Time for clarity on RWD in Early Access Programs

Clinical data capture within Early Access Programs (aka Pre-approval Access, Compassionate Use Programs, Named Patient Supply etc.) has suddenly fallen under the spotlight, being discussed at many recent healthcare conferences. We’re pleased to see this development, having been focusing on real-world data capture in EAPs for several years.

The US is the most straight forward of all countries for collecting data within an Early Access Program (EAP), due to clear guidelines, requirement for a protocol and site contracting. However, the US is typically the smallest component of a global EAP and is usually the country where the EAP is open for the shortest duration and comprises the minority of patients on a global program. To gain meaningful data, especially for products for rare diseases, data capture beyond the US is often necessary.

In Europe, each country interpreted and enshrined the overarching EU EAP legislation differently, and data capture was generally not considered when these country-specific regulations were put in place. Data capture is therefore not commonly mentioned, and where it is referred to it is in vague terms, meaning that how to approach data capture (or even whether data capture is possible), is not clear. On top of the country-specific EAP regulations, each country’s data privacy regulations adds another layer of complexity.

However, even within these confines, it is possible to capture meaningful, clinical-level data from patients in EAPs in Europe. By EAPs, we mean a standalone program, not an OLE/PIIIb study, which are inefficient, cumbersome and expensive approaches to providing access to medicines ahead of licensing.

The best approach to RWD capture in an EAP is dictated principally by: the purpose/end use of the data to be captured, the disease landscape, and the number of patients required to provide meaningful data.

Key steps for Success:

  1. Where possible, use a participating physician as a ‘Principal Investigator’
  2. Ensure ethics approval (central or local) is gained where required
  3. Keep data points limited to what would be captured as part of routine treatment
  4. Utilize in-country CRAs to facilitate data capture and cleaning
  5. Ensure all honoraria are handled in line with Sunshine Act/EU equivalent requirements
  6. Agree with your vendor that you only pay for data once patient numbers have passed a pre-agreed threshold

Inceptua believes that there is a moral and ethical obligation to capture clinical level/outcomes/PRO data from patients participating in EAPs, for 2 main reasons:

  1. when allowing (in some cases) experimental medicines to be used outside the confines of a clinical trial it should be expected that you use that opportunity to find out if and how the medicine benefited the patient
  2. in rare diseases, where every patient is a valuable and critical source of data, it is imperative that those patients have the opportunity to contribute to the wider benefit of future patients

Inceptua is working with multiple stakeholders to seek to, at least, clarify the data capture practicalities within EAPs in Europe, and ideally to at some point harmonize or mandate RWD capture during EAPs. With the much greater focus on early patient access, EAPs are becoming more and more the norm in oncology and rare diseases, especially. Given the value in obtaining data from more patients sooner, any steps the regulators can make to facilitate this would be welcome.

Contact:

Stuart Bell
stuart.bell@inceptua.com
+44 73 8726 5293

Latest News and Insights

BIO

CEO and Board Member

Stefan Fraenkel

Stefan Fraenkel is the CEO of the Inceptua Group and is also on the Inceptua Board. He has extensive experience in the pharmaceutical industry. Before joining Inceptua, he held senior management positions at Sobi (Swedish Orphan Biovitrum), Sweden’s largest publicly listed specialty pharmaceutical company, leading Marketing & Sales and serving as Head of Corporate Development and Strategy.

Previously, Stefan worked at Pfizer and Wyeth in international commercial leadership roles across Europe and the USA, gaining deep insights into global pharmaceutical markets and strategies. Stefan has also spent part of his career in management consulting. Stefan holds a PhD in International Economics, an MBA, and a BSc in Engineering.

BIO

Member of the Board

Chris Hasslinger

Chris Hasslinger is a Partner of Vesey Street Capital Partners and serves as a member of the Firm’s Investment Committee. He joined VSCP in 2023 and is responsible for sourcing and evaluating new investment opportunities and general portfolio company management. Mr. Hasslinger has nearly three decades of experience in healthcare and technology strategy and deal-making within the industry as well as in investment banking and private equity. He has extensive M&A experience, having closed over $20 billion in transaction value, and has established and structured a number of large commercial partnerships.

BIO

Executive Vice Chairman

Alan Raffensperger

Alan Raffensperger has a robust leadership background in the pharmaceutical industry, having served as CEO of Inceptua and COO of Sobi (Swedish Orphan Biovitrum), along with significant international executive roles at Amgen, Roche, and Pharmacia.

He has also been CEO for venture capital-owned medical device companies, showcasing his versatility in healthcare leadership. Alan’s early career as an advanced life support paramedic provided a strong foundation in emergency healthcare.

He holds an MBA and a BA in Emergency Health Care Management.

BIO

Member of the Board

Blake Goodner

Blake Goodner is a founder member of the investment firm Bridger Capital. He previously worked as a healthcare analyst at Tiger Management and a healthcare investment banker at Morgan Stanley. He currently serves as an advisor and board member for a range of healthcare companies. Mr. Goodner has been a member of the Trinity College Board of Visitors and the Duke Annual Fund Executive Committee. He is a current advisory board member with The Duke Margolis-Center for Health Policy.

BIO

Member of the Board

Adam Feinstein

Adam Feinstein is the Managing Partner of Vesey Street Capital Partners. Mr. Feinstein has 30 years of investment experience exclusively in the healthcare services sector. Prior to founding Vesey Street Capital Partners in 2014, he was a Managing Director on Wall Street and a healthcare industry executive. He held the position of Senior Vice President of Corporate Development, Strategic Investments, and Office of the Chief Executive Officer at LabCorp. Before his tenure at LabCorp, he spent 14 years as the Managing Director in Equity Research at Lehman Brothers/Barclays Capital. Mr. Feinstein is the Chairman of VSCP’s investment committee. He is also actively involved in working with portfolio company executives and sourcing new investment opportunities. At the same time, he oversees all of the firm’s investment activities and employees.

