Marketing Authortitzations
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Questions and Answers

What is the meaning of FPPs?

  • Finished Pharmaceutical Products (correct)
  • Finished Pharmaceutical Procedures
  • Finished Pharmaceutical Preparations
  • Finished Physical Products
  • The essential feature of a batch is its homogeneity.

    True (A)

    What is the term used for a medicinal product intended for research and development purposes?

    Magistral Preparations

    How are veterinary drugs regulated?

    <p>By the same agencies regulating human drugs, but with separate regulatory pathways (C)</p> Signup and view all the answers

    Preclinical studies can provide a clear indication of how a drug will behave in humans.

    <p>False (B)</p> Signup and view all the answers

    What is the primary reason for the marketing authorization process?

    <p>To minimize foreseeable risks associated with placing the medicine on the market.</p> Signup and view all the answers

    The Summary of Product Characteristics (SmPC) is a document included in the marketing authorization dossier.

    <p>True (A)</p> Signup and view all the answers

    Which types of medicines are typically subjected to a centralized procedure for marketing authorization?

    <p>Biotechnology-prepared products for AIDS, cancer, or neurodegenerative diseases (B)</p> Signup and view all the answers

    The requirements for approval of a generic medicine are the same as those for an originator medicine.

    <p>False (B)</p> Signup and view all the answers

    What is the purpose of a biosimilar medicine?

    <p>To provide a cheaper alternative to a brand-name medicine (A)</p> Signup and view all the answers

    The marketing authorization of biosimilar medicines typically takes place at a national level.

    <p>False (B)</p> Signup and view all the answers

    What is the main body responsible for evaluating herbal medicines in the European Union?

    <p>The Committee on Herbal Medicinal Products (HMPC)</p> Signup and view all the answers

    What are the two main categories of EU monographs for herbal medicines?

    <p>Well-established use and traditional use (C)</p> Signup and view all the answers

    Homeopathic medicines are typically regarded as equivalent to other medicines for treating conditions.

    <p>False (B)</p> Signup and view all the answers

    What type of evidence is usually required for the simplified registration of homeopathic medicines?

    <p>Evidence of the suitability and validity of the indications for treatment and the safety of the product.</p> Signup and view all the answers

    What is the main factor that determines the duration of the registration application process?

    <p>The type of regulatory procedure used (A)</p> Signup and view all the answers

    Once a marketing authorization is granted, it is valid indefinitely.

    <p>False (B)</p> Signup and view all the answers

    What is a sunset clause in the context of marketing authorization?

    <p>A legal provision stating that a medicine's marketing authorization will cease to be valid if it's not placed on the market within three years of being granted or if it is removed from the market for three consecutive years.</p> Signup and view all the answers

    What does 'off-label use' of a registered medicine signify?

    <p>Using a medicine for unapproved indications or in a way not specified in the approved SmPC (D)</p> Signup and view all the answers

    Off-label use is a common practice, particularly in pediatrics.

    <p>True (A)</p> Signup and view all the answers

    What is the main responsibility of a doctor using a registered medicine off-label?

    <p>To inform the patient about the benefits and risks of the off-label use, including potential consequences.</p> Signup and view all the answers

    What is the purpose of the 'named-patient basis' program?

    <p>To allow patients to access unauthorized medicines or authorized medicines from different countries (B)</p> Signup and view all the answers

    Compassionate use programs are governed solely by the European Medicines Agency (EMA).

    <p>False (B)</p> Signup and view all the answers

    What is the main criterion for allowing the use of a medicine in a compassionate use program?

    <p>The medicine is expected to help patients with life-threatening, long-lasting, or seriously debilitating illnesses that cannot be treated satisfactorily with any currently authorized medicine.</p> Signup and view all the answers

    Clinical trials in humans typically involve smaller groups of patients compared to commercial trials.

    <p>True (A)</p> Signup and view all the answers

    Which of the following best describes the role of pharmacovigilance after a medicine is marketed?

