All pharmaceutical products have inherent risks, and their use involves trade-offs between their therapeutic benefits and their risks. However, the public has a limited understanding of the benefits and risks of drugs, and many individuals believe that drugs approved by the U.S. Food and Drug Administration (FDA) carry no risks. The FDA is responsible for evaluating and balancing the potential risks of drugs with their potential benefits. Assessing, managing, and communicating the benefit-risk profile of a pharmaceutical product is a complex and nuanced scientific, political, and sociological challenge. Once the assessment is made, the FDA is then responsible for managing how to communicate these risks and make healthcare decisions based on them. To explore these issues, the Forum on Drug Discovery, Development, and Translation conducted a public workshop entitled Understanding the Benefits and Risks of Pharmaceuticals, with the broad goals of gaining a better understanding of the current system used to evaluate benefit and risk, and to identify opportunities for improvement. This workshop was held in Washington, D.C., on May 30-31, 2006.The benefit-risk profiles of pharmaceuticals are constantly evolving as new data are collected throughout the life cycle of a drug. Discussions during the workshop focused on the following: (1) premarket assessment, during which clinical trial data are used to assess benefit and risk; (2) communication of that information to prescribing physicians and their patients; (3) healthcare decisions made by prescribing physicians and their patients; and (4) the accumulation of benefit-risk information from postmarketing experience, which feeds back into the other phases. Understanding the Benefits and Risks of Pharmaceuticals: Workshop Summary explains in detail the discussions during this workshop.
Forum on Drug Discovery, Development, and Translation, Leslie Pray, Rapporteur
1 Front Matter; 2 Summary; 3 1 Introduction; 4 2 Regulatory Assessment; 5 3 The Challenge of Communication; 6 4 The Importance of Context in Healthcare Decision Making; 7 5 Patient Experience with Drugs over Time; 8 6 Next Steps; 9 References; 10 Appendix A Workshop Agenda; 11 Appendix B Discussion Leader and Speaker Biographies
National Research Council, Division of Behavioral and Social Sciences and Education, Institute of Medicine, and Families Board on Children, Youth, Steve Olson
Institute of Medicine, Board on the Health of Select Populations, and Transgender Health Issues and Research Gaps and Opportunities Committee on Lesbian, Gay, Bisexual
Institute of Medicine, Board on Population Health and Public Health Practice, Division of Health Promotion and Disease Prevention, Division of International Health
Institute of Medicine, Committee to Develop Methods Useful to the Department of Veteran Affairs in Estimating Its Physician Requirements, Joseph Lipscomb
and Medicine National Academies of Sciences, Engineering, Health and Medicine Division, Board on Health Sciences Policy, Forum on Medical and Public Health Preparedness for Disasters and Emergencies, Scott Wollek, Benjamin Kahn, Leslie Pray
and Medicine National Academies of Sciences, Engineering, Health and Medicine Division, Board on Health Sciences Policy, and Translation Forum on Drug Discovery, Development, Carolyn Shore, Andrew March, Theresa Wizemann
Institute of Medicine, Board on Health Sciences Policy, Food and Nutrition Board, Planning Committee for a Workshop on Potential Health Hazards Associated with Consumption of Caffeine in Food and Dietary Supplements, Diana Pankevich, Ann L. Yaktine, Leslie Pray
and Medicine National Academies of Sciences, Engineering, Health and Medicine Division, Board on Health Sciences Policy, and Translation Forum on Drug Discovery, Development, Carolyn Shore, Eeshan Khandekar, Joe Alper
National Research Council, Institute of Medicine, Board on Health Care Services, National Cancer Policy Forum, Board on Health Sciences Policy, Roundtable on Translating Genomic-Based Research for Health, and Translation Forum on Drug Discovery, Development, Division on Earth and Life Studies, Board on Life Sciences, Policy and Global Affairs, and Law Committee on Science, Technology, Anne-Marie Mazza, Mary Fraker
and Medicine National Academies of Sciences, Engineering, Health and Medicine Division, Board on Health Sciences Policy, National Cancer Policy Forum, and Translation Forum on Drug Discovery, Development
Institute of Medicine, Board on Health Sciences Policy, and Translation Forum on Drug Discovery, Development, Forum on Neuroscience and Nervous System Disorders, Clare Stroud, Christopher DeFeo, Evelyn Strauss, Sheena M. Posey Norris
Institute of Medicine, Board on Health Sciences Policy, and Translation Forum on Drug Discovery, Development, Steve Olson, Rebecca A. English, Anne B. Claiborne