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Presented by 
Mpharm (ceutics) 
Mahaboobjani 
Guieded by: RAJA REDDY 
SIR 
R.NO:256212886021
• SCHEDULE Y: 
REQUIREMENTS AND GUIDELINES FOR 
PERMISSION TO IMPORT AND OR MANUFACTURE OF 
NEW DRUGS FOR SALE OR TO UNDERTAKE 
CLINICALTRIALS. 
See Schedule Y rules: l22A, l22B, 122D, 122DA, 
122DAA and 122E. includes 
Responsibilities 
Applications 
Appendices 
Refinements
• PART XA OF D&C RULES 1945: 
122A: Application for permission to import new drug. 
122B: Application for approval to manufacture new drug. 
122D: Permission to import or manufacture FDC. 
122DA: Permission to conduct clinical trials for new drug / 
investigational new drug. 
122DAA: Clinical Trial Definitions 
122E: New Drug Definitions
Drug Regulatory Laws 
1940: Drug and Cosmetic Act. 
1985: Narcotic drugs and psychotropic substances act. 
2000: Ethical guidelines for biomedical research on human 
subjects ,ICMR. 
2001: Indian GCP guidelines. 
2002: Amendment to D & C act. 
2005: Revised 
Future: 1) Guidelines for pre-clinical data for r- DNA 
vaccines, diagnostics & biologicals , DBT. 
2) Draft guidelines for stem cell research/ 
regulation, ICMR.
Why there was need for amendment 
REVISED OLD 
1.Application for permission 1.Clinical Trials 
2.Clinical Trials 1.1:Nature of Clinical Trials 
1.Approal for Clinical Trials 1.2:Permission for Trials 
2.Responsibility of sponser 1.3:Responsibility of sponser/ investigator 
3.Responsibility of investigator 
4.Informed consent-new 
5.Responsibility of ethics committee-new 
6.Human pharmacology(ph I) 5.Human clinical pharmacology(ph I) 
7.Therapeutic exploratory trials(ph II) 6.Exploratory trials(ph II) 
8.Therapeutic exploratory trials(ph III) 7.Confirmatory trials(ph III) 
9.Post marketing trials(ph IV)-NEW 
3.Studies in special population 8.Special studies 
1.geriatric,pediatric 
2.Pregnant or nursing women, 
3.post marketing surveillance , BA/BE 12.Post marketing surveillance
Application for permission: 
 Application for permission to import or manufacture new 
drugs for sale or to undertake clinical trials shall be made in 
Form 44. 
• chemical and pharmaceutical information as prescribed in 
Appendix I; 
• animal pharmacology data as prescribed in item 3 of 
Appendix I and Appendix IV 
• animal toxicology data as prescribed in Appendix I and 
Appendix III; 
• human Clinical Pharmacology Data as prescribed in 
Appendix I 
• regulatory status in other countries as prescribed in 
Appendix I. 
 the application for import of small quantities of drugs for 
such purpose should also be made in Form 12.
122 – DAA: 
Clinical Trial Definition 
Systematic study of new drugs in human subjects; 
to generate data for discovering/verifying clinical, 
pharmacological (PK & PD) or adverse effects; 
to determine safety and efficacy of the new drug;
CLINICAL TRIAL: 
(1) Approval for clinical trial 
 Clinical trial on a new drug shall be initiated only after 
the permission has been granted by the Licensing Authority 
under rule 21 (b), and the approval obtained from the 
respective ethics committee(s). The Licensing Authority as 
defined shall be informed of the approval of the respective 
institutional ethics committee(s) as prescribed in Appendix 
VIII, and the trial initiated at each respective site only after 
obtaining such an approval for that site. 
 All trial Investigator(s) should possess appropriate 
qualifications, training and experience and should have access 
to such investigational and treatment facilities as are relevant 
to the proposed trial protocol. A qualified physician (or dentist, 
when appropriate) who is an investigator or a sub-investigator 
for the trial, should be responsible for all trial-related medical 
(or dental) decisions.
(2) Responsibilities of Sponsor: 
 The clinical trial Sponsor is responsible for implementing 
and maintaining quality assurance systems to ensure that the 
clinical trial is conducted and data generated , documented and 
reported in compliance with the protocol and Good Clinical 
Practice(GCP) Guidelines issued by the Central _Drugs 
Standard Control Organization , Directorate General of Health 
Services, Government of India as well as with all applicable 
statutory provisions. 
 Sponsors are required to submit a status report on the 
clinical trial to the Licensing Authority at the prescribed 
periodicity. 
 Trial Status Report to Licensing Authority : Annually 
 Premature Termination : Summary report within 
3m ( Study, , Dose, Duration, ADR &reasons for discontinuati 
on ). 
 Serious Adverse Event : Report to LA & other investigators 
within 14 days.
(3) Responsibilities of the Investigator( s): 
(i)The Investigator(s) shall be responsible for the conduct of 
the trial according to the protocol and the GCP Guidelines and 
also for compliance as per the undertaking given in Appendix 
VII. 
(ii) Document SOPs. Management of all ADR / AE 
Reporting unexpected AE to :- Sponsor within 24 hours. 
- EC within 7 day. 
(4) EC RESPONSIBILITIES: 
(i) Safeguard rights, safety & well being 
(ii) Protect vulnerable subjects 
(iii) Obtain and maintain record of SOPs 
(iv) Ongoing review based on Periodic progress report 
(v) If EC revokes its approval- 
1.Record reasons for it 2.Inform the Investigator & LA 
immediately .
(5) Informed Consent: 
 In all trials, a freely given, informed, written consent is 
required to be obtained from each study subject. The 
Investigator must provide information about the study verbally 
as well as using a patient information sheet, in a language that 
is non-technical and understandable by the study subject. The 
Subject's consent must be obtained in writing using an 
'Informed Consent Form'. Both the patient information sheet as 
well as the Informed Consent Form should have been approved 
by the ethics committee and furnished to the Licensing 
Authority. 
 Where a subject is not able to give informed consent. The 
same may be obtained from a legally acceptable representative.
ESSENTIAL STEPS OF CLINICAL PHARMACOLOGY: 
 Phase I: (Human Pharmacology)Safety & Tolerability ( PK, 
PD & MTD. 
 Phase II: (Therapeutic Exploratory Trial)Therapeutic benefits 
in few patients. 
