title: An update on the first decade of the European centralized procedure: how many innovative drugs?
abstract: OBJECTIVE
  In a previous paper, we proposed an algorithm to assess the degree of therapeutic innovation of the agents approved by the European centralized procedure, which must be followed by biotechnological products and is optional for drugs claimed as innovative. A low overall degree of therapeutic innovation (about 30%) was found. This figure may be an underestimate of the actual level of innovation, because common biotechnological products, such as recombinant human insulins, must follow this procedure. To test the hypothesis that therapeutic innovation prevails among nonbiotechnological products, we evaluated separately the degree of therapeutic innovation of biotechnological vs. nonbiotechnological agents in the first decade of European Medicines Agency activity, also studying a possible time trend.
  
  
  METHODS
  We assessed, for each drug: (i) the seriousness of the target disease, (ii) the availability of previous treatments, and (iii) the extent of therapeutic effect according to the previously proposed algorithm.
  
  
  RESULTS
  Our analysis considered 251 medicinal products corresponding to 198 active substances, classified according to four main areas as therapeutic agents (88.9%), diagnostics (5.5%), vaccines (5.1%) and life-style drugs (0.5%). Among all therapeutic agents, 49 out of 176 agents (28%) were classified as having an important degree of therapeutic innovation. Fifteen out of 60 biotechnological therapeutic agents were considered important therapeutic innovations (25%), whereas this figure was 29% for nonbiotechnological agents.
  
  
  CONCLUSIONS
  Among active substances claimed as innovative by the manufacturers, only a minority deserve this definition according to our algorithm.
authors.affiliation: Department of Pharmacology and Interuniversity Research Centre for Pharmacoepidemiology, University of Bologna, Bologna, Italy.
authors.forename: Domenico
authors.initials: D
authors.lastname: Motola
authors.forename: Fabrizio
authors.initials: F
authors.lastname: De Ponti
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Poluzzi
authors.forename: Nello
authors.initials: N
authors.lastname: Martini
authors.forename: Pasqualino
authors.initials: P
authors.lastname: Rossi
authors.forename: Maria Chiara
authors.initials: MC
authors.lastname: Silvani
authors.forename: Alberto
authors.initials: A
authors.lastname: Vaccheri
authors.forename: Nicola
authors.initials: N
authors.lastname: Montanaro
mesh_terms: D017277:Drug Approval; D005062:European Union; D006801:Humans; D007880:Legislation, Drug; D012189:Retrospective Studies; D013678:Technology, Pharmaceutical / Q000331:legislation & jurisprudence / Q000639:trends*