2. Bijeenkomst Jaarbeurs Utrecht 2013
Programma
Nr. onderwerp wie tijd
Ontvangst met koffie 9.00 uur
1 Opening + context en samenhang van de bijdragen Rob de Haan 9.30 uur
2 Elektronische dossiers: 9.45 uur
•eCTD Ricco van den
o introductie Lifecycle Management bij CBG Hoorn
o validatie
•eApplication Form
•Introductie parallel registratie dossier standaard
•Central Repository
•Veterinaire ontwikkeling
3 e-business en nieuwe PhV-wetgeving Anja van Haren 10.30 uur
4 koffie 11.00 uur
5 Internationale ontwikkelingen (ICH) Stan van Belkum 11.15 uur
6 CESP Stan van Belkum 11.30 uur
7 Vragen en antwoord: panel Allen 12.00 uur
Lunch 12.30 uur
2 14-03-13
27. Bijeenkomst Jaarbeurs Utrecht 2013
Are you accepting the eAF (in
pdf/XML) as a valid AF within e-
submissions (eCTD/NeeS)?
Christa Wirthumer-Hoche 27
29. Bijeenkomst Jaarbeurs Utrecht 2013
Does your NCA has the intention to
re-use the data from the xml eAF in
order to populate national data
base?
Christa Wirthumer-Hoche 29
30. Bijeenkomst Jaarbeurs Utrecht 2013
Does your NCA has the intention to
ask mandatory for the submission of
the xml eAF instaed of the pdf/word
document?
Christa Wirthumer-Hoche 30
47. E-business
en de nieuwe farmacovigilantie wetgeving
12 maart 2013
Anja van Haren
48. Disclaimer
Bijeenkomst Jaarbeurs Utrecht 2013
• The information contained in these slides is for general
purposes only and presents the state of knowledge at
12 March 2013
• No rights can be derived from this information
• The Medicines Evaluation Board accepts no liability for
direct or consequential damage resulting from the use of,
reliance on or action taken on the basis of this information
provided during this session
48
49. Bijeenkomst Jaarbeurs Utrecht 2013
1. Introduction
2. PSUR and RMP
3. Reporting of suspected Adverse Drug Reactions
4. Art 57(2) / IDMP
5. Closure
51. Implementation new legislation
Bijeenkomst Jaarbeurs Utrecht 2013
New pharmacovigilance legislation entered into force
in July 2012
Stepwise implementation
Criteria for prioritisation:
1.public health activities
2.transparency and communication activities
3. simplification activities
52. New PV legislation: 4 topic areas
Bijeenkomst Jaarbeurs Utrecht 2013
Impact beyond pharmacovigilance
53. ICT related changes
Bijeenkomst Jaarbeurs Utrecht 2013
E-PSUR Art 57(2)
EudraVigilance
E-RMP
Repositories ISO standards
Medicines Web Portal Gateway adaptation
Fee collection
PAS Registry
pragmatic use of existing systems
Support PRAC
until budget available
53
54. Pharmacovigilance legislation
Bijeenkomst Jaarbeurs Utrecht 2013
References use of internationally agreed terminology,
formats and standards
(Dir 2010/84/EU Art. 108, Reg.1235/2010 Art. 87a)
Further specified in Implementing Regulation:
– Periodic Safety Update Report (E)
- Risk Management Plan (E)
- Study protocol, abstract and end-of-study report
(for Post Authorisation Safety Studies - PASS)
- Suspected Adverse Drug Reactions (E)
- Medicinal Product Information (E)
59. PSUR vs PBRER
Bijeenkomst Jaarbeurs Utrecht 2013
ICH E2C(R1) ‘PSUR’ is replaced by ICH E2C(R2) ‘PBRER’
• PSUR: Periodic Safety Update Report
• PBRER: Periodic Benefit Risk Evaluation Report
Different mindset:
From periodic review to cumulative review benefit-risk
•EU legislation: ‘PSUR’
