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DDD x > week 11 part 1 > Flashcards

week 11 part 1 Flashcards

1
Q

What does EU law require?

A

All the medicinal product to obtain a Marketing Authorisation before they can be put on the market

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2
Q

In 1965, what was the first pharmaceutical Directive (65/65/EEC) triggered by?

A

The thalidomide catastrophe with aim to protect public health

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3
Q

What is necessary in order to place a medicinal product on the market?

A

Permission (authorisation)

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4
Q

What must the authorisation be granted by?

A

One or more member states or the European Comission for centrally authorised product (i.e. via the EMA)

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5
Q

What criteria must the product need to statisfy and to be submitted in a marketing authorisation application dossier?

A
  1. Quality
  2. Safety
  3. Efficacy
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6
Q

What are the current pharmaceutical Legislation?

A
  1. Directive 2001/83/EC
    - Core legislation
    - Regulation of drugs in the EU
    - provides framework for regulation of medicine at national level
  2. Regulation (EC) No 726/2004
    - Establishes the EMA and sets out the centralised procedure
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7
Q

What does scientific advice support?

A

Medicine development

non-compulsory regulation

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8
Q

What is scientific advice?

A

A company developing a product comes to regulators and says give us advice on what studies to do
peculiar to the development

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9
Q

What happens before the first marketing authorisation?

A

Companies ask questions on:

  1. Manufacturing
  2. Non-clinical and clinical trials
  3. Risk management plans
  4. Ways to develop generics
  5. Biosimilars
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10
Q

What is scientific advice good for?

A
  1. Significant benefit for orphan medicine

2. Development in children

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11
Q

What is post MA?

A

Extension of indication to different age groups and stages of the disease
different conditions
+ safety aspect

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12
Q

What happens if a product has market authorisation?

A

Development of product continues and the research will continue

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13
Q

What is scientific advice main activity so fat?

A
  1. Scientific advice
  2. Protocol assistance for orphan drugs
  3. 2001 - 70 questions
  4. 2015 - over 500 questions
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14
Q

What does protocol assistance apply to?

A

orphan medicine

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15
Q

What did the study of positive impact of SA adherence on MAA procedure and outcome show?

A

If the company follows the advice given, they are more likely to get the marketing relation

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16
Q

What does clinical trial in human require?

A

Authorisation from national competent authorities

Ethical approval

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17
Q

What supports national decision at EU level?

A

Clinical trial facilitation groups

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18
Q

Where is clinical trials done?

A

National level

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19
Q

What is clinical trial regulation?

A
  1. New
  2. Not fully enforced yet
  3. Faciliate approval of clinical trials
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20
Q

What is marketing authorisation?

A

A license to market a medicine

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21
Q

Who can use a product in the market?

A
  1. Doctor
  2. National health service
  3. Very special situations
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22
Q

What are the 4 different routes to get marketing authorisation?

A
  1. National procedure
  2. Mutual Recognition procedure
  3. Decentralised procedure
  4. Centralised procedure (Via EMA)
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23
Q

National procedure

A

still possible for authorisation by a single MS

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24
Q

Mutual Recognition procedure + Decentralised procedure

A

Authorisation by several MSs

Based on assessment by Reference MS

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25
Q

Centralised procedure

A

Authorisation by European commission

Based on assessment by EMA

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26
Q

What is mutual recognition procedure?

A

European authorisation route resulting in a mutually recognised product

Mutual recognition must be used when a product is already authorised in at least one Member State on a national basis and the Marketing Authorisation Holder wishes to obtain a Marketing Authorisation (MA) for the same product in at least one other Member State

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27
Q

What is decentralised procedure?

A

DCP may be used if the product is not already authorised in any Member State, but does not want to use the centralised procedure, or the product is not eligible for the centralised procedure

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28
Q

What does the reference member states do?

A

the initial evaluation of the product and issues a draft assessment report

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29
Q

What does the Concerned member states do?

