Управление вопросами страхования при проведении клинических исследований (международный и отечественный опыт)
DOI:
https://doi.org/10.54500/2790-1203-2024-3-122-27-35Ключевые слова:
клинические исследование, система страхования субъектовАннотация
Вопрос страхования участников клинических исследований является одним из важных факторов при формировании «безопасной» исследовательской экосистемы. Клинические исследования могут сталкиваться с неблагоприятными исходами, и исследователи ориентированы соблюдать баланс между безопасностью участников исследования и бюрократическими препятствиями в правовом аспекте на пути научных открытий.
Цель исследования: Выработка рекомендаций по совершенствованию системы страхования клинических исследований Казахстана на основе проведенного анализа лучших практик.
Проведен анализ опыта 14 стран по вопросам страхования клинических исследований по 3 параметрам: устойчивость института страхования; регуляция вопроса страхования; механизм возмещения страховых выплат; и тарифная политика.
Каждая страна имеет собственные стандартизированные протоколы и требования к страхованию клинических исследований. Ряд стран придают страхованию «обязательный» характер, закрепляя его на законодательном уровне (большинство стран Европы), другие страны - рекомендательный (США, Великобритания). Практикуется две формы страхования исследования: «ответственности» инициаторов и «от несчастных случаев» участников. Различаются и подходы при определении страховых лимитов – одни покрывают только страховых выплаты по факту, другие - устанавливают минимальное покрытие страхового случая. В Казахстане зарегулирована норма обязывающая проводить страхование участников клинических исследования, но
отсутствует механизм, правила и требования к процессу. Отсутствие четких требований к содержанию документа о страховании
жизнь и здоровью участников исследования является барьером для спонсоров.
Выводы. Ориентируясь на опыт международных практик, в Казахстане необходимо закрепить национальную модель страхования при проведении клинических исследований. Ключевыми аспектами для продвижения на политическом уровне системы страхования клинических исследований в Казахстане выделяется: определение страхования, страхового случая, размера страховых выплат, страховые тарифы, порядок выплаты страховой премии, порядок заключения договора и срока его действия, права и обязанности сторон договора и застрахованных лиц, порядок осуществления страховой выплаты.
Скачивания
Библиографические ссылки
Declaration of Helsinki of the World Medical Association, 1964 (with clarification 2008). Website. [Cited 10 Aprl 2024] Available from URL: https://www.mediasphera.ru/upload/medialibrary/Declaration_of_Helsinki. pdf ysclid=lwmf727jpj782953421
WHO International Clinical Trials Registry Platform. Website. [Cited 11 Aprl 2024]. Available from URL: https:// www.who.int/observatories/global-observatory-on-health-research-and-development/monitoring/number-of-trialregistrations- by-year-location-disease-and-phase-of-development
Kaur R.J., Singh S., Sidhu P., Sharma P.K. TGN-1412 and BIA-2474 Trials with Tragic End: Lessons Learnt To Make Clinical Trials Safer. Rev Recent Clin Trials 2018; 13(4): 252-256.
Eddleston M., Cohen A.F., Webb D.J. Implications of the BIA-102474-101 study for review of first-into-human clinical trials Br J Clin Pharmacol 2016; 81(4):582-6.
Statista (СОРЕ). Website. [Cited 17 May 2024]. Available from URL: https://www.statista.com/statistics/732954/global-clinical-registered-studies-by-location/
Zhuravlev K, Nayanova O. Clinical Trials in the USA, 2019. Website. [Cited 17 Aprl 2024] Available from URL: https://
accellclinical.com/clinical-trials-in-usa/
Clinical trials handbook. United States of America, Baker & McKenzie 2019:20. Electronic resource. Access mode:
handbook--us.pdf
Clinical Treatment Act. H.R.913 - 116th Congress (2019-2020): January 30, 2019. Electronic resource. Access mode: https://www.congress.gov/bill/116th-congress/house-bill/913
Brettler D. For Global Human Clinical Trials. Insurance&Risk Management: For Global Human Clinical Trails, 2018: 6. Electronic resource. Access mode: https://www.connerstrong.com/wp-content/uploads/2018/03/1468CSB-LS-Clinical-
Human-Trial-Article.pdf
Kregler J., Butler L. Global Effort: Navigating the Intricacies of Insuring International Clinical Trials, 2022:4. Electronic
resource. Access mode: https://www.chubb.com/content/dam/chubb-sites/chubb-com/us-en/business
insurance/globalclinical-trials/documents/pdf/Chubb_Multinational_LS%20Advisory_051622.pdf
Regulation (EC) No 536/2014 of the European Parliament and of the Council on clinical trials of medicinal products
for human use, 16 April 2014. Available from URL: https://mknc.ru/contents/posts/9260000/9260079/document9260079.
pdf?ysclid=lwdvsyx36x961985735
Private Vs Public Health Insurance In Germany [English Guide], 2024. Website. [Cited 5 Aprl 2024] Available from
Germany%2C%20the%20minimum%20sum,compensation%20for%20pain%20and%20suffering
Federal Law Gazette. Medicinal Products Act (Arzneimittelgesetz – AMG): 19 July 2023, №197. Electronic resource.