 Phase III: (Therapeutic Confirmatory Trial)Therapeutic 
benefit in more patients . 
 Phase IV: (Post Marketing Trials)Related to Approved 
indication.
(6)Human Pharmacology(Phase I): 
 The objective of studies in this Phase is the estimation of 
safety and tolerability with the initial administration of an 
investigational new drug into human(s). Studies in this Phase 
of development usually have non-therapeutic objectives and 
may be conducted in healthy volunteers subjects or certain 
types of patients. 
 Studies conducted in Phase I: 
(a) Maximum tolerated dose: To determine the tolerability of 
the dose range expected to be needed for later clinical studies 
and to determine the nature of adverse reactions. 
(b) Pharmacokinetics: characterization of a drug's absorption, 
distribution, metabolism and excretion. 
(c) Pharmacodynamic data, It may guide the dosage and dose 
regimen to be applied in later studies.
(7) Therapeutic exploratory trials (Phase II): 
 The primary objective of Phase II trials is to evaluate the 
effectiveness of a drug for a particular indication or indications 
in patients with the condition under study and to determine the 
common short-term side-effects and risks associated with the 
drug. 
 An important goal for this Phase is to determine the dose((s) 
and regimen for Phase III trials. Doses used in Phase II are 
usually (but not always) less than the highest doses used in 
Phase 1. 
 Additional objectives of Phase II studies can include 
evaluation of potential study endpoints, therapeutic regimens 
(including concomitant medications) and target populations 
(e.g. mild versus severe disease) for further studies in Phase II 
or III.
(8) Therapeutic confirmatory trials (Phase III): 
 Phase III studies have primary objective of demonstration or 
confirmation of therapeutic benefit(s). Studies in Phase III are 
designed to confirm the preliminary evidence accumulated in 
Phase II that a drug is safe and effective for use in the intended 
indication and recipient population. These studies should be 
intended to provide an adequate basis for marketing approval. 
 For drugs intended to be administered for long periods, trials 
involving extended exposure to the drug are ordinarily 
conducted in Phase III. 
 For new drugs approved outside India, Phase III studies need to 
be carried out primarily to generate evidence of efficacy and 
safety of the drug in Indian patients when used as 
recommended in the prescribing information. Prior to conduct 
of Phase III studies in Indian subjects, Licensing Authority 
may require pharmacokinetic studies to be undertaken to verify 
that the data generated in Indian population is in conformity 
with the data already generated abroad.
(9) Post Marketing Trials (Phase IV): 
 Post Marketing trials are studies (other than routine 
surveillance) performed after drug approval arid related to the 
approved indication(s). 
 These trials go beyond the prior demonstration of the drug's 
safety, efficacy and dose definition. 
 These trials may not be considered necessary at the time of 
new drug approval but may be required by the 
 Licensing Authority for optimizing the drug's use. 
 They may be of any type but should have valid, scientific 
objectives. 
 Phase IV trials include additional drug-drug interaction(s), 
dose-response or safety studies and trials designed to support 
use under the approved indication(s), e.g. mortality/morbidity 
studies, epidermiological studies etc.
REGULATORY REQUIREMENTS FORCLINICAL 
PHARMACOLOGY: 
 Drug discovered in India : Phase I data 
 Drug discovered outside India : Foreign Phase I data 
required for Phase II/III permission 
 Accompanying documents : Protocol, CRF,IB, IC, EC 
Clearance , Investigator’s undertaking. 
Sample size : Depending upon type of study 
 EC application can parallel DCGI application 
 Toxicological / clinical data abbreviate, deferred or 
omitted for life threatening diseases (or diseases of special 
relevance to Indian health Scenario) 
 Amendments notified to DCGI & EC within 30 days& 
approval obtained.
3. Studies in special populations: 
Information supporting the use of the drug in children, 
pregnant women, nursing women, elderly patients, patients 
with renal or other organ systems failure, and those on specific 
concomitant medication is required to be submitted. 
(1)Geriatrics: 
 Geriatric patients should be included in Phase III clinical trials 
(and in Phase II trials, at the Sponsor's option) in meaningful 
numbers, if- 
 the disease intended to be treated is characteristically a disease 
of aging; 
 the population to be treated is known to include substantial 
numbers of geriatric patients; 
 when the new drug is likely to alter the geriatric patient's 
response (with regard to safety or efficacy)compared with that 
of the non-geriatric patient.
(2) Paediatrics: 
 The timing of paediatric studies in the new drug development 
program will depend on the medicinal product, the type of 
disease being treated, safety considerations, and the efficacy 
and safety of available treatments. 
 If the new drug is for diseases predominantly or exclusively 
affecting paediatric patients, clinical trial data should be 
generated in the paediatric population except for initial safety 
and tolerability data, which will usually be .obtained in adults. 
 If the new drug is intended to treat serious or life-threatening 
diseases, occurring in both adults and paediatric patients, for 
which there are currently no or limited therapeutic options, 
paediatric population should be included in the clinical trials 
early, following assessment of initial safety data and 
reasonable evidence of potential benefit.
 If the new drug has a potential for use in paediatric patients – 
Paediatric studies should be conducted. 
 The paediatric studies should include - 
 (a) clinical trials, 
 (b) relative bioequivalence comparisons of the paediatric 
formulation with the adult formulation performed in adults, 
 (c) definitive pharmacokinetic studies for dose selection 
across the age ranges of paediatric patients in whom the drug is 
likely to be used. 
 If the new drug is a major therapeutic advance for the paediatric 
population – the studies should begin early in the drug development , 
and this data should be submitted with the new drug application. 
 For clinical trials conducted in the paediatric population, the 
reviewing ethics committee should include members who are 
knowledgeable about pediatric , ethical, clinical and psychosocial 
issues.
(3) Pregnant or nursing women.- 
 Pregnant or nursing women should be included in clinical trials 
only when the drug is intended for use by pregnant/nursing women 
or foetuses/nursing infants. 
 For new drugs intended for use during pregnancy, follow-up data 
on the pregnancy, foetus and child will be required. Where 
applicable, excretion of the drug or its metabolites into human milk 
should be examined and the infant should be monitored for predicted 
pharmacological effects the drug. 
