The pharmaceutical industry is witnessing a transformative shift in how real-world evidence (RWE) influences drug development and regulatory decisions. 2019 emerged as a landmark year, featuring unprecedented regulatory approvals and collaborative initiatives that signal a new era in clinical research.
Breakthrough in Regulatory Acceptance
In a groundbreaking development, Pfizer secured FDA approval for a supplemental New Drug Application (sNDA) expanding Ibrance's (palbociclib) breast cancer indication to include male patients. While the primary efficacy determination came from the PALOMA 2 and 3 randomized clinical trials, the approval notably incorporated real-world evidence from electronic health records, insurance claims, and safety databases.
"We are encouraged by the FDA approval... supported by RWE derived from analysis of data in electronic health records, insurance claims and Pfizer's global safety database," stated Christopher Boone, Vice President at Pfizer, highlighting the significance of this regulatory milestone.
Cross-Industry Collaboration Advances RWE Validation
The Friends of Cancer Research study emerged as a pivotal initiative, bringing together 11 competing organizations in a "Frenemy" collaboration to examine real-world endpoints in lung cancer. The study demonstrated remarkable consistency between real-world endpoints across different data sets and traditional randomized clinical trial outcomes.
Tanvi Shah, Director of Alliance Management at Bristol-Myers Squibb, noted, "In 2019, we witnessed exponential growth in the level of interest in RWE and a genuine desire to understand its benefits across industry, regulatory bodies, and provider organisations."
Challenges and Future Directions
Despite significant progress, the industry faces several challenges. The FDA's guidance on real-world data usage in comparator cohorts remains vague, leading to inconsistent interpretations among stakeholders. Additionally, data quality, standardization, and accessibility continue to present hurdles.
Looking ahead, experts project a 30-50% increase in regulatory decisions incorporating RWE in 2020. This growth will primarily stem from single-arm trials utilizing real-world data as comparator cohorts. The industry is also witnessing a shift in organizational capabilities, with companies developing more sophisticated approaches to data collection and analysis.
Impact on Precision Medicine
As precision medicine advances, pharmaceutical companies increasingly focus on developing therapies for specific biological profiles. This trend creates new challenges in finding appropriate real-world data cohorts that match stringent trial criteria. Industry leaders are actively working to address these challenges through innovative data modeling and partnership approaches.
The evolution of RWE represents a critical turning point in drug development, promising to accelerate patient access to effective treatments while maintaining rigorous scientific standards. As one industry expert noted, "We are closing in on the most important milestone in the use of RWE, where the impact of this work will be experienced by patients."