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Record W4414870087 · doi:10.1377/hlthaff.2024.01476

Impact Of Risk Evaluation And Mitigation Strategies On Generic Approvals Of US Pharmaceutical Products

2025· article· en· W4414870087 on OpenAlexaff
Jennifer L. Kao, Victor L. Van de Wiele, Reed F. Beall, Ameet Sarpatwari

Bibliographic record

VenueHealth Affairs · 2025
Typearticle
Languageen
FieldEconomics, Econometrics and Finance
TopicPharmaceutical Economics and Policy
Canadian institutionsUniversity of Calgary
Fundersnot available
KeywordsOrphan drugDrug approvalRisk assessmentGeneric drugDrugMEDLINE

Abstract

fetched live from OpenAlex

Risk evaluation and mitigation strategy (REMS) programs help ensure that the benefits of certain high-risk medications outweigh their risks. With the routine use of REMS programs, however, concerns have emerged that they may delay the approval of generic alternatives. Using a data set of novel small-molecule drugs approved during the period 2000-13, linked to generic approvals through 2024, we assessed the impact of REMS programs on generic approval. We found that the existence of a REMS program was associated with a 25 percent delay in generic approvals after patent length, approval timing, approved indication, boxed warning status, orphan drug status, and drug use were controlled for. Our findings provide insight into future regulatory efforts that can facilitate timely access to safe, effective, and affordable generic drugs.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.029
metaresearch head score (Gemma)0.111
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.029
Threshold uncertainty score0.152

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0290.111
Meta-epidemiology (narrow)0.0010.000
Meta-epidemiology (broad)0.0010.001
Bibliometrics0.0020.001
Science and technology studies0.0010.001
Scholarly communication0.0030.003
Open science0.0010.002
Research integrity0.0010.003
Insufficient payload (model declined to judge)0.0060.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.086
GPT teacher head0.398
Teacher spread0.312 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations1
Published2025
Admission routes1
Has abstractyes

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