(4) Post Marketing Surveillance.- 
 (i) Subsequent to approval of the product, new drugs should be 
closely monitored for their clinical safety once they are 
marketed. The applicants shall furnish Periodic Safety Update 
Reports (PSURs) in order to- 
 (a) report all the relevant new information from appropriate 
sources; 
 (b) relate these data to patient exposure;
 Ordinarily all dosage forms and formulations as well as indications for new 
drugs should be covered in one PSUR. 
 All relevant clinical and non-clinical safety data should cover only the 
period of the report (interval data). 
 The PSUR submitted -6 months for first 2 years after approval of the drug 
is granted to the applicant. 
 For subsequent two years - the PSURs need to be submitted annually. 
 PSURs due for a period must be submitted within30 days of the last day of 
the reporting period. 
 In all cases involving serious unexpected adverse reactions must be 
reported to the licensing authority within 15 days of initial receipt of the 
information by the applicant. 
 If marketing of the new drug is delayed by the applicant after obtaining 
approval to market, such data will have to be provided on the deferred basis 
beginning from the time the new drug is marketed. 
 New studies specifically planned or conducted to examine a safety issue 
should be described in the PSURs.
(v) A PSUR should be structure 
(a) A title page stating: 
(b) Introduction, 
(c) Current worldwide market authorization status, 
(d) Update of actions taken for safety reasons, 
(e) Changes to reference safety information, 
(1) Estimated patient exposure, 
(g) Presentation of individual case histories, 
(h) Studies, 
(I) Other information, 
(j) Overall safety evaluation, 
(k) Conclusion, 
(I) Appendix providing material relating to indications, 
dosing, pharmacology and other related information.
 (5) Special studies: Bioavailability/Bioequivalence 
 For drugs approved elsewhere in the world and absorbed 
systemically, bioequivalence with the reference formulation 
should be carried out wherever applicable. These studies 
should be conducted under the labelled conditions of 
administration. 
 Evaluation of the effect of food on absorption following oral 
administration should be carried out. Data from dissolution 
studies should also be submitted for all solid oral dosage forms. 
 Dissolution and bioavailability data submitted with the new 
drug application must provide information that assures 
bioequivalence or establishes bioavailability and dosage 
correlations between the formulation(s) sought to be marketed 
and those used for clinical trials during clinical development of 
the product. 
 Compliance with ICMR guidelines BA/ BE studies.
APPLICATION 
FORM44 
-Imp ff 
-Imp rm 
-Mfg ff 
-Mfg rm 
-C T 
APPROVAL FORM 
45(IMP FF) 
APPROVAL FORM 
45A(IMP RM) 
APPROVAL FORM 
46(MFG FF) 
APPROVAL FORM 
46A(MFG RM) 
NOC FOR C T AND 
TEST LICENSE FOR 
IMPORT
Application Fees: 
Import ff/ Mfg ff/ Import bulk + Mfg ff=Rs 50,000/- of new 
drug. 
Application by same applicant, =Rs 15,000/-for modified 
dosage form or with new claim. 
Secondary applicants after 1=Rs 15,000/-year of approval 
Import / Mfg FDC=Rs 15,000/- 
Conduct Clinical trial with ND/IND 
Phase I =Rs 50,000/- 
Phase II=Rs 25,000/- 
Phase III=Rs 25,000/- 
No separate fee to be paid along with application for import / 
mfg based on successful completion.
TEST LICENCE 
Application form No. 12 
Material Justification Plan 
Treasury Challan ( Rs. 100 ) 
Test License obtained in form 11
122 – E: 
New drug definition 
Investigational New Drug (IND): New chemical entity or 
product having therapeutic indication but never tested on 
human beings. 
Not used in the country 
Approved drug : 1. New claims(Indications, dosage , dosage 
form, route) 
2. FDCs(New / Modified) 
Note: 
Vaccines are new drugs unless 
1. Certified 
2. Till 4 year or 
3. Included in IP
Appendices: 
I : Data required for import/manufacture/conduct CT of new 
drugs. 
I A : ….Drugs approved in other country 
II : Format for clinical study reports(ICH E6) 
III : Animal toxicology 
IV : Animal pharmacology 
V :Informed consent. 
VI: FDC 
VII: Undertaking by the investigator. 
VIII : Ethics committee 
IX : Stability testing 
X : Proposed protocol 
XI : SAE Reporting
APPENDIX I: 
DATA TO BE SUBMITTED ALONG WITH THE 
APPLICATION TO CONDUCT CLINICAL 
TRIALS/IMPORTIMANUFACTURE OF NEW DRUGS 
FOR MARKETING IN THE COUNTRY 
1. Introduction 
2. Chemical and pharmaceutical information 
2.1. Information on active ingrédients 
2.2. Physicochemical Data 
2.3. Analytical Data 
2.4. Complete monograph specification 
2.5. Validations 
2.6. Stability Studies 
2.7. Data on Formulation
3. Animal Pharmacology 
4. Animal Toxicology 
5. Human / Clinical pharmacology 
6. Therapeutic exploratory trials (Phase II) 
7. Therapeutic confirmatory trials (Phase III) 
8. Special studies 
9. Regulatory status in other countries 
10. Prescribing information 
11. Samples and Testing Protocol/s 
APPENDIX -IA: 
DATA REQUIRED TO BE SUBMITTED BY AN APPLICANT FOR 
GRANT OF PERMISSION TO IMPORT AND / OR MANUFACTURE A 
NEW DRUG ALREADY APPROVED IN THE COUNTRY. 
1.Introduction
REVISED OLD 
Data should be submitted along with 
application to conduct clinical 
trials/import/manufacture of new drug. 
Data required to submitted with application 
for permission to market a new drug. 
2.1 Information of active ingredients 2.1Specifications of API/In active 
ingredients 
2.2 Physicochemical data 2.2 Physicochemical proportion 
2.3 Analytical data-NEW 
2.4 Monograph Specifications 2.4 Tests for identifications of API. 
2.5 Validations-NEW 
2.7 Data on formulation 2.2 and 2.5 
3.4 Safety pharmacology-NEW 
4.3 Male Fertility Studies-NEW 
4.6 Allergenicity / Hypersensitivity-NEW 
11.Samples and testing protocol 10.3 Sample… with testing protocol
2.Chemical and Pharmaceutical information. 
3. Marketing information 
4. Special studies conducted with approval of Licensing 
Authority . 
