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Martinsen DS, Schrama R. Networked Health Care Governance in the European Union. J Health Polit Policy Law 2021; 46:93-116. [PMID: 33085962 DOI: 10.1215/03616878-8706627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The European Union (EU) increasingly resorts to new forms of governance to establish unified health and welfare policies without member states having to transfer their sovereignty to a supranational level. European Administrative Networks are important instruments in the toolbox of new forms of governance, dealing with rulemaking, rule monitoring, and rule enforcement. Operating beyond, but not above, the state, European networks of national administrative units allow for interaction and exchange to coordinate national responses to increased interaction across their borders. The authors use social network analysis to uncover the pattern of interaction among national representatives in two central EU health care networks. Their analysis finds not only that the network in the area of pharmacovigilance has more competences, resources, and capacity to improve the enforcement of EU rules than the network regarding cross-border health care but also that the driving forces behind network interaction appear to differ quite a bit as well. While the supranational character becomes apparent in the former network, network interactions in the latter seem aimed at mitigating the impact of patient mobility rather than improving cross-border health care take up.
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Mendes D, Rigueiro G, Silva RS, Penedones A, Alves C, Sousa G, Batel-Marques F. Intensive safety monitoring program of antineoplastic medicines: A pilot study in a Portuguese oncology hospital. J Oncol Pharm Pract 2019; 26:133-140. [PMID: 31117914 DOI: 10.1177/1078155219849277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE The aim of this study was to test the feasibility and the usefulness of an intensive safety monitoring program to identify adverse drug reactions for medicines under additional monitoring that are used to treat cancer patients within a Portuguese oncology hospital. METHODS This pilot intensive safety monitoring program was a three-month prospective, observational study. Patients undergoing treatment with one of the following medicines were included: nivolumab, olaparib, palbociclib, pembrolizumab, pertuzumab, ramucirumab, ribociclib, trastuzumab emtansine, or trifluridine/tipiracil. Potential eligible patients were identified by pharmacists based on prescription data. Clinicians used proper paper-based reporting forms to record adverse drug reactions. Clinical secretariats sent those reports through an electronic platform to the pharmacovigilance department for analysis. RESULTS Seventy-five patients were on treatment with selected medicines. Of those, 33 (44%) experienced adverse drug reactions: 23 (69.7%) cases were serious and 5 (15.2%) unexpected. Considering the number of patients exposed to each medicine and the number of patients experiencing adverse drug reactions, trifluridine/tipiracil (72.7%; 8/11) was associated with the highest rate of toxicity, followed by olaparib (66.7%; 2/3), trastuzumab emtansine (50.0%; 3/6), pertuzumab (47.8%; 11/23), pembrolizumab (45.5%; 5/11), palbociclib (25.0%; 1/4), and nivolumab (18.8%; 3/16). A total of 59 adverse drug reactions were identified (i.e. 1.8 adverse drug reactions/patient), mainly gastrointestinal disorders (n = 15; 25.4%), and blood and lymphatic system disorders (n = 14; 23.7%). CONCLUSION This intensive safety monitoring program was feasible and allowed identifying serious and unexpected adverse drug reactions, adding value to pharmacovigilance and therefore contributing to improve patient safety. Further research is needed to confirm the findings of this pilot study.
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Affiliation(s)
- Diogo Mendes
- DruSER.Net - Drug Safety and Effectiveness Research Network, Coimbra, Portugal.,AIBILI - Association for Innovation and Biomedical Research on Light and Image, CHAD - Centre for Health Technology Assessment and Drug Research, Coimbra Regional Pharmacovigilance Unit (UFC), Coimbra, Portugal
| | - Graça Rigueiro
- DruSER.Net - Drug Safety and Effectiveness Research Network, Coimbra, Portugal.,IPO-C - Instituto Português Oncologia de Coimbra Francisco Gentil, E. P. E., Coimbra, Portugal
| | - Rui S Silva
- DruSER.Net - Drug Safety and Effectiveness Research Network, Coimbra, Portugal.,IPO-C - Instituto Português Oncologia de Coimbra Francisco Gentil, E. P. E., Coimbra, Portugal
| | - Ana Penedones
- DruSER.Net - Drug Safety and Effectiveness Research Network, Coimbra, Portugal.,AIBILI - Association for Innovation and Biomedical Research on Light and Image, CHAD - Centre for Health Technology Assessment and Drug Research, Coimbra Regional Pharmacovigilance Unit (UFC), Coimbra, Portugal.,Laboratory of Social Pharmacy and Public Health, School of Pharmacy, University of Coimbra, Coimbra, Portugal
| | - Carlos Alves
- DruSER.Net - Drug Safety and Effectiveness Research Network, Coimbra, Portugal.,AIBILI - Association for Innovation and Biomedical Research on Light and Image, CHAD - Centre for Health Technology Assessment and Drug Research, Coimbra Regional Pharmacovigilance Unit (UFC), Coimbra, Portugal.,Laboratory of Social Pharmacy and Public Health, School of Pharmacy, University of Coimbra, Coimbra, Portugal
| | - Gabriela Sousa
- DruSER.Net - Drug Safety and Effectiveness Research Network, Coimbra, Portugal.,IPO-C - Instituto Português Oncologia de Coimbra Francisco Gentil, E. P. E., Coimbra, Portugal
| | - Francisco Batel-Marques
- DruSER.Net - Drug Safety and Effectiveness Research Network, Coimbra, Portugal.,AIBILI - Association for Innovation and Biomedical Research on Light and Image, CHAD - Centre for Health Technology Assessment and Drug Research, Coimbra Regional Pharmacovigilance Unit (UFC), Coimbra, Portugal.,Laboratory of Social Pharmacy and Public Health, School of Pharmacy, University of Coimbra, Coimbra, Portugal
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Borg JJ, Tanti A, Kouvelas D, Lungu C, Pirozynski M, Serracino-Inglott A, Aislaitner G. European Union pharmacovigilance capabilities: potential for the new legislation. Ther Adv Drug Saf 2015; 6:120-40. [PMID: 26301067 DOI: 10.1177/2042098615591802] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
European Directives and Regulations introduced between late 2010 and 2012 have substantially overhauled pharmacovigilance processes across the European Union (EU). In this review, the implementation of the pharmacovigilance legislative framework by EU regulators is examined with the aim of mapping Directive 2010/84/EU and Regulation EC No. 1235/2010 against their aspired objectives of strengthening and rationalizing pharmacovigilance in the EU. A comprehensive review of the current state of affairs of the progress made by EU regulators is presented in this paper. Our review shows that intense efforts by regulators and industry to fulfil legislative obligations have resulted in major positive shifts in pharmacovigilance. Harmonized decision making, transparency in decision processes with patient involvement, information accessibility to the public, patient adverse drug reaction reporting, efforts in communication and enhanced cooperation between member states to maximize resource utilization and minimize duplication of efforts are observed.
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Affiliation(s)
- John Joseph Borg
- Medicines Authority, 203 Level 3, Rue D'Argens, Gzira, GZR 1368, Malta
| | | | - Dimitrios Kouvelas
- School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Michal Pirozynski
- Department of Anaesthesiology and Critical Care Medicine, Postgraduate Medical School, Warsaw, Poland
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