    <p>To monitor and detect any potential adverse effects or safety concerns related to the medicine (D)</p> Signup and view all the answers

    The marketing authorization process for a medicine is typically completed when the medicine is approved for sale in the market.

    <p>False (B)</p> Signup and view all the answers

    What are some reasons why a manufacturer might decide to stop supplying a medicine to a particular country?

    <p>Commercial decisions or interruptions in the supply chain.</p> Signup and view all the answers

    The marketing authorization of a medicinal product is governed by a single uniform set of rules across all EU countries.

    <p>False (B)</p> Signup and view all the answers

    Flashcards

    Medicinal Product (MP)

    Any substance or combination of substances with therapeutic or preventive properties used to influence physiological functions through pharmacological, immunological, or metabolic effects.

    Finished Pharmaceutical Products (FPPs)

    Finished Pharmaceutical Products (FPPs) are manufactured by the pharmaceutical industry. They are the final form of a medicinal product, marketed under a specific name, and packaged in a specific way. FPPs are produced in batches.

    Magistral Preparation

    A magistral preparation is a customized medication prepared by a pharmacist based on a specific patient's needs or prescription.

    Batch

    A batch refers to a quantity of medicinal products produced in one production cycle. The essential feature of a batch is its homogeneity.

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    Human Drugs - Regulatory Approval

    Drugs intended for human use must undergo rigorous clinical trials and regulatory approval processes by agencies like the European Medicines Agency (EMA) or the U.S. Food and Drug Administration (FDA).

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    Veterinary Drugs - Regulatory Approval

    Veterinary drugs are regulated by agencies like the U.S. Food and Drug Administration's Center for Veterinary Medicine (CVM) or the European Medicines Agency (EMA) but with separate regulatory pathways.

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    Preclinical Trials

    Preclinical trials involve testing a new drug on non-human subjects, primarily animals, to evaluate its safety and potential efficacy.

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    Clinical Trials

    Clinical trials are conducted on human volunteers to further assess the safety and efficacy of a new drug. These trials are conducted in phases and involve different participant groups.

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    Marketing Authorisation

    The marketing authorisation process involves a comprehensive evaluation of a drug to ensure it is safe, effective, and of high quality before being placed on the market.

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    Marketing Authorisation Dossier

    The dossier is a comprehensive document submitted by the manufacturer to the regulatory authorities, containing detailed information about a drug's development and characteristics.

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    Summary of Product Characteristics (SmPC)

    The Summary of Product Characteristics (SmPC) is a document providing detailed information on a medicinal product for healthcare professionals.

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    Patient Information Leaflet (PIL)

    The Patient Information Leaflet (PIL) is a document providing essential information about a medicinal product for patients.

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    National Procedure

    The national procedure is a process for approving a medicinal product in a specific country. This procedure is less common nowadays.

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    Mutual Recognition Procedure (MRP)

    The Mutual Recognition Procedure (MRP) involves a drug being approved in one EU member state and then recognized by other member states.

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    Decentralised Procedure (DCP)

    The Decentralised Procedure (DCP) is used for marketing authorisation of new drugs in multiple EU countries simultaneously.

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    Centralized Procedure

    The Centralized Procedure involves a centralised evaluation by the European Medicines Agency (EMA) for drugs that require specific safety and efficacy standards.

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    Common Technical Document (CTD)

    The Common Technical Document (CTD) is a standardized format for presenting documentation about a drug's development, harmonizing data requirements for global registration.

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    Biosimilars

    Biosimilars are biological medicines that are similar to an already approved medicine, meeting high standards for safety and efficacy. They are approved after patent protection of the original product expires.

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    Committee on Herbal Medicinal Products (HMPC)

    The Committee on Herbal Medicinal Products (HMPC) evaluates herbal substances and preparations for safety and efficacy. It supports national authorities in approving herbal products.

