The Future of Pharmacovigilance: Hot Issues on the Horizon in … · Pharmacovigilance •...

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BEIJING BRUSSELS CHICAGO DALLAS FRANKFURT GENEVA HONG KONG LONDON LOS ANGELES NEW YORK SAN FRANCISCO SHANGHAI SINGAPORE TOKYO WASHINGTON, D.C. The Future of Pharmacovigilance: Hot Issues on the Horizon in the EU Maurits Lugard, Partner November 8, 2007

Transcript of The Future of Pharmacovigilance: Hot Issues on the Horizon in … · Pharmacovigilance •...

Page 1: The Future of Pharmacovigilance: Hot Issues on the Horizon in … · Pharmacovigilance • Published January 25, 2007 • Took effect immediately • Applies to medicinal products

BEIJING BRUSSELS CHICAGO DALLAS FRANKFURT GENEVA HONG KONG LONDON LOS ANGELES NEW YORK SAN FRANCISCO SHANGHAI SINGAPORE TOKYO WASHINGTON, D.C.

The Future of Pharmacovigilance: Hot Issues on the Horizon in the EU

Maurits Lugard, Partner

November 8, 2007

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EU PV System Re-design

The Commission recently announced that it intends to re-design the EU PV system

Follows an open consultation from Spring 2006

Commission’s primary goals:

Achieve a better implementation of the current PV system

Introduce changes to the legal framework to clarify and simplify standards and reporting requirements

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EU PV System Re-design

2004 Commission launches call for proposals for

independent study of strengths and weaknesses of current system

2005 Study conducted by

Fraunhofer

Institute & University of

Tűbingen

2006 Public consultation on outcome study

2007 New strategy announced by

Commissioner Verheugen & impact assessment

2008 New legal proposal adopted by

Commission

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Some

Key Weaknesses

in EU PV Regime:

Legal framework is complex and difficult to rapidly understand

Implementation is not the same in all MS

Complex system with many players

Frequent duplication of work

Quality management is lacking

Resources vary considerably–

50 persons in Germany; a handful in some new Member States

Funding is problematic

Decision-making can be slow, especially at EU level

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Better Implementation of Current

EU PV System

Commission will:

Fund studies into both the safety of medicines and general methodologies used to conduct PV

Make efforts for the EU Member States to resolve implementation issues (reporting)

Ensure the EMEA has a stronger coordinating role in the overall process

Including better use of the Eudravigilance

database

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Anticipated Changes

to the PV Legal Framework

Minimize duplications between Member States and the EMEA

Strengthen rules on transparency relating to PV data, assessment and decision-making

Involve stakeholders in the processes (patient groups)

Establish clear standards (Good Vigilance Practices)

Simplify reporting of ADRs

Establish a clear legal requirement to conduct post-

authorization safety studies (PASS)

BIG OPEN QUESTION: Entirely new legal framework??

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Instruments for Regulating PhV

in the EU

Council Regulation

EU Directives

EU Guidances

National legislation

International fora

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Council Regulation

Adopted by the Council and the European Parliament based on a proposal from the European Commission

Directly applicable

in EU Member States•

Consistency of law throughout the EU territory is safeguarded -

“no discrepancies”•

Published

in the Official Journal•

Available

in all official languages•

Full legal

certainty

-

Council Regulation 726/2004 (for central authorization – in force since 20 November 2005)

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EU Directives

Adopted by the Council and the European Parliament based on a proposal from the European Commission

National implementation

is required –

“not directly applicable”

Discrepancies

in national implementing

laws•

Published

in the Official Journal•

Available

in all official languages•

Legal

certainty, but no EU uniform

regime

-

Directive 2001/83/EC (for national authorization and mutual recognition – important amendments were to be implemented by EU Member States by 30 October 2005)

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EU Guidances

Commission guidances•

Drafted by DG Enterprise in consultation with EMEA and other experts

No systematic input from other Commission services•

No input from EU institutions, e.g. Council or European Parliament

Legally binding?• Sometimes ambiguous provisions • Available only

on Internet (DG Enterprise website) and in English

-

Eudralex Volume 9A

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EU Guidances

EMEA guidance documents•

Drafted by Pharmacovigilance

Working Party•

Not adopted through a legislative process•

Legally binding?

-

EMEA/CHMP/313666/05 Note for Guidance on the Exposure to Medicinal Products during Pregnancy: Need for Post-Authorisation Data (Adopted November 2005)

-

EMEA/115735/2004 Note for Guidance on the Electronic Data Interchange (EDI) of Individual Case Safety Reports (ICSRS) and Medicinal Product Reports (MPRS) in Pharmacovigilance during the Pre-and Post-Authorisation Phase in the European Economic Area (EEA) (EudraVigilance TIG adopted September 2004)

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National legislation

• Country specific• Exists side-by-side with EU PhV

legislation• Complex network of 27 national rules in

national languages• Harmonization does not mean uniformity -

rules are transposed differently and at different speeds in different Member States

Necessary to comply with different national obligations, including reporting requirements and timeframes

• Duplication of national efforts ties up resources that could be better spent on drug safety

Page 16: The Future of Pharmacovigilance: Hot Issues on the Horizon in … · Pharmacovigilance • Published January 25, 2007 • Took effect immediately • Applies to medicinal products
Page 17: The Future of Pharmacovigilance: Hot Issues on the Horizon in … · Pharmacovigilance • Published January 25, 2007 • Took effect immediately • Applies to medicinal products

International Agreements

• International Conference on Harmonization (‘ICH’)

• Council for International Organizations of Medicinal Sciences (‘CIOMS’)

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A PhV

Council Regulation could address (certain) weaknesses in EU PV System

• Detailed clear and concise provisions

• Directly applicable in EU Member States

• Eliminates national discrepancies

• Prepared with input from all interested parties

• Legally binding on all interested parties

• Published in the Official Journal in all official languages

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Volume 9A: Guidelines on Pharmacovigilance

Published January 25, 2007

Took effect immediately

Applies to medicinal products for human use authorized in the EU

New content compared to Volume 9–

Revised guidelines on previously covered topics

New guidelines on new topics

Collection of other guidelines in one document

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Part I, Section 1.2.1 –

Role & Responsibilities Of The QPPV

Two types of responsibilities:

(1) those that cannot be delegated and for which there is “direct

responsibility”

by the QPPV

(2)

those that can be delegated, but for which the QPPV must maintain “oversight

responsibility”

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Part I, Section 1.2.1 –

Role & Responsibilities Of The QPPV

QPPV’s

direct

responsibilities are:

1.

establish/maintain/manage MAH PV system

2. have overview of safety profiles and emerging safety concerns for all products for which the MAH holds authorization

3. be single contact point for Competent Authorities (24 hours!)

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Part I, Section 1.2.1 –

Role & Responsibilities Of The QPPV

QPPV’s

oversight

responsibilities are:

ensure collection of adverse reactions at one point in the EU

ensure preparation of ICSRs, PSURs, reports on PASSs

ensure continuous overall post-authorization PV evaluation

ensure that requests from CAs

are answered fully & promptly

ensure that CAs

are provided with any other relevant information re: risk-benefit, including information on PASS and data from sources related to reporting in special situations

Page 25: The Future of Pharmacovigilance: Hot Issues on the Horizon in … · Pharmacovigilance • Published January 25, 2007 • Took effect immediately • Applies to medicinal products

Part I, Section 1.2.1 –

Role & Responsibilities Of The QPPV

QPPV also

has oversight responsibility to cover the

functioning of the PV system in all relevant aspects including:•

quality control and assurance procedures

SOPs

database operations

contractual arrangements

compliance data

audit reports

PV training of personnel

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Part I, Section 1.2.2 –

Role & Responsibilities Of The MAH v. QPPV

Pharmaceutical groups with more than 1 PV system can have more than 1 QPPV

“Each company (i.e. Applicant/MAH

or group of

MAHs

using the same PV system) should appoint 1 QPPV responsible for overall PV for all medicinal products…”

Page 27: The Future of Pharmacovigilance: Hot Issues on the Horizon in … · Pharmacovigilance • Published January 25, 2007 • Took effect immediately • Applies to medicinal products

