Change The Way Drugs Are Approved In England, But Do Not Endanger Safety

The Medicines and Health Products Regulatory Agency (MHRA) is the UK’s regulatory authority for pharmaceutical clearance. 

In 2003, two independent organizations, the Medicines Control Agency and the Medical Device Agency, merged to become the MHRA. 

Before a drug enters the market, the agency works to ensure its safety, quality, and efficacy. 

The main goal of this project is to learn about the practice and regulatory procedures for registering a medication in the United Kingdom under the MHRA rules. 

They are in charge of ensuring that medications and medical equipment are acceptable in terms of safety and do not damage people.

The problem with the current system

The National Institute For Health and Care Excellence (NICE) unveiled proposals last month to alter the way new medications are evaluated. 

This board selects which medications can be used in England and Wales’ National Health Services. 

While some ideas are plainly desirable, such as requiring companies to submit NICE submissions in simple English, others, such as allowing less carefully conducted studies as supporting data, should be approached with caution.

The reforms, according to NICE, are intended to speed up the launch of new medications and encourage pharmaceutical companies’ innovation. 

It also aims to encourage pharmaceutical firms to debut their drugs in the United Kingdom first, given that the country has exited the European Union. 

Faster access to medications appears to be an unqualified benefit, but the US Food and Drug Administration’s (FDA) experience in attempting to accomplish the same goal is a cautionary story.

The FDA performs a different function than NICE

The Food and Drug Administration (FDA) is responsible for protecting the public health by ensuring the safety, efficacy, and security of human and veterinary drugs, biological products, and medical devices.

The Medicines and Healthcare Products Regulatory Agency in the United Kingdom is a similar agency. 

NICE evaluates medications based on a fourth criterion: if the treatment’s advantages outweigh the cost. 

Nonetheless, the FDA and NICE function as brakes, preventing pharmaceutical companies from marketing any drugs they choose.

The FDA has been chastised for allowing an increasing number of goods to be examined under expedited procedures that require less proof. 

Companies that receive fast-track approval are required to conduct randomized studies after the introduction of their medication to demonstrate that it is truly effective and to discontinue marketing their treatment if the trial reveals that it is ineffective.

A different approach

However, the mechanism does not always function as planned. 

The businesses’ post-approval trials are frequently postponed for years. 

A medication may not be discontinued even if a test is negative; a review of fast-tracked cancer drugs in the United States revealed that one-third were still in use years after being shown not to work.

The FDA’s most recent scandal stemmed from its approval of Aduhelm to treat Alzheimer’s disease in June, despite the fact that its scientific advisory group recommended against it, resulting in resignations and an investigation.

How this would work in practice

The mere fact that the FDA is having these issues does not imply that NICE will follow suit. 

However, NICE’s consultation paper, which asks the public to comment on its recommendations, creates the impression that caution is unnecessary. 

According to the company’s website, the changes would provide patients “early access to vital new therapies.” 

Few individuals are expected to answer that they desire a delayed supply of medications, implying that the consultation is merely a public relations stunt.

Acceptance of less rigorous types of corroboration, such as non-randomized trials and “real-world evidence,” is another recommended reform. 

In practice, this entails hearing from persons with the appropriate medical condition about their experiences with the medicine or their desire to get it.

These testimonies are frequently organized by patient support organizations that get income from companies, and so may be prejudiced. 

According to a 2019 research, seven out of ten such organizations contributing to NICE assessments have recently gotten funding from the maker of the drug under consideration.

To conclude

NICE already has a difficult task balancing patient demands with National Health Service funds while avoiding offending big pharma. 

It now has political masters who want it to perform a new function: proving that Brexit was a success. 

Let us hope that this vital medical body is able to walk the tightrope effectively.