•Format of PSURs follows structure described in
Implementing Regulation
•ICH E2C(R2) principles implemented in GVP Module VII
60. E-PSUR and E-RMP
Bijeenkomst Jaarbeurs Utrecht 2013
• Electronic format not part of ICH PSUR/PBRER work
• HL7 project to define electronic format for PSUR & RMP
- utilizes modular structure
61. How to submit PSUR?
Bijeenkomst Jaarbeurs Utrecht 2013
EMA shall set up and maintain a repository for PSURs
and the corresponding assessment reports
[Reg. Art. 25a]
MAHs shall submit PSURs electronically to EMA
[Dir. Art. 107b]
Transitional provisions in Dir. 2010/84:
till 12 months after the PSUR repository is fully
operational PSURs will be sent directly to the MSs
where the products/substances are authorised
62. How to submit PSUR?
Bijeenkomst Jaarbeurs Utrecht 2013
http://www.ema.europa.eu/docs/en_GB/document_library/Regulatory
_and_procedural_guideline/2012/05/WC500127658.pdf
63. How to submit PSUR?
Bijeenkomst Jaarbeurs Utrecht 2013
65. Bijeenkomst Jaarbeurs Utrecht 2013
1. Introductie
2. PSUR and RMP
3. Reporting of suspected Adverse Drug Reactions
4. Art 57(2) / IDMP
5. Closure
66. Implementing Regulation (EU) 520/2012
Bijeenkomst Jaarbeurs Utrecht 2013
Specifies internationally agreed formats for transmission of
suspected adverse drug reactions:
•ICH E2B(R2) ‘Maintenance of the ICH guideline on clinical
safety data management: data elements for transmission of
Individual Case Safety Reports’
•ICH M2 standard ‘Electronic Transmission of Individual Case
Safety Reports Message Specification’
From 1 July 2016:
•ISO 27953-2:2011 Health Informatics, Individual case safety
reports (ICSRs) in pharmacovigilance — Part 2: Human
pharmaceutical reporting requirements for ICSR (ISO 27953-
2:2011)
67. From ICH E2B (R2) to ICH E2B(R3)
Bijeenkomst Jaarbeurs Utrecht 2013
ICH has developed an Implementation Guide (IG) on
how to use this ISO ICSR standard: ICH E2B(R3)
Will replace the current ICH E2B(R2) message
Final ICH E2B(R3) package to be published on
ICH website March/April 2013
68. ISO ICSR/ICH E2B (R3)
Bijeenkomst Jaarbeurs Utrecht 2013
ICH E2B(R3) package:
ICH E2B(R3) Implementation Guide (IG)
- Appendix I (A) ICH ICSR schemas
- Appendix I (B) Backwards & Forwards Compatibility (BFC)
(convert R2 into R3 message and vice versa)
- Appendix I (C) Schema files
- Appendix I (D) Reference instances for XML-files (ICSR and ACK)
- Appendix I (E) Example instances of report cases
- Appendix I (F) ICH E2B code lists
- Appendix I (G) Technical Information
- Appendix I (H) SGML & XML conversion
68
69. ICH E2B (R2) vs E2B (R3)
Bijeenkomst Jaarbeurs Utrecht 2013
• Fields removed or updated (size increased, new values)
• Some fields are repeatable (“r”) (indication)
• New concepts introduced by:
– Adding new fields
– New values for existing fields
• Improved user instruction for fields
• Some changes capture information differently
-seriousness at event level
-country of occurrence at event level
69
70. Message structure:
ICH E2B (R2) vs E2B (R3)
Bijeenkomst Jaarbeurs Utrecht 2013
E2B(R2) E2B(R3)
71. EU Implementation Guide
Bijeenkomst Jaarbeurs Utrecht 2013
ICH E2B(R3) Implementation Guide (IG)to be
complemented by EU Regional Implementation Guide
Under preparation by EudraVigilance Expert Working Group
Will address:
•Business Rules
•Additional ISO/HL7 data fields (drug section)
•Integration with ISO IDMP standards
•ICSR classification
•Use of standard terminologies
•What to do in system failure
•…
Expected delivery in 2013, will be subject to public
consultation
72. Testing E2B(R3)
Bijeenkomst Jaarbeurs Utrecht 2013
• FDA-EU joint pilot testing
- will assist in defining requirements for future
EudraVigilance enhancements and drafting of EU regional
implementation guide
• FDA test tool
http://www.accessdata.fda.gov/esubmissions/ftpare
a/esubmitter/platforms/Windows/IncludeJvm/jinst
all_CBER_ICSR.zip
72
74. Simplified routing ADR reporting
- Future
Bijeenkomst Jaarbeurs Utrecht 2013
Own
products MAH