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    Traditional Herbal Medicinal Products

    Traditional herbal medicinal products are those that have been used traditionally for at least 30 years, with at least 15 years of use in the EU.

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    European Union Monographs

    European Union monographs provide comprehensive scientific data for herbal substances and preparations, supporting the harmonisation of the European market.

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    European Union List

    The European Union list (formerly Community list) contains data on traditional herbal products, enabling national authorities to assess safety and traditional use without requiring additional data.

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    Homeopathic Medicine

    A homeopathic medicine is prepared from specific substances using a specific homeopathic manufacturing process as described in the European Pharmacopoeia.

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    Homeopathic Medicine - Registration

    The registration procedure for homeopathic medicines involves specific requirements based on the type of product and its intended use.

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    Named-Patient Basis Treatment

    Named-patient basis access is the provision of unregistered or authorized medicines from another country for specific patients. It is usually used when other treatments are unavailable.

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    Compassionate Use

    Compassionate use programs allow access to unregistered medicines for patients with serious conditions when no satisfactory authorized therapies exist.

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    Clinical Evaluation of Medicines

    Clinical evaluation of medicines involves testing a drug on patients through approved clinical trials, ensuring safety and efficacy before authorization.

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    Off-Label Use

    Off-label use involves using a registered medicine in a manner not described in the approved Summary of Product Characteristics (SmPC).

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    Sunset Clause

    The 'sunset clause' states that if a medicine is not placed on the market within three years after authorization or if it is removed from the market for three consecutive years, the authorization will lapse.

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    Parallel Distribution

    Parallel distribution is the distribution of a centrally authorized medicinal product from one Member State to another by a pharmaceutical company that is independent of the marketing-authorisation holder.

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    Parallel Import

    Parallel import involves importing a centrally authorized medicinal product from another EU country. The imported product must be identical and safe.

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    Study Notes

    Marketing Authorization of Medicines, Unregistered Drugs

    • Marketing authorization is a process for placing medicines on the market.
    • The process aims to minimize foreseeable risks associated with placing medicines on the market.
    • Finished Pharmaceutical Products (FPPs) are produced in batches, and have the essential quality of homogeneity.
    • FPPs can be over-the-counter (OTC) or prescription only.
    • Magistral (Magistral Compounding/ Magistral Preparations) are customized medications for individual patients.
    • Medicinal products (MPs) are classified by use (human or veterinary) and manufacturing process (FPP, Magistral Preparation/Compounding).
    • Human drugs undergo clinical trials and regulatory approval by agencies like the EMA or FDA.
    • Veterinary drugs are similarly regulated, but with separate pathways.
    • Products not classified as MPs are often considered food supplements, cosmetics, or health products.
    • The development of a new drug typically involves stages: chemistry, preclinical studies, industrial process, phase I, II, III and IV, NDA, registration, market introduction.
    • Drug approval is a complex, multi-year process requiring thorough testing and regulatory review.
    • Preclinical trials have limited value when transferred to humans.
    • Clinical trials involve a relatively small number of volunteers and specific conditions
    • Drug safety is evaluated during and after marketing authorisation. This involves ongoing review/updates to the benefit-risk ratio. This includes factors like pharmacoepidemiological research and pharmacovigilance.
    • The State Institute for Drug Control (SUKL) of the Czech Republic and the EMA (European Medicines Agency) are responsible regulatory bodies for medicine marketing authorisation.
    • The FDA (Food and Drug Administration) in the United States also plays a role in regulating the use of medicines.

    Outline of the Lecture

    • Topics included medicinal products, new drug development, legislation/registration, European legislation, and non-standard regimens for using medicines.

    Aims of the Lecture

    • To identify the classification of medicinal products and which ones are subject to marketing authorisation
    • Understand different marketing authorization processes.
    • Describe the process of registering medicines.
    • Define differences in registering medicinal products, generics, biosimilars, homeopathics and herbal products,
    • To explain what the SmPC is.
    • Identify non-standard drug regimens for use.