APPENDIX II: 
STRUCTURE, CONTENTS AND FORMAT FOR 
CLINICAL STUDY REPORTS 
1. Title Page: 
2.Study Synopsis 
3. Statement of compliance with the 'Guidelines for Clinical 
Trials. 
4. List of Abbreviations and Definitions 
5. Table of contents 
6. Ethics Committee:
7. Study Team 
8. Introduction 
9. Study Objective 
10. Investigational Plan 
11. Trial Subjects 
12. Efficacy evaluation 
13. Safety Evaluation 
14. Discussion and overall Conclusion 
15. List of References 
16. Appendices 
APPENDIX III: 
ANIMAL TOXICOLOGY (NON-CLINICAL TOXICITY 
STUDIES) 
1. General Principles:
1.1 Systemic Toxicity Studies 
Single-dose Toxicity Studies(2 rodents) 
Repeated-dose Systemic Toxicity Studies 
1.2) Dose Ranging Study 
1.3) Male Fertility Study 
1.4) Female Reproduction and Development Toxicity Studies. 
1.5)Local toxicity 
1.6)Allergenicity /Hypersensitivity 
1.7)Genotoxicity and Carcinogenicity
APPENDIX IV: ANIMAL PHARMACOLOGY 
General Principles 
1.1 Specific Pharmacological actions 
1.2 General Pharmacological Actions 
1.3 Follow-up and Supplemental Safety Pharmacology 
Studies 
1.4 Conditions Under Which Safety Pharmacology 
Studies Are Not Necessary 
1.5 Timing Of Safety Pharmacology Studies In Relation 
To Clinical Development 
1.6 Application Of Good Laboratory Practices (GLP)
APPENDIX V: INFORMED CONSENT 
Checklist for study Subject's informed consent documents. 
APPENDIX VI: FIXED DOSE COMBINATIONS (FDCs) 
Fixed Dose Combinations refer to products containing one or 
more active ingredients used for a particular indications. 
APPENDIX VII: UNDERTAKING BY THE 
INVESTIGATOR 
APPENDIX VIII: ETHICS COMMITTEE 
The number of persons in an Ethics Committee should have at 
least seven members. 
APPENDIX IX: STABILITY TESTING OF NEW DRUGS 
Stability testing is to be performed to provide evidence on how 
the quality of a drug substance or formulation varies with time 
under the influence of various environmental factors such as 
temperature, humidity and light, and to establish shelf life for 
the formulation and storage conditions.
APPENDIX X: CONTENTS OF THE PROPOSED 
PROTOCOL FOR CONDUCTING CLINICAL TRIALS 
1. Title Page 
2. Table of Contents 
3. Study Objective(s) 
4. Study Design 
5. Study Population 
6. Subject Eligibility 
7. Study Assessments 
8. Study Conduct stating the types of study activities 
9. Study Treatment 
10. Adverse Events. 
11. Ethical Considerations 
12. Investigational Product Management 
13. Study Monitoring and Supervision:
APPENDIX XI: Data Elements for reporting serious adverse 
events occurring in a clinical trial 
1. Patient Details 
2.Suspected Drug(s) 
3. Other Treatment(s) 
4. Details of Suspected Adverse Drug Reaction(s) 
5. Outcome 
6. Details about the Investigator* 
- Name 
- Address 
-Telephone number 
- Profession (speciality) 
- Date of reporting the event to Licensing Authority 
- Date of reporting the event to Ethics Committee 
- Signature of the Investigator
Loopholes in Schedule Y: 
 New drug remains new for 4 years. Thus, Phase IV trials 
require permission. However, Approved drug and indication 
need not require permission. 
 Approval of Amendment could be a problem. 
 SOPs for investigators and documentation of tasks – 
Template required. 
 Unmet medical needs to be added to CT waiver. 
 EC chairman outside institute is a rarity. 
 Exhaustive species data (App .I-A)and comparative 
evaluation (App. I) not helpful for differentiation. 
 All CT supplies to be included in Form 11. 
 Requirement to support data protection
Unattended Areas 
Regulations for : 
1. Biologics : vaccines 
Blood products 
Tissue Cellular/gene therapy 
2. Herbals 
3. Medical devices 
4. Pharmacovigilance 
5. Electronic records
 Dr Reddy's Laboratories on Wednesday said it has launched its 
generic Lamotrigine extended-release tablets, used for treating 
epilepsy, in the American market following approval by the US 
health regulator. 
 Hyderabad-based pharma major Dr Reddy's Laboratories 
( DRL) on Friday said it had launched anti-cancer drug 
Decitabine in the injectable form, a copy cat version of Dacogen, 
in the US market on July 11. The brand is manufactured and sold 
by Japanese drug giant Eisai Inc under license from Astex 
Pharmaceuticals Inc. 
 SUN PHARMA announced that the US FDA has granted its 
subsidiary final approval for its abbreviated new drug application 
for generic version of diabetes drug Prandin. Repaglinide tablets, 
1mg and 2mg are therapeutic equivalents of Novo Nordisk's 
Prandin.
No Drug Name Active 
Ingredient 
Date Use 
1 Tivicay Dolutegravir 8/12/13 Treat HIV-1 infection 
2 Simponi Aria golimumab 7/18/13 In Rheumatoid Arthritis 
3 Gilotrif afatinib 7/12/13 Non-small lung cancer 
4 Mekinist trametinib 5/29/13 Treat tumors 
5 Tafinlar dabrafenib 5/29/13 Treat melanoma 
6 Xofigo Radium Ra 223 
dichloride 
5/15/13 treat symptomatic late-stage 
(metastatic) 
prostate cancer 
7 Breo Ellipta fluticasone 
furoate 
5/10/13 airflow obstruction in 
patients with chronic 
obstructive pulmonary 
disease (COPD). 
8 Nesina a alogliptin 1/25/13 To improve blood sugar 
control in adults with type 
2 diabetes 
9 Invokanac canagliflozin 3/29/13 to improve glycemic
The Clinical Trials Innovation Core develops, tests and 
implements new methodological and technological innovations to 
enhance clinical trial designs in neurodegenerative diseases. The 
Core designs algorithms to identify the best subjects, measures, 
time intervals and statistical approaches to detect the slightest yet 
important changes in subjects during a clinical trial. 
