国外医疗器械产品在中国注册情况(续八)

国外医疗器械产品进入中国市场,必须通过国家医药管理局办理市场准入注册。未获得注册证的产品,不得以任何方式在中国销售。为依法加强医疗器械的行政监督管理工作,特在《中国医疗器械杂志》上专栏公布已获市场准入注册的国外医疗器械产品清单,供各医院和医疗器械购销...     

国外医疗器械产品在中国注册情况(续八)

国外医疗器械产品进入中国市场，必须通过国家医药管理局办理市场准入注册。未获得注册证的产品，不得以任何方式在中国销售。为依法加强医疗器械的行政监督管理工作，特在《中国医疗器械杂志》上专栏公布已获市场准入注册的国外医疗器械产品清单，供各医院和医疗器械购销...     

国外医疗器械产品在中国注册情况(续七)

国外医疗器械产品进入中国市场，必须通过国家医药管理局办理市场准入注册。未获得注册证的产品，不得以任何方式在中国销售。为依法加强医疗器械的行政监督管理工作，特在《中国医疗器械杂志》上专栏公布已获市场准入注册的国外医疗器械产品清单，供各医院和医疗器械购销单位参考掌握。国外医疗器械产品在中国注册情况(续七)$国家医药管理局医疗器械行政监督司!100810     

国外医疗器械产品在中国注册情况(续四)

国外医疗器械产品进入中国市场，必须通过国家医药管理局办理市场准入注册。未获得注册证的产品，不得以任何方式在中国销售。为依法加强医疗器械的行政监督管理工作，特在《中国医疗器械杂志》上专栏公布已获市场准入注册的国外医疗器械产品清单，供各医院和医疗器械购销单位参考掌握。国外医疗器械产品在中国注册情况(续四)$国家医药管理局医疗器械行政监督司!100810     

国外医疗器械产品在中国注册情况(续六)

国外医疗器械产品进入中国市场，必须通过国家医药管理局办理市场准入注册。未获得注册证的产品，不得以任何方式在中国销售。为依法加强医疗器械的行政监督管理工作，特在《中国医疗器械杂志》上专栏公布已获市场准入注册的国外医疗器械产品清单，供各医院和医疗器械购销单位参考掌握。国外医疗器械产品在中国注册情况(续六)$国家医药管理局医疗器械行政监督司!100810     

国外医疗器械产品在中国注册情况(续二)

国外医疗器械产品进入中国市场，必须通过国家医药管理局办理市场准入注册。未获得注册证的产品，不得以任何方式在中国销售。为依法加强医疗器械的行政监督管理工作，特在《中国医疗器械杂志》上专栏公布已获市场准入注册的国外医疗器械产品清单，供各医院和医疗器械购销单位参考掌握。国外医疗器械产品在中国注册情况(续二)$国家医药管理局医疗器械行政监督司!100810     

俄罗斯对医疗器械市场准入的要求

介绍了俄罗斯医疗器械法规要求,以及负责医疗器械监管的相关部门,并简要介绍了俄罗斯医疗器械市场准入所需要注册程序和认证要求。     

FDA对医疗器械市场准入前的行政审批

简略介绍了FDA对医疗器械的分类以及FDA对医疗器械市场准入的要求.     

医疗器械产品市场准入审查规定

国家医药管理局1月6日以“国药器监字(1996)第6号”文发布《医疗器械产品市场准入审查规定》。全文如下: 根据国办发(94)66号通知的规定,国家医药管理局负责医疗器械产品的市场准入登记和审批,制定医疗器械进出口管理规定等医疗器械行政监督工作。为此,从保障使用者人身安全和维护使用者利益出发,结合国内医疗器械监督管理的实际经验和国外的基本作法,对国内外医疗器械产品进入中国市场的审查做出如下规定:     

医疗器械产品市场准入审查新规定

医疗器械产品市场准入审查新规定日前，国家医药管理局发布关于“医疗器械产品市场准入审查规定”，对国内外医疗器械（医械）产品进入中国市场的审查做出新的规定：自１９９６年１月８日起，进入中国市场的任何一种医械产品须由产品生产者或其委托代理人向中国政府医械行...     

