PURPOSE: This nationwide study is aimed at describing to what extent the European Paediatric Regulation has met therapeutic needs in children. METHODS: Data for each drug substance in defined daily doses (DDD) were extracted from the national Danish data base. We evaluated if drug substances were used off-label and whether they had a paediatric investigation plan (PIP). This study did not include drug prescriptions for individual paediatric patients; thus, it was not possible to make use of all off-label categories previously used. Additionally, paediatric standard assortments (SA) were compared to the European survey on paediatric medicinal products. RESULTS: Thirteen percent of the 100 most used drug substances were determined as being used off-label, four of which had a PIP and one had a full waiver. Only one of the three drug substances used off-label most often, accounting for 85 % of such use, had a PIP. Neonates were included in one-third of PIPs and adolescents in 15. Nineteen out of 21 PIPs had a waiver and 14 PIPs were deferred. In line with the European survey, carbapenems, corticosteroids and proton pump inhibitors were frequent found in SAs. CONCLUSION: PIPs only cover a small proportion of the drugs found to be used off-label in this study. Despite waivers granted, drug substances were used nonetheless. Unmet regulatory needs are still considerable in some therapeutic areas in neonates as well as in children.
PURPOSE: This nationwide study is aimed at describing to what extent the European Paediatric Regulation has met therapeutic needs in children. METHODS: Data for each drug substance in defined daily doses (DDD) were extracted from the national Danish data base. We evaluated if drug substances were used off-label and whether they had a paediatric investigation plan (PIP). This study did not include drug prescriptions for individual paediatric patients; thus, it was not possible to make use of all off-label categories previously used. Additionally, paediatric standard assortments (SA) were compared to the European survey on paediatric medicinal products. RESULTS: Thirteen percent of the 100 most used drug substances were determined as being used off-label, four of which had a PIP and one had a full waiver. Only one of the three drug substances used off-label most often, accounting for 85 % of such use, had a PIP. Neonates were included in one-third of PIPs and adolescents in 15. Nineteen out of 21 PIPs had a waiver and 14 PIPs were deferred. In line with the European survey, carbapenems, corticosteroids and proton pump inhibitors were frequent found in SAs. CONCLUSION:PIPs only cover a small proportion of the drugs found to be used off-label in this study. Despite waivers granted, drug substances were used nonetheless. Unmet regulatory needs are still considerable in some therapeutic areas in neonates as well as in children.
Authors: P C Nathan; G Tomlinson; L L Dupuis; M L Greenberg; S Ota; U Bartels; B M Feldman Journal: Support Care Cancer Date: 2005-07-29 Impact factor: 3.603
Authors: Anna Girardi; Emanuel Raschi; Silvia Galletti; Elisabetta Poluzzi; Giacomo Faldella; Karel Allegaert; Fabrizio De Ponti Journal: Drug Saf Date: 2015-06 Impact factor: 5.606
Authors: Eric Vermeulen; John N van den Anker; Oscar Della Pasqua; Kalle Hoppu; Johanna H van der Lee Journal: J Pharm Pharmacol Date: 2016-09-27 Impact factor: 3.765