国外已上市连续制造药品的注册审评情况及其启示

目的：借鉴国外已上市连续制造药品的注册审评要点,为我国推进药品连续制造相关监管法规、 技术指南和标准制定等方面提供参考。方法：调查研究全球已上市口服固体制剂连续制造产品在注册过程中的工艺评估及审评情况,结合案例分析和连续制造相关的法规要求,梳理连续工艺产品在注册和审评过程中的关注点。结果与结论：药品连续制造在国外已经有较为成功的应用,监管部门应重视与业界早期沟通,并在审评阶段重点关注批量的定义、工艺验证、技术转移等研究资料。随着ICH Q13的落地实施,建议我国借鉴国外已上市连续制造药品的工艺评估情况并结合相关法规要求,制定符合国情的注册审评指南。     

美国FDA药品监管体系发展分析

目的：为发展和完善我国药品监管体系提供建议。方法：介绍美国FDA药品监管体系的发展,分析美国FDA监管系统改革举措。结果与结论：美国FDA药品监管体系建立了系统、连续的体系,监管方面的改革具有一定先进性和灵活性,我国可借鉴美国的相关经验,在监管体系改革过程中做出相关改进。     

基于ICHQ13的碳酸钙原料药连续制造监管探析

目的：通过实际案例研究找寻ICH Q13指南背后的基本原理,促进连续制造技术在我国制药行业的应用。方法：以原料药碳酸钙生产为实例,分析其连续制造生产线中部分工序的连续生产设计与实现方式,并参照ICH Q13指南的要求,提出监管层面的考虑。结果与结论：类似于碳酸钙这种工艺简单的品种非常适合转化为先进的连续制造工艺,现有条件可实现部分工序连续生产,也非常有望实现真正的全过程连续制造,为药品连续制造在我国的顺利落地实施提供了实践参考。     

国内外药品安全法律责任的比较分析

摘 要 目的： 借鉴国外药品安全法律经验,分析我国药品监管法律责任制度。方法: 对我国和美国、加拿大、新加坡、澳大利亚、日本、韩国的药品安全监管法律责任制度进行比较研究。分析我国药品监管法规的缺陷。结果:各国药品监管法律责任制度存在差异,上述六国药品安全监管法律责任制度健全,我国尚无药师法,应当完善相关法律责任制度,进一步提高我国药品安全监管水平。结论: 完善我国药品监管法律责任制度对提高药品安全监管水平至关重要。     

药包材变更管理的分析与探讨

目的：通过汇总分析美国对药包材变更的管理法规和管理方式,为我国实施关联审评审批后对药包材变更管理提供借鉴,从而保证药品在整个生命周期内的安全、有效和质量可控。方法：从法规和技术层面分析美国FDA对制药企业以及药包材企业的变更监管,探讨其优势和存在的问题,对比中国与美国行业的特点。结果：中国与美国在监管理念和法规上日渐趋同,但是国内药包材企业与美国在规模和管理上还存在较大差异。结论：药包材变更是药品生命周期维护的组成部分,行业监管机构需要出具相应的变更技术指导原则以及相应的法规路径作为研发人员对变更评估的重要参考依据。     

药品标签和说明书中药用辅料信息的规范标注

目的 进一步规范我国药用辅料在药品标签、说明书中的标注,保障公众用药安全、促进合理用药。方法 对比国内外相关法规规定,对我国药用辅料在药品标签及说明书中的标注问题提出完善的建议。结果 我国药用辅料在标签、说明书中标注的相关法律法规及技术指南体系尚需进一步完善。结论 建议我国相关法规规定做好顶层设计和统筹谋划,明确辅料定义和标注范围,制定相应的技术指南,使生产者易遵从、监管者可执行、使用者更安全。     