The Program will: 
 Investigate and implement methodological and technological 
innovations for neurodegenerative disease clinical trials. 
 Develop novel approaches to subject selection, study design, 
and data analysis, to maximize power. 
 Provide direction of how to install and operate the most 
appropriate tools. 
 Provide expert core staff members to actively support 
investigators designing new trials. 
 Continually import and refine new algorithms and other tools to 
enable clinical trials.
References: 
 Dr. B.S. KUCHEKAR ,Mr. A. M. KHADATARE , 
Mr . SACHIN C . ITKAR; Forensic Pharmacy , Sixth 
edition , Nirali Prakashan,pg.no:5.270-5.301. 
 http://www.slideshare.net/pgpritigupta1/schedule-y-pritigupta 
http://www.scribd.com/doc/7211784/Schedule-Y 
http://www.authorstream.com/Presentation/Malarkodi- 
863587-schedule-y-guidelines/
Schedule Y rules for clinical trials and new drug applications

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Schedule Y rules for clinical trials and new drug applications

  • 1. Presented by Mpharm (ceutics) Mahaboobjani Guieded by: RAJA REDDY SIR R.NO:256212886021
  • 2. • SCHEDULE Y: REQUIREMENTS AND GUIDELINES FOR PERMISSION TO IMPORT AND OR MANUFACTURE OF NEW DRUGS FOR SALE OR TO UNDERTAKE CLINICALTRIALS. See Schedule Y rules: l22A, l22B, 122D, 122DA, 122DAA and 122E. includes Responsibilities Applications Appendices Refinements
  • 3. • PART XA OF D&C RULES 1945: 122A: Application for permission to import new drug. 122B: Application for approval to manufacture new drug. 122D: Permission to import or manufacture FDC. 122DA: Permission to conduct clinical trials for new drug / investigational new drug. 122DAA: Clinical Trial Definitions 122E: New Drug Definitions
  • 4. Drug Regulatory Laws 1940: Drug and Cosmetic Act. 1985: Narcotic drugs and psychotropic substances act. 2000: Ethical guidelines for biomedical research on human subjects ,ICMR. 2001: Indian GCP guidelines. 2002: Amendment to D & C act. 2005: Revised Future: 1) Guidelines for pre-clinical data for r- DNA vaccines, diagnostics & biologicals , DBT. 2) Draft guidelines for stem cell research/ regulation, ICMR.
  • 5. Why there was need for amendment REVISED OLD 1.Application for permission 1.Clinical Trials 2.Clinical Trials 1.1:Nature of Clinical Trials 1.Approal for Clinical Trials 1.2:Permission for Trials 2.Responsibility of sponser 1.3:Responsibility of sponser/ investigator 3.Responsibility of investigator 4.Informed consent-new 5.Responsibility of ethics committee-new 6.Human pharmacology(ph I) 5.Human clinical pharmacology(ph I) 7.Therapeutic exploratory trials(ph II) 6.Exploratory trials(ph II) 8.Therapeutic exploratory trials(ph III) 7.Confirmatory trials(ph III) 9.Post marketing trials(ph IV)-NEW 3.Studies in special population 8.Special studies 1.geriatric,pediatric 2.Pregnant or nursing women, 3.post marketing surveillance , BA/BE 12.Post marketing surveillance
  • 6. Application for permission:  Application for permission to import or manufacture new drugs for sale or to undertake clinical trials shall be made in Form 44. • chemical and pharmaceutical information as prescribed in Appendix I; • animal pharmacology data as prescribed in item 3 of Appendix I and Appendix IV • animal toxicology data as prescribed in Appendix I and Appendix III; • human Clinical Pharmacology Data as prescribed in Appendix I • regulatory status in other countries as prescribed in Appendix I.  the application for import of small quantities of drugs for such purpose should also be made in Form 12.
  • 7. 122 – DAA: Clinical Trial Definition Systematic study of new drugs in human subjects; to generate data for discovering/verifying clinical, pharmacological (PK & PD) or adverse effects; to determine safety and efficacy of the new drug;
  • 8. CLINICAL TRIAL: (1) Approval for clinical trial  Clinical trial on a new drug shall be initiated only after the permission has been granted by the Licensing Authority under rule 21 (b), and the approval obtained from the respective ethics committee(s). The Licensing Authority as defined shall be informed of the approval of the respective institutional ethics committee(s) as prescribed in Appendix VIII, and the trial initiated at each respective site only after obtaining such an approval for that site.  All trial Investigator(s) should possess appropriate qualifications, training and experience and should have access to such investigational and treatment facilities as are relevant to the proposed trial protocol. A qualified physician (or dentist, when appropriate) who is an investigator or a sub-investigator for the trial, should be responsible for all trial-related medical (or dental) decisions.
  • 9. (2) Responsibilities of Sponsor:  The clinical trial Sponsor is responsible for implementing and maintaining quality assurance systems to ensure that the clinical trial is conducted and data generated , documented and reported in compliance with the protocol and Good Clinical Practice(GCP) Guidelines issued by the Central _Drugs Standard Control Organization , Directorate General of Health Services, Government of India as well as with all applicable statutory provisions.  Sponsors are required to submit a status report on the clinical trial to the Licensing Authority at the prescribed periodicity.  Trial Status Report to Licensing Authority : Annually  Premature Termination : Summary report within 3m ( Study, , Dose, Duration, ADR &reasons for discontinuati on ).  Serious Adverse Event : Report to LA & other investigators within 14 days.
  • 10. (3) Responsibilities of the Investigator( s): (i)The Investigator(s) shall be responsible for the conduct of the trial according to the protocol and the GCP Guidelines and also for compliance as per the undertaking given in Appendix VII. (ii) Document SOPs. Management of all ADR / AE Reporting unexpected AE to :- Sponsor within 24 hours. - EC within 7 day. (4) EC RESPONSIBILITIES: (i) Safeguard rights, safety & well being (ii) Protect vulnerable subjects (iii) Obtain and maintain record of SOPs (iv) Ongoing review based on Periodic progress report (v) If EC revokes its approval- 1.Record reasons for it 2.Inform the Investigator & LA immediately .
