Dir2001 83 Cons 20081230 Enkonsolideret
Dir2001 83 Cons 20081230 Enkonsolideret
Dir2001 83 Cons 20081230 Enkonsolideret
001 — 1
This document is meant purely as a documentation tool and the institutions do not assume any liability for its contents
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►M1 Directive 2002/98/EC of the European Parliament and of the Council of L 33 30 8.2.2003
27 January 2003
►M2 Commission directive 2003/63/EC of 25 June 2003 L 159 46 27.6.2003
►M3 Directive 2004/24/EC of the European Parliament and of the Council of L 136 85 30.4.2004
31 March 2004
►M4 Directive 2004/27/EC of the European Parliament and of the Council of L 136 34 30.4.2004
31 March 2004
►M5 Regulation (EC) No 1901/2006 of the European Parliament and of the L 378 1 27.12.2006
Council of 12 December 2006
►M6 Regulation (EC) No 1394/2007 of the European Parliament and of the L 324 121 10.12.2007
Council of 13 November 2007
►M7 Directive 2008/29/EC of the European Parliament and of the Council of L 81 51 20.3.2008
11 March 2008
2001L0083 — EN — 30.12.2008 — 006.001 — 2
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DIRECTIVE 2001/83/EC OF THE EUROPEAN PARLIAMENT
AND OF THE COUNCIL
of 6 November 2001
on the Community code relating to medicinal products for human
use
Having regard to the opinion of the Economic and Social Committee (1),
Acting in accordance with the procedure laid down in Article 251 of the
Treaty (2),
Whereas:
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the supply of medicinal products for human use (1), Council
Directive 92/27/EEC of 31 March 1992 on the labelling of
medicinal products for human use and on package leaflets (2),
Council Directive 92/28/EEC of 31 March 1992 on the adver
tising of medicinal products for human use (3), Council Directive
92/73/EEC of 22 September 1992 widening the scope of
Directives 65/65/EEC and 75/319/EEC on the approximation of
provisions laid down by law, regulation or administrative action
relating to medicinal products and laying down additional
provisions on homeopathic medicinal products (4) have been
frequently and substantially amended. In the interests of clarity
and rationality, the said Directives should therefore be codified
by assembling them in a single text.
(2) The essential aim of any rules governing the production, distri
bution and use of medicinal products must be to safeguard public
health.
(3) However, this objective must be attained by means which will
not hinder the development of the pharmaceutical industry or
trade in medicinal products within the Community.
(4) Trade in medicinal products within the Community is hindered
by disparities between certain national provisions, in particular
between provisions relating to medicinal products (excluding
substances or combinations of substances which are foods,
animal feeding-stuffs or toilet preparations), and such disparities
directly affect the functioning of the internal market.
(5) Such hindrances must accordingly be removed; whereas this
entails approximation of the relevant provisions.
(6) In order to reduce the disparities which remain, rules should be
laid down on the control of medicinal products and the duties
incumbent upon the Member States' competent authorities should
be specified with a view to ensuring compliance with legal
requirements.
(7) The concepts of harmfulness and therapeutic efficacy can only be
examined in relation to each other and have only a relative
significance depending on the progress of scientific knowledge
and the use for which the medicinal product is intended. The
particulars and documents which must accompany an application
for marketing authorization for a medicinal product demonstrate
that potential risks are outweighed by the therapeutic efficacy of
the product.
(8) Standards and protocols for the performance of tests and trials on
medicinal products are an effective means of control of these
products and hence of protecting public health and can facilitate
the movement of these products by laying down uniform rules
applicable to tests and trials, the compilation of dossiers and the
examination of applications.
(9) Experience has shown that it is advisable to stipulate more
precisely the cases in which the results of toxicological and
pharmacological tests or clinical trials do not have to be
provided with a view to obtaining authorization for a medicinal
product which is essentially similar to an authorized product,
while ensuring that innovative firms are not placed at a disad
vantage.
(10) However, there are reasons of public policy for not conducting
repetitive tests on humans or animals without over-riding cause.
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(11) The adoption of the same standards and protocols by all the
Member States will enable the competent authorities to arrive
at their decisions on the basis of uniform tests and by reference
to uniform criteria and will therefore help to avoid differences in
evaluation.