加入PIC/S与推进我国药品监管国际化的思考

目的：回顾和分析了全球药品监管合作实践及我国药品监管的国际化历程,为我国尽早加入药品检查合作计划（PIC/S）从而实现GMP检查互信提出建议。方法：根据PIC/S对申请机构的要求,为迎接 PIC/S对我国检查机构的评估做好准备,本文结合文献综述、检查现状分析和PIC/S审计清单指标解读, 分析我国药品检查体系目前存在的差距。结果与结论：加入PIC/S有助加强各国监管机构间的合作和实现GMP检查互信,进一步推进我国药品监管的国际化进程。为顺利通过PIC/S对我国药品检查机构的正式评估、尽早成为PIC/S成员机构,我国应尽快在GMP标准提高、检查流程优化、检查员能力提升、检查机构质量体系建设等方面开展对标工作。     

我国药品附条件批准程序实施情况及相关思考

目的：对我国药品附条件批准上市相关政策和实施情况进行深入分析和探讨,参考美国与欧盟药品附条件上市政策,对我国附条件批准上市的实施和推进提出建议。方法：通过梳理药品注册管理办法发布后国家药品监督管理局(NMPA)药品附条件批准上市申请审评审批法规政策实施情况,重点围绕当前法规中的准入条件、准入程序、上市后监管要求、撤销情形以及撤销程序进行综述,针对实施过程中发现的问题,借鉴美国食品药品管理局(FDA)药品加速审批(Accelerate Approval)与欧洲药品管理局(EMA)药品附条件批准(Conditional Marketing Authorisation)经验以及对各国附条件政策进行比较分析,探讨我国药品附条件批准上市政策的发展方向。结果与结论：为了加快具有突出价值的临床急需药品上市,缩短新技术临床应用时间,美国与欧盟均设立了相对完备的附条件上市法规政策及程序。我国的附条件批准制度虽然建立时间较短,但有欧美的经验作为参考,结合我国的临床实践和监管需要, 相关法规也在趋于完善。未来,监管部门更多需要考虑的是对程序和技术要求的细化、制度之间的衔接 (如疫苗的紧急使用授权与附条件批准制度),以及加强上市后监管等方面。     

欧盟公告机构用医疗器械类别新框架研究

目的：分析欧盟公告机构用医疗器械类别新框架,为建立我国医疗器械行业相关监管法规提供借鉴和参考。方法：对比分析欧盟医疗器械监管新法规体系下指定公告机构用产品类别新框架与原框架的异同,分析新框架与新法规体系下分类规则、命名系统的相关性。结果和结论：欧盟公告机构用医疗器械类别新框架使公告机构指定范围的划分更为精准合理,新框架中相关条目与分类规则、命名系统的整体化设计思路体现了欧盟整体协调一致的监管法规系统的工作思路。     

美国药品标识监管体系研究

目的：通过研究和分析美国药品说明书和标签监管体系,重点阐述现有监管制度上的环节要求,以期为完善我国药品说明书和标签监管体系提供较为全面的参考和借鉴,进一步提高用药安全水平。方法：采用非接触性研究中的内容分析方法,广泛查询FDA及美国联邦政府的官方网站、中国知网数据库等,收集整理与美国标识监管体系相关的资料,包括法律文件8个、指南36个及50余个FDA官网网页资料和报告文件等。结果与结论：围绕上市前、上市后和信息公开管理,并通过不断修订加强法律法规,美国药品标识逐步形成了法律、法规及指南3个层面的逻辑清晰的完整监管体系。我国药品说明书和标签监管体系建设工作相差明显,应尽快建立我国药品说明书和标签功能定位监管认识的新视角,完善上市前、上市后和信息公开管理制度机制,抓住《药品管理法》修订的契机,系统性安排药品说明书和标签立法工作计划,开展全国调研,为全面规范药品说明书和标签管理提供科学保障。     

PIC/S实时放行检测相关要求的研究与借鉴

目的：通过分析药品检查合作计划（PIC/S）药品生产质量管理规范（GMP）指南及实时放行检测（RTRT）附录的要求,为我国制药行业实时放行检测技术的发展和应用提供思路和建议。方法：对PIC/S的GMP指南及RTRT附录进行深入研究,并结合国内外RTRT相关法规、文献,探讨RTRT在我国制药行业的可行性及对我国药品监管的启示。结果与结论：建议我国药监部门尽早对标PIC/S相关技术要求,结合参数放行的试点经验及我国制药行业发展特点,出台符合国情的RTRT指南,保障RTRT在我国制药行业落地,为我国加入PIC/S,更好地与国际接轨奠定基础。     

