| Product Registration | | | | pharmacovigilance it is most relevant to products |
| Getting marketing authorisation for medicinal products | | | | authorised by the national, mutual recognition and |
| in more than one Member State in the EU is done by | | | | decentralised procedures. The Member States are |
| using one of three procedures: | | | | the licensing authorities in these procedures. |
| | | | Regulation 726/2004. This concerns centrally |
| "Mutual Recognition Procedure" and | | | | authorised products. The European Commission is the |
| "Decentralised Procedure" - Directive 2001/83/EC. | | | | licensing authority for these products. |
| As well as these, national authorisations still allow | | | | Directive 2001/20. This is the Clinical Trials Directive |
| products to be marketed in individual countries in the | | | | and includes extensive coverage of pharmacovigilance |
| EU. Products could be authorised separately in several | | | | for interventional clinical trials pre- and |
| Member States by a number of national | | | | post-authorisation. |
| authorisations, alternatively one of these | | | | Guidelines |
| authorisations could be used to apply for | | | | A word to the wise here. The guidelines tends to be |
| authorization using the Mutual Recognition Procedure. | | | | suggestions or recommended methods. When it |
| Where products have national authorisation, the | | | | comes to EU pharmacovigilance law the guidelines are |
| regulatory agency of the country concerned has to | | | | considered to be compulsory as far as pharmaceutical |
| monitor and assess the safety of any products that | | | | companies are concerned. |
| have national authorisation. | | | | The European Commission guidelines provide detail |
| Centralised Procedure | | | | and interpretation as to how the directives and |
| The EMEA administers the centralized procedure, | | | | regulations should be followed.The guidelines are also |
| where a single application, if approved, grants | | | | aimed at regulatory authorities and provide detailed |
| marketing authorisation for all the countries in the | | | | requirements for the way that they must carry out |
| European Union (and the European Economic Area, | | | | pharmacovigilance as well. The guidelines are: |
| that's the EU countries plus Iceland, Norway and | | | | Volume 9A of the Rules Governing Medicinal Products |
| Liechtenstein). The European Commission becomes | | | | in the European Community - for post-authorisation |
| the responsible authority for products which come to | | | | pharmacovigilance |
| market through the centralised procedure. This | | | | Volume 10 of the Rules Governing Medicinal Products |
| procedure is available to all new or innovative | | | | in the European Community. This applies to clinical |
| pharmaceuticals and is the only way to authorise | | | | trials pre- and post-authorisation and incorporates the |
| biotechnology medicines. Where products contain | | | | guideline Detailed guidance on the collection, |
| new substances for treating serious diseases, they | | | | verification and presentation of adverse reaction |
| would use the centralised procedure. | | | | reports arising from clinical trials on medicinal products |
| The regulatory agency of one Member State is then | | | | for human use |
| appointed as the Rapporteur and they will then carry | | | | As well as these laws and regulatory guidelines there |
| out initial assessments of the application for | | | | are also various voluntary guidelines, generated for |
| Marketing Authorisation; a second agency is | | | | the most part by two organizations: |
| appointed as Co-Rapporteur. These countries will then | | | | The Council for International Organizations of Medical |
| be responsible for leading the monitoring and | | | | Sciences (CIOMS) |
| assessment of safety of the product when it is | | | | The International Conference on Harmonization of |
| subsequently marketed. | | | | Technical Requirements for the Registration of |
| Mutual Recognition Procedure | | | | Pharmaceuticals (ICH). |
| In the Mutual Recognition Procedure the marketing | | | | CIOMS is a body set up under the World Health |
| authorisation of one member State is recognised and | | | | Organization and UNESCO. It has developed a series |
| copied by the other member states. In this | | | | of guidelines on pharmacovigilance, drawn up by a |
| procedure, the 'Reference Member State', is "mutually | | | | committee of volunteers from Industry, regulatory |
| recognised" by other 'Concerned Member States'. | | | | authorities, WHO and others. The main guidelines |
| Once the application for mutual recognition has gone | | | | concern the international reporting form (CIOMS I); |
| in, there is a 90 day assessment period. After the | | | | periodic safety update reports (CIOMS II); core data |
| assessment period the Member States grant a | | | | sheets (CIOMS III); benefit-risk assessments (CIOMS |
| marketing authorisation with an identical summary of | | | | IV); practical issues in pharmacovigilance (CIOMS V); |
| product characteristics to the one in the Reference | | | | clinical trial safety data (CIOMS VI); and development |
| Member State as long as they accept the original | | | | safety update reports (CIOMS VII). |
| assessment of the product. If a Member State raises | | | | Whilst CIOMS guidelines are very influential they are |
| objections and does not recognise the original | | | | not "official" regulatory guidelines, they have no legal |
| marketing authorisation then the matter may be | | | | force and are generally there just to provide a |
| referred to the EMEA for discussion among the | | | | consensus on good practices and new methodologies. |
| parties: if this fails, binding arbitration is imposed. | | | | ICH consists of representatives of the regulatory |
| Decentralised Procedure | | | | authorities from the EU, Japan and US, with |
| The decentralised procedure can apply where there is | | | | representatives of the corresponding industry regional |
| no authorisation yet in any of the Member States. | | | | organizations and Health Canada and WHO as |
| The same dossier is submitted to all Member States | | | | observers. ICH establishes guidelines applicable to the |
| where a marketing authorisation is needed. The | | | | EU, US and Japan through a series of expert working |
| applicant selects a Reference Member State and | | | | groups. There is a stepwise development of the |
| prepares a preliminary assessment report within 120 | | | | guidelines. At Step 4, there is consensus |
| days and sends it to the other states, the Concerned | | | | internationally and at Step 5, an agreement by the |
| Member States. They then approve the assessment | | | | regulators that they will introduce the guidelines into |
| or the application will continue into a facilitation or, if | | | | legislation, although there may be some divergence |
| this fails, a binding arbitration procedure applies. | | | | when these are actually put into effect in the |
| Laws and guidelines | | | | different regions. |
| Laws | | | | The three areas covered by ICH guidelines are |
| In the EU there are EU laws which are directives and | | | | Efficacy, Safety and Multidisciplinary. Paradoxically, the |
| regulations, and national laws. Once an EU regulation | | | | "Efficacy" guidelines include clinical (human) safety, |
| comes into effect it is in force in all the Member | | | | whereas the "Safety" guidelines concern only |
| States of the European Union. However EU directives | | | | pre-clinical (animal toxicology) safety. |
| are different, once an EU directive comes into force | | | | The main guidelines concerning pharmacovigilance are: |
| it must first be enacted in national law in each EU | | | | E1: populations to be studied for safety and efficacy |
| Member State within a specified time-frame. As well | | | | E2A: reporting on safety in clinical trials |
| as the national laws that put EU directives into action, | | | | E2B: electronic reporting of adverse events |
| there may also be national laws governing | | | | E2C: periodic safety update reports |
| pharmacovigilance practice. | | | | E2D: reporting on safety post-marketing |
| The principal EU laws concerning pharmacovigilance | | | | E2E: pharmacovigilance planning |
| are: | | | | E2F: development safety update reports |
| Directive 2001/83, amended by Directive 2004/27. | | | | M1: Medical Dictionary for Regulatory Activities |
| This concerns all medicinal products, although for | | | | M4: the Common Technical Document (i.e. |