Real-world evidence

Making greater use of real-world evidence and real-world data can improve the evidence base for benefit-risk decisions. This can help bring medicines to patients. Real-world data are observational data stored in repositories such as electronic health records and disease registries.
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Updated on 8 April 2025:
'HMA-EMA catalogues of real-world data sources and studies' section

The European Medicines Agency (EMA) and the European medicines regulatory network are working to establish a sustainable framework enabling better integration of real-world data and real-world evidence into regulatory decisions.

For more information, see:

Darwin EU

EMA has established a coordination centre to provide timely and reliable evidence on the use, safety and effectiveness of human medicines, including vaccines, from real-world healthcare databases across the European Union (EU).

This capability is called the Data Analysis and Real World Interrogation Network (Darwin EU)

For more information, see:

HMA-EMA catalogues of real-world data sources and studies

Two online catalogues are available from HMA and EMA, one for real-world data sources and one for real-world data studies:

The catalogues serve to:

  • help regulators, researchers and pharmaceutical companies identify the most suitable data sources to address specific research questions;
  • support the assessment of study protocols and results;
  • promote transparency;
  • encourage the use of good practices;
  • build trust in research based on real-world data. 

They enhance and replace two databases previously maintained by EMA:

CatalogueDiscontinued database 
Real-word data sources European Network of Centres for Pharmacoepidemiology and Pharmacovigilance (ENCePP) catalogue
Real-world data studiesEuropean Union electronic register of post-authorisation studies (EU PAS Register)

The catalogues use an agreed list of metadata to describe and connect data sources to studies, using ‘FAIR’ (Findable, Accessible, Interoperable and Reusable) data principles. EMA reviews and updates the list of metadata periodically, based on feedback from catalogue users. 

The following documents are also available to support users of the catalogues:

A good practice guide which provides regulators, researchers and other stakeholders with recommendations on how to use the catalogues effectively to identify and assess the suitability of data sources.

A document summarising the outcome of the public consultation on the good practice guide is also available below.

A user guide that supports users submitting data to the catalogues. It provides descriptions of the data fields and definitions, as well as guidance on how to submit and maintain records in the catalogues. EMA updates it periodically to reflect changes in the list of metadata. 

EMA encourages all stakeholders to use these catalogues if they are interested in having their data: 

  • used for medicine regulation;
  • or mandated by the policy on non-interventional post-authorisation safety studies (PASS).

Stakeholders include:

  • All European data holders;
  • Marketing authorisation holders;
  • Networks;
  • Researchers and institutions.

Use of real-world evidence

A guide is available on how EMA can help generate real-world evidence.

It is meant for EU regulators and decision-makers, including EMA's scientific committees, working parties and groups, as well as national competent authorities, healthcare technology assessment bodies and payers.

It covers:

  • how the mentioned stakeholders can request real-world data studies from EMA;
  • what types of studies can be performed;
  • how EMA can help identify resources to address research questions.

EMA cannot consider requests from other bodies and institutions, including academia, pharmaceutical companies and contract research organisations.

The guide builds on EMA's experience in using real-world evidence to support regulatory decision-making, described in the report below.

Graphs, charts and numbers symbolising real-world evidence

Infosheet - Review: real-world data studies

Cumulative experience gained from September 2021 to February 2024, including the challenges and opportunities of providing real-world evidence to support EMA regulatory decision making

The studies included in this report addressed the following research questions:

  • disease epidemiology;
  • medicine use, safety and effectiveness;
  • design and feasibility of clinical trials;
  • clinical management.

Highlights include:

  • The Darwin EU network has grown from 10 to 20 partners in its second year of establishment
  • The increased number of partners has enabled the network to access data from around 130 million patients from 13 European countries
  • Forty studies were either completed or ongoing, including 13 studies on vaccine safety and effectiveness, and related public health emergencies
  • EMA conducted for the first time studies to support the monitoring of supply and demand of critical medicines, on herbal substances and to support health technology assessment

For more information, see:

Find below information on the first EMA real-world evidence report covering the period from September 2021 to February 2023.

Select the expandable panel to read the main findings and the complete report.

Key findings of the first EMA real-world evidence report include:

  • Real-world evidence can support decision-making in various regulatory contexts
  • Regulators need access to additional data sources such as secondary care databases, claims databases and registries from across Europe
  • Research needs should be identified as early as possible so that studies can be conducted in time for regulatory decisions
  • More information on data source characteristics is needed to facilitate the interpretation of real-world evidence derived from these sources
  • There is a need to build more capability and capacity for real-world evidence generation

For more information, see:

Guidance on real-world evidence

Roadmap for guidance development

EMA has developed a roadmap to produce guidance on real-world evidence to support regulatory decision-making.

A document describing the roadmap and the journey that led to it is available below.

It includes a review of existing real-world evidence guidance that regulators have issued. It also proposes topics for further guidance development. 

Reflection paper on non-interventional studies

A reflection paper on non-interventional studies that use real-world data to generate real-world evidence for regulatory purposes is available.

It is relevant for all stakeholders involved in the planning, conduct and analysis of this type of non-interventional studies. This includes marketing authorisation holders and applicants.

The reflection paper was available for public consultation between May and August 2024.

Guideline on registry-based studies

Guidance is available on the methodological, regulatory and operational aspects involved in using registry-based studies to support regulatory decision-making: 

International collaboration on real-world evidence

EMA works to help integrate real-world evidence into regulatory decision-making across the world, within the International Coalition of Medicines Regulatory Authorities (ICMRA).

In June 2022, ICMRA held a workshop enabling regulators to share experience in obtaining and using real-world evidence for the assessment of medicines. In July 2022, it also issued a pledge to foster global efforts in this area. 

For more information, see:

A reflection paper is available aiming to harmonise real-world evidence terminology and optimise the use of real-world data to support regulatory decision-making.

For more information, see: 

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