4.6 Review Book Chapter

Model-Informed Precision Dosing: Background, Requirements, Validation, Implementation, and Forward Trajectory of Individualizing Drug Therapy

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Publisher

ANNUAL REVIEWS
DOI: 10.1146/annurev-pharmtox-033020-113257

Keywords

model-informed precision dosing; MIPD; individualized dosing; pharmacokinetic/pharmacodynamic modeling; systems pharmacology; clinical decision support systems; electronic health records

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Model-informed precision dosing (MIPD) is a modern approach to individualizing drug therapy, focusing on the characteristics of each patient rather than a one-size-fits-all alternative. This review covers the historical perspective on dose variability, technical aspects of MIPD, novel approaches to patient variability, and current debates on MIPD.
Model-informed precision dosing (MIPD) has become synonymous with modern approaches for individualizing drug therapy, in which the characteristics of each patient are considered as opposed to applying a one-size-fits-all alternative. This review provides a brief account of the current knowledge, practices, and opinions on MIPD while defining an achievable vision for MIPD in clinical care based on available evidence. We begin with a historical perspective on variability in dose requirements and then discuss technical aspects of MIPD, including the need for clinical decision support tools, practical validation, and implementation of MIPD in health care. We also discuss novel ways to characterize patient variability beyond the common perceptions of genetic control. Finally, we address current debates on MIPD from the perspectives of the new drug development, health economics, and drug regulations.

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