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December 2011
Pharmacovigilance
Are you concerned enough?
What is Pharmacovigilance (PV)?
The science and activities relating to the detection, assessment,
understanding and prevention of adverse effects or any other
medicine-related problem
– World Health Organization
Pharmaco - Vigilance
 Pharmaco = medicine
 Vigilare = to watch
 alert watchfulness
 wakefulness
 watchfulness in respect of danger; care; caution; circumspection
 the process of paying close and continuous attention
Definition
 Adverse Drug Reaction
 "A response to a drug which is noxious and unintended, and which occurs at
doses normally used in man for the prophylaxis, diagnosis, or therapy of disease,
or for the modification of physiological function."
 Adverse Event
 Any untoward medical occurrence that may present during treatment with a
pharmaceutical product but which does not necessarily have a causal relationship
with this treatment
 Side Effect
 Any unintended effect of a pharmaceutical product occurring at doses normally
used in man which is related to the pharmacological properties of the drug
The Aims of Pharmacovigilance
 To improve patient care and safety
 To improve public health and safety
 To contribute to the assessment of benefit, harm,
effectiveness and risk of medicines
 To promote understanding, education and clinical training
What to Report?
SERIOUS ADRS
 A serious adverse event (experience) or reaction is any
untoward medical occurrence that at any dose:
 results in death,
 is life-threatening,
 requires inpatient hospitalization of prolongation of existing
hospitalization,
 is a congenital anomaly/birth defect.
NOTE: The term “life-threatening” in the definition of “serious” refers to an event
in which the patient was at risk of death at the time of the event; it does not
refer to an event which hypothetically might have caused death if it was more
severe.
Adverse Reactions:Possible Causes
 Intrinsic factors of the drug
 Pharmacological
 Idiosyncratic
 Carcinogenicity, Mutagenicity
 Teratogenicity
 Extrinsic factors
 Adulterants
 Contamination
 Underlying medical conditions
 Interactions
 Wrong usage
What Should be Reported
 New drugs
 Report all suspected reactions including minor ones
 For established or well known drugs
 All serious, unexpected, unusual ADRs
 Change in frequency of a given reaction
 ADRs to generics not seen with innovator products
 ADRs to traditional medicines
What Should be Reported
 All suspected drug-drug, drug-food, drug-food supplement
interactions
 Statement highlighting marine source of supplements such
as glucosamine so that can be avoided by those with allergy
to sea food
 ADRs associated with drug withdrawals
 ADRs due to medication errors
 eg vincristine given IT
 ADRs due to lack of efficacy or suspected pharmaceutical
defects
Why ADRs are important ?
 5% of hospital admissions
 Death of 1 in 1000 medical inpatients
 Complicates drug therapy
 Decrease compliance
Why ADRs are important ?
30 – 50% of all ADRs are preventable
Why do we need
pharmacovigilance?
Why do we need
pharmacovigilance?
Reason 1:
 Humanitarian concern –
 Insufficient evidence of safety from clinical trials
 Animal experiments
 Phase 1 – 3 studies prior to marketing authorization
Why do we need
pharmacovigilance?
Reason 2
 Medicines are supposed to save lives
 Dying from a disease is sometimes unavoidable; dying from a
medicine is unacceptable.
WHO. Geneva 2005
Why do we need
pharmacovigilance?
Reason 3: ADRs are expensive !!
 6.5% of admissions are due to ADRs
 Seven 800-bed hospitals are occupied by ADR patients
Cost of ADRs ?
 ADR related cost to the country exceeds the cost of the
medications themselves
Why do we need
pharmacovigilance?
Reason 4:
 Promoting rational use of medicines and adherence
Pharmacovigilance system
 Records medication related errors
 Analyses those errors
 Implements interventions
 Promotes patient safety
 Prevent 'preventable errors'
Actionable learning system
ARGUS – ARIS Global – Phase Forward (Empirica)
Passive - Proactive
Future Pro-Active State
Risk
Management
Aggregate
Reporting
Signal Detection
Adverse Case
Management
Passive - Proactive
Current Passive State
Risk
Management
Signal Detection
Aggregate
Reporting
What can we do?
What can we do?
 Develop procedures for the identification, reporting and
follow up of adverse drug events
What can we do?
 Assess the current technology used in the drug safety process
and assist in implementation of new systems
What can we do?
 Evaluate data quality and data integrity controls in place
What can we do?
 Prepare risk minimization action plan (RiskMAP)
What can we do?
 Assess current drug safety and pharmacovigilance training
programs
What can we do?