(12) With the exception of those medicinal products which are subject
to the centralized Community authorization procedure established
by Council Regulation (EEC) No 2309/93 of 22 July 1993 laying
down Community procedures for the authorization and super
vision of medicinal products for human and veterinary use and
establishing a European Agency for the Evaluation of Medicinal
Products (1) a marketing authorization for a medicinal product
granted by a competent authority in one Member State ought
to be recognized by the competent authorities of the other
Member States unless there are serious grounds for supposing
that the authorization of the medicinal product concerned may
present a risk to public health. In the event of a disagreement
between Member States about the quality, the safety or the
efficacy of a medicinal product, a scientific evaluation of the
matter should be undertaken according to a Community
standard, leading to a single decision on the area of disagreement
binding on the Member States concerned. Whereas this decision
should be adopted by a rapid procedure ensuring close cooper
ation between the Commission and the Member States.
(15) In order better to protect public health and avoid any unnecessary
duplication of effort during the examination of application for a
marketing authorization for medicinal products, Member States
should systematically prepare assessment reports in respect of
each medicinal product which is authorized by them, and
exchange the reports upon request. Furthermore, a Member
State should be able to suspend the examination of an application
for authorization to place a medicinal product on the market
which is currently under active consideration in another
Member State with a view to recognizing the decision reached
by the latter Member State.
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(18) Any rules governing radiopharmaceuticals must take into account
the provisions of Council Directive 84/466/Euratom of 3
September 1984 laying down basic measures for the radiation
protection of persons undergoing medical examination or
treatment (1). Account should also be taken of Council
Directive 80/836/Euratom of 15 July 1980 amending the
Directives laying down the basic safety standards for the health
protection of the general public and workers against the dangers
of ionizing radiation (2), the objective of which is to prevent the
exposure of workers or patients to excessive or unnecessarily
high levels of ionizing radiation, and in particular of Article 5c
thereof, which requires prior authorization for the addition of
radioactive substances to medicinal products as well as for the
importation of such medicinal products.
(19) The Community entirely supports the efforts of the Council of
Europe to promote voluntary unpaid blood and plasma donation
to attain self-sufficiency throughout the Community in the supply
of blood products, and to ensure respect for ethical principles in
trade in therapeutic substances of human origin.
(20) The rules designed to guarantee the quality, safety and efficacy of
medicinal products derived from human blood or human plasma
must be applied in the same manner to both public and private
establishments, and to blood and plasma imported from third
countries.
(21) Having regard to the particular characteristics of these homeo
pathic medicinal products, such as the very low level of active
principles they contain and the difficulty of applying to them the
conventional statistical methods relating to clinical trials, it is
desirable to provide a special, simplified registration procedure
for those homeopathic medicinal products which are placed on
the market without therapeutic indications in a pharmaceutical
form and dosage which do not present a risk for the patient.
(22) The anthroposophic medicinal products described in an official
pharmacopoeia and prepared by a homeopathic method are to be
treated, as regards registration and marketing authorization, in the
same way as homeopathic medicinal products.
(23) It is desirable in the first instance to provide users of these
homeopathic medicinal products with a very clear indication of
their homeopathic character and with sufficient guarantees of
their quality and safety.
(24) The rules relating to the manufacture, control and inspection of
homeopathic medicinal products must be harmonized to permit
the circulation throughout the Community of medicinal products
which are safe and of good quality.
(25) The usual rules governing the authorization to market medicinal
products should be applied to homeopathic medicinal products
placed on the market with therapeutic indications or in a form
which may present risks which must be balanced against the
desired therapeutic effect. In particular, those Member States
which have a homeopathic tradition should be able to apply
particular rules for the evaluation of the results of tests and
trials intended to establish the safety and efficacy of these
medicinal products provided that they notify them to the
Commission.
(26) In order to facilitate the movement of medicinal products and to
prevent the controls carried out in one Member State from being
(1) OJ L 265, 5.10.1984, p. 1. Directive repealed with effect from 13 May 2000
by Directive 97/43/Euratom (OJ L 180, 9.7.1997, p. 22).
(2) OJ L 246, 17.9.1980, p. 1. Directive as amended by Directive
84/467/Euratom (OJ L 265, 5.10.1984, p. 4), repealed with effect from 13
May 2000 by Directive 96/29/Euratom (OJ L 314, 4.12.1996, p. 20).
2001L0083 — EN — 30.12.2008 — 006.001 — 6
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repeated in another, minimum requirements should be laid down
for manufacture and imports coming from third countries and for
the grant of the authorization relating thereto.
(27) It should be ensured that, in the Member States, the supervision
and control of the manufacture of medicinal products is carried
out by a person who fulfils minimum conditions of qualification.