  • 11. (5) Informed Consent:  In all trials, a freely given, informed, written consent is required to be obtained from each study subject. The Investigator must provide information about the study verbally as well as using a patient information sheet, in a language that is non-technical and understandable by the study subject. The Subject's consent must be obtained in writing using an 'Informed Consent Form'. Both the patient information sheet as well as the Informed Consent Form should have been approved by the ethics committee and furnished to the Licensing Authority.  Where a subject is not able to give informed consent. The same may be obtained from a legally acceptable representative.
  • 12. ESSENTIAL STEPS OF CLINICAL PHARMACOLOGY:  Phase I: (Human Pharmacology)Safety & Tolerability ( PK, PD & MTD.  Phase II: (Therapeutic Exploratory Trial)Therapeutic benefits in few patients.  Phase III: (Therapeutic Confirmatory Trial)Therapeutic benefit in more patients .  Phase IV: (Post Marketing Trials)Related to Approved indication.
  • 13.
  • 14.
  • 15. (6)Human Pharmacology(Phase I):  The objective of studies in this Phase is the estimation of safety and tolerability with the initial administration of an investigational new drug into human(s). Studies in this Phase of development usually have non-therapeutic objectives and may be conducted in healthy volunteers subjects or certain types of patients.  Studies conducted in Phase I: (a) Maximum tolerated dose: To determine the tolerability of the dose range expected to be needed for later clinical studies and to determine the nature of adverse reactions. (b) Pharmacokinetics: characterization of a drug's absorption, distribution, metabolism and excretion. (c) Pharmacodynamic data, It may guide the dosage and dose regimen to be applied in later studies.
  • 16. (7) Therapeutic exploratory trials (Phase II):  The primary objective of Phase II trials is to evaluate the effectiveness of a drug for a particular indication or indications in patients with the condition under study and to determine the common short-term side-effects and risks associated with the drug.  An important goal for this Phase is to determine the dose((s) and regimen for Phase III trials. Doses used in Phase II are usually (but not always) less than the highest doses used in Phase 1.  Additional objectives of Phase II studies can include evaluation of potential study endpoints, therapeutic regimens (including concomitant medications) and target populations (e.g. mild versus severe disease) for further studies in Phase II or III.
  • 17. (8) Therapeutic confirmatory trials (Phase III):  Phase III studies have primary objective of demonstration or confirmation of therapeutic benefit(s). Studies in Phase III are designed to confirm the preliminary evidence accumulated in Phase II that a drug is safe and effective for use in the intended indication and recipient population. These studies should be intended to provide an adequate basis for marketing approval.  For drugs intended to be administered for long periods, trials involving extended exposure to the drug are ordinarily conducted in Phase III.  For new drugs approved outside India, Phase III studies need to be carried out primarily to generate evidence of efficacy and safety of the drug in Indian patients when used as recommended in the prescribing information. Prior to conduct of Phase III studies in Indian subjects, Licensing Authority may require pharmacokinetic studies to be undertaken to verify that the data generated in Indian population is in conformity with the data already generated abroad.
  • 18. (9) Post Marketing Trials (Phase IV):  Post Marketing trials are studies (other than routine surveillance) performed after drug approval arid related to the approved indication(s).  These trials go beyond the prior demonstration of the drug's safety, efficacy and dose definition.  These trials may not be considered necessary at the time of new drug approval but may be required by the  Licensing Authority for optimizing the drug's use.  They may be of any type but should have valid, scientific objectives.  Phase IV trials include additional drug-drug interaction(s), dose-response or safety studies and trials designed to support use under the approved indication(s), e.g. mortality/morbidity studies, epidermiological studies etc.
  • 19.
  • 20. REGULATORY REQUIREMENTS FORCLINICAL PHARMACOLOGY:  Drug discovered in India : Phase I data  Drug discovered outside India : Foreign Phase I data required for Phase II/III permission  Accompanying documents : Protocol, CRF,IB, IC, EC Clearance , Investigator’s undertaking. Sample size : Depending upon type of study  EC application can parallel DCGI application  Toxicological / clinical data abbreviate, deferred or omitted for life threatening diseases (or diseases of special relevance to Indian health Scenario)  Amendments notified to DCGI & EC within 30 days& approval obtained.
  • 21.
  • 22. 3. Studies in special populations: Information supporting the use of the drug in children, pregnant women, nursing women, elderly patients, patients with renal or other organ systems failure, and those on specific concomitant medication is required to be submitted. (1)Geriatrics:  Geriatric patients should be included in Phase III clinical trials (and in Phase II trials, at the Sponsor's option) in meaningful numbers, if-  the disease intended to be treated is characteristically a disease of aging;  the population to be treated is known to include substantial numbers of geriatric patients;  when the new drug is likely to alter the geriatric patient's response (with regard to safety or efficacy)compared with that of the non-geriatric patient.
  • 23. (2) Paediatrics:  The timing of paediatric studies in the new drug development program will depend on the medicinal product, the type of disease being treated, safety considerations, and the efficacy and safety of available treatments.  If the new drug is for diseases predominantly or exclusively affecting paediatric patients, clinical trial data should be generated in the paediatric population except for initial safety and tolerability data, which will usually be .obtained in adults.  If the new drug is intended to treat serious or life-threatening diseases, occurring in both adults and paediatric patients, for which there are currently no or limited therapeutic options, paediatric population should be included in the clinical trials early, following assessment of initial safety data and reasonable evidence of potential benefit.
  • 24.  If the new drug has a potential for use in paediatric patients – Paediatric studies should be conducted.  The paediatric studies should include -  (a) clinical trials,  (b) relative bioequivalence comparisons of the paediatric formulation with the adult formulation performed in adults,  (c) definitive pharmacokinetic studies for dose selection across the age ranges of paediatric patients in whom the drug is likely to be used.  If the new drug is a major therapeutic advance for the paediatric population – the studies should begin early in the drug development , and this data should be submitted with the new drug application.  For clinical trials conducted in the paediatric population, the reviewing ethics committee should include members who are knowledgeable about pediatric , ethical, clinical and psychosocial issues.
