Published Nov 2003
Acquadro C, Berzon R, Dubois D, et al. Incorporating the patients' perspective into drug development and communication: an ad hoc task force report of the patient-reported outcomes (PRO) harmonizing group meeting at the Food and Drug Administration, February 16, 2001. Value Health. 2003;6(5):522-531.
Background: The extent to which patient-based outcomes
can be used to evaluate and communicate the effect
of new drugs and devices is a subject of much debate.
Criteria for evaluating the scientific quality of data to
support health-related quality of life (HRQL) and other
patient-based labeling and promotional claims in the
United States and Europe have been proposed by various
scientists and organizations. Since March 2000, a working
group composed of members of the International
Society for Quality of Life Research (ISOQOL), the International
Society for Pharmacoeconomics and Outcomes
Research (ISPOR), the Pharmaceutical Manufacturer’s
Association Health Outcomes Committee (PhRMAHOC),
and the European Regulatory Issues on Quality of
Life Assessment (ERIQA) met to discuss and coordinate
the various recommendations by their respective groups
and address the need to harmonize outcomes review criteria
within and across United States and European
regulatory agencies. Over time, the discussion expanded
from HRQL outcomes to include any outcome based on
data provided by the patient or patient proxy, that is,
patient-reported outcomes (PROs). The working group
therefore became known as the PRO Harmonization
Methods: Working with a member of the US Food and Drug Administration (FDA), four key issues requiring clarification were identified: how PROs are defined and put into operation for research purposes; the added value of PROs in the drug review and evaluation process; selected questions related to the PRO measurement and research methodology; and the interest and demand for PRO information by decision makers. On February 15, 2001, all members of the PRO Harmonization Group attended a meeting in Rockville, Maryland, to discuss these four issues further, and on February 16, 2001, a formal presentation was made to representatives from various departments and reviewing divisions of the FDA. These presentations are summarized in this report.
Results: All participants agreed that PROs are important for understanding the impact of treatment on patient functioning and well-being. They also stressed the need to communicate PRO information to key decision makers, including regulatory agencies, clinicians, patients and their families, and payers. Finally, the meeting resulted in plans for continuing the dialogue on PRO measurement and interpretation. Summary: The February 16, 2001, meeting represented an important step in harmonizing efforts across various organizations and in opening a dialogue with the FDA around major issues related to methodologic standards for measuring and interpreting PROs in the drug evaluation process.
Keywords: claims, health-related quality of life (HRQL), patient-reported outcomes (PRO), regulatory issues.