Innovation in Clinical Trial Design and Product Promotion: Evolving the Patient Perspective With Regulatory and Technological Advances

Practices and trends in clinical trial registration in the Pan African Clinical Trials Registry (PACTR): a descriptive analysis of registration data

BACKGROUND

The Pan African Clinical Trials Registry (PACTR) is a WHO International Clinical Trials Registry Platform primary register, which caters for clinical trials conducted in Africa. PACTR is the first and, at present, the only member of the Network of WHO Primary Registers in Africa. The aim is to describe and report on the trends of trial records registered in PACTR.

METHODS

PACTR was established in 2007 as the AIDS, Tuberculosis, and Malaria Clinical Trials Registry. The scope of the registry was then expanded in 2009 to include all diseases. This is a cross-sectional study of trials registered in PACTR from inception to 18 August 2021. A descriptive analysis of the use and trends of the following data fields: study intervention, disease condition, sex of the participants, sample size, ethics, funding and availability of results was conducted using Microsoft Excel.

RESULTS

The number of trials registered has increased year on year, reaching 606 trials registered in 2020. The total number of trials registered at the time of the analysis was 2998. More than half of the trials in the registry (1655 of 2998, ie, 55%) were prospectively registered. Ethical approval was received by 90% (2691 of 2998) of the registered trials. Factorial assignment as an intervention model was in 20% (589 of 2998) of the trials registered. There were 36% (1083 of 2998) completed trials, of which 3% (94 of 1083) had results available in the registry. The most dominant funding source indicated was self-funding in 23% (693 of 2998) of the registered trials, and 55% (1639 of 2998) had no funding.

CONCLUSION

Registration on PACTR continues to grow; however, our analysis shows that researchers' capacity-building is needed to understand the importance of the registry and how this information informs healthcare decisions. Promoting prospective trial registration remains critical to avoid selective reporting bias to inform research gaps.

Key Steps Toward a Promotional Communications Strategy: Collaboration Best Practices for Teams Creating Promotional Materials and Regulatory Colleagues

A promotional communications strategy is considered early in prescription medical product development by commercial disciplines (e.g., commercial/marketing) and informs promotional materials to key stakeholders such as healthcare providers and patients. Health economics and outcomes research (HEOR) is a scientific discipline that is also responsible for the generation of promotional materials to other key stakeholders such as payors. The overarching promotional strategy benefits from consistent partnerships with regulatory affairs colleagues, culminating in cost savings and patient-centric promotional materials. Yet there is a paucity of published content that details effective collaboration between promotional teams and regulatory colleagues prior to medical/legal/regulatory (MLR) review. The following review aims to showcase such organizational innovation from the perspective of teams developing promotional materials (i.e., commercial and HEOR). Behind-the-scenes marketing activities are described in relation to the following key steps that build the strategy's foundation: insight gathering from key stakeholders; sub-strategy development; tactic identification; and promotional message development. Integration of regulatory colleagues with teams developing promotional materials is imperative to accomplish these key steps prior to any MLR review. Finally, four themes in best practices for collaboration with regulatory colleagues are shared from the perspective of commercial disciplines and HEOR, alongside a real-world example for each: (1) Alignment of Strategies; (2) Shared Process & Tools; (3) Creative Problem-Solving; and (4) Culture of Connecting.