    Medicinal Product (MP)

    • A substance or combination of substances with therapeutic or preventive properties.
    • Used to restore, modify, or influence physiological functions.
    • Used for establishing a medical diagnosis.
    • Can be divided by intended use and manufacturing method.

    MP - Distribution by Production/Preparation

    • FPPs (Finished Pharmaceutical Products) are manufactured by the pharmaceutical industry.
    • A batch is a quantity of medicinal products produced in one cycle.
    • Batch must have homogeneity, and can be OTC or prescription-only.
    • Magistral preparations/compounding are individualized medications prepared for specific needs.

    MP - Distribution by Users

    • Human drugs undergo rigorous clinical trials and regulatory approval.
    • Veterinary drug regulation is handled by agencies like CVM (Center for Veterinary Medicine) or EMA, but with separate pathways.
    • Products not deemed to be medicinal products might fall under food supplements, cosmetics, or health products.

    Development of a new drug over time

    • Details of the steps for evaluating a new drug are clearly outlined. This illustrates the stages in the preclinical and clinical testing of a medication. It is critical to understand the various stages/steps required for developing a new medicine.

    Drug Safety Evaluation

    • Evaluating the benefit vs. risk ratio of new pharmacotherapy.
    • Continues to refine the therapeutic and benefit-risk ratio after marketing.

    Introduction to Marketing Authorization of Medicines

    • Medicines undergo approval before being placed on the market.
    • The main aim of the approval process is risk minimization.
    • The regulatory body (SÚKL/EMA) ensures the efficacy, safety, and high-quality of supplied medicines.

    Introduction to Marketing Authorization of Medicines

    • The full registration dossier includes the necessary data to demonstrate the safety, efficacy and quality of the medicinal product.
    • A summary of product characteristics (SmPC) is a critical source of information.

    What is and is not subject to Marketing Authorization?

    • Manufactured medicines are subject
    • Magistral preparations, research/development MPs, blood products, and dietary supplements are not subject.

    Regulatory Authority of Marketing Authorization

    • The Czech Republic has its own regulatory bodies.
    • The EU and US have their respective bodies (EMA, FDA).

    Marketing Authorization (MA) Procedures

    • Different types of MP authorization procedures are possible.
    • These include national, mutual recognition (MRP), centralized, and decentralized.

    National Procedure

    • Valid only within one country, for products already authorized or awaiting approval in the EU.

    Mutual Recognition Procedure (MRP)

    • A medicinal product authorized in one EU member state will also be recognized in other states.

    Decentralized Procedure (DCP)

    • Authorization for multiple EU countries at once on a specific medicinal product.

    Rules for the Approval/Marketing Authorization of MP

    • Uniform rules in Europe for quality, safety, and efficiency evaluations.
    • Requirements and scopes for submitting approval data are detailed in each nation's regulations.
    • Necessary documentation from manufacturing to chemical analysis must be comprehensive.

    Who Grants EU-Wide Marketing Authorization?

    • The EMA gives recommendations to the European Commission which in turn decides on official authorization for an EU-wide release.
    • While the EMA/European Commission authorizes many new and innovative medicines, numerous generic or "off-the-shelf" medications are approved at a national level.

    Common Technical Document (CTD)

    • A common format for technical documentation.
    • The result of an agreement between EU, US, and Japan.
    • The goal is reducing resources for multiple-territory dossiers.
    • Electronic submission is mandatory since 2015.

    Structure of CTD

    • The CTD has five modules covering administrative, regional/national information, and expert opinions.
    • Modules 3, 4, and 5 elaborate on the quality, safety, and efficacy of products, respectively.

    Registration Documentation Requirements in the Czech Republic

    • Applicants need to be EU/EEA-based to obtain marketing authorization.
    • Dossier requirements vary based on the type of application.
    • Document language must adhere to the local regulations. Fees are dependent on the type of registration.

