Utility of registries for post-marketing evaluation of medicines. A survey of Swedish health care quality registries from a regulatory perspective

Abstract

Aim: The aim of this study was to describe content and procedures in some selected Swedish health care quality registries (QRs) of relevance to regulatory decision-making.

Methods: A workshop was organized with participation of seven Swedish QRs which subsequently answered a questionnaire regarding registry content on drug treatments and outcomes. Patient populations, coverage, data handling and quality control, as well as legal and ethical aspects are presented. Scientific publications from the QRs are used as a complementary measure of quality and scientific relevance.

Results: The registries under study collect clinical data of high relevance to regulatory and health technology agencies. Five out of seven registries provide information on the drug of interest. When applying external quality criteria, we found a high degree of fulfillment, although information on medication was not sufficient to answer all questions of regulatory interest. A notable strength is the option for linkage to the Prescribed Drug Registry and to information on education and socioeconomic status. Data on drugs used during hospitalization were also collected to some extent. Outcome measures collected resemble those used in relevant clinical trials. All registries collected patient-reported outcome measures. The number of publications from the registries was substantial, with studies of appropriate design, including randomized registry trials.

Conclusions: Quality registries may provide a valuable source of post-marketing data on drug effectiveness, safety, and cost-effectiveness. Closer collaboration between registries and regulators to improve quality and usefulness of registry data could benefit both regulatory utility and value for health care providers.

Key words:

• Drug regulation
• health technology assessment
• medical devices
• pharmacoepidemiology
• quality registries
• real world data

Acknowledgements

The contributions with essential information by the registry representatives of SWEDEHEART (Thomas Jernberg, Stefan James), Swedish Rheumatology Quality Registry (Sofia Ernestam, Johan Askling), MS Registry (Jan Hillert), National Prostate Cancer Registry (Pär Stattin), National Diabetes Registry (Ann-Marie Svensson, Soffia Gudbjörnsdottir), Riksstroke (Eva-Lotta Glader), and Eye-Net (Susanne Albrecht) are highly appreciated.

Disclosure statement

The authors declare no conflict of interest. The views presented in this paper are those of the authors and are not necessarily representative of the MPA.

Additional information

Funding

The study was entirely funded by the Medical Products Agency (MPA).