Efficient model-based bioequivalence testing

Kathrin Möllenhoff (Corresponding author), Florence Loingeville, Julie Bertrand, Thu Thuy Nguyen, Satish Sharan, Liang Zhao, Lanyan Fang, Guoying Sun, Stella Grosser, France Mentré, Holger Dette

Research output: Contribution to journalArticleAcademicpeer-review

6 Citations (Scopus)
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The classical approach to analyze pharmacokinetic (PK) data in bioequivalence studies aiming to compare two different formulations is to perform noncompartmental analysis (NCA) followed by two one-sided tests (TOST). In this regard, the PK parameters area under the curve (AUC) and Cmax are obtained for both treatment groups and their geometric mean ratios are considered. According to current guidelines by the U.S. Food and Drug Administration and the European Medicines Agency, the formulations are declared to be sufficiently similar if the 90% confidence interval for these ratios falls between 0.8 and 1.25 . As NCA is not a reliable approach in case of sparse designs, a model-based alternative has already been proposed for the estimation of AUC and Cmax using nonlinear mixed effects models. Here we propose another, more powerful test than the TOST and demonstrate its superiority through a simulation study both for NCA and model-based approaches. For products with high variability on PK parameters, this method appears to have closer type I errors to the conventionally accepted significance level of 0.05, suggesting its potential use in situations where conventional bioequivalence analysis is not applicable.

Original languageEnglish
Pages (from-to)314-327
Number of pages14
Issue number1
Early online date22 Jul 2020
Publication statusPublished - 13 Jan 2022

Bibliographical note

© The Author 2020. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.


  • bioequivalence
  • noncompartmental bioequivalence analysis
  • nonlinear mixed effects model
  • pharmacokinetics
  • two one-sided tests


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