(28) Before an authorization to market an immunological medicinal
product or derived from human blood or human plasma can be
granted, the manufacturer must demonstrate his ability to attain
batch-to-batch consistency. Before an authorization to market a
medicinal product derived from human blood or human plasma
can be granted, the manufacturer must also demonstrate the
absence of specific viral contamination, to the extent that the
state of technology permits.
(29) The conditions governing the supply of medicinal products to the
public should be harmonized.
(30) In this connection persons moving around within the Community
have the right to carry a reasonable quantity of medicinal
products lawfully obtained for their personal use. It must also
be possible for a person established in one Member State to
receive from another Member State a reasonable quantity of
medicinal products intended for his personal use.
(31) In addition, by virtue of Regulation (EC) No 2309/93, certain
medicinal products are the subject of a Community marketing
authorization. In this context, the classification for the supply
of medicinal products covered by a Community marketing
authorization needs to be established. It is therefore important
to set the criteria on the basis of which Community decisions
will be taken.
(32) It is therefore appropriate, as an initial step, to harmonize the
basic principles applicable to the classification for the supply of
medicinal products in the Community or in the Member State
concerned, while taking as a starting point the principles
already established on this subject by the Council of Europe as
well as the work of harmonization completed within the
framework of the United Nations, concerning narcotic and
psychotropic substances.
(33) The provisions dealing with the classification of medicinal
products for the purpose of supply do not infringe the national
social security arrangements for reimbursement or payment for
medicinal products on prescription.
(34) Many operations involving the wholesale distribution of
medicinal products for human use may cover several Member
States simultaneously.
(35) It is necessary to exercise control over the entire chain of distri
bution of medicinal products, from their manufacture or import
into the Community through to supply to the public, so as to
guarantee that such products are stored, transported and handled
in suitable conditions. The requirements which must be adopted
for this purpose will considerably facilitate the withdrawal of
defective products from the market and allow more effective
efforts against counterfeit products.
(36) Any person involved in the wholesale distribution of medicinal
products should be in possession of a special authorization. Phar
macists and persons authorized to supply medicinal products to
the public, and who confine themselves to this activity, should be
exempt from obtaining this authorization. It is however necessary,
in order to control the complete chain of distribution of medicinal
products, that pharmacists and persons authorized to supply
2001L0083 — EN — 30.12.2008 — 006.001 — 7
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medicinal products to the public keep records showing trans
actions in products received.
(37) Authorization must be subject to certain essential conditions and
it is the responsibility of the Member State concerned to ensure
that such conditions are met; whereas each Member State must
recognize authorizations granted by other Member States.
(38) Certain Member States impose on wholesalers who supply
medicinal products to pharmacists and on persons authorized to
supply medicinal products to the public certain public service
obligations. Those Member States must be able to continue to
impose those obligations on wholesalers established within their
territory. They must also be able to impose them on wholesalers
in other Member States on condition that they do not impose any
obligation more stringent than those which they impose on their
own wholesalers and provided that such obligations may be
regarded as warranted on grounds of public health protection
and are proportionate in relation to the objective of such
protection.
(39) Rules should be laid down as to how the labelling and package
leaflets are to be presented.
(40) The provisions governing the information supplied to users
should provide a high degree of consumer protection, in order
that medicinal products may be used correctly on the basis of full
and comprehensible information.
(41) The marketing of medicinal products whose labelling and
package leaflets comply with this Directive should not be
prohibited or impeded on grounds connected with the labelling
or package leaflet.
(42) This Directive is without prejudice to the application of measures
adopted pursuant to Council Directive 84/450/EEC of 10
September 1984 relating to the approximation of the laws, regu
lations and administrative provisions of the Member States
concerning misleading advertising (1).
(43) All Member States have adopted further specific measures
concerning the advertising of medicinal products. There are
disparities between these measures. These disparities are likely
to have an impact on the functioning of the internal market, since
advertising disseminated in one Member State is likely to have
effects in other Member States.
(44) Council Directive 89/552/EEC of 3 October 1989 on the coordi
nation of certain provisions laid down by law, regulation or
administrative action in Member States concerning the pursuit
of television broadcasting activities (2) prohibits the television
advertising of medicinal products which are available only on
medical prescription in the Member State within whose juris
diction the television broadcaster is located. This principle
should be made of general application by extending it to other
media.
(45) Advertising to the general public, even of non-prescription
medicinal products, could affect public health, were it to be
excessive and ill-considered. Advertising of medicinal products
to the general public, where it is permitted, ought therefore to
satisfy certain essential criteria which ought to be defined.