    Particulars of an Application for Marketing Authorization for a Medicinal Product

    • Requires data encompassing all medicinal components; storage and storage conditions; descriptions of control methods, along with related preclinical and clinical trials.
    • Details of dosage form (indications, side effects, administration etc).
    • Complies with all mandatory packaging regulations.
    • Information needed on quality/safety measures should be presented.

    The requirements for marketing authorization vary according to the type of medicine

    • Registration of originator medications differs from registrations of generic medications, biosimilars, herbal, and homeopathic drugs.

    Marketing Authorization for Originator Medicines

    • The required tests/trials lasting up to several years demonstrate the safety and efficacy (risk-benefit ratio) of the medication
    • Data on all requirements specified are needed for official authorization.

    Marketing Authorization of Generic and Hybrid Medicines

    • Pharmacological and toxicological tests are not required; demonstrating bioequivalence is instead required.
    • Authorization is granted if the medication meets the criteria of being a generic of a medication that has been authorized for at least eight years.
    • The INN (International Nonproprietary name) for the medicine is used in the new generic application.

    Biosimilars and Their Marketing Authorization

    • These are similar biomedicines that are released to the market after the patent for the original medicine expires.
    • Require comprehensive testing for parameters like quality, safety, and efficacy.

    Comparison of Data Requirements for Approval of a Biosimilar Versus the Reference Medicine

    • A detailed comparison of clinical and preclinical study requirements is illustrated. This comparative analysis is useful in understanding the standards required for the biosimilar and the reference medicine.

    Criteria for Marketing Authorization for Biosimilars in the EU

    • Biosimilars require high similarity in physical, chemical, and biological properties to already existing approved medications.
    • Clinical effect must not vary significantly, with manufacturing variation strictly regulated.

    Marketing Authorization for Biosimilars

    • The authorization is granted at a pan-European level by EMA after comprehensive review.
    • This authorization may also be granted at a national level in exceptional circumstances.

    Marketing Authorization for Herbal Medicinal Products

    • The Committee on Herbal Medicinal Products (HMPC) issues scientific opinions that can be used for preparation, or assessment of an application for marketing or registration of herbal medicinal products within the EU.

    Traditional Herbal Medicines

    • Traditional herbal medicinal products must meet specific parameters/criterion for usage and conditions (oral, in specific strength and dosage, etc.). Must contain scientific reasoning for use over a considerable time period (at least 30 years).

    Herbal Medicines: Regulatory and Scientific Support

    • Utilizing the EMA and HMPC is a helpful procedure for gaining access to the European market for new herbal medicines
    • National procedures can be used in conjunction with supporting scientific data from the HMPC and the EMA.

    Herbal medicines – European Union monographs and list entries

    • Helps harmonize regulations among member States.
    • Provides a unique reference point when considering a new herbal medicinal product (well-established vs. traditional use).

    Well-established use

    • This pertains to herbal medicines that have been in use for over 10 years with demonstrable safety and efficacy.

    Using EU Herbal Monographs for Applications

    • Final EU monographs can be used in applications for both standard and traditional use registrations
    • Comprehensive information (with all relevant opinions and clarifications) is available about the application process

    Herbal Medicines – European Union List Entries

    • List entries are important components for evaluating new applications when applying EU rules for herbal medicines.
    • These are used to support safety and efficacy for the medicine and the traditional use by national authorities within the EU.

    Marketing Authorization for Homeopathic Medicines

    • Homeopathic medicines are viewed differently than other medicines.
    • No specific regulatory framework exists in all countries relating to homeopathic medicine.
    • Registration procedures differ from traditional medicines.

    Homeopathic Medicine – Definition

    • Homeopathic medicines are prepared from specific substances and must follow guidelines for manufacturing, such as those included in the European Pharmacopoeia.