A

either agree with the RMS’s evaluation or they ask further questions/raise objections

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30
Q

What is found between regulation authority?

A

Internal market

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31
Q

The more licensing work

A

The more income you get from regulatory authority

32
Q

What is a referral?

A

procedure used to resolve issues such as concerns over the safety or benefit-risk balance of a medicine or a class of medicines

33
Q

What are the reasons that a referral may be started?

A
  1. Concerns over the safety of class of medicine

2. Disagreement among member states on the use of medicine

34
Q

What are safety-related referrals are assessed by?

A

Pharmacovigilance Risk Assessment Committee (PRAC) and then either by the Committee for Medicinal Products for Human Use (CHMP) or, for nationally authorised medicines, by the Coordination Group for Mutual Recognition and Decentralised Procedures - Human (CMDh);

35
Q

What are the vast majority of product being authorised by MRP/DCP?

A

Generics

36
Q

What are DCP being used for?

A

New product:

  1. Monoclonal antibodies
  2. New chemical entities
37
Q

What are the pros of MR/DC procedure

A
  1. Flexibility
    - Choice of RMS
    - Choice of CMS - Multiple licenses
    - multiple (invented) names possible
38
Q

What is required in order to do marketing?

A

Infrastructure margin

39
Q

What are the cons of MR/DC procedure?

A
  1. Complexity
    - Slot rationing
  2. Lack of 2nd primary review
40
Q

What is centralised procedure used for?

A

Innovative products

41
Q

What are the European economic area?

A
  1. Iceland
  2. Norway

Not Switzerland

42
Q

What is identical to the European Union?

A

European economic area for medicine regulation

43
Q

What happens when authorisation are granted in EU?

A

It is also validated in this country

44
Q

What is common product information?

A

Leaflet inbox

45
Q

What controls how the medicine are marketed?

A

Summary of product characteristics

46
Q

What is illegal for the company to do?

A

Market product outside of summary of product characteristic

47
Q

What are the features of centralised procedure?

A
  1. 1 Marketing Authorisation valid throughout EU/EEA
  2. 1 (invented) name
  3. 1 Common product information
    - Identical in all official languages including Icelandic and Norwegian
    - Summary of product characteristic
    - User package Leaflet + Labelling

Maximum time limit
-210 days evaluation —> opinion

48
Q

In 2016, how many applications were innovative product?

A

40 applications

  • 45 for generic and biosimilars
  • 24 applications for orphan medicine
49
Q

Features of Centralised Procedure (CP)

A
  1. Dedicated to innovative products
  2. May be open to ‘‘old’’ substances in a new delivery system or in a new indication
  3. Products eligible are defined in the legislation
  4. Human and Veterinary Medicinal Products
50
Q

What are examples of product that have to go to the centralised procedure, and by European Law cannot go through the National procedure?

A
  1. Recombinant DNA technology
  2. Controlled gene expression
  3. Monoclonal antibodies
  4. Orphan medicinal product (product for rare diseases)
  5. New active substance
  6. Advanced therapy medicinal product
51
Q

What are examples of advanced therapy medicinal product?

A
  1. Gene therapy
  2. Cell therapy
  3. Tissue Engineer therapy
52
Q

What is the assessment process in centralised procedure?

A
  1. A company comes and submit a market regulated dossier
  2. Primary evaluation and list of questions that goes back to the company
  3. Company answers the question and then there is a second evaluation
  4. There is a list of outstanding issues
  5. Final evaluation which leads to a decision by opinion of committee
53
Q

What is clock stop?

A

active assessment time in the regulatory authorities stop while we wait for questions to be answered by the company

54
Q

What can the total active assessment time taken out the clock stop cannot go over?

A

210 days

At the end you get an opinion of the CHMP which is the scientific opinion and then a number of days later you get a legal document from the European commission

55
Q

Why does the company withdraw the dossier?

A

To prevent transparency

56
Q

What happens when the marketing refuse?

