Dynamic Product Labeling Overview

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Customizing Drug Product Labeling with Evidence Layers and Personalization

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Dynamic Product LabelingJon Duke MD, MS Regenstrief Institute

Pre-1960 1960-1969 1970-1979 1980-1989 1990-1999 2000-20090

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Date of Drug Approval

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Drug Labels are Growing Longer

All Drugs

Bisphosphonates

Beta Blockers

Benzodiazepines

NSAIDs

Statins

ACE-Inhibitors

Proton Pump Inhibitors

5-HT1 Agonists (Triptans)

Atypical Antipsychotics

SSRI's

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Mean Number of ADE's per label

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Drug Labels are Packed with Warnings

Duke J, Friedlin J, Ryan P. A Quantitative Analysis of Adverse Events and ‘Overwarning’ in Drug Labeling. Archives of Internal Medicine. May 2011;171(10):944-6.

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We’ve Got a Global Problem

Kesselheim AS, Franklin JM, Avorn J, Duke J. Speaking the same language? International variations in the safety information accompanying top-selling prescription drugs. BMJ Journal of Quality and Safety. 2013 22(9):727-734.

Drug labels have become more relevant toindustry, regulators, researchers, and lawyersthan they are to patients and providers

Dynamic Product Labeling refers to customizing the user experience of a drug label to make it

- More patient-specific- More provider-relevant

Zaxyza

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Augmenting the User Experience with Layers

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Evidence Layers

Observational Data

Literature Evidence

Adverse Event Reporting

Malpractice / Tort Cases

Provider Historical Data

Ontologies

+ Patient Data

Zaxyza

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Enter drug name

Additional Data Layers

Observational Data

Literature Evidence

Adverse Event Reporting

Malpractice / Tort Cases

Provider Historical Data

Ontologies

Observational Data Analysis

Abnormal Hepatic Function

with Zaxyza

+ Patient Data

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Enter drug name

Additional Data Layers

Observational Data

Literature Evidence

Adverse Event Reporting

Malpractice / Tort Cases

Provider Historical Data

Ontologies

Literature Evidence onAbnormal Hepatic Function with Zaxyza

3 Randomized Controlled Studies5 Observational Studies11 Case Reports2 Review Papers

+ Patient Data

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Enter drug name

Additional Data Layers

Observational Data

Literature Evidence

Adverse Event Reporting

Malpractice / Tort Cases

Provider Historical Data

Ontologies

+ Patient Data

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Enter drug name

Additional Data Layers

Observational Data

Literature Evidence

Adverse Event Reporting

Malpractice / Tort Cases

Provider Historical Data

Ontologies

Malpractice Cases involvingSeizure and Zaxyza

127 cases on Lexis-Nexis135 cases on Westlaw

87 cases on PACER

+ Patient Data

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Enter drug name

Additional Data Layers

Observational Data

Literature Evidence

Adverse Event Reporting

Malpractice / Tort Cases

Provider Historical Data

Ontologies In your patients on Zaxyza

Myalgia has occurred in 4 of 86 patients

+ Patient Data

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Dynamic Product Labeling requires a lot knowledge- Knowledge of the evidence (literature, observational data)

- Knowledge of the patient (manual entry, EHR)

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- The label customization framework itself is lightweight (Javascript, CSS, HTML5)- Initially targeting SPLs but ultimately extensible

to SPCs and other drug safety content

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Thank you.

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