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域外国家窄治疗指数药品的仿制药替代政策及其对我国的启示

Foreign generic drug substitution policies for narrow therapeutic index drugs and their implications for China
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摘要 为了保障窄治疗指数(narrow therapeutic index,NTI)药品仿制药替代的安全有效性,完善与优化我国的仿制药替代政策,通过检索国外文献数据库以及政府网站,梳理域外国家保障NTI药品仿制药替代安全有效性的代表性举措,涉及药物研发注册、仿制药临床替代和上市后监测等环节,在对比分析的基础上总结我国可以借鉴参考的做法。研究发现我国在NTI药品仿制药替代方面存在NTI药品的生物等效性研究对象不明确、NTI药品的仿制药替代决策依据合理性有待提升和上市后监测系统不完善等问题和挑战。建议制定NTI药品清单、充分发挥医师和药师在仿制药替代中的作用、依据用药风险高低调整NTI药品仿制药替代和完善仿制药替代不良反应事件报告系统等建议。 In order to ensure the safety and efficacy of generic drugs for the substitution of narrow therapeutic index(NTI)drugs,and to improve and optimize China's generic drug substitution policy,we searched foreign literature databases and government websites to collect and sort out the typical measures taken by some foreign countries to ensure the safety and efficacy of generic drugs for the substitution of NTI drugs,including R&D registration,generic drug substitution and post-market surveillance.On the basis of comparative analysis,this paper summarizes the practices China can learn from.It can be seen that there are problems and challenges in China's generic drug substitution for NTI drugs,such as unclear targets for bioequivalence studies of NTI drugs,insufficient rational decision-making basis for generic substitution of NTI drugs,and imperfect post-market surveillance system,etc.It is recommended that we should formulate a list of NTI drugs,play the roles of physicians and pharmacists in generic drug substitution,adjust the generic drug substitution for NTI drugs according to the level of risk of drug use,and improve the reporting system for adverse reactions due to generic drug substitution.
作者 刘敬峰 左臣伟 史扬帆 颜建周 LIU Jingfeng;ZUO Chenwei;SHI Yangfan;YAN Jianzhou(The Research Center of National Drug Policy&Ecosystem,China Pharmaceutical University,Nanjing 211198,China)
出处 《中国药科大学学报》 CAS CSCD 北大核心 2024年第4期565-572,共8页 Journal of China Pharmaceutical University
基金 教育部人文社会科学研究规划基金项目(No.22YJAZH126)。
关键词 窄治疗指数药品 仿制药替代 安全有效性 典型举措 narrow therapeutic index drugs generic drug substitution safety and efficacy typical measures
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