A

there is a detailed public assessment report that explains why

57
Q

Re-examination of opinion

A

Re-examination = ‘‘Appeal’’

15 days to request re-examination

60 days to submit grounds

CHMP 60 days to consider revision of initial opinion

No new data

Scientific advisory group may be consulted

58
Q

What is the Centralised procedure (post-opinion)?

A
  1. Linguistic phase
  2. Draft EC decision
  3. Standing Committee
  4. Adoption of EC decision
59
Q

What is the Linguistic review?

A
  1. 27 days
  2. Translation in all EU/EEA official languages
    provided by MAH and reviewed by national competent authorities
  3. European Commission prepares a draft decision
60
Q

What is standing committee?

A

on Medicinal Products for Human Use gives opinion on draft decision

EC adopts the decision on granting or refusing Marketing Authorisation, which takes effect from data of notification

Outcome is published by EC and EMA (including assessment reports and clinical data)

61
Q

What are the Pro’s of centralised procedure?

A
  1. Pan-EU license
  2. Transparency
  3. Predictable timeline
  4. Two independent primary reviews
  5. Dedicated EMA product Team
62
Q

What are the Cons of Centralised procedure?

A
  1. Restricted access to CP
  2. No control over CHMP Rapp appointment
  3. All or nothing outcome
  4. Single (invented) name - single MAH
  5. No independent ‘‘appeal’’ body
63
Q

What are there different types of marketing authorisation for?

A

Different types of products

64
Q

Fixed dose combination - Ace inhibitor and diuretic

A
  1. Been in the market as single use component
  2. Very well established
  3. The company splits the two to find formulations
65
Q

What are the requirement for generic product?

A

Need all the information on quality and manufacturing but not the clinical stuff

You need bioequivalence study

66
Q

What does the manufacturing methods have?

A

Profound impact on the molecule

67
Q

What is biosimilar?

A

Where a biological medicinal product which is similar to a reference biological product does not meet the conditions in the definition of generic medicinal product, owing to, in particular, differences relating to raw materials or differences in manufacturing processes of the biological medicinal product and the reference biological medicinal product, the results of appropriate pre-clinical test or clinical trials relating to these conditions must be provided

68
Q

Medicinal product shall be subject to medical prescription where they:

A
  1. are likely to present a danger either directly or indirectly, even when used correctly, if utilized without medical supervision
  2. Are frequently and to a very wide extent used incorrectly, and as a result are likely to present a direct or indirect danger to human health
  3. Contain substances or preparations, the activity and or adverse reactions of which require further investigation
  4. Are normally prescribed by a doctor to be administered parenterally
69
Q

What is organ designation?

A

∇ Is a legislation about a millennium
∇ Tries to stimulate companies to produce medicine for rare diseases
∇ It gives the company a monopoly for 10 years what’s on the market
∇ COMP: Committee on orphan on medicinal product – assess the product in development are eligible to be called an orphan medicine

70
Q

What are orphan designation criteria?

A
  1. Prevalence
  2. Seriousness of condition
  3. Comparison to available treatment
71
Q

Prevalence of orphan designation criteria

A

Rare condition affecting not more than 5 in 10,000 person in the EU

Unlikely that the medicine would generate sufficient returns to justify investment

72
Q

Seriousness of condition

A

Life threatening and/or chronically debilitating condition

73
Q

Comparison to available treatment

A

No satisfactory methods exist

or significant benefit vs. existing method

74
Q

What are the types of marketing authorisation?

A
  1. Normal MA
  2. Conditional MA
  3. MA under exceptional circumstances
75
Q

What is Accelerated assessment?

A

For product of major interest from the point of view of public health and in particular from the viewpoint of therapeutic innovation

Request to be submitted and agreed in advance of submitting the MA application

Maximum active time is 150 days

76
Q

What happens to a product not marketed in EU for 3 consecutive year peiod

A

Lose their authorisation

DDD x (17 decks)

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