美国FDA2012财年医疗器械注册新变化

近日美国FDA公布了其2012财年的医疗器械产品注册收费标准和工作目标.本文对比了FDA2011财年的收费标准和以往的工作目标,发现各项收费均有所下调,而审批的时间全面增加.     

美国FDA突破性器械项目政策介绍及对我国的启示

重点介绍美国FDA鼓励治疗或诊断危害生命或不可逆衰老疾病的医疗器械快速上市的政策--突破性器械项目,该相关制度设计和经验值得我国在制定、完善临床急需医疗器械相关规定时予以借鉴。     

Mise sur le marché européen des dispositifs médicaux innovants à haut risque : l’efficacité clinique et la sécurité sont-elles garanties ?

BackgroundInnovative high-risk medical devices, such as new types of heart valves or hip prostheses, become available on the European market more rapidly than in USA. This is due to the European legislation allowing early marketing of innovative high-risk medical devices before high-quality clinical evidence is obtained from randomized controlled trials.MethodsWe studied the premarket clinical evaluation of innovative high-risk medical devices in Europe compared with the USA. We also discussed patient safety and the transparency of information. The literature and regulatory documents were checked. Representatives from industry, competent authorities, notified bodies, ethics committees, and health technology assessment agencies were consulted.ResultsIn contrast to the US, there is no requirement in Europe to demonstrate the clinical efficacy of high-risk devices in the premarket phase. For the patient, this implies earlier access to innovative technology, but at the risk of potential safety issues. At this moment, European requirements for clinical studies are lower for medical devices than for drugs, and data from premarket clinical trials are scarce or remain unpublished. The European Medical Device Directives are currently being reworked.ConclusionsFor innovative high-risk devices, and while awaiting a reworked Medical Device Directive, patient risk should be minimized by limiting the market introduction of novel high-risk devices with minimal clinical data to physicians with the necessary training and expertise. The new European legislation should require the premarket demonstration of clinical efficacy and safety, using a randomized controlled trial if possible, and a transparent clinical review, preferably centralized.     

Legislation to regulate medical devices.

The history of medical device regulation began with the need to rid the marketplace of bogus inventions which were either harmful in themselves or harmful because they delayed meaningful treatment of illness. Since World War II, sophistication in medical technology and development of electronic and other types of medical devices has created a new need for regulation of safety and performance of devices used to cure and mitigate disease in man. The 1938 amendments to the Food, Drug, and Cosmetic Act gave FDA authority over labeling and advertising of devices, enforceable only after devices were marketed. In 1969 a study by an HEW commission documented the need for further legislation. The commission recommended three categories of medical devices: those requiring premarket clearance or scientific review, those for which standards could be established to protect the public, and those which are generally recognized as safe and for which nor standards would be necessary. In 1974 the Senate unanimously approved Senator Kennedy's "Medical Device Amendments of 1973" legislation which fulfills the recommendations of the HEW commission report. The House of Representatives failed to pass their version of the legislation in the 93rd Congress. Senator Kennedy re-introduced the bill in the 94th Congress and it passed the Senate in April 1975. Representative Rogers re-introduced an amended bill. The bill is expected to become law in 1975.     

GHTF医疗器械说明书和标签指导原则介绍

目的：为我国完善和发展医疗器械标签和说明书的管理提供借鉴。方法：采用内容翻译和比较研究方法,主要资料是GHTF网站发布的指导原则《医疗器械标签和说明书指导原则》。结果：介绍了GHTF医疗器械标签和说明书的要求,包括定义、通用原则、标签内容、说明书内容等45项条款内容。结论：我国应借鉴GHTF指南文件,将标签纳入上市前审查范围,建立说明书和标签指导原则,以确保医疗器械安全、有效地使用。     

Genehmigungsverfahren von klinischen Prüfungen mit Medizinprodukten

The 4th amendment of the Medical Device Law introduced the authorization procedure for clinical trials with medical devices. The Federal Institute for Drugs and Medical Devices ("Bundesinstitut für Arzneimittel und Medizinprodukte", BfArM) has now drawn the first substantial interim balance on the basis of daily practice in order to describe results achieved by applications of clinical trials with medical devices. Overall, realization of the new authorization procedure of clinical trials is well underway. This empirical practical analysis of the first 405 applications points out further possibilities for improvements for future applicants. Furthermore, initial figures demonstrate the cooperative relationship with national and international applicants. Because the by far largest percentage of the premarket clinical trials with medical devices in the European Community are conducted in Germany (28%), the analysis also provides a comparison with other European countries in order to detect differences in specific areas as the result of the implementation of Directive 2007/47/EC.     

中美临检类医疗器械产品监管比较研究

本研究通过对美国与我国临检类医疗器械产品的定义、分类、管理类别、市场准入模式、审批流程、技术审查要点等方面的对比分析和研究,结合我国临检类医疗器械产品的生产及管理现状的分析,得出结论我国在医疗器械法规体系、监管模式以及行政资本的有效利用上与美国还存在很大差距,指出要进一步完善我国临检类医疗器械的监督管理,需要使监督管理方式与临检类医疗器械的自身特点保持内在的一致,并且提出了建立动态化管理、闭环式管理、层次化管理、一体化管理体系,建立政府告知、企业承诺、符合性评估的企业许可审批制度等监管方式。本研究以中美两国临检类医疗器械产品的监管法规和技术审查指南文件为依据,对比了近两年来两国对临检类医疗器械产品的监管数据和技术审查方面的差异,从一类医疗器械产品的角度比较出了美国监管体系的合理性、充分性和有效性,为国内医疗器械监管体系的建设和完善以及行政资本的更有效利用提出了建设性意见。     

Assessing risk by analogy: a case study of us medical device risk management policy

Medical devices occupy an increasingly important place in global medical care, and yet the risk management systems that govern them are largely overlooked in academic literatures. In the US, home to the largest medical devices market, Food and Drug Administration (FDA) regulation allows most medical devices to enter the market based on analogy, or substantial equivalence, with previously marketed devices. Thus, risk assessment is administered without premarket clinical trials for safety and efficacy. This system represents a permissive regulatory regime based in neoliberal tenets, where risk, in the form of adverse events, is inherently tolerated within governance structures, evidencing risk colonisation. This paper employs a case study approach, examining market clearances of vaginal mesh surgical devices, which have been the subject of US multi-district litigation. We identified 266 devices cleared before 31 December 2017 and analysed the complicated web of device ‘ancestry’ whereby devices as disparate as cardiac patches and hernia mesh allowed clearance of surgical devices for urogynecology. Perhaps of greatest concern, 10 recalled or withdrawn devices influenced new device clearances for up to 17 years after their market-removal. While the FDA must balance its dual mandate to safeguard patients and promote innovation, we find that medical device regulation structurally favours innovation over safety. ‘Light touch’ risk assessment is not counterbalanced with postmarket mechanisms to safeguard against residual and developmental risks that are associated with medical devices, particularly permanent implants. The proportionality principle associated with a precautionary approach should inform medical device risk management.     

Policy and Research Recommendations Emerging from the Scientific Evidence Connecting Environmental Factors and Breast Cancer

Abstract

A substantial body of evidence links environmental exposures to increases in breast cancer incidence over the past decades. State and federal legislative initiatives that could help prevent breast cancer include: federal standards to achieve consistency in radiation-emitting medical and dental equipment; improved state quality assurance standards for radiation-emitting equipment; federal and state exposure limits for electromagnetic radiation; an overhaul of the federal Toxic Substances Control Act to reduce unsafe chemical exposures; strengthened premarket health and safety testing and regulation of pesticides; a federal ban on the manufacture, distribution and sale of consumer products containing bisphenol A and phthalates; and strengthened oversight and regulation of the cosmetics industry. We recommend public and private investment in research on low dose exposures, mixtures, and the timing of chemical exposures, as well as the development of health tracking and biomonitoring programs designed to link data from pollution surveillance systems with disease registries.