    Marketing Authorization for Homeopathic Medicines

    • Two distinct registration procedures for homeopathic products: simplified or a specific product registration process
    • The required quality standards are the same in both processes.

    Simplified Registration Procedure for Homeopathic Medicines

    • There is an absence of stated therapeutic indication on the packaging
    • Dosage and administration methods must be outlined and the product dilution must meet safety standards

    Registration by the so-called Procedure for Specific Homeopathic Medicines

    • Requires more extensive documentation from the applicant, including evidence from homeopathy literature that verifies the product’s safety and appropriateness for use for a specified therapeutic objective.
    • Suitable for minor conditions or ailments that don't necessitate continuous medical attention.

    When Will the Registration Application Be Approved?

    • A complex evaluation by the regulatory authority determines approval.
    • Numerous factors including preparation/quality, product type, regulatory workload/prior experience can influence the approval timing.
    • Geographic region could also possibly provide a framework for how a registration will be processed.

    When Will the Registration Application Be Approved? (Type of Regulatory Procedure)

    • Depending on which authorization procedure is used there are various time frames for approval and completion
    • Timeframes vary depending on the individual steps in the procedure, and any potential delays

    Decision on Marketing Authorization

    • A comprehensive annex is required containing the approved SmPC, package leaflet, and package
    • The decision includes classifications (prescription-only, with or without restrictions).

    Marketing Authorization Number

    • A registration number is provided to uniquely identify each medicine after approval.
    • The assignment and generation of the number depends on the type of authorization (e.g. for non-EU countries versus centralized, EU-wide authorization).

    Marketing Authorization Number

    • The format of marketing authorization numbers may vary between EU countries
    • The number may or may not reflect all possible strengths or pharmaceutical forms of a medication
    • Some regions may also have a "global" number, whereas other number systems can be more complex.

    Marketing Authorization Numbers Assigned by the Institute (SÚKL)

    • Details on the structure and components of marketing authorization numbers used by SÚKL (Czech Republic).
    • This section provides a key understanding of the unique systems/structures used for each country within the EU relating to medicinal product authorization numbers.

    Marketing Authorization Numbers of Centrally Authorised Medicinal Products (EMA)

    • Structure of marketing authorization codes used across all the member states of the EU. This provides specific details about the coding system within the European system
    • An explanation of each component/segment of the code format used for authorized/centrally authorized medicinal products.

    Marketing Authorization Numbers of Centrally Authorised Medicinal Products – Parallel Distribution

    • How parallel distribution is reflected in the overall/centralized authorization numbers

    Parallel Distribution

    • This is used for the distribution of certain medicinal products from one member state to another.

    Parallel Import

    • This is the process of legally importing medicinal products that have already been authorized but are not being marketed in the particular country
    • Medicinal products imported via the parallel import procedure must be identical.

    Parallel Import - Labeling

    • Essential instructions and information for correctly labeling medicinal products
    • The process of labeling for parallel products has detailed requirements that need to be followed.

    Summary of Product Characteristics (SmPC)

    • The core of information used for healthcare professionals on dosage, use, benefits, and possible risks of a medicinal product.
    • The SmPC details the product and its associated aspects and information for physicians and pharmacists concerning the product.
    • Each form/strength of a medicine has its own unique SmPC.

    Summary of Product Characteristics (SmPC)

    • Legally binding document for off-label use also.
    • Information is structured and includes medicinal substance, excipients, form, dosage, use, interactions, and adverse reactions.
    • Established framework to follow.

    Summary of Product Characteristics (SmPC)

    • Specific details/components of the SmPC document are illustrated/explained.
    • Information regarding the requirements/format for the summary for each component including dosage form, usage information, pharmacological data etc, needs to be carefully followed.

    What the SmPC Does Not Include

    • Information about off-label uses, restrictions regarding indication(s) based on referrals, or data on specific groups (e.g., pediatric, pregnant, breastfeeding).
    • It also doesn't normally include general recommendations for how a disease state could be treated, which may be given in guidelines rather than the SmPC.

