The path a drug travels from a lab to patient is usually long, and every
drug takes a unique route. Most drugs that undergo preclinical (animal)
testing never even make it to human testing and review by the FDA. The drugs
that do must undergo the agency's rigorous evaluation process, which
scrutinizes everything about the drug--from the design of clinical trials to
the severity of side effects to the conditions under which the drug is
manufactured.
Drug Approval
Process In United States
In United states USFDA controls the drug-approval process and is tasked
with reviewing new drugs, biologics and medical devices before companies can
sell them.
Drugs intended for human use are evaluated by FDA’s Center for Drug
Evaluation and Research (CDER) to ensure that drugs marketed in the United
States are safe and effective. Biological products are evaluated by FDA’s
Center for Biologics Evaluation and Research.
A pharmaceutical company seeking FDA approval to sell a new prescription
drug must complete a five-step process: discovery/concept, preclinical
research, clinical research, FDA review and FDA post-market safety monitoring.
First, the company must conduct laboratory tests and try the drug on
animals and then people to make sure it works and is safe.
The FDA doesn’t actually test the drug itself
before making a decision. The agency does, however, inspect the facilities
where the drug will be manufactured as part of the approval process. It is the
responsibility of the company seeking approval to market a drug to conduct
laboratory and animal tests on the safety and effectiveness of a proposed new
drug and then to submit that information to FDA for review process by CDER
Physicians, Statisticians, Chemists, Pharmacologists and other scientist.
The drug approved by USFDA and can be marketed in the United states.
USFDA will continue to monitor the drug post -approval.
Different types
of drug applications that can be submitted to FDA
Investigational
New Drug (IND): Federal law
requires that a drug be the subject of an approved marketing application before
it is transported or distributed across state lines.
New Drug
Application (NDA): When the
sponsor of a new drug believes that enough evidence on the drug's safety and
effectiveness has been obtained to meet FDA's requirements for marketing
approval, the sponsor submits a new drug application (NDA) to FDA. The
application must contain data from specific technical viewpoints for review,
including chemistry, pharmacology, medical, biopharmaceutics, and statistics.
If the NDA is approved, the product may be marketed in the United States.
Abbreviated New
Drug Application (ANDA): An Abbreviated
New Drug Application contains data that provides for the review and ultimate
approval of a generic drug product. Generic drug applications are called
"abbreviated" because they are generally not required to include
preclinical (animal) and clinical (human) data to establish safety and
effectiveness. Instead, a generic drug applicant must scientifically
demonstrate that its product is bioequivalent (performs in the same manner as
the innovator drug). Once approved, an applicant may manufacture and market the
generic drug product.
Biologic License Application (BLA): Biological products
are approved for marketing under the provisions of the Public Health Service
Act. The Act requires a firm who manufactures a biologic for sale in interstate
commerce to hold a license for the product. A biologics license application is
a submission that contains specific information on the manufacturing processes,
chemistry, pharmacology, clinical pharmacology and the medical affects of the
biologic product. If the information provided meets FDA requirements, the
application is approved and a license is issued allowing the firm to market the
product.
Drug Approval Process in Europe
To protect public health and ensure the
availability of high quality, safe and effective medicines for European
citizens, all medicines must be authorised before they can be placed on the
market in the EU. The European system offers different routes for such an
authorisation.
The European medicines regulatory
system is based on a network of around 50 regulatory authorities from the 30
EEA countries (27 EU Member States plus Iceland, Liechtenstein and Norway), the
European Commission and EMA.
EMA and the Member States cooperate
and share expertise in the assessment of new medicines and safety information.
They also rely on each other for exchange of information in the regulation of
medicine, for example regarding the reporting of side effects of medicines, the
oversight of clinical trials and the conduct of inspections of medicines’
manufacturers and compliance with good clinical practice (GCP), good
manufacturing practice (GMP), good distribution practice (GDP), and good
pharmacovigilance practice (GVP). This works because EU legislation requires
that each Member State operates to the same rules and requirements regarding
the authorisation and monitoring of medicines.
Routes of Drug Registration Process
in EU:
Centralized Procedure: The centralised procedure allows the marketing of a
medicine on the basis of a single EU-wide assessment and marketing
authorisation which is valid throughout the EU. Pharmaceutical companies submit
a single authorisation application to EMA. The Agency’s Committee for Medicinal
Products for Human Use (CHMP) or Committee for Medicinal Products for
Veterinary Use (CVMP) then carries out a scientific assessment of the
application and gives a recommendation to the European Commission on whether or
not to grant a marketing authorisation. Once granted by the European
Commission, the centralised marketing authorisation is valid in all EU Member
States. The use of the centrally authorised procedure is compulsory for most
innovative medicines, including medicines for rare diseases.
National Procedure: The national procedure only one member state is
involved. The documents submitted to an authority are very specific to that
particular authority and evaluation of the application is carried out by the
same member state. The evaluation time for an application for a national
marketing authorization is 210 days from the receipt of the application.
When a company wants to authorise a
medicine in several Member States, it can use one of the following procedures:
Decentralised procedure: Where companies can apply for the
simultaneous authorisation of a medicine in more than one EU Member State if it
has not yet been authorised in any EU country and does not fall within the
scope of the centralised procedure.
Mutual-recognition procedure: Where companies
that have a medicine authorised in one EU Member States can apply for this
authorisation to be recognised in other EU countries. This process allows
Member States to rely on each other’s scientific assessments.
Rules and requirements applicable to
pharmaceuticals in the EU are the same, irrespective of the authorisation route
for a medicine.
A European Public Assessment Report,
or EPAR, is published for every human or veterinary medicine that has been
granted or refused a marketing authorisation following an assessment by EMA.
