FDA approval does not mean that a drug works well; it means only that the Agency deemed its benefits to outweigh its harms. Comparative efficacy data, other than to placebo, may be missing from the label. In 2006, the FDA revised the drug label design, adding a “highlights” section to emphasize the drug’s indications and warnings. It also issued guidance about reporting trial results in the label and emphasized the importance of effectiveness data. Yet some recent label updates (e.g., for Lunesta and Rozerem) are substantively unchanged. Use of “Prescription Drug Facts Boxes,” featuring a data table of benefits and toxicities has been proposed. Recently, the FDA’s Risk Advisory Committee recommended that the FDA adopt these boxes as the standard for their communications. FDA leadership is deciding whether and how to use the boxes in reviews, labels, or both. Also proposed is the generation of a standardized executive summary of FDA drug reviews. These summaries should include data tables of the main results of the phase 3 trials, highlight reviewers’ uncertainties, and note whether drug approval was conditional upon a post-approval study. While publication of new comparative-effectiveness results is helpful, publications generally occur post approval. In contrast, much is known about drug effectiveness and drug safety at approval that could better guide physician and patient choice if this information was more widely disseminated.
Source: New England Journal of Medicine