Continuous flow technology vs. the batch-by-batch approach to produce pharmaceutical compounds

Introduction: For the manufacture of small molecule drugs, many pharmaceutical innovator companies have recently invested in continuous processing, which can offer significant technical and economic advantages over traditional batch methodology. This Expert Review will describe the reasons for this interest as well as many considerations and challenges that exist today concerning continuous manufacturing.

Areas covered: Continuous processing is defined and many reasons for its adoption are described. The current state of continuous drug substance manufacturing within the pharmaceutical industry is summarized. Current key challenges to implementation of continuous manufacturing are highlighted, and an outlook provided regarding the prospects for continuous within the industry.

Expert commentary: Continuous processing at Lilly has been a journey that started with the need for increased safety and capability. Over twelve years the original small, dedicated group has grown to more than 100 Lilly employees in discovery, development, quality, manufacturing, and regulatory designing in continuous drug substance processing. Recently we have focused on linked continuous unit operations for the purpose of all-at-once pharmaceutical manufacturing, but the technical and business drivers that existed in the very beginning for stand-alone continuous unit operations in hybrid processes have persisted, which merits investment in both approaches.     

Update and trends on pharmacokinetic studies in patients with impaired renal function: practical insight into application of the FDA and EMA guidelines

Introduction: The incidence of kidney dysfunction increases with age and is highly prevalent among patients with hypertension. Since many therapeutic compounds are primarily eliminated through the kidneys, impaired renal function can have negative consequences on drug disposition, efficacy and safety. Therefore, regulatory agencies such as the Food and Drug Administration (FDA) and European Medicines Agency (EMA) have issued detailed guidelines for new drug applications to determine posology requirements for patients with renal impairment.

Areas covered: The current review highlights and contrasts agency requirements for pharmacokinetic renal impairment clinical studies. While many of the guidelines are similar among the two agencies, glomerular filtration rate (GFR) determination and reporting differ. Design considerations for a reduced, full or dialysis renal impairment study, as well as modifications to the FDA’s draft guidance are discussed. Furthermore, scenarios where pharmacokinetic modelling analysis can benefit a drug development program are also reviewed. Moreover, practical solutions for patient recruitment challenges are addressed.

Expert commentary: We summarize how ‘one size does not fit all’ for GFR assessment, and recommend when to use certain modalities. Finally, we highlight the need for the pharmaceutical industry to engage therapeutic experts to assist in protocol development for renal impairment studies, as these experts understand the nuances of this special population and recommended guidelines.     

The role of healthcare communications agencies in maintaining compliance when working with the pharmaceutical industry and healthcare professionals

ABSTRACT

Background: Relationships between the pharmaceutical industry and healthcare professionals continue to drive discussion about the potential for conflicts of interest. Despite greater regulation and oversight, there are still calls for increased transparency and further restrictions on these relationships. Regulatory authorities, the pharmaceutical industry, professional societies, and other interested parties have responded by developing robust guidelines for interactions between the pharmaceutical industry and healthcare professionals. This, in turn, is driving change in the way that healthcare communications agencies work, increasing the need for them to visibly demonstrate processes that ensure their employees comply with relevant laws, regulations, and guidelines.

Exposition: In our group of healthcare communications agencies we have established an internal compliance program and developed a policy that reflects the services we provide, and we recommend that other agencies adopt a similar program. Compliance training, implemented by a nominated compliance team, can be enforced by including compulsory tests for employees who interact with the pharmaceutical industry and healthcare professionals, with annual reassessment. The compliance team also has an important role to play in ensuring ongoing communication and staff education, including awareness of new legal and best practice developments. Management of the compliance program is essential, with clear mechanisms for auditing and evaluation, and the inclusion of compliance adherence in staff performance objectives. A visible framework for handling potential compliance issues should also be developed, with clear definitions of different levels of noncompliance and potential associated consequences. Compliance programs may also include other elements, such as terminology and documentation guidance, so that the program becomes an integral tool used by employees on a daily basis.

