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What are the advantages of going to India for clinical research?    
     
  • Availability: With a booming Indian population, there is an
    availability of a large pool of treatment naïve patients providing for a multiethnic and multiracial base.
  • Speed: Owing to the large base, patient recruitment in the country is rapid, thereby reducing the development process.
  • Spectrum of diseases: The country has witnessed the presence of varied diseases that are not prevalent in the West. These include diseases such as multi drug resistant pneumonia, hepatitis B, diabetes and some forms of cancer.
  • Economy: While all sectors are leveraging India's benefits with economy through outsourcing, the drug companies too are tapping the potential with the country as they can save up to 30 to 50% overall on the cost of conducting the trials here in India.
  • Trained investigators: The investigators in India are generally trained in the US or Europe and have gained further exposure with Multinational trials based on the guidelines for GCP.
  • Regulatory compliance and standards: Based on the USFDA, any drug before it is released in the market must first be tested on a global population.
  • Recruitment of subjects: Subject willingness is critical for the compliance to undergo the full process. In India, with a large section of the population unable to afford their own treatments, subjects opt for these trials as they are assured on quality treatment and healthcare, which would have not been available otherwise. Hence the subject return rates are amongst the highest in the world in India.
 


 
Global consultancy: McKinsey & Co estimates that by 2010, global pharma majors would spend around $1-1.5 billion just for drug trials in the country. Pharma giants are also magnetised by India due to the fact that the country offers nearly 700,000 specialty hospital beds, 221 medical colleges and skilled English-speaking medical personnel.
     
What questions /objections have there been to outscourcing to India?

The clients are usually sceptical with regards to timeline for regulatory approval. With a dedicated regulatory consulting team who strive to meet the expected timelines, clients are bound to have a positive and encouraging experience.

What is FDA's policy regarding patient populations from India? What is acceptable regarding a more homogenous population that may not fully reflect the US?

FDA has a policy on inclusion of foreign patient data for registration of drugs for marketing in USA. There is no negative or positive bias towards India. A white paper on the subject is on our website. Numerous audits of global sponsors and US FDA in India are a testimony to the level of quality. Data from clinical studies in India have been successfully filed with international regulatory agencies. The overall impression is that the data quality in India is usually excellent.

In oncology, what subspecialties are covered in clinical studies (e.g., Leukemia, Lymphoma, Solid Tumors, Etc.)?

There are premiere oncology institutes in India where all subspecialty investigators are present. There are medical oncologists, surgical oncologists, radiologists, paediatric oncologists, head & neck cancer specialists and breast cancer specialists who are involved in various studies. Thus, most of the subspecialty studies have been conducted in India.

What is the regulatory process In India?

For the regulatory process in India click on the icon on the left.
  Has the FDA reviewed or audited the sites?

FDA has been to India and has audited sites in India. FDA has provided a green signal for the same.

Please describe the study site infrastructure (e.g., Pharmacy, Study Coordinators)

The study site depending on the type of study would have the following personnel - Principal Investigator, Co-Investigators, Specialty Physician (depending on type of study, for instance a radiologist, etc), Study Coordinator, Study Nurse and a Pharmacist.

What import issues/limitations are there regarding US drugs coming into India for study? How are these handled?

Import license has to be obtained from the Drugs Controller General of India for import of drugs to India. An application will be forwarded to the regulatory agency along with the clinical trial application with justification as to the number of drugs to be imported. The import license would be awarded along with the approval to conduct the clinical study.

How is cancer care different/similar in India to that in the US?

The medical care to cancer is similar to US, but due to genetic variation there might be difference in the response to therapies in India as compared to US.  
 
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