The European Network of Centres of Pharmacoepidemiology & Pharmacovigilance (ENCePP)

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The European Network of Centres of Pharmacoepidemiology & Pharmacovigilance (ENCePP) & The Code of Conduct Presented by: Dr Stella Blackburn EMA Risk Management Development and Scientific Lead An agency of the European Union

Disclaimer The views expressed are those of the speaker and may not necessarily be the official view of the Agency 2

Why we need ENCePP (or why we need to do more post-authorisation research)? What is ENCePP? The Code of Conduct 3

Public expectations We want drugs to be as safe as possible Knowledge about drug We need access to new medicines as soon as possible Time 4

5

6

Building a better system 7

Why Europe? 27 Member States 495 million people Heterogenous population Different health care systems Orphan diseases may need whole of EU to get study population!? Different target population to RoW 8

Increasing need for studies PASS Efficacy PASS Real world Drug utilisation Effectiveness Risk Min Efficacy PASS PASS Clin trials 9

Analysis of needs Ability to do pro-active Pharmacovigilance Pharmacovigilance Ability to do high quality Pharmacoepidemiology studies Pharmacoepidemiology Increase research capacity and awareness Ability to do studies in different EU countries Ability to do multicentre studies across Europe Centres European Network 10

11 What is ENCePP? An EMA-led project bringing together expertise in the fields of PhEpi and PhV scattered across Europe The Aim Strengthen further the post-authorisation monitoring of medicinal products in Europe facilitate post authorisation studies: high quality Independent multi-centre

ENCePP Expertise 2011 85 partner organisations From 18 EEA countries 13 Networks 12

Perception of scientific research 13

Perception of Sponsored research Study Results 14

ENCePP study To reinforce confidence of: Public Other researchers Regulators that research done under the ENCePP seal is as far as possible free from biases and commercial, financial and personal influences. 15

Development of principles Secretariat (EMA) Support Advice WG Research Standard & practice Outputs Checklist of Methodological Standards Result Steering Group Governance WG Transparency & Independence WG Data Sources & Multi-source studies Code of Conduct Resources database EU Research Institutions & Networks Expertise WG Inventory of EU research centres Task forces: e-register of studies Access to data 16 Non interventional studies

Requirements for ENCePP study Lead Investigator from ENCePP Database of resources + ENCePP Code of Conduct signed declaration and checklist Methodological standards for ENCePP study protocols signed checklist Prior registration in e- Database of studies 17

The Code Of Conduct 18

The Code of Conduct - Rationale There is a need to have clarity of roles and responsibilities in studies. Transparency on roles and responsibilities and on the details of the design and the conduct of studies is a cornerstone in building trust and confidence. It is recognised that there are areas in PhEpi and PhV research which would benefit from a higher level of openness, communication and accountability. 19

Code of Conduct History May 2009: First draft prepared by Working Group Transparency & Independence (chair: Helen Dolk). Sept - Nov 2009: Consultation of ENCePP partnership; Adoption of revised draft by ENCIAG. Nov 2009 Jan 2010: Public Consultation. Jan 2010 April 2010: Review and implementation of comments. May 2010: Adoption by Steering Group. 20 Sept 2010: 1st revision

Objectives of the Code of Conduct Best practice in the relationship between investigators and study funders + Transparency throughout research process Scientific independence of study 21

Main provisions of Code Primary purpose scientific not promotional Study not designed to achieve a particular result Contract covering: interaction, remuneration, protocol agreement, analysis of results, publication of results Results published or made available Information 22 on research process made available

ENCePP Code of Conduct for Studies Checklist for ENCePP Studies 23 1. General: study designed in adherence to the CoC and max levels of transparency 2. Research contract: mention of CoC in the contract/financial agreement between funder and investigators 3. Registration of studies: in e-register of studies 4. Study protocol: latest version uploaded in the e-register, all changes need to be documented, detailed statistical analysis plan available, contribution of individuals 5. Data ownership and access to data: system in place to record data and provision to make them available when final study report available 6. Declaration of interests: collected and publically available. Once protocol finalised, exclusion from any activity that could influence results or interpretation 7. Study Steering Group: no conflict of interests, composition publicly available 8. Publication/Reporting of studies: regardless of positive/negative findings 9. Confidential information: data generated in study are not confidential!

TRANSPARENCY: Study registration & availability of protocol Registration in publicly accessible register prior to study start (ENCePP Studies ENCePP Register of Studies). Publication of the study protocol after final study report: 2 versions - Initial version at study start & final version. Documentation of relevant steps in study & changes to the protocol. Update of entry in register, as appropriate, incl. changes to the protocol that may affect the interpretation of the study. 24

TRANSPARENCY: Study results Always publish results! a summary of the main results, whether positive or negative and including results from pre-maturely terminated studies, ENCePP studies: abstract of the findings within 3 months after final report, A full report of results with a scientific or public health impact. Report changes to the protocol during the course of the study that may affect its interpretation Make available reports and/or comments from reviewers (upon request). Make available comments from the funder (publicly). 25

TRANSPARENCY: Affiliations and interests Make publicly available: Identity, affiliations and potential conflicts of interest of investigators in advance and when publishing. Information on all parties involved in writing and adoption of the protocol incl a brief description of their contribution. Composition of Steering Group. Other Make available on request: 26 Reports from reviewers, data set used for analysis, research contract (actual figures may be redacted).

Declaration of Interests Who? All parties involved in the conduct of the study Steering Group members (if applicable) What? Direct or indirect interests of a commercial, financial or personal nature that might impact the impartiality in relation to the study. 27

Roles of investigator & funder 1. Registration of study & application for ENCePP Study Seal. 2. Final responsibility for study protocol. Investigator Funder 1. Requirement to follow the Code laid down in research contract. 2. Can be involved in design of protocol. 4. Has intellectual contribution/ ownership of data. 28 3. Ultimately responsible for the study. 5. Right to independently publish study results. Research contract 5. Right to review publications before submission & require deletion of confidential information. 3. Will be informed about study progress; may be observer in Study Steering Group. 4. In principle, joint ownership of data recommended.

Thank you 29 Also thanks to Stefanie Prilla