A New Approach to Equivalence Assessment in Standard Comparative Bioavailability Trials by Means of the Mann-Whitney Statistic

By a suitable transformation of the pairs of observations obtained in the successive periods of the trial, bioequivalence assessment in a standard comparative bioavailability study reduces to testing for equivalence of two continuous distributions from which unrelated samples are available. Let the two distribution functions be given by F(x) = P[X ≤ x], G(y) = P[Y ≤ y] with (X, Y) denoting an independent pair of real-valued random variables. An intuitively appealing way of putting the notion of equivalence of F and G into nonparametric terms can be based on the distance of the functional P[X > Y] from the value it takes if F and G coincide. This leads to the problem of testing the null hypothesis H_o P[X > Y] ≤ 1/2 - ε₁ or P[X > Y] ≥ 1/2 + ε₂ versus H₁ : 1/2 ? ε₁ < P[X > Y] < 1/2 + ∈₂, with sufficiently small ε₁, ε₂ ∈ (0, 1/2). The testing procedure we derive for (₀, H₁) and propose to term Mann-Whitney test for equivalence, consists of carrying out in terms of the U-statistics estimator of P[X > Y] the uniformly most powerful level a test for an interval hypothesis about the mean of a Gaussian distribution with fixed variance. The test is shown to be asymptotically distribution-free with respect to the significance level. In addition, results of an extensive simulation study are presented which suggest that the new test controls the level even with sample sizes as small as 10. For normally distributed data, the loss in power as against the optimal parametric procedure is found to be almost as small as in comparisons between the Mann-Whitney and the t-statistic in the conventional one or two-sided setting, provided the power of the parametric test does not fall short of 80%.     

An Alternative Approach for the Assessment of Bioequivalence Between Two Formulations of a Drug

The problem of the assessment of bioequivalence between a test formulation (T) and a reference formulation (R) of a drug using a two-way crossover experiment is considered. To claim bioequivalence between two formulations, it is required by the United States Food and Drug Administration (FDA) to demonstrate that the true ratio of means μT/μR of pharmacokinetic parameters of concern falls within some reasonable limits (e.g., (80%, 120%)) with certain assurance. A commonly used approach is to construct an approximate 90% confidence interval for μT/μR and compare it with (80%, 120%). In this paper, an exact approach according to the FDA's criteria is proposed. The proposed procedure is derived by constructing an exact confidence region (an ellipse) for (μR, μT) and comparing it with the region bounded by μT = 0.8 μR and μT = 1.2 μR. Bioequivalence is concluded if the ellipse is within the critical region.     

Interval Estimation for Ratios in Bioequivalence Trials

The problem for assessment of equivalence in variability of bioavailability between two drug products is considered. An exact confidence region for the ratio between intrasubject variabilities is derived when the intersubject variance is known. When the intersubject variance is unknown, a large sample approximation is considered. The proposed method for assessing equivalence in variability of bioavailability appears to be asymptotically uncorrelated with the sample mean ratio for average bioavailabilty. As a result, the proposed method in conjunction with the sample mean ratio method can be utilized for assessing population bioequivalence. An example concerning a bioequivalence trial with 24 healthy volunteers is presented to illustrate the proposed method.