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ir urriufi:J:;Isgfinnn'irnrr ru tfr:.1.:fifi alci'i'r srl
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ra fr'n nr : air ritg fi n r.ir r.: r u n r I n ru u r n n il : s r Yt s Yl'rI n n
6q fi o ua itd'lunr :ff or : rxr o r*#6tri'ur riu a o n ah n dr r.l
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lu:J:s tnelanig a rru3nr ra #n nr:64.r:J:vT usf
un;orrrutfiu{ uia benefits vs risk lJC'.lu'l Grufrnr:
u*4 Y A
uorJ:lJ$Rsnlnuo l'r lilnS]1tJ'tuu'lni.:rt:nrfi oil:cu'ltrr
AS il fitirum Federal Food, Drug and Cosmetic Act
19 3 8 (il.Fi. 24 I 1) tfl un g n ur uari-u rr:nfi rSrurirrar*o
1ri'f i ura n"'n gr uria r anr r ru rJ a a o n-s t a.: s r ri a u a a n eh4'a I
q nrn si o ilrt{i'fi nr:utitt n g n rur u tfi ru rG ru 6 o Kefauuer-
Harris Drug Amendments 1962 (il,er. 2SOS) d.:
rfta uotri'fi un n-n gr urio t o I ur dr u lil
ru n :J :s fr n Gn r r^r
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4 0 oi'r ur ft dr ruu o ao ulunuuai'r:J:gfl:J n?1 il d1 r5o rn g da?ilqn0:[nu?nu pharmacology, acute toxicity, phar-
,9_ & us & d f j
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iu au il61 ri'qh n rir ulu?ia rqa "r er fr "r il 1 : n n:r-ltei oi'.: u n o.: :J:cfr yrinril rn sn?1 il rilufi t*s o.: ur Io a dn :*r rfi sr n-u
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j"
nr:i o-rl In;il"sru1u'llu ri il:tn auoi'r uriur rt* lism, mechanism of action
j,
ua: pharmacology rfirurfirt
s q a
flnnytfl'tfiil n0 tfiom route and frequency of administration fitilmggil
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I$nal,[n 1 t:Jun'l:nuy{lj9t?u"ts.ltno?'tnn1T fr so
lq{
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Early Research Clinical tilals
,/Pteclinical
Testing Phasa 1 Phase 2 Phase 3 FDA Phase 4
Years 6.5 2.0 3.5 1.3 Additional
Test population Laboratory 20 to 80 100 to 300 1,000 to 3,000 Review Post-marketing
And animal healthy patient patient Process/ Testing
Studies volunteers volunteers volunteers appr0val radttiratl
By FDA
Purpose Assess safety Determine Evaluate Confirm
And biological Safety and Effectiveness, Eflectiveness,
activity dosage Look for side Monitor adverse
Effects Reactions kom
Long-term use
Success rate 5,000 5 enter trials 1 approved
compounds
Timeline 0 Years 6.5 Years 8.0 Years 10.0 Years 13.5 Years 15.0 Years
grJid r rfi,roounr:ii'rr$ncfrarrrrsr'lnilor.r*ioiiuaariGt#rirurirE lilyiaonalo
fillr : Gilbertsom EW, Francesco AS. Clinical development, regutations, and trends for OTC drugs. In : Guarino
AR, editor. New drug approval process. 3'd ed. New York : Marcel Dei<ker; 2000. p. 384
nltg!_ilnu_13
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phase'l rfl unr:rirurrurdnsrlunurfl un:"tu:n Yl.1 fi O R1 u 1 : n Ut [:.J U 1.[fi1 lJ 0 q A fi U? U.l',] 1{fi ? U €l tJ U1
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orflraru-er:srnrludrJ:vruril 2o-80 nu (nioarofi r g
A
gl1T1tl'l 1 Phases of clinical investigation
Phase Number of Patients Lenglh Purpose Percent of drugs
Successfully tested'
1 20-200 Several month Mainly safety 70 o/o
2 Up to several hundred Several months Some short-term 33 o/o
To 2 years safety, dosage and effectiveness
3 Several hundred to 1 to 4 years Safety, dosage, effectiveness 25-30 oh
several thousand
fir:t : Troetel MW. The investigational new drug application and the investigaor's brochure. In: Guarino
AR, editor. New drug approval process. 3'o ed. New York : Marcel Dekker; 2OOO. p.59
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benef it vs risk riJ un d'n nr:air ri'E filflun1:tAorrill
Guidance for Industry "Premarketing Risk Assessment" a^qe & . o &q
ea)-. 0 uil n lil u1uuo't lt1.{1 u 0 an flfl a{ a n1a :'] ilfl .: [un1:
a:Iu16ounqr*R'rnil 2547 rfi orfluuurnr.:1unr: 9T
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rfi oil:clusfal flo $REaon?1 il rfi u.:so.J pirh u us FDA 16Y
Itg
oanil*n1fl "A Guide to Managing the Benefits and Risks
of Medicines" oriu16ouriuuluu 2545 rijuuurnr.:
fA%c u 8e q d
ufl u9r fl"t14TUru tTU"t lUtT0.te.: n n1?
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