BIO

Member of the Board

Larry Marsh

Larry is a General Partner of Vesey Street Capital Partners and serves as a member of the Firm’s Investment Committee. He joined VSCP in 2016, and currently sits on the Board of QualityMetric, Safecor Health, and HRGi. He is responsible for portfolio company management and for evaluating new investment opportunities. Prior to VSCP, Larry was EVP, New Market Development & Chief Strategy Officer at Fortune 10 AmerisourceBergen. Prior to that, Larry was the #1 ranked Healthcare Technology & Distribution analyst on Wall Street for over a decade, at Barclays, Lehman Brothers, Salomon Smith Barney, and Wheat First Butcher & Singer. Larry worked with Adam, Bryan, Dan, and Joe at Barclays and Lehman. Larry received a B.S. in Economics & Management as well as an M.B.A. from the University of Richmond, and an M.P.H. from Columbia University.

BIO

Member of the Board

Heyward Donigan

Heyward Donigan is a seasoned healthcare CEO, Board Member, and Private Equity Advisor with broad industry experience and a track record of profitable growth. From 2019 to 2023, Ms. Donigan served as Rite Aid’s president and chief executive officer, making her one of the few women CEOs of a Fortune 500 company. While at Rite Aid, Ms. Donigan led the company to through a major brand, merchandise and technology transformation, debt reduction/refinancing, while also leading the company through a pandemic. Ms.Donigan is currently a strategic advisor to Vesey Street Capital Partners, Arima Health, and a board member of OnMed.

BIO

Executive Chairman

Doug Cook

Doug Cook is the Executive Chairman at Inceptua. Mr. Cook began his career driving the early success of Livingston Healthcare, leading to the purchase by UPS to become what is today UPS’s Global Healthcare business. After Livingston Healthcare, Mr. Cook moved to AmerisourceBergen (now called Cencora/COR) in 1998 and had an impressive career overseeing most of Cencora’s high growth, manufacturer-facing business. Mr. Cook ultimately served as the Executive Vice President, President Commercialization and Animal Health for COR.

You are about to leave!

You are now leaving an Inceptua website. Links to external websites are provided as a resource to the viewer. This website is neither owned or controlled by Inceptua . Inceptua accepts no responsibility for the content or services of the linked site.

You are about to leave!

You are now leaving an Inceptua website. Links to external websites are provided as a resource to the viewer. This website is neither owned or controlled by Inceptua . Inceptua accepts no responsibility for the content or services of the linked site.

You are about to leave!

You are now leaving an Inceptua website. Links to external websites are provided as a resource to the viewer. This website is neither owned or controlled by Inceptua . Inceptua accepts no responsibility for the content or services of the linked site.

You are about to leave!

You are now leaving an Inceptua website. Links to external websites are provided as a resource to the viewer. This website is neither owned or controlled by Inceptua . Inceptua accepts no responsibility for the content or services of the linked site.

You are about to leave!

You are now leaving an Inceptua website. Links to external websites are provided as a resource to the viewer. This website is neither owned or controlled by Inceptua . Inceptua accepts no responsibility for the content or services of the linked site.

You are about to leave!

You are now leaving an Inceptua website. Links to external websites are provided as a resource to the viewer. This website is neither owned or controlled by Inceptua . Inceptua accepts no responsibility for the content or services of the linked site.

You are about to leave!

You are now leaving an Inceptua website. Links to external websites are provided as a resource to the viewer. This website is neither owned or controlled by Inceptua . Inceptua accepts no responsibility for the content or services of the linked site.

You are about to leave!

You are now leaving an Inceptua website. Links to external websites are provided as a resource to the viewer. This website is neither owned or controlled by Inceptua . Inceptua accepts no responsibility for the content or services of the linked site.

You are about to leave!

You are now leaving an Inceptua website. Links to external websites are provided as a resource to the viewer. This website is neither owned or controlled by Inceptua . Inceptua accepts no responsibility for the content or services of the linked site.

You are about to leave!

You are now leaving www.inceptuapharma.com to enter the Inceptua Group website: www.inceptua.com. Links to external websites are provided as a resource to the viewer, and the content is not controlled by Inceptua Pharma.

You are about to leave!

You are now leaving www.inceptuapharma.com to enter the Inceptua Group website: www.inceptua.com. Links to external websites are provided as a resource to the viewer, and the content is not controlled by Inceptua Pharma.

You are about to leave!

You are now leaving www.inceptuapharma.com to enter the Inceptua Group website: www.inceptua.com. Links to external websites are provided as a resource to the viewer, and the content is not controlled by Inceptua Pharma.

You are about to leave!

You are now leaving www.inceptuapharma.com to enter the Inceptua Group website: www.inceptua.com. Links to external websites are provided as a resource to the viewer, and the content is not controlled by Inceptua Pharma.

You are about to leave!

You are now leaving www.inceptuapharma.com to enter the Inceptua Group website: www.inceptua.com. Links to external websites are provided as a resource to the viewer, and the content is not controlled by Inceptua Pharma.

You are about to leave!

You are now leaving www.inceptuapharma.com to enter the Inceptua Group website: www.inceptua.com. Links to external websites are provided as a resource to the viewer, and the content is not controlled by Inceptua Pharma.

You are about to leave!

You are now leaving an Inceptua website. Links to external websites are provided as a resource to the viewer. This website is neither owned or controlled by Inceptua . Inceptua accepts no responsibility for the content or services of the linked site.