all
Domestic
NCA..1
Domestic
NCA..2
Domestic
NCA..28
75. Transitional period
Bijeenkomst Jaarbeurs Utrecht 2013
Transitional Period; submit to MS and/or EV:
-obligation to submit non-serious varies between MS
Direct reporting by NCAs and MAHs to EV will apply
after successful audit of EV system:
-Comply with ISO ICSR/IDMP standards
-Re-routing of ICSRs to NCAs
-Support signal detection activities
-Access to EV
- reporting of ICSRs to WHO (on behalf of member states)
-Exchange with EMCDDA
-…
76. Interim period
Annex to GVP Module VI
Bijeenkomst Jaarbeurs Utrecht 2013
78. Lareb reports
Bijeenkomst Jaarbeurs Utrecht 2013
In the near future Lareb cases will be sent to
MAHs only via:
- gateway, E2B(R2) format
- e-mail (XML-file + html file)
79. Bijeenkomst Jaarbeurs Utrecht 2013
1. Introduction
2. PSUR and RMP
3. Reporting of suspected Adverse Drug Reactions
4. Art 57(2) / IDMP
5. Closure
80. Article 57(2)
Bijeenkomst Jaarbeurs Utrecht 2013
EMA to create a list of all medicinal products authorised in
the EU regardless of licensing procedure
• Coordinate the regulation, safety-monitoring and
pharmacovigilance activities of medicines across the EU
• Identify medicines accurately, especially in ICSRs
• Facilitate the international harmonisation activities
81. Article 57(2) implementation
Bijeenkomst Jaarbeurs Utrecht 2013
Notification of
Initiation of quality Update in
electronic Electronic
review and compliance with
submission format submission & data
maintenance of Art ISO IDMP
(July 2011, revised processing
57(2) data standards
March 2012)
xEVMPD update,
guidances, xEVPRM format will
By 2 July 2012
controlled vocs, be replaced
Q&As
This obligation does not involve traditional herbal medicinal products (Chapter 2a of Directive 2001/83/EC) , homeopathic
medicinal products registered according to the simplified registration procedure (Article 14 of Directive 2001/83/EC)
82. ISO IDMP standards (final Oct 2012)
Bijeenkomst Jaarbeurs Utrecht 2013
ISO 11615:2012, Health Informatics, Identification of Medicinal Products (IDMP)
standard ‘Data elements and structures for unique identification and exchange
of regulated medicinal product information’
ISO 11616:2012, Health Informatics, Identification of Medicinal Products (IDMP)
standard ‘Data elements and structures for unique identification and exchange
of regulated pharmaceutical product information’
ISO 11238:2012, Health Informatics, Identification of Medicinal Products (IDMP)
standard ‘Data elements and structures for unique identification and exchange
of regulated information on substances’
ISO 11239:2012, Health Informatics, Identification of Medicinal Products (IDMP)
standard ‘Data elements and structures for unique identification and exchange
of regulated information on pharmaceutical dose forms, units of presentation,
routes of administration and packaging’
ISO 11240:2012, Health Informatics, Identification of Medicinal
Products (IDMP) standard ‘Data elements and structures for unique
identification and exchange of units of measurement’
83. Implementation ISO IDMP standards
Bijeenkomst Jaarbeurs Utrecht 2013
1. Information model
HL7 (SPL)
2. Messaging
XML
xEVPRM
Maintenance
Organisation(s)
3. Terminologies
84. Article 57(2) implementation
Bijeenkomst Jaarbeurs Utrecht 2013
Art 57 Joint Implementation Working Group
(18 October 2012, 24 January 2013)
Discussion:
- Further defining requirements for data
maintenance (e.g. handling of variations,
migration of data, controlled vocabularies)
- Submission of structured substance information
(SSI)
- Implementation of ISO IDMP standards
(XEVRPM to be replaced by new message format)
86. Bijeenkomst Jaarbeurs Utrecht 2013
1. Introduction
2. PSUR and RMP
3. PASS
4. Reporting of suspected Adverse Drug Reactions
5. Art 57(2)
6. Closure
87. Closure
Bijeenkomst Jaarbeurs Utrecht 2013
Simplification:
budget and technology limitations
ICT-changes essential for efficient compliance with
pharmacovigilance obligations
