Thursday, October 10, 2013

E-cigarettes will not be controlled as medicinal products in Europe

On 8 October 2013, European Parliament adopted anti-smoking bill but refused to control e-cigarettes as medicinal products.
Electronic cigarettes will therefore continue to be available in tobacco shops or specialist stores, with the exception of any brands claiming curative properties. They will also be banned for sale to minors and no advertising allowed.

The parliament’s vote will set the stage for negotiations with the EU’s member states over final legislation.

Refer following links for more information.

Tuesday, October 1, 2013

European Medicines Agency (EMA) publishes a video explaining the concept of medicines under additional monitoring on 1 October 2013.


The concept of additional monitoring and the black symbol were introduced by new EU laws on the safety-monitoring of medicines, started to come into effect in 2012.

Any new medicine authorized after 1 September 2013 which is subject to additional monitoring will include the black symbol in the package leaflet and the summary of product characteristics when it is placed on the EU market.

The legislation affects medicines authorized in the EU after 1 January 2011. Therefore, there will be a transition period for medicines authorized between January 2011 and August 2013.

For medicines that are already authorized, marketing-authorization holders are encouraged to use the new template at the next regulatory procedure affecting the product information. If there are no such procedures, companies should submit a type-IAIN variation no later than 31 December 2013.

The European Medicines Agency has published a video and a factsheet in all official European Union (EU) languages today 1 October explaining the meaning of the black triangle, which is now starting to appear in the product information of certain authorized medicines in the EU.

All medicines on the EU market are carefully monitored. If a medicine is labelled with the inverted black triangle, it does not mean that it is unsafe; the purpose of the symbol is to actively encourage healthcare professionals and patients to report any suspected adverse reactions observed with the medicine, either because the medicine is new to the market or because there is a limitation to the data available on its safety.

This system will help Regulatory authorities to collect information to monitor real-life experience with medicines. Regulatory authorities look at all reports of adverse reactions, alongside all the information they already have, to make sure that the benefits of medicines remain greater than their risks and to take any necessary action to optimize safe and effective use.

Following criteria applies for additional monitoring status to a medicine:

  • it contains a new active substance authorized in the EU after 1 January 2011;
  • it is a biological medicine, such as a vaccine or a medicine derived from plasma (blood), authorized in the EU after 1 January 2011
  • it has been given a conditional approval (where the company that markets the medicine must provide more data about it) or approved under exceptional circumstances (where there are specific reasons why the company cannot provide a comprehensive set of data)
  • the company that markets the medicine is required to carry out additional studies, for instance, to provide more data on long-term use of the medicine or on a rare side effect seen during clinical trials.
Other medicines can also be placed under additional monitoring, based on a decision by the Agency's Pharmacovigilance Risk Assessment Committee (PRAC). 
 

Thursday, September 26, 2013

New Drug marketing within a period of six months from obtaining permission is mandatory in India

The principal national drug authority for India - the Central Drug Standards Control Organization (CDSCO) has announced that the new drug should be launched for marketing within a period of six months from obtaining the license from CDSCO.

CDSCO reviews the new drug applications under the Drugs and Cosmetics Rules, 1945 and grants the permission to manufacture a new drug. Based on the permission received from CDSCO, manufacturer obtains manufacturing licence from the concerned State Licensing Authorities.

As per schedule Y, Periodic safety Update reports (PSURs) of new drugs are required to be submitted every six months for initial 2 years and then annually for subsequent 2 years. However CDSCO observed that the manufacturers do not launch their products even after years of getting approval from the authority and do not submit required PSUR, while the drug does not remain new drug after a period of 4 years. The assessment of safety and efficacy of such new drugs in post marketing scenario remains incomplete.

Therefore CDSCO has decided that in case manufacturer fails to launch the product for marketing in the country within a period of 6 months from obtaining the permission from CDSCO, the permission will be treated as cancelled.

For information refer http://www.cdsco.nic.in/

Monday, September 23, 2013

New Identification System for Medical Devices gets finalized in the USA

On 20 September the U.S. Food and Drug Administration announced the unique device identification system (UDI) that, once implemented, will provide a consistent way to identify medical devices.
FDA News release says, UDI represents a landmark step in improving patient safety, modernizing post market surveillance system for medical devices, and facilitating medical device innovation.
As part of the UDI system, the FDA is also creating the Global Unique Device Identification Database (GUDID) which will include a standard set of basic identifying elements for each device with a UDI. Most of this information will be made available to the public so that users of a medical device can easily look up information about the device.
The UDI system consists of two core items. The first is a unique number assigned by the device manufacturer to the version or model of a device, called a unique device identifier. This identifier will also include production-specific information such as the product’s lot or batch number, expiration date, and manufacturing date when that information appears on the label.
 The second component is a publicly searchable database administered by the FDA, called the Global Unique Device Identification Database (GUDID) that will serve as a reference catalogue for every device with an identifier. No identifying patient information will be stored in this device information center.
UDI system will help trace the devices quickly in analyzing any adverse events.  A more robust post market surveillance system can also be leveraged to support premarket approval or clearance of new devices and new uses of currently marketed devices. It will also help to efficiently manage Medical devices recall. Finally UDI system will serve a foundation for global distribution chain and help address counterfeiting.
Compliance dates for UDI implementation are defined in UDI rule. In general, high-risk medical devices (Class III) will be required to carry unique device identifiers on their label and packaging within one year and this number and corresponding device information must be submitted to the new database. Manufacturers will have three years to act for most Class II (moderate risk) devices. Manufacturers of Class I devices not exempt from UDI requirements will have five years to act.
For more information refer
http://www.fda.gov/MedicalDevices/DeviceRegulationandGuidance/UniqueDeviceIdentification/default.htm

Sunday, September 22, 2013

Does this mean Biosimilars are delayed in the USA market?



Abbott filed a citizen petition with the U.S. Food and Drug Administration on 2 April 2012, asking the agency to refrain from accepting Biosimilars applications under the Biologics Price Competition and Innovation Act (BPCIA). The BPCIA, which provides an approval pathway for Biosimilars biological products and constitutes a portion of the Patient Protection and Affordable Care Act that was signed into law on March 23, 2010, allows the FDA to accept Biosimilars applications four years after a reference product has been licensed and to approve such applications twelve years after the reference product has been licensed. Abbotts’ patent on Humira® is set to expire in December 2016.
Abbott  has highlighted following points that "the reference product sponsor has invested massive amounts of capital . . . and has taken great risk to develop, test, and seek a license to market the reference product," Abbott argues that "an innovator's resulting license application typically reflects more than a decade of research and contains analytical, preclinical, and clinical data, as well as detailed manufacturing information, most of which qualifies as trade secrets," and contends that "these trade secrets are the private property of the reference product sponsor.  According to Abbott's Petition, "when FDA approves a Biosimilars biological product on the grounds that the reference product has been shown safe, pure, and potent, it uses these trade secrets."
Abbott also notes that when it submitted its BLA for Humira® in 2002, the company "had no notice, or reasonable expectation, that the agency would use its trade secrets to approve another company's product," and in fact, had "developed and submitted those trade secrets in reasonable reliance on FDA's lack of legal authority to approve Biosimilars, confirmed by years of agency statements that it lacked such authority."  The Petition suggests that other innovators who submitted pre-enactment BLAs also "reasonably expected -- on the basis of applicable law and agency statements -- that the trade secrets contained in their applications would not be used to benefit a competitor." 
Abbott also expresses a belief "that at least three companies have begun preclinical and/or clinical testing of Biosimilar adalimumab," but notes that it "does not know whether FDA is advising any companies about the contents of a Biosimilars application citing approval of Humira®.
The FDA continues to collect comments regarding Abbott's Citizen Petition, and has thus far received comments from the Generic Pharmaceutical Association (GPhA), Therapeutic Proteins International, LLC (a manufacturer and supplier of finished Biosimilars recombinant therapeutic proteins products), and Zuckerman Spaeder LLP (a litigation firm).  Each of these commenters has asked the FDA to deny Abbott's Petition.  Last month, the Washington Legal Foundation (WLF), a public interest law and policy centre, became the most recent group to submit comments on Abbott's Citizen Petition, but in contrast with the GPhA, TPI, and the Zuckerman firm, submitted its comments in support of Abbott's Petition.
The WLF's commented that any company that submitted a biologics license application (BLA) to FDA after adoption of the BPCIA in 2010 was on notice that FDA would be using information submitted in support of the application to evaluate the safety of Biosimilars.  But many if not all companies that submitted a BLA to FDA before adoption of the BPCIA (including Abbott, which submitted an application for Humira® in 2002) would very reasonably have believed that their trade secret information would not be used to assist their competitors in this manner and, on the basis of that belief, invested heavily in the development of their biological product. As a result, the WLF supports Abbott's request that the FDA not approve any application or any investigational new drug (IND) application for a Biosimilars that cites a reference product for which the BLA was submitted to the FDA prior to March 23, 2010.
FDA has held 21 Pre-IND sponsor meetings, has received 35 Pre-IND meeting requests for proposed Biosimilars to 11 reference products, and has received 9 INDs. FDA has not yet even approved (let alone filed) a Section 351(k) biosimilar application submitted pursuant to the procedures established by the BPCIA.
On the comments received from GPhA, FDA has stated that the 2010 law expressly states that an interchangeable biological product may be substituted for the reference product without the intervention of the health care provider who prescribed the reference product. Substitutability helped spur the growth of the generic drug industry at an earlier time and is similarly essential to help foster competition in the biologic drug market. Ultimately, such competition will spur innovation, improve consumer choice and drive down medical costs. The high standards for approval of biosimilar and interchangeable products mean that patients and health care professionals can be assured that, when these products go to market, they will meet the standards of safety, efficacy and high quality that everyone expects and counts on. Efforts to undermine trust in these products are worrisome and represent a disservice to patients who could benefit from these lower cost treatments. FDA does not have a position on any particular state legislation, but it is important for everyone to approach these issues with an understanding of both FDA's expertise in this area and what the 2010 law requires for approval of biosimilar and interchangeable products.
 It is likely that the issues raised in Abbott’s Citizen Petition ultimately will have to be decided by the courts. The final outcome could impact the viability of the biosimilar framework, and have far-reaching effects on the biotechnology industry, as well as on healthcare costs and patient care. 

