Orphan drug approvals of 2015: Europe and the United States

Rare Diseases: Joining Mainstream Research and Treatment Based on Reliable Epidemiological Data

Despite growing acceptance of patient registries and natural history studies to provide useful information, the rare disease community suffers from the absence of reliable epidemiological data on the prevalence and incidence of most rare diseases in national and global populations. Likewise, the patients and health care providers lack adequate information on the pathophysiology of rare diseases and expected outcomes of these disorders. The rare diseases community includes all of the stakeholders involved in the research and development and dissemination of products and information for the diagnosis, prevention or treatment of rare diseases or conditions. To replace many of the perceptions with realities, several global efforts have been implemented to sustain and increase the reported progress with the thousands of rare diseases. The first efforts is to develop a global research infrastructure of qualified investigators to stimulate and coordinate research efforts by seeking ways to provide access to clinical trials at multi-national research sites with common protocols and multi-disciplinary research teams. Next, is the continued identification and expansion of worldwide partnerships and collaborations of Patient Advocacy Groups (PAGs), research investigators, the biopharmaceutical and medical devices industries, and the government research and regulatory agencies for a specific rare disease or group of related diseases. Gaining access to information about rare diseases, patient advocacy groups, ongoing and planned research studies and products in research protocols continue to improve the lives of patients and their families. Many basic, clinical and translational research investigators, public and private sector funding organizations, patient advocacy groups, foundations, and the pharmaceutical, biotechnology, and medical devices industries are committed to translating research discoveries that will be useful in the treatment and care of patients with rare diseases over their lifespan. Evidence from well-constructed epidemiological studies will provide the evidence that point to the value of additional clinical studies to increase the understanding of rare diseases.

[Orphan drugs : New opportunities for the treatment of rare diseases]

Not only in Europe and USA, but also in many other countries rare disorders-so-called orphan diseases-have attracted more and more attention. The formation of specialized centers for rare disorders has enabled the diagnosis of diseases that have been widely unknown before. In addition, pharmaceutical companies have recognized orphan diseases as a profitable source of revenue. The development and marketing of new drugs for rare diseases-so-called orphan diseases-means a great challenge for all who participate in the health care system: Because the number of patients who are available for a clinical study is mostly very small, it is often very difficult or even impossible to show statistically firm evidence of efficacy. The standard placebo-controlled, double-blind clinical trial is often inappropriate for the approval procedure of an orphan drug; thus other study designs or other parameters (e.g. biomarkers) have to be used to prove clinical efficacy of the study drug. Only relatively small amounts of drugs can be sold to the generally few patients affected by an orphan disease and clinical trials require an high amount of financial investment; therefore orphan drugs have in general extremely high prices. How long these high expenses can be borne by the health care system in view of the great number of rare diseases remains questionable.