For a medicine that is authorised by a Member State, details on the assessment
of the medicine are also available in a Public Assessment Report.
The role of the European Commission
in Drug Approval
The European Commission plays an
important role in the regulation of medicines in the EU. On the basis of
scientific assessments carried out by EMA, it grants or refuses, changes or
suspends marketing authorisations for medicines that have been submitted via
the centralised procedure. It can also take EU-wide action when a safety issue
has been identified for a nationally authorised product and when harmonised
regulatory measures in all MSs are considered necessary following assessment by
EMA’s PRAC. The European Commission can also take action concerning other
aspects of medicine regulation.
The role of the European Medicines
Agency (EMA) in Drug Approval
EMA is responsible for the
scientific evaluation, primarily of innovative and high-technology medicines
developed by pharmaceutical companies for use in the EU. EMA was established in
1995 to ensure the best use of scientific resources across Europe for the
evaluation, supervision and pharmacovigilance of medicines.
The EMA has seven scientific committees that carry
out its scientific assessments.
EMA’s scientific committees
|
Committee for Medicinal Products for Human Use (CHMP)
|
Pharmacovigilance Risk Assessment Committee (PRAC)
|
Committee for Medicinal Products for Veterinary Use (CMVP)
|
Committee for Orphan Medicinal Products (COMP)
|
Committee on Herbal Medicinal Products (HMPC)
|
Committee for Advanced Therapies (CAT)
|
Paediatric Committee (PDCO)
|
The role of National competent
Authorities in Drug Approval
The national competent authorities (NCAs),
responsible for the regulation of human and veterinary medicines in the EU,
coordinate their work in a forum called Heads of Medicines Agencies (HMA). The
heads of the NCAs work closely with EMA and the European Commission to maximise
cooperation and ensure the European medicines regulatory network functions efficiently. The HMA
meets four times per year to address key strategic issues for the network, such
as the exchange of information, IT developments and sharing of best practices,
and to streamline mutual recognition and decentralised procedures.
Regulatory submission pathways and requirements
for US and Europe are entirely different from one another, Similarities and
differences in drug approval process in US and Europe is detailed below.
Particulars
|
US
|
Europe
|
General Information
|
Regulatory Agency
|
USFDA
|
EMA
National
Agencies
|
Application
|
IND
NDA
ANDA
BLA
|
MAA
[Article
8(3) Full Application, Article 10(1) Generic, Article 10(3)Hybrid(mixed)Application,
Article 10(4) Biosimilars, Article 10(a) well established use, Article 10(b)
Fixed combination products, Article 10(c) Informed consent/Duplicate]
|
Registration Process
|
One Registration
Process
|
Multiple
Registration Process
Ø
Centralized Procedure (European Community)
Ø
Decentralized Procedure (Atleast 2 member states)
Ø
Mutual Recognition Procedure (Atleast 2 member states)
Ø
National Procedure (1 member states)
|
Approval Timeline
|
10
Months (Standard review)
|
210
Days –CHMP opinion
Centralized
procedure 210+67(EC Decision: Granting/Refusing)=277 days
CHMP
Opinion (Ensure that medicinal
products have a positive risk - benefit balance in favour of
patients/users)
EC
Decision – Granting/Refusing
|
Administrative Part
|
Debarment Certification
|
Applicable
|
Not
Applicable
|
Agent letter of appointment
|
Applicable
|
Not
Applicable
|
Environmental
Assessment Report
|
Applicable
|
Applicable
|
Pharmacovigilance
|
Not
Applicable
|
Applicable
|
Specifying Medicinal product name in Braille format
|
Not
Applicable
|
Applicable
|
Quality
|
Number of batches
|
3
batches
|
3
batches
|
Container closure DMF
Requirements
|
Applicable
|
Not
applicable
|
API DMF Requirements
|
DMF
(Type II)
|
ASMF/CEP
|
Number of API lots for Submission batches
|
A minimum
of two lots of the drug substance should be used to prepare the three primary
batches of drug product.
|
No
specific requirements
|
Executed BMR
|
Applicable
(Part of Dossier Filing)
|
Not
part of Dossier filing
|
Blank (Commercial ) BMR
|
Applicable
(Part of Dossier Filing)
|
Not part
of Dossier filing
|
Stability Data Requirements
|
Minimum
6 Month data – Accelerated, Long term & Intermediate (if applicable)
|
Minimum
6 Month data – Accelerated, Long term & Intermediate (if applicable)
|
Container orientation For primary batches of liquids,
solutions, semi-solids, and suspensions
|
Product
should be place in worst case and non-worst case scenarios (Up right/Inverted
or Vertical/Horrizontal)
|
No such
requirements
|
Antimicrobial Effectiveness testing (AET) Requirements
|
Applicable
(One Batch)
|
Applicable
(One Batch)
|
Special stability studies conducted to confirm the quality of
the constituted drug products (for example, parenterals and/or powders
reconstituted with diluents and/or drug admixtures)
|
Applicable
(One Batch)
|
Applicable
(One Batch)
|
API DMF requirements
|
Type
– II DMF
|
CEP
ASMF
|
Miscellaneous
|
Initial Screening
|
Applicable
(60 Days)
|
Screening
will be done only for administrative part
|
Fee Requirements
|
Applicable
|
Applicable
|
Faster Approval Pathways
|
Accelerated
Approval
Priority
Review
Fast
Track
Break
through Therapy
|
Accelerated
Approval
Conditional
Marketing Authorization
|
Goal Date
|
Applicable
|
Not
applicable
|
Time Slot booking Requirements for dossier filing
|
Not
Applicable
|
Applicable
|
Types of Queries
|
IR/DRL/CRL
|
Day 50/Day
100/Day 120/Day 180
|