OnCo
ideasIdea

One international registry, not one per country, for conditional approvals

When a drug is approved early, each country often demands its own follow-up study. A single shared registry would answer the safety questions faster and better.

Post-authorisation safety and efficacy studies are imposed region by region, producing several small, slow registries for the same product. The proposal is for regulators participating in concurrent review to agree a single international registry protocol (core dataset, governance, open aggregate reporting) as the shared condition, hosted by an academic consortium with sponsor funding. National regulators receive the same interim analyses on the same schedule.

Hypothesis
A shared registry reaches the pre-specified sample size for its primary safety question at least twice as fast as the median regional post-authorisation study and results in fewer unmet post-marketing commitments.
Rationale
Rare adverse events and effectiveness in under-represented groups need numbers that no single region accrues quickly; pooling is the only way to answer them within the drug's useful life.
What would test it
Pilot with the next three concurrent conditional oncology approvals across FDA, EMA and MHRA, with one shared registry each, and compare time to primary analysis with each agency's prior post-authorisation studies.
Maturity
speculative
Who has to act
regulator
Cost to try
Medium ($1M to $50M)
Years to first evidence
4
Bottlenecks it attacks

Connected

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