 Reconcile internal processes for recording safety data received
from multiple sources
For more information:
Monica Dema, Manager New
Business Development
973.658.3133
Or
Monica.Dema@RCMT.com
Or
@MonicaDema

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pharmacovigilance-111031093044-phpapp01.pdf

  • 2. What is Pharmacovigilance (PV)? The science and activities relating to the detection, assessment, understanding and prevention of adverse effects or any other medicine-related problem – World Health Organization
  • 3. Pharmaco - Vigilance  Pharmaco = medicine  Vigilare = to watch  alert watchfulness  wakefulness  watchfulness in respect of danger; care; caution; circumspection  the process of paying close and continuous attention
  • 4. Definition  Adverse Drug Reaction  "A response to a drug which is noxious and unintended, and which occurs at doses normally used in man for the prophylaxis, diagnosis, or therapy of disease, or for the modification of physiological function."  Adverse Event  Any untoward medical occurrence that may present during treatment with a pharmaceutical product but which does not necessarily have a causal relationship with this treatment  Side Effect  Any unintended effect of a pharmaceutical product occurring at doses normally used in man which is related to the pharmacological properties of the drug
  • 5. The Aims of Pharmacovigilance  To improve patient care and safety  To improve public health and safety  To contribute to the assessment of benefit, harm, effectiveness and risk of medicines  To promote understanding, education and clinical training
  • 6. What to Report? SERIOUS ADRS  A serious adverse event (experience) or reaction is any untoward medical occurrence that at any dose:  results in death,  is life-threatening,  requires inpatient hospitalization of prolongation of existing hospitalization,  is a congenital anomaly/birth defect. NOTE: The term “life-threatening” in the definition of “serious” refers to an event in which the patient was at risk of death at the time of the event; it does not refer to an event which hypothetically might have caused death if it was more severe.
  • 7. Adverse Reactions:Possible Causes  Intrinsic factors of the drug  Pharmacological  Idiosyncratic  Carcinogenicity, Mutagenicity  Teratogenicity  Extrinsic factors  Adulterants  Contamination  Underlying medical conditions  Interactions  Wrong usage
  • 8. What Should be Reported  New drugs  Report all suspected reactions including minor ones  For established or well known drugs  All serious, unexpected, unusual ADRs  Change in frequency of a given reaction  ADRs to generics not seen with innovator products  ADRs to traditional medicines
  • 9. What Should be Reported  All suspected drug-drug, drug-food, drug-food supplement interactions  Statement highlighting marine source of supplements such as glucosamine so that can be avoided by those with allergy to sea food  ADRs associated with drug withdrawals  ADRs due to medication errors  eg vincristine given IT  ADRs due to lack of efficacy or suspected pharmaceutical defects
  • 10. Why ADRs are important ?  5% of hospital admissions  Death of 1 in 1000 medical inpatients  Complicates drug therapy  Decrease compliance
  • 11. Why ADRs are important ? 30 – 50% of all ADRs are preventable
  • 12. Why do we need pharmacovigilance?
  • 13. Why do we need pharmacovigilance? Reason 1:  Humanitarian concern –  Insufficient evidence of safety from clinical trials  Animal experiments  Phase 1 – 3 studies prior to marketing authorization
  • 14. Why do we need pharmacovigilance? Reason 2  Medicines are supposed to save lives  Dying from a disease is sometimes unavoidable; dying from a medicine is unacceptable. WHO. Geneva 2005
  • 15. Why do we need pharmacovigilance? Reason 3: ADRs are expensive !!  6.5% of admissions are due to ADRs  Seven 800-bed hospitals are occupied by ADR patients
  • 16. Cost of ADRs ?  ADR related cost to the country exceeds the cost of the medications themselves
  • 17. Why do we need pharmacovigilance? Reason 4:  Promoting rational use of medicines and adherence
  • 18. Pharmacovigilance system  Records medication related errors  Analyses those errors  Implements interventions  Promotes patient safety  Prevent 'preventable errors' Actionable learning system ARGUS – ARIS Global – Phase Forward (Empirica)
  • 19. Passive - Proactive Future Pro-Active State Risk Management Aggregate Reporting Signal Detection Adverse Case Management
  • 20. Passive - Proactive Current Passive State Risk Management Signal Detection Aggregate Reporting
  • 21. What can we do?
  • 22. What can we do?  Develop procedures for the identification, reporting and follow up of adverse drug events
  • 23. What can we do?  Assess the current technology used in the drug safety process and assist in implementation of new systems
  • 24. What can we do?  Evaluate data quality and data integrity controls in place
  • 25. What can we do?  Prepare risk minimization action plan (RiskMAP)
  • 26. What can we do?  Assess current drug safety and pharmacovigilance training programs
  • 27. What can we do?  Reconcile internal processes for recording safety data received from multiple sources
  • 28. For more information: Monica Dema, Manager New Business Development 973.658.3133 Or Monica.Dema@RCMT.com Or @MonicaDema