  • 25. (3) Pregnant or nursing women.-  Pregnant or nursing women should be included in clinical trials only when the drug is intended for use by pregnant/nursing women or foetuses/nursing infants.  For new drugs intended for use during pregnancy, follow-up data on the pregnancy, foetus and child will be required. Where applicable, excretion of the drug or its metabolites into human milk should be examined and the infant should be monitored for predicted pharmacological effects the drug. (4) Post Marketing Surveillance.-  (i) Subsequent to approval of the product, new drugs should be closely monitored for their clinical safety once they are marketed. The applicants shall furnish Periodic Safety Update Reports (PSURs) in order to-  (a) report all the relevant new information from appropriate sources;  (b) relate these data to patient exposure;
  • 26.  Ordinarily all dosage forms and formulations as well as indications for new drugs should be covered in one PSUR.  All relevant clinical and non-clinical safety data should cover only the period of the report (interval data).  The PSUR submitted -6 months for first 2 years after approval of the drug is granted to the applicant.  For subsequent two years - the PSURs need to be submitted annually.  PSURs due for a period must be submitted within30 days of the last day of the reporting period.  In all cases involving serious unexpected adverse reactions must be reported to the licensing authority within 15 days of initial receipt of the information by the applicant.  If marketing of the new drug is delayed by the applicant after obtaining approval to market, such data will have to be provided on the deferred basis beginning from the time the new drug is marketed.  New studies specifically planned or conducted to examine a safety issue should be described in the PSURs.
  • 27. (v) A PSUR should be structure (a) A title page stating: (b) Introduction, (c) Current worldwide market authorization status, (d) Update of actions taken for safety reasons, (e) Changes to reference safety information, (1) Estimated patient exposure, (g) Presentation of individual case histories, (h) Studies, (I) Other information, (j) Overall safety evaluation, (k) Conclusion, (I) Appendix providing material relating to indications, dosing, pharmacology and other related information.
  • 28.  (5) Special studies: Bioavailability/Bioequivalence  For drugs approved elsewhere in the world and absorbed systemically, bioequivalence with the reference formulation should be carried out wherever applicable. These studies should be conducted under the labelled conditions of administration.  Evaluation of the effect of food on absorption following oral administration should be carried out. Data from dissolution studies should also be submitted for all solid oral dosage forms.  Dissolution and bioavailability data submitted with the new drug application must provide information that assures bioequivalence or establishes bioavailability and dosage correlations between the formulation(s) sought to be marketed and those used for clinical trials during clinical development of the product.  Compliance with ICMR guidelines BA/ BE studies.
  • 29. APPLICATION FORM44 -Imp ff -Imp rm -Mfg ff -Mfg rm -C T APPROVAL FORM 45(IMP FF) APPROVAL FORM 45A(IMP RM) APPROVAL FORM 46(MFG FF) APPROVAL FORM 46A(MFG RM) NOC FOR C T AND TEST LICENSE FOR IMPORT
  • 30. Application Fees: Import ff/ Mfg ff/ Import bulk + Mfg ff=Rs 50,000/- of new drug. Application by same applicant, =Rs 15,000/-for modified dosage form or with new claim. Secondary applicants after 1=Rs 15,000/-year of approval Import / Mfg FDC=Rs 15,000/- Conduct Clinical trial with ND/IND Phase I =Rs 50,000/- Phase II=Rs 25,000/- Phase III=Rs 25,000/- No separate fee to be paid along with application for import / mfg based on successful completion.
  • 31. TEST LICENCE Application form No. 12 Material Justification Plan Treasury Challan ( Rs. 100 ) Test License obtained in form 11
  • 32. 122 – E: New drug definition Investigational New Drug (IND): New chemical entity or product having therapeutic indication but never tested on human beings. Not used in the country Approved drug : 1. New claims(Indications, dosage , dosage form, route) 2. FDCs(New / Modified) Note: Vaccines are new drugs unless 1. Certified 2. Till 4 year or 3. Included in IP
  • 33. Appendices: I : Data required for import/manufacture/conduct CT of new drugs. I A : ….Drugs approved in other country II : Format for clinical study reports(ICH E6) III : Animal toxicology IV : Animal pharmacology V :Informed consent. VI: FDC VII: Undertaking by the investigator. VIII : Ethics committee IX : Stability testing X : Proposed protocol XI : SAE Reporting
  • 34. APPENDIX I: DATA TO BE SUBMITTED ALONG WITH THE APPLICATION TO CONDUCT CLINICAL TRIALS/IMPORTIMANUFACTURE OF NEW DRUGS FOR MARKETING IN THE COUNTRY 1. Introduction 2. Chemical and pharmaceutical information 2.1. Information on active ingrédients 2.2. Physicochemical Data 2.3. Analytical Data 2.4. Complete monograph specification 2.5. Validations 2.6. Stability Studies 2.7. Data on Formulation
  • 35. 3. Animal Pharmacology 4. Animal Toxicology 5. Human / Clinical pharmacology 6. Therapeutic exploratory trials (Phase II) 7. Therapeutic confirmatory trials (Phase III) 8. Special studies 9. Regulatory status in other countries 10. Prescribing information 11. Samples and Testing Protocol/s APPENDIX -IA: DATA REQUIRED TO BE SUBMITTED BY AN APPLICANT FOR GRANT OF PERMISSION TO IMPORT AND / OR MANUFACTURE A NEW DRUG ALREADY APPROVED IN THE COUNTRY. 1.Introduction
  • 36. REVISED OLD Data should be submitted along with application to conduct clinical trials/import/manufacture of new drug. Data required to submitted with application for permission to market a new drug. 2.1 Information of active ingredients 2.1Specifications of API/In active ingredients 2.2 Physicochemical data 2.2 Physicochemical proportion 2.3 Analytical data-NEW 2.4 Monograph Specifications 2.4 Tests for identifications of API. 2.5 Validations-NEW 2.7 Data on formulation 2.2 and 2.5 3.4 Safety pharmacology-NEW 4.3 Male Fertility Studies-NEW 4.6 Allergenicity / Hypersensitivity-NEW 11.Samples and testing protocol 10.3 Sample… with testing protocol