No ‘short-term’ electronic formats expected
for PSUR, RMP
EMA is in a process to develop roadmap towards
implementation of ISO IDMP/ICSR standards in the EU
- 2016; subject to available budget
Some changes not only IT systems, but also impact your current
business process
93. GVPs available
Bijeenkomst Jaarbeurs Utrecht 2013
No Module title
I Pharmacovigilance Systems & Quality Systems
II Pharmacovigilance System Master File
III Pharmacovigilance Inspections
IV Pharmacovigilance Audits
V Risk Management Systems
VI Management & Reporting of Adverse Reactions to Medicinal Products
VII Periodic Safety Update Report
VIII Post-Authorisation Safety Studies
IX Signal Management
X Additional Monitoring (public consultation closed, expected Q1/Q2 2013)
XV Safety Communication
94. GVPs under development
Bijeenkomst Jaarbeurs Utrecht 2013
Release public
No Module title
consultation
XI Public participation in pharmacovigilance Q2 2013
Continuous pharmacovigilance, ongoing benefit-
XII risk evaluation, regulatory action and planning Q1 2013
of public communication
XIV International cooperation Q2 2013
Risk-minimisation measures: selection of tools
XVI Q1 2013
and effectiveness indicators
95. ‘Special’ GVPs
Bijeenkomst Jaarbeurs Utrecht 2013
Considerations for product- and population-specific
pharmacovigilance
P I - Vaccines (revision of previous guideline)
Public consultation scheduled for Q1 2013
More planned:
• Biological medicinal products
• Pregnancy
• Children
• Elderly
•……
96. Post Authorisation Safety Studies (PASS)
Bijeenkomst Jaarbeurs Utrecht 2013
Implementing Regulation
GVP
Module VIII
97. Post Authorisation Safety Studies (PASS)
Bijeenkomst Jaarbeurs Utrecht 2013
EMA to make public protocols and public abstracts
of (non-interventional) PASS falling within the
scope of the new procedures involving the PRAC
MAHs should have information on the study entered
prior to the start of data collection into the
electronic register of non-interventional PASS
98. EU PAS Register
Bijeenkomst Jaarbeurs Utrecht 2013
Before the EU PAS register is fully operational, studies should be registered
in the ENCePP E-register of studies
99. EMA Q&A document - PASS
Bijeenkomst Jaarbeurs Utrecht 2013
4.8. Is the ENCePP website amenable to receiving an
Extensible Markup Language (XML) file that encodes the
values for the fields required for registration? (New November
2012)
The ENCePP E-Register of studies must be populated via the data
entry form and it does not accept XML files for upload.
100. Submission of PASS
Bijeenkomst Jaarbeurs Utrecht 2013
Requirements for the registration of PASS is available in
GVP Module VIII - chapter VIII.B.4
http://www.ema.europa.eu/docs/en_GB/document_library/Scientific_gui
deline/2012/02/WC500123204.pdf
103. Bijeenkomst Jaarbeurs Utrecht 2013
ICH en onderwerpen met een e-component
Werkgroep Onderwerpen Status
M2 Allerlei procedurezaken (o.a. Work in progress
evaluaties, onderhoud) etc.
M5 IDMP gerelateerde standaarden Final standards
M8 Regulatory Product Submission Draft standard
E2b Zie presentatie Anja van Haren
103 14-03-13
106. Bijeenkomst Jaarbeurs Utrecht 2013
Historie
• Na papier op zoek naar een nieuwe vijand: CD/DVD
• Oplossing: portal, maar geen 27 portals
• 2010 bijeenkomst: 1 platform?
• Start CESP:
– Feasibility study
– PoC
– Preproduction pilot
– …….
– Production
106 14-03-13
107. Wat is CESP?
Bijeenkomst Jaarbeurs Utrecht 2013
CESP is een online systeem voor het veilig versturen van
registratie informatie naar één of meer registratie autoriteiten
in één handeling
Kenmerken:
• Eenvoudig, snellere verwerking en veilig
• Werkt voor MRP, DCP, Nationaal zowel humaan als veterinair
• Werkt bij alle soorten aanvragen, variaties, partijkeuringen en
export certificaten
• Onafhankelijk van elektronische standaarden
• One-way met notificaties
• Onafhankelijk grootte indiening
• Geen fysieke media (CD, DVD) + papieren brief +AF
109. Bijeenkomst Jaarbeurs Utrecht 2013
Wie doen er mee?
