The right RWE study design depends on the research objective, available data, and stakeholder expectations. IQVIA applies a fit-for-purpose design approach that balances scientific rigor, therapeutic area expertise with real-world feasibility, ensuring studies are practical to execute and aligned with audience requirements, whether regulatory, payer, physician or patients.
Real-world evidence delivers the greatest value when planned as part of an integrated evidence plan (IEP) developed alongside the clinical development plan. Across the product lifecycle, RWE complements clinical trial data by addressing evidence gaps from early evidence generation through post-approval safety, effectiveness, and comparative value.
Different research questions and use cases require different real-world data and study approaches. Generally, RWD is either existing data collected for another purpose or prospective data collected for a specific research need. To generate RWE, a study may use either existing data, prospectively collected data, or a combination of both. Real World study designs can include surveys, chart reviews, database studies, pragmatic trials and observational studies, each suited to specific endpoints, timelines, and stakeholder expectations.
External comparators provide meaningful context in single arm studies, where comparison to placebo is impractical or unethical. They are also used to contextualize clinical trial results with payers, to reflect an additional comparator cohort often representing real world experience. External comparators constructed from RWD allow sponsors to contextualize current standard of care, disease progression, survival, or functional outcomes observed in a single arm trial relative to historical or contemporary real-world patients.
Lower-burden study designs improve participation and data completeness without compromising evidence quality. The use of secondary data, automated data flows, efficient CRFs, and decentralized participation models can help reduce the burden on sites and patients and as a result improve participation in studies.
Regulatory-grade RWE requires fit-for-purpose data, prespecified protocols, scientific rigor and full transparency. To meet the needs of regulators or payers effectively, early dialog with these stakeholders is crucial to understanding their expectations. These insights can then be incorporated into study planning and execution to ensure the right evidence is generated in support of regulatory and reimbursement decisions.
Extension studies assess long-term safety, durability of treatment effect, and late-emerging outcomes. While these studies can pose challenges on sponsors because of their long duration, there are options to designing long-term follow-up studies using registry linkages, passive follow-up, and digital tools to allow study design to evolve over time, reduce burden while maintaining scientific rigor.