Affiliations: The University of Arizona College of Pharmacy, Tucson,
AZ, USA
Note: [] Corresponding address: College of Pharmacy, University of
Arizona, Pharmacy-Pulido Center, P.O. Box 210202, Tucson, AZ 85721-0202, USA.
Tel.: +1 443 509 8299; E-mail: [email protected]
Abstract: This paper explores the US context of the opportunities and
challenges of collecting and using patient-reported outcomes (PROs) in the
post-approval environment. Firstly, an overarching goal of real-world
comparisons of therapies based on their benefits and harms is borne in mind
whilst placing PROs in the landscape of comparative effectiveness research.
Secondly, a review of opportunities and challenges relating to the collection
and use of real-world patient-reported outcome (PRO) data in clinical and
community settings is presented, highlighting patient monitoring such as in
post-marketing/post-approval (phase IV) studies, through formulary management
and reimbursement systems, and the utilization of available technologies. The
paper ends with a summary of policy considerations in optimizing these
opportunities and addressing the related challenges. Throughout this paper, the
use of the term `pre-approval environment' is intended to refer to the time and
efforts preceding the regulatory approval of a pharmaceutical product, and
'post-approval environment' on the other hand refers to the time and efforts
proceeding the attainment of product approval and the respective labeling
claims. 'Real-world' is intended to refer to settings other than clinical
trials (i.e., clinical practice and community settings, and similar patient
monitoring programs).