• Austria (AGES) • Ireland (IMB)
• Belgium (FAGG) • Italy (AIFA)
• Croatia (HALMED) • Luxembourg(Ministere de la Sante)
• Cyprus (MOH) • Malta (MITTS)
• Czech Republic (UKZBL) • Netherlands (MEB)
• Denmark (DKMA) • Norway (NOMA)
• Estonia (Ravimiamet) • Portugal (infarmed)
• Finland (Fimea) • Slovenia (JAZMP)
• France (Anses) • Spain (AEMPS)
• Germany (BfArM) • Sweden (MPA)
• Germany(PEI) • United Kingdom (MHRA)
• Iceland (IMA) • United Kingdom (VMD)
Industrie
Project Structuur
•EGA
•EGGVP •Chair : UK (MHRA)
•AESGP •Co Chair: NL (MEB)
•EFPIA •Technical: IE (IMB) , AT (Ages)
•IFAH-Europe
110. Hoe werkt CESP?
Bijeenkomst Jaarbeurs Utrecht 2013
User logs on to
registration Registration
server and Server
creates delivery
file
Agency A
User
downloads
delivery
file to local
PC
Agency B
Industry
User
Files are moved
to agency
User uploads
servers
submission and
delivery file to FTP
File Transfer Agency C
server
Server
113. Bijeenkomst Jaarbeurs Utrecht 2013
Statistieken (2)
Onderwerp Aantal
CESP in bedrijf 16 wkn
Bedrijven 390
Gebruikers 1100
Aantal zendingen 7900
Grootste aanvraag 6GB
% Veterinair 8%
113 14-03-13
114. Bijeenkomst Jaarbeurs Utrecht 2013
Wat zijn de grote voordelen van CESP?
• Geen tijdverlies en kosten voor verzenden CD/DVD
• Duurzaam & goedkoop
• Snellere opvolging bij updates of vragen van CBG ivm CD/DVD
• Geen handmatige handelingen rond de logistiek (verliezen,
vergeten, kapot gaan) en hiermee dus ook veiliger
• Mogelijkheid tot verdere automatisering en verkorting
doorlooptijd
• Eenvoudig en sneller communiceren met CESP-nummer
115. Bijeenkomst Jaarbeurs Utrecht 2013
En
• Iedereen is positief, bevestiging in joint meeting industrie
en registratieautoriteiten in Ierland 19-2-2013
115 14-03-13
116. Bijeenkomst Jaarbeurs Utrecht 2013
Maar……
• Nog te weinig CESP pakketten (CBG per dag 10-15%)
• Nog veel kwaliteitsproblemen (oorzaken??):
– Alleen een XML-file
– Alleen documenten
– Ontbrekende informatie in XML-file
• Dubbele of driedubbele zendingen
– Via CESP
– En via CD/DVD
– En via mailbox
116 14-03-13
117. Bijeenkomst Jaarbeurs Utrecht 2013
Onze boodschap
• Aandeel CESP zendingen op totaal MOET omhoog
• Percentage foutieve CESP pakketten MOET omlaag: hou je
aan de instructies en vul zorgvuldig in & CESP team
onderzoekt enkele technische zaken nader
• Geen dubbele of driedubbele zending
CBG gaat in de loop van het jaar samen met de andere
deelnemers in CESP onderzoeken of verplicht stellen van
indienen via CESP mogelijk is
117 14-03-13
14-03-13 Laat de deelnemers de presentielijst tekenen Wijs de deelnemers naar hun plek met hun naambordje Heet iedereen welkom en stel jezelf voor Vraag de deelnemers hun mobiele telefoons uit te schakelen of op stil te zetten Licht het programma toe Start de training
14-03-13
14-03-13
March 14, 2013
En die U ziet dat de EMEA databank nu allerlei dubbelmeldingen krijgt, dus dat kan nooit een gewenste situatie zijn.
Ook wordt tzt een nieuw format gepubliceerd, dat helemaal in lijn zal zijn met de ISO IDMP standaarden en de bijbehorende HL7 message structuur. Verder zal de EMA met de betrokken stakeholders kijken hoe de data verder moet onderhouden. Hoe we uiteindelijk tóch de substance data gaan indienen. En hoe we tot een goede implementatie komen van de ISO IDMP standaarden.