Conclusion: With a robust internal compliance program, healthcare communication agencies can play a significant role in helping maintain appropriate pharmaceutical industry–healthcare professional relationships in an increasingly regulated and scrutinized environment.     

Advancing Product Quality: a Summary of the Inaugural FDA/PQRI Conference

On September 16 and 17, 2014, the Food and Drug Administration (FDA) and Product Quality Research Institute (PQRI) inaugurated their Conference on Evolving Product Quality. The Conference is conceived as an annual forum in which scientists from regulatory agencies, industry, and academia may exchange viewpoints and work together to advance pharmaceutical quality. This Conference Summary Report highlights key topics of this conference, including (1) risk-based approaches to pharmaceutical development, manufacturing, regulatory assessment, and post-approval changes; (2) FDA-proposed quality metrics for products, facilities, and quality management systems; (3) performance-based quality assessment and clinically relevant specifications; (4) recent developments and implementation of continuous manufacturing processes, question-based review, and European Medicines Agency (EMA)-FDA pilot for Quality-by-Design (QbD) applications; and (5) breakthrough therapies, biosimilars, and international harmonization, focusing on ICH M7 and Q3D guidelines. The second FDA/PQRI conference on advancing product quality is planned for October 5–7, 2015.     

The nanomedicines alliance: an industry perspective on nanomedicines

The field of nanomedicines has expanded significantly in recent years in the breadth of compounds under development as well as in the types of technology that are being applied to generate nanomedicines. The pathway to licensure of new nanomedicines is sufficiently well defined by existing regulations and guidance. The future of nanomedicines requires collaboration between industry and regulatory agencies to ensure that safe and effective nanomedicines emerge from this field.From the Clinical EditorWith the expansion of translational nanomedicine research, the “last steps” of translation, such as making sure all regulatory approvals are met, the availability of appropriate larger-scale production technologies, are becoming critically important. This review provides a perspective from the biomedical and pharmaceutical industry on the above issues.     

Misunderstanding <Emphasis Type="Italic">Design Space</Emphasis>: a Robust Drug Product Control Strategy Is the Key to Quality Assurance

ICH guidelines Q8/11, Q9, and Q10 introduced risk-based approaches and enhanced scientific understanding as an opportunity to encourage continuous process improvement for pharmaceutical manufacturing. Conceptually, Quality by Design (QbD) promised to improve confidence in quality through the lifecycle of pharmaceutical products. A primary incentive for industry is the prospect of global regulatory concordance for new applications and post approval changes. Unfortunately, during the last decade, the industry has experienced regulatory divergence regarding the interpretation of ICH guidelines across geographic regions. Rather than truly harmonized regulatory expectations, localized interpretations of ICH guidance have resulted in different technical requirements posing significant challenges for a global industry. As a result, the increased complexity of manufacturing supply chains and the regulatory burden associated with maintaining compliance with these diverse regulatory expectations serves as a barrier to continual improvement and innovation. The QbD paradigm has effectively demonstrated a risk-based link between a product’s control strategy and patient needs that has prompted meaningful improvement in the industry’s approach to product quality assurance. Divergent interpretations of the concepts and definitions used in the modern QbD approach to product development and manufacturing, however, has led to challenges in achieving a common implementation of design space, control strategy, prior knowledge, proven acceptable range, and normal operating range. While the concept of design space remains an appealing focal point for demonstrating process understanding, the authors suggest that Control Strategy is the most important QbD concept, and one that assures product quality for patients. A focus by both regulators and manufacturers on the significance of Control Strategy could facilitate management of post approval changes to improve manufacturing processes and enhance product quality while also engendering regulatory harmonization.