Part I, Section 1.3 –

Contractual Arrangements

New section

MAH may transfer any and all its PV tasks, including those of QPPV, to others (person/organization), but ultimate responsibility always remains with MAH

MAH must have “detailed and clear documented contractual arrangements” in place to meet PV obligations

MAH must provide authorities with “information on such arrangements”

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Part I, Section 4 Requirements for Expedited Reporting of Individual Case

Safety Reports

Clock for expedited reporting: starts (“day 0”) as soon as the minimum information has been brought to the attention of:

Any personnel of the MAH or

An organization having a contractual arrangement with the MAH, including medical representatives

Page 30: The Future of Pharmacovigilance: Hot Issues on the Horizon in … · Pharmacovigilance • Published January 25, 2007 • Took effect immediately • Applies to medicinal products

Penalties Regulation

• Commission Regulation (EC) No 658/2007 of 14 June 2007 concerning financial penalties for infringement of certain obligations in connection with marketing authorisations granted under Regulation (EC) No 726/2004 of the European Parliament and of the Council, OJ L 155, 15.6.2007, p. 10.

Effective from July 5, 2007

Top line:–

applies to centrally authorized products–

lays down rules concerning the imposition of financial penalties to MAHs

in respect of 17 infringements, including re: PV obligations

financial risk associated with non-compliance: up to 5% of total EU annual turnover

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Infringements covered

17 different types of infringement, which can be divided into four

main categories:

I.

completeness and accuracy of submissions to EMEA (article 1.1)

II.

breach of the conditions and restrictions imposed in the marketing authorization re safe and effective use (articles 1.2 to 1.3)

III.

breach of post-marketing obligations (articles 1.4 to 1.11)

IV. infringement of PV rules, including: QPPV, AE reporting, communication (articles 1.12 to 1.17)

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Enforcement procedures

Investigation stage (I):●

By who? To be initiated by EMEA (article 5) either

at its own initiative; orat the request of the European Commission; orat the request of an EU Member State.

When? In cases where the infringement concerned •

may have significant public health implications in the Community, or

where it has a Community dimension by taking place or having its effects in more than one Member State, or

where interests of the Community are involved

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Enforcement Procedures

Investigation stage (II)•

Third parties have no formal right to request an investigation by way of complaint

EU Member States and MAHs

are required to cooperate with EMEA in its request for information

failure to do so by MAH may result in fines up to 0.5% EU annual turnover, and periodic penalty payments per day of up to 0.5% of MAH’s daily EU turnover in case of continuous non- cooperation

MAH has right of access to the file

MAH has right to submit written observations prior to adoption of EMEA report

Page 36: The Future of Pharmacovigilance: Hot Issues on the Horizon in … · Pharmacovigilance • Published January 25, 2007 • Took effect immediately • Applies to medicinal products

Forms of Penalties

Financial penalties can take two forms:

a fine of up to 5% of the MAH’s annual EU turnover; and

periodic penalty payments per day of up to 2.5% of average EU daily turnover in case of continuous infringement

Page 37: The Future of Pharmacovigilance: Hot Issues on the Horizon in … · Pharmacovigilance • Published January 25, 2007 • Took effect immediately • Applies to medicinal products

Determination level of financial penalty

Which level of fine is appropriate?–

European Commission has broad discretion

Principles of “effectiveness, proportionality and dissuasiveness”

taking into account a long list if circumstancesseriousness and effects of infringement;

presence or absence of good faith or evidence of willful deceit;

degree of diligence and cooperation or any obstruction by MAH;

need to adopt provisional measures as a matter of urgency;

repetition, frequency or duration of infringement;

prior sanctions imposed on MAH;

turnover of medicinal product concerned.

Page 38: The Future of Pharmacovigilance: Hot Issues on the Horizon in … · Pharmacovigilance • Published January 25, 2007 • Took effect immediately • Applies to medicinal products

Questions?

Thank you!

Maurits J.F. LugardPartner

Sidley Austin LLPSquare de Meeûs 35

B–1000 Brussels, BelgiumTel: + 32 2 504 64 17

E-mail: [email protected]