For more  information refer following links.

Saturday, September 14, 2013

Biosimilars: Twist and turn with a silver lining

I just came across, fantastic news about the first time Biosimilar versions of a monoclonal antibody (mAb) drug that have been recommended for approval in the European Union (EU), opening a new chapter in the developing market for cheaper copies of biologic medicines. CHMP has issued positive opinions on biosimilar versions of Johnson & Johnson's arthritis and Crohn's disease treatment Remicade (infliximab) filed by Celltrion Healthcare and Hospira. The reference product posted European sales of over $2bn last year.

To date a total of 12 medicines have been approved under the biosimilar regulatory pathway first laid out by the EMA in 2006, covering a range relatively small protein-based drugs including epoetins, filgrastims, growth hormones and recombinant human interferon alfa-2a.

The first time that the biosimilar concept has been successfully applied to such a complex molecule as the increased size and complexity of mAbs makes it more challenging to be able to demonstrate that their biosimilars do not have any meaningful differences from the reference medicine in terms of quality, safety or efficacy. So above news is fantastic in that sense.

It’s interesting to know some simple facts of biological drugs. But these simple cornerstones will help understand regulatory guidelines on biosimilars. Before understanding biological drugs let’s see them in comparison to chemical drugs.  It would help understand the difference in regulatory requirements of both.

Biological drugs (Bios) are different from small molecule medicines in many aspects first of it is they are made in living system such as microorganisms or animal cells. Small molecule medicines are typically manufactured by chemical synthesis. Both types of drugs differ in their manufacturing techniques, molecular size and complexity.

The production of biological medicines is a complex process which requires a very high level of technical expertise with typically about 250 in-process tests being conducted compared to about 50 tests for a small molecule medicine. The production of biological medicines involves processes such as fermentation and purification.

Size matters….....acetylsalicylic acid (ASA), aspirin's active ingredient with a molecular weight of about 180 g/mol or 180 Da and biologics molecule (protein) which are composed of more than 1,300 amino acids and can be as heavy as 150,000 g/mol (or 150 kDa).

Small molecule medicines generally have well-defined chemical structures. Bios have variability in the molecule (protein) as they are made in living systems and same protein exists in different forms.
For example enzyme Creatine kinase, the presence of which in the blood can be used as an aid in the diagnosis of heart attack, exists in 3 isoforms. Another source of variability is due to the type and length of sugar or carbohydrate group attached to the protein called glycosylation.

Due to the variability in structure of bios molecules it is more difficult to characterize it and exactly reproduce. Therefore batch to batch variation is controlled by manufacturers and regulators within accepted pre-defined limit.

Biological medicines have the potential to be recognized by the body as foreign due to their big size and therefore have the potential to induce immune reactions whereas chemical medicines are usually small molecule, to be recognized by immune system. This potential to induce immune reaction is called immunogenicity.

Biosimilar is a regulatory term used in the EU to denote the comparability between biosimilar and its reference medicinal product.  Biosimilar products are systematically developed and their comparability is performed in several steps.

1.       First step - quality comparability (physicochemical and biological comparability).

2.       Second step - non-clinical comparability (comparative non-clinical studies)

3.       Third step - clinical comparability (comparative clinical studies)

Comparability is an additional element to the normal requirement of the quality dossier. 
The exhaustive comparability exercise at quality level may allow reduction of the non-clinical and clinical data.

Differences in impurity profile and significant differences in product related substances may have consequences with regards to the amount of non-clinical and clinical data requirement in order to make satisfactory justification of the safety and efficacy of the biosimilar.

Quality comparability is established with regard to the molecular structure as well as with regard to the functionality.  Structural analysis is done using apt analytical methodology to deduce primary structures such as amino acid sequence; higher order structures including secondary, tertiary and quaternary structures, enzymatic post translational modifications such as glycosylation; other modifications such as protein deamidation, oxidation and intentional chemical modifications. 
Functional assays include bioassays, binding assays and enzyme kinetics. This information helps design clinical immunogenicity.

The non-clinical and clinical comparability then provides the confidence that any differences observed at the quality level have no impact on the safety and efficacy of the biosimilar medicinal product when compared to the reference medicinal product.

Animal data requires toxicity and PK PD profile. Immunogenicity studies are performed in animals when there is difference in impurity profile and excipients of biosimilar and reference medicinal product. Clinical studies include PK, PD studies and analysis of immunogenicity.

As a scientific matter, comparative safety and effectiveness data will be necessary to support a demonstration of biosimilarity if there are residual uncertainties about the biosimilarity of the two products based on structural and functional characterization, animal testing, human PK and PD data, and clinical immunogenicity assessment.

If interested refer following links.

http://www.ema.europa.eu/docs/en_GB/document_library/Press_release/2013/06/WC500144941.pdf
 http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/UCM291128.pdf
http://ec.europa.eu/enterprise/sectors/healthcare/files/docs/biosimilars_report_en.pdf