(46) Furthermore, distribution of samples free of charge to the general
public for promotional ends must be prohibited.
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(47) The advertising of medicinal products to persons qualified to
prescribe or supply them contributes to the information
available to such persons. Nevertheless, this advertising should
be subject to strict conditions and effective monitoring, referring
in particular to the work carried out within the framework of the
Council of Europe.
(48) Advertising of medicinal products should be subject to effective,
adequate monitoring. Reference in this regard should be made to
the monitoring mechanisms set up by Directive 84/450/EEC.
(49) Medical sales representatives have an important role in the
promotion of medicinal products. Therefore, certain obligations
should be imposed upon them, in particular the obligation to
supply the person visited with a summary of product characte
ristics.
(50) Persons qualified to prescribe medicinal products must be able to
carry out these functions objectively without being influenced by
direct or indirect financial inducements.
(51) It should be possible within certain restrictive conditions to
provide samples of medicinal products free of charge to
persons qualified to prescribe or supply them so that they can
familiarize themselves with new products and acquire experience
in dealing with them.
(52) Persons qualified to prescribe or supply medicinal products must
have access to a neutral, objective source of information about
products available on the market. Whereas it is nevertheless for
the Member States to take all measures necessary to this end, in
the light of their own particular situation.
(53) Each undertaking which manufactures or imports medicinal
products should set up a mechanism to ensure that all information
supplied about a medicinal product conforms with the approved
conditions of use.
(54) In order to ensure the continued safety of medicinal products in
use, it is necessary to ensure that pharmacovigilance systems in
the Community are continually adapted to take account of
scientific and technical progress.
(55) It is necessary to take account of changes arising as a result of
international harmonisation of definitions, terminology and tech
nological developments in the field of pharmacovigilance.
(56) The increasing use of electronic networks for communication of
information on adverse reactions to medicinal products marketed
in the Community is intended to allow competent authorities to
share the information at the same time.
(57) It is the interest of the Community to ensure that the pharmacov
igilance systems for centrally authorised medicinal products and
those authorised by other procedures are consistent.
(58) Holders of marketing authorisations should be proactively
responsible for on-going pharmacovigilance of the medicinal
products they place on the market.
(59) The measures necessary for the implementation of this Directive
should be adopted in accordance with Council Decision
1999/468/EC of 28 June 1999 laying down the procedures for
the exercise of implementing powers conferred on the
Commission (1).
(60) The Commission should be empowered to adopt any necessary
changes to Annex I in order to take into account scientific and
technical progress.
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(61) This Directive should be without prejudice to the obligations of
the Member States concerning the time-limits for transposition of
the Directives set out in Annex II, Part B.
TITLE I
DEFINITIONS
Article 1
For the purposes of this Directive, the following terms shall bear the
following meanings:
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__________
2. Medicinal product:
(a) Any substance or combination of substances presented as
having properties for treating or preventing disease in human
beings; or
(b) Any substance or combination of substances which may be
used in or administered to human beings either with a view
to restoring, correcting or modifying physiological functions by
exerting a pharmacological, immunological or metabolic action,
or to making a medical diagnosis.
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3. Substance:
Any matter irrespective of origin which may be:
— human, e.g.
human blood and human blood products;
— animal, e.g.
micro-organisms, whole animals, parts of organs, animal
secretions, toxins, extracts, blood products;
— vegetable, e.g.
micro-organisms, plants, parts of plants, vegetable secretions,
extracts;
— chemical, e.g.
elements, naturally occurring chemical materials and chemical
products obtained by chemical change or synthesis.
4. Immunological medicinal product:
Any medicinal product consisting of vaccines, toxins, serums or
allergen products:
(a) vaccines, toxins and serums shall cover in particular:
(i) agents used to produce active immunity, such as cholera
vaccine, BCG, polio vaccines, smallpox vaccine;
(ii) agents used to diagnose the state of immunity, including in
particular tuberculin and tuberculin PPD, toxins for the
Schick and Dick Tests, brucellin;
(iii) agents used to produce passive immunity, such as
diphtheria antitoxin, anti-smallpox globulin, antilym
phocytic globulin;
2001L0083 — EN — 30.12.2008 — 006.001 — 10
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(b) ‘allergen product’ shall mean any medicinal product which is
intended to identify or induce a specific acquired alteration in
the immunological response to an allergizing agent.