Access mode: https://www.gesetze-im-internet.de/englisch_amg/
Renner M., Anliker B, Sanzenbacher R, Schuele S. Regulation of Clinical Trials with Advanced Therapy Medicinal
Products in Germany. In: Galli M., Serabian M. (eds). Regulation Aspects of Gene Therapy and Cell Therapy Products. Advances in Experimental Medicine and Biology, 2015; 871.
Federal Institute for Drugs and Medical Devices. Website. [13 May 2024]. Available from URL: https://medicaljournal.
kz/index.php/mua/Template-for-a-review-article
Global Experiences from Regulatory Sandboxes. Finance, Competitiveness and Innovation Global Practice.
The World Bank Group, 2020; 8:87. Electronic resource. Access mode: https://documents1.worldbank.org/curated/
en/912001605241080935/pdf/Global-Experiences-from-Regulatory-Sandboxes.pdf
Schott M., Grossniklaus Jan, Bär & Karrer. Clinical Trials: Overview (Switzerland), Thomson Reuters Practical Law,
Global Guide, 2024: 24. Electronic resource. Access mode: https://uk.practicallaw.thomsonreuters.com/w-039-1860?transitio nType=Default&contextData=(sc.Default)&firstPage=true
Kristina M.L. Acri née Lybecker, Barua B. Universal Insurance for Pharmaceuticals in Switzerland and the Netherlands,
: 62. Electronic resource. Access mode: https://www.fraserinstitute.org/sites/default/files/universal-insurance-forpharmaceuticals-in-switzerland-and-the-netherlands-execsum.pdf
Caniza V., Hobson J., Livne O., Calderón С. Life Sciences 2024: Switzerland: Chambers and Partners, 2024. Website.
May 2024]. Available from URL: https://practiceguides.chambers.com/practice-guides/life-sciences-2024
Hebenstreit S., Cepic M, Kröpfl M. Life Sciences 2024. Website. [17 May 2024]. Available from URL: https://
practiceguides.chambers.com/practice-guides/life-sciences-2024/austria
Decree Governing Clinical Trials of Medicinal Products, Ethical Committees for Medicinal Products Research and the
Spanish Register of Clinical Trials (Real Decreto 1090/2015, de 4 de diciembre, por el que se regulan los ensayos clínicos con medicamentos, los Comités de Ética de la Investigación con medicamentos y el Registro Español de Estudios Clínicos): 2015, 1090/2015. Electronic resource. Access mode: https://www.boe.es/buscar/doc.php?id=BOE-A-2015-14082
Gerboles A, Bailach J., Gonzalo C., Martinez J. Life Sciences 2024. Website. [18 March 2024]. Available from URL:
https://practiceguides.chambers.com/practice-guides/life-sciences-2024/spain
Rowena Byrne-Jones. Clinical Trials Liability Insurance. A detailed review of cover and impact, 2020:9. Electronic
resource. Access mode: https://assets.crawco.com/docs/uk-resource-2020-q3-Report-Clinical-Trials.pdf
Sweden Clinical Trials Support Service Market Analysis. Website. [18 March 2024]. Available from URL: https://
www.insights10.com/report/sweden-clinical-trials-support-service-market-analysis/
Leadley J., Gillert J. Clinical trials handbook: United Kingdom, 2019:10.
Guidance on insurance and compensation in the event of injury in Phase I clinical trials. Guidance developed by the
Association for the British Pharmaceutical Industry, the BioIndustry Association and the Clinical Contract Research Association in consultation with the Department of Health and the National Research Ethics Service, 2015: 10. Electronic resource. Access mode: https://www.abpi.org.uk/publications/insurance-and-compensation-in-the-event-of-injury-in-phase-i-clinicaltrials/
Clinical Trial Compensation Guidelines. Association of the British Pharmaceutical Industry. 2014, 8. Electronic
resource. Access mode: https://www.abpi.org.uk/publications/clinical-trial-compensation-guidelines/
Chingarande G.R., Moodley K. Disparate compensation policies for research related injury in an era of multinational
trials: a case study of Brazil, Russia, India, China and South Africa. BMC Medical Ethics, 2018; 19: 8.
Kashiwabara P., Trojan V., Vicenti G., Mezher G. Life Sciences 2024. Website. [18 March 2024]. Available from URL:
https://practiceguides.chambers.com/practice-guides/life-sciences-2024/brazil
Brazil Clinical Trials Support Service Market Analysis, 2024: 37.
Kalikar M.V, Dakhale G.i, Sinha V., Giradkar A. Analysis of clinical trial agreement and insurance policy submitted to
the ethics committee of a tertiary care teaching institute in central India. Perspectives in Clinical Research, 2021: 13(3): 151-
Vennu V., Saini P. P. India's Clinical Trial Regulatory Changes, Indian Researcher?s Awareness of Recently Changed
Regulations, and the Impact of the New Drugs and Clinical Trial Rules: A Review. Indian J Pharm Sci, 2020; 82(5): 726-740.
Sridharan K., Deshpande S. at el. Knowledge about clinical trial agreement and clinical trial related insurance among
Ethics Committee members: A cross-sectional survey. Perspectives in Clinical Research, 2016; 7(4): 191.
Clement Ngai, Elva Yao. Clinical trials handbook: China. Baker McKenzie, 2019:11. Electronic resource. Access mode:
Zhang Shu, Zhu Dongyun, Qin Jie. Study on the rights and interests of subject in clinical trials. Public Policy and Administration Research, 2019; 12(9).
China accounts for 27.7% share of global clinical trial activity in 2022. Website. [January 10, 2023]. Available from
/
Clinical Trials - Insurance and Indemnity. NSW Health, 2024: 22. Electronic resource. Access mode: https://www1.
health.nsw.gov.au/pds/ActivePDSDocuments/PD2011_006.pdf
Global Clinical Trial Support Services Market by Service (Administrative Staff, Clinical Trial Site Management,
Data Management), Phase (Phase I, Phase II, Phase III), Study Design, Indication, Sponsor - Forecast 2024-2030, 2024: 192.
Website. [January 10, 2023]. Available from URL: https://www.asdreports.com/market-research-report-646182/clinicaltrial-
support-services-global-forecast
Federal Law of the Russian Federation. On circulation of medicines: 2010: 61-FZ. Website. [January 10, 2023].
Available from URL: https://wipolex-res.wipo.int/edocs/lexdocs/laws/en/ru/ru239en.html#:~:text=This%20Federal%20
Law%20regulates%20relations,the%20Russian%20Federation%2C%20export%20from
Federal Law of the Russian Federation. About biomedical cell products: 2016: 180-FZ. Website. [January 10, 2023].
Available from URL: https://cis-legislation.com/document.fwx?rgn=86404
Об утверждении Типовых правил обязательного страхования жизни и здоровья пациента, участвующего
в клинических исследованиях лекарственного препарата. Постановление Правительства РФ от 13 сентября 2010,
№714. Режим доступа: https://base.garant.ru/12178762/
Ob utverzhdenii Tipovyh pravil objazatel'nogo strahovanija zhizni i zdorov'ja pacienta, uchastvujushhego v klinicheskih
issledovanijah lekarstvennogo preparata. Postanovlenie Pravitel'stva RF (Model rules for compulsory life and health insurance of a patient participating in clinical trials of a medicinal product. Resolution of the Government of the Russian Federation) [in Russian], ot 13 sentjabrja 2010, №714. Rezhim dostupa: https://base.garant.ru/12178762/
On insurance activities. The Law of the Republic of Kazakhstan dated 18 December, 2000, No. 126.43. Available from
of%20opening%2C%20licensing%20regulation%2C
On approval of the rules for conducting clinical trials of drugs and medical devices for diagnostics outside the living
organism (in vitro) and the requirements for clinical bases and the provision of the state service "Issuance of permission to
conduct a clinical trial and (or) testing of pharmacological and medicinal products, medical devices". Order of the Minister of Health of the Republic of Kazakhstan. : December 11, 2020, No DSM-248/2020. Available from URL: https://adilet.zan.kz/eng/docs/V2000021898/compare
On Amendments and Additions to Certain Legislative Acts of the Republic of Kazakhstan on Health Issues. Resolution
of the Government of the Republic of Kazakhstan. On the draft Law of the Republic of Kazakhstan: dated June 29, 2022, No. 444. Electronic resource. Access mode: https://www.wto.org/english/thewto_e/acc_e/kaz_e/wtacckaz50a1_leg_3.pdf