    Patient Information Leaflet (PIL)

    • Information for general users/patients.
    • Readability and clarity are tested to ensure good understanding.

    Conditional Registration of a Medicinal Product

    • A conditional authorization is possible during urgent situations concerning public health, where the benefit has to outweigh immediate patient needs.

    Referral Procedure

    • A review of specific marketing authorizations, frequently due to identified safety and/or efficacy issues
    • Initiated for harmonization or clarification
    • A referral can be initiated by EMA, member states, or the company, with notification to all affected nations.

    Articles 30, 31, and 107i of Directive 2001/83/EC

    • Detailed regulations pertaining to the different types of referrals and the potential outcomes
    • Procedures for variations, suspensions, or cancellations of the authorization are found within these articles.

    Extension of Marketing Authorization

    • The possibility of re-evaluating a medicine for an extension after 5 years

    Change/Suspension/Cancellation of Marketing Authorization

    • A medicinal product's approval may be subject to change or cancellation if certain conditions are deemed to be present.

    Sunset Clause

    • A regulation where a marketing authorization ceases if a product is not placed on the market within 3 years, or removed for 3 years consecutively.
    • Does not apply to centrally authorized medicinals for instance.

    After Marketing Authorization

    • Post-marketing processes/steps such as pharmacovigilance, adverse event reporting, periodic updates, risk minimization, and others.

    Changes in Legislation since 2024

    • Recent updates and improvements for regulations on medicines
    • Simplified procedures and combating antimicrobial resistance (AMR) are key elements of the more recent changes.

    Non-standard drug regimens

    • Non-standard ways to use medicines (unregistered or registered but outside the usual context in the SmPC).

    Use of unregistered medicines

    • Reasons/justifications for using unregistered medications
    • Various specific circumstances may justify the use of unregistered medicines

    Named-patient program

    • Access to drugs not yet authorized, for conditions with no readily available treatment alternatives in a given country.

    Compassionate use

    • Use of unregistered medications for individuals with serious and/or life-threatening illnesses and for whom standard treatments are not appropriate or will not provide appropriate relief.
    • EMA recommendations and regulations on compassionate use programs.

    Compassionate use - Article 83 of Regulation (EC) No 726/2004

    • Important aspects of the regulation for compassionate use.

    Comparison to Individual Basis Treatment

    • Differentiating compassionate use versus "Named-patient" treatment, specifically who is responsible for the product.

    Compassionate use recommendations

    • EMA recommendations on how unregistered medicines can be used for compassionate use programs, details on what will/will not be considered as a criteria, and also associated requirements/protocols.
    • EU's recommendations for compassionate use programs.

    Compassionate use - Which medicines can be made available in this way?

    • The criteria for a program/procedure for compassionate use are included in this section.

    How do compassionate use programmes work?

    • How a compassionate use program operates, including the responsibility of the physicians (who need to notify authorities) and how the national authorities ensure that the side effects can be carefully tracked.

    Clinical evaluation of medicines

    • How patients may be enrolled in clinical trials using unregistered medications.
    • Procedures for patients and healthy volunteers to take part in clinical trials.

    Use of registered MPs outside the SmCP

    • Off-label use, which means authorized products can be used in unconventional ways, outside standard usage as described in the SmPC

    Off label use

    • Circumstances under which authorization may be granted for using a medicine in a manner/dose/combination not detailed in the official SmPC
    • A physician's role and responsibilities when prescribing an off-label treatment

    Off label use - Duties of the doctor

    • A list of duties a doctor bears when using a product in an off-label manner
    • Necessary actions to ensure patient well-being

    Off label use

    • Responsibilities of the health care facilities/providers
    • Requirements relating to off-label procedures

    Conclusion

    • A summary of the key aspects of marketing authorization, including importance, process, and significance.

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