-0246
                https://orcid.org/0000-0003-3260-2623
                https://orcid.org/0000-0003-2656-7059
                Article
                CTS13801 CTS-2023-0470
                10.1111/cts.13801
                11022296
                38629484
                ef28b1b0-0728-423c-97ef-21b0348bb755
                © 2024 The Authors. Clinical and Translational Science published by Wiley Periodicals LLC on behalf of American Society for Clinical Pharmacology and Therapeutics.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

                History
                : 17 March 2024
                : 23 November 2023
                : 07 April 2024
                Page count
                Figures: 1, Tables: 7, Pages: 14, Words: 7300
                Categories
                Article
                Articles
                Custom metadata
                2.0
                April 2024
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.4.0 mode:remove_FC converted:17.04.2024

                Medicine
                Medicine

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