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External control arms

Trusted scientific leadership and multi-disciplinary expertise in designing and executing external control arms

Enhance your external control arm (ECA) study design, plan efficiently, and boost the chance of stakeholder acceptance with our proven ECA expertise and fit-for-purpose real-world data selection.

External Control Arms at ISPOR

ECA and real-world evidence expertise

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External control arm study experts providing guidance in the planning, design, and execution of ECA studies for submission to FDA, EMA, and payers
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Expertise in applying a data-agnostic approach to the selection of fit-for-purpose data using our knowledge of a wide range of real-world data sources
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Multi-disciplinary teams, including pharmaco-epidemiologists and biostatisticians, experienced across therapeutic areas such as oncology and rare diseases

Developing ECAs for regulatory and HTA agencies

The effective use of external control arm studies remains a challenging proposition which requires significant expertise and experience to successfully navigate the data selection, design, analyses, and reporting required.

Why use an ECA?

To contextualize single-arm trial data (efficacy comparison, benchmark), when:

  • It is not feasible or ethical to use a placebo (recruitment challenges, etc)
  • Standard of care is likely to be updated over the course of the study.

You’ll find a collection of in-depth thought leadership resources on the topic of ECA studies below, including a publications list showing examples of our ECA-related work across therapeutic areas, and our recent contribution to ISPOR’s Value & Outcomes Spotlight publication.

Looking for a partner to help you develop an ECA strategy and navigate their methodological complexity?

Informed by published guidelines and frameworks, our teams offer a strong track record of scientific leadership in ECA study design and execution, deep methodological expertise, and a data-agnostic approach that ensures the data we leverage is fit-for-purpose.

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Our approach

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Feasibility and design

    • Strategy support
    • Target trial and target estimand planning
    • Data source selection
    • Sample size estimation
    • Endpoint identification and evaluation
    • Development of study protocol and statistical analysis plan
    • Evaluation of relevant literature
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Study execution

  • Analytic execution of the study
  • Multiple methods for estimating causal effect
  • Tailored approach to reduce bias and confounding based on feasibility
  • Sensitivity analyses to evaluate robustness of results
  • Missing data methods implementation
  • Multiplicity adjustments
  • Rigorous quality control
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Communication

      • Result interpretation
      • Final study report
      • Submission support
      • Compliance with regulatory requirements
      • Publication strategy and execution (abstracts, posters, manuscripts)

Our leadership team

Our ECA leadership team reflects the deep experience and expertise we have in this field

Image of Allie Sosinsky

Alexandra Sosinsky

Director of
Pharmacoepidemiology & Safety

Allie is a pharmacoepidemiologist who has led numerous label expansion, external control arm, natural history, post-marketing, post-authorization safety, and meta-analytic studies, many of which have been submitted to regulatory agencies/HTA bodies and successfully supported authorization and reimbursement decision-making. She has 10+ years of experience, authored 20+ peer-reviewed publications, and received her ScM in Epidemiology and Maternal Child Health from the Harvard T.H. Chan School of Public Health.

Craig Parzynski

Craig Parzynski

Executive Director &
Head of Biostatistics & Analytics

Craig has 18 years of experience in research conduct and 13 years of experience in the field of statistics. He is an expert in causal inference methods with a focus on external control arms, having conducted or consulted on more than 15 external control arm studies. He has contributed to over 40 peer-reviewed journal articles across many fields and therapeutic areas.  Prior to Genesis Research Group, he spent over 9 years as a statistician at Yale Center for Outcomes Research and Evaluation.

Deb Casso

Deborah Casso

Vice President &
Head of Real-world Evidence

Deb has 30+ years of experience in the design and conduct of observational research studies, including 17 years partnering with pharmaceutical clients on the design, implementation, and strategic considerations of pharmacoepidemiology and drug safety studies and RWE for both pre- and post-approval regulatory decision-making (including external control arm studies). Deb holds an MPH in Epidemiology from the University of Washington and was trained at the Fred Hutchinson Cancer Research Center.

Resources

'Developing Fit-for-Purpose External Control Arms to Optimize Submissions to Regulatory and Health Technology Assessment Agencies'. Presented at ISPOR 2023.

Ask a question or request slides

Read our external control arm contribution to the July/August issue of ISPOR’s Value & Outcomes Spotlight

The Role of External Control Arms in Drug Development and Considerations for Success by Alexandra Z. Sosinsky, Craig S. Parzynski, and Deborah Casso

View article online
ECA case study

Effectiveness of tisagenlecleucel versus real-world standard of care in r/r FL with EMA review

To contextualize effectiveness of tisagenlecleucel, an autologous anti-CD19 CAR-T cell therapy, against physician’s choice standard of care in relapsed/refractory follicular lymphoma, to support a submission to the European Medical Association (EMA) requesting a Type II variation to the marketing authorization.

Genesis Research Group developed and executed an external control arm study for submission to the EMA. It was accepted as supportive evidence and the EMA ultimately approved the Type II variation to the marketing authorization in question.

Download full case study

Watch our webinar on data selection and RWE approaches to regulatory and HTA audiences

In spring 2024, we produced a webinar referencing external control arm studies and our approach to data selection titled Fit-for-purpose Matchmaking: a Data Selection and RWE Approach for both Regulatory and HTA Audiences. Speakers included Allie Sosinsky, Director, Pharmacoepidemiology and Safety at Genesis Research Group, and Carole Longson MBE, Professor and Independent Senior Advisor.

Ask a question or request slides

Selected ECA-related publications

Our team members have co-authored over 1000 publications. View our ECA-related publications below.

TitleGR Author(s)YearTherapeutic AreaData SourceJournal/ConferenceLink
An Externally Controlled Trial to Indirectly Compare Tazemetostat Plus Lenalidomide and Rituximab Versus Lenalidomide and Rituximab after at Least One Prior Systemic Therapy in Patients with Refractory and Relapsed Follicular Lymphoma.Sosinsky A, Crowley A, Lieb C2023OncologySymphony/FHRDBloodView
External Control Analysis of Overall Survival in BRAF V600 Mutated Metastatic NSCLC: Comparing Single-Arm Dabrafenib + Trametinib Clinical Trial Outcomes with Real-World Standards of CareKanakamedala H, Wu WH2020NSCLCFlatironValue in HealthView
Comparison of clinical outcomes of patients with METΔex14 NSCLC treated with first-line capmatinib in the GEOMETRY mono-1 study with those of a cohort of real-world patientsKanakamedala H, Wu WH2020OncologyFlatironAnnals of OncologyView
Utilization of External Control Arm to Contextualize Clinical Efficacy of Tisagenlecleucel Treated Among Patients with Relapsed/Refractory Follicular Lymphoma from the Single-Arm Elara Trial Wei-Chun Hsu, Parzynski C, Rhodes R, Wen-Hsing Wu2021Oncologyn/aBloodView
Comparison of Clinical Outcomes Among Patients with Relapsed/Refractory Follicular Lymphoma Treated with Tisagenlecleucel in the Elara Trial Versus a Real-World External Control Arm of Patients Treated with Standard of Care Wei-Chun Hsu, Parzynski C, Rhodes R, Wen-Hsing Wu2021OncologyFHRDBloodView
Effectiveness of Alpelisib + Fulvestrant Compared with Real-World Standard Treatment Among Patients With HR+, HER2–, PIK3CA-Mutated Advanced Breast CancerKanakamedala H, Wei-Chun Hsu2021OncologyCGDBThe OncologistView

Explore our data-agnostic real-world evidence solutions and methodological expertise

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Headquarters:

HOBOKEN
111 River Street, Suite 1120
Hoboken, New Jersey 07030, US