  • 37. 2.Chemical and Pharmaceutical information. 3. Marketing information 4. Special studies conducted with approval of Licensing Authority . APPENDIX II: STRUCTURE, CONTENTS AND FORMAT FOR CLINICAL STUDY REPORTS 1. Title Page: 2.Study Synopsis 3. Statement of compliance with the 'Guidelines for Clinical Trials. 4. List of Abbreviations and Definitions 5. Table of contents 6. Ethics Committee:
  • 38. 7. Study Team 8. Introduction 9. Study Objective 10. Investigational Plan 11. Trial Subjects 12. Efficacy evaluation 13. Safety Evaluation 14. Discussion and overall Conclusion 15. List of References 16. Appendices APPENDIX III: ANIMAL TOXICOLOGY (NON-CLINICAL TOXICITY STUDIES) 1. General Principles:
  • 39. 1.1 Systemic Toxicity Studies Single-dose Toxicity Studies(2 rodents) Repeated-dose Systemic Toxicity Studies 1.2) Dose Ranging Study 1.3) Male Fertility Study 1.4) Female Reproduction and Development Toxicity Studies. 1.5)Local toxicity 1.6)Allergenicity /Hypersensitivity 1.7)Genotoxicity and Carcinogenicity
  • 40. APPENDIX IV: ANIMAL PHARMACOLOGY General Principles 1.1 Specific Pharmacological actions 1.2 General Pharmacological Actions 1.3 Follow-up and Supplemental Safety Pharmacology Studies 1.4 Conditions Under Which Safety Pharmacology Studies Are Not Necessary 1.5 Timing Of Safety Pharmacology Studies In Relation To Clinical Development 1.6 Application Of Good Laboratory Practices (GLP)
  • 41. APPENDIX V: INFORMED CONSENT Checklist for study Subject's informed consent documents. APPENDIX VI: FIXED DOSE COMBINATIONS (FDCs) Fixed Dose Combinations refer to products containing one or more active ingredients used for a particular indications. APPENDIX VII: UNDERTAKING BY THE INVESTIGATOR APPENDIX VIII: ETHICS COMMITTEE The number of persons in an Ethics Committee should have at least seven members. APPENDIX IX: STABILITY TESTING OF NEW DRUGS Stability testing is to be performed to provide evidence on how the quality of a drug substance or formulation varies with time under the influence of various environmental factors such as temperature, humidity and light, and to establish shelf life for the formulation and storage conditions.
  • 42. APPENDIX X: CONTENTS OF THE PROPOSED PROTOCOL FOR CONDUCTING CLINICAL TRIALS 1. Title Page 2. Table of Contents 3. Study Objective(s) 4. Study Design 5. Study Population 6. Subject Eligibility 7. Study Assessments 8. Study Conduct stating the types of study activities 9. Study Treatment 10. Adverse Events. 11. Ethical Considerations 12. Investigational Product Management 13. Study Monitoring and Supervision:
  • 43. APPENDIX XI: Data Elements for reporting serious adverse events occurring in a clinical trial 1. Patient Details 2.Suspected Drug(s) 3. Other Treatment(s) 4. Details of Suspected Adverse Drug Reaction(s) 5. Outcome 6. Details about the Investigator* - Name - Address -Telephone number - Profession (speciality) - Date of reporting the event to Licensing Authority - Date of reporting the event to Ethics Committee - Signature of the Investigator
  • 44. Loopholes in Schedule Y:  New drug remains new for 4 years. Thus, Phase IV trials require permission. However, Approved drug and indication need not require permission.  Approval of Amendment could be a problem.  SOPs for investigators and documentation of tasks – Template required.  Unmet medical needs to be added to CT waiver.  EC chairman outside institute is a rarity.  Exhaustive species data (App .I-A)and comparative evaluation (App. I) not helpful for differentiation.  All CT supplies to be included in Form 11.  Requirement to support data protection
  • 45. Unattended Areas Regulations for : 1. Biologics : vaccines Blood products Tissue Cellular/gene therapy 2. Herbals 3. Medical devices 4. Pharmacovigilance 5. Electronic records
  • 46.  Dr Reddy's Laboratories on Wednesday said it has launched its generic Lamotrigine extended-release tablets, used for treating epilepsy, in the American market following approval by the US health regulator.  Hyderabad-based pharma major Dr Reddy's Laboratories ( DRL) on Friday said it had launched anti-cancer drug Decitabine in the injectable form, a copy cat version of Dacogen, in the US market on July 11. The brand is manufactured and sold by Japanese drug giant Eisai Inc under license from Astex Pharmaceuticals Inc.  SUN PHARMA announced that the US FDA has granted its subsidiary final approval for its abbreviated new drug application for generic version of diabetes drug Prandin. Repaglinide tablets, 1mg and 2mg are therapeutic equivalents of Novo Nordisk's Prandin.
  • 47. No Drug Name Active Ingredient Date Use 1 Tivicay Dolutegravir 8/12/13 Treat HIV-1 infection 2 Simponi Aria golimumab 7/18/13 In Rheumatoid Arthritis 3 Gilotrif afatinib 7/12/13 Non-small lung cancer 4 Mekinist trametinib 5/29/13 Treat tumors 5 Tafinlar dabrafenib 5/29/13 Treat melanoma 6 Xofigo Radium Ra 223 dichloride 5/15/13 treat symptomatic late-stage (metastatic) prostate cancer 7 Breo Ellipta fluticasone furoate 5/10/13 airflow obstruction in patients with chronic obstructive pulmonary disease (COPD). 8 Nesina a alogliptin 1/25/13 To improve blood sugar control in adults with type 2 diabetes 9 Invokanac canagliflozin 3/29/13 to improve glycemic
  • 48. The Clinical Trials Innovation Core develops, tests and implements new methodological and technological innovations to enhance clinical trial designs in neurodegenerative diseases. The Core designs algorithms to identify the best subjects, measures, time intervals and statistical approaches to detect the slightest yet important changes in subjects during a clinical trial. The Program will:  Investigate and implement methodological and technological innovations for neurodegenerative disease clinical trials.  Develop novel approaches to subject selection, study design, and data analysis, to maximize power.  Provide direction of how to install and operate the most appropriate tools.  Provide expert core staff members to actively support investigators designing new trials.  Continually import and refine new algorithms and other tools to enable clinical trials.
  • 49. References:  Dr. B.S. KUCHEKAR ,Mr. A. M. KHADATARE , Mr . SACHIN C . ITKAR; Forensic Pharmacy , Sixth edition , Nirali Prakashan,pg.no:5.270-5.301.  http://www.slideshare.net/pgpritigupta1/schedule-y-pritigupta http://www.scribd.com/doc/7211784/Schedule-Y http://www.authorstream.com/Presentation/Malarkodi- 863587-schedule-y-guidelines/