Every clinical trial is led by a principal investigator, who is usually a doctor, along with a team of nurses and others researchers. The FDA requires a multi-phase clinical trials process to be completed before deciding if the medicine under investigation is safe and effective for a broader patient population. Usually, the number of human volunteers in the trial increases as the treatment moves through these phases, which is why innovative medicines cannot be developed without the help of volunteers who participate in clinical trials.
Scientists at the FDA carefully review all the data from all of the studies on the drug under investigation and, after weighing the benefits and risks of the potential medicine, decide whether to grant approval. Occasionally, the FDA will ask for additional research before granting approval or even convene an independent expert panel to consider data presented by the FDA and the company. The panel will then advise the agency on whether to approve the application and under what conditions.
Developing a new medicine begins with understanding the disease or condition as thoroughly as possible. Basic research provides clues about how to treat diseases and potential ways to target the symptoms or underlying causes. Armed with an idea, researchers work to understand biological targets for a potential medicine. A “drug target” can be a protein, RNA, DNA or other molecule that is somehow involved in the disease. Researchers conduct studies in cells, tissues and animal models to determine whether the target can be influenced by a medicine. They then look for a lead compound — a promising molecule that could influence the target and, potentially, become a medicine. This is the first step in the discovery and development process, which spans from initial research to the delivery of life-saving or life-enhancing new medicine.
Increasing diverse enrollment in clinical trials is a critical step to improving access to medicine development and the biopharmaceutical industry has taken steps to enhance clinical trial diversity. The demographics of a clinical trial should, to the extent possible, reflect the intended treatment population. In addition to individual company efforts, PhRMA and its members voluntarily developed and adopted industry wide principles on clinical trial diversity. These principles, which took effect in April of 2021, focus on four main areas: building trust and acknowledging the historic mistrust of clinical trials within Black and Brown communities, reducing barriers to clinical trial access, using real-world data to enhance information on diverse populations beyond product approval and enhancing information about diversity and inclusion in clinical trial participation. Yet despite progress and the steps taken by the FDA and the biopharmaceutical industry, clinical trials do not always reflect the demographics of the intended treatment populations for many reasons.
Stakeholders must come together to address systemic barriers to participation if we are going to make further progress. Effective and meaningful engagement, education, and multi-stakeholder partnerships are critically important to address these barriers and build trust among communities that have been underrepresented.
Clinical trial data transparency aims to improve access to clinical trial research and results in order to inform medical decision-making, advance scientific discovery and accelerate the development of new treatments to benefit patients. The biopharmaceutical industry has long-established commitments to facilitate appropriate transparency throughout the lifecycle of a clinical trial including registration, results reporting, and data sharing, and the biopharmaceutical industry is at the forefront of initiatives to improve access to clinical trial data in order to advance medical research.
Updated May 2022