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4a. Advanced therapy medicinal product:
A product as defined in Article 2 of Regulation (EC)
No 1394/2007 of the European Parliament and of the Council of
13 November 2007 on advanced therapy medicinal products (1).
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5. Homeopathic medicinal product:
Any medicinal product prepared from substances called homeo
pathic stocks in accordance with a homeopathic manufacturing
procedure described by the European Pharmacopoeia or, in the
absence thereof, by the pharmacopoeias currently used officially
in the Member States. A homeopathic medicinal product may
contain a number of principles.
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6. Radiopharmaceutical:
Any medicinal product which, when ready for use, contains one or
more radionuclides (radioactive isotopes) included for a medicinal
purpose.
7. Radionuclide generator:
Any system incorporating a fixed parent radionuclide from which
is produced a daughter radionuclide which is to be obtained by
elution or by any other method and used in a radiopharmaceutical.
8. ►M4 Kit ◄:
Any preparation to be reconsitituted or combined with radionu
clides in the final radiopharmaceutical, usually prior to its admi
nistration.
9. Radionuclide precursor:
Any other radionuclide produced for the radio-labelling of another
substance prior to administration.
10. Medicinal products derived from human blood or human plasma:
Medicinal products based on blood constitutents which are
prepared industrially by public or private establishments, such
medicinal products including, in particular, albumin, coagulating
factors and immunoglobulins of human origin.
11. Adverse reaction:
A response to a medicinal product which is noxious and unin
tended and which occurs at doses normally used in man for the
prophylaxis, diagnosis or therapy of disease or for the restoration,
correction or modification of physiological function.
12. Serious adverse reaction:
An adverse reaction which results in death, is life-threatening,
requires inpatient hospitalisation or prolongation of existing hospi
talisation, results in persistent or significant disability or inca
pacity, or is a congenital anomaly/birth defect.
13. Unexpected adverse reaction:
An adverse reaction, the nature, severity or outcome of which is
not consistent with the summary of product characteristics.
14. Periodic safety update reports:
The periodical reports containing the records referred to in
Article 104.
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15. Post-authorisation safety study:
A pharmacoepidemiological study or a clinical trial carried out in
accordance with the terms of the marketing authorisation,
conducted with the aim of identifying or quantifying a safety
hazard relating to an authorised medicinal product.
16. Abuse of medicinal products:
Persistent or sporadic, intentional excessive use of medicinal
products which is accompanied by harmful physical or psycho
logical effets.
17. Wholesale distribution of medicinal products:
All activities consisting of procuring, holding, supplying or
exporting medicinal products, apart from supplying medicinal
products to the public. Such activities are carried out with manu
facturers or their depositories, importers, other wholesale distri
butors or with pharmacists and persons authorized or entitled to
supply medicinal products to the public in the Member State
concerned.
18. Public service obligation:
The obligation placed on wholesalers to guarantee permanently an
adequate range of medicinal products to meet the requirements of
a specific geographical area and to deliver the supplies requested
within a very short time over the whole of the area in question.
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18a Representative of the marketing authorisation holder:
The person, commonly known as local representative, designated
by the marketing authorisation holder to represent him in the
Member State concerned.
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19. Medicinal Prescription:
Any medicinal prescription issued by a professional person
qualified to do so.
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20. Name of the medicinal product:
The name, which may be either an invented name not liable to
confusion with the common name, or a common or scientific name
accompanied by a trade mark or the name of the marketing auth
orisation holder.
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21. Common name:
The international non-proprietary name recommended by the
World Health Organization, or, if one does not exist, the usual
common name.
22. Strength of the medicinal product:
The content of the active substances expressed quantitatively per
dosage unit, per unit of volume or weight according to the dosage
form.
23. Immediate packaging:
The container or other form of packaging immediately in contact
with the medicinal product.
24. Outer packaging:
The packaging into which is placed the immediate packaging.
25. Labelling:
Information on the immediate or outer packaging.
26. Package leaflet:
2001L0083 — EN — 30.12.2008 — 006.001 — 12
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A leaflet containing information for the user which accompanies
the medicinal product.
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27. Agency:
The European Medicines Agency established by Regulation (EC)
No 726/2004 (1).
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TITLE II
SCOPE
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Article 2
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3. Notwithstanding paragraph 1 and Article 3(4), Title IV of this
Directive shall apply to medicinal products intended only for export
and to intermediate products.
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Article 3
Article 4
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medical examination or treatment, or from the Community rules laying
down the basic safety standards for the health protection of the general
public and workers against the dangers of ionizing radiation.
3. The provisions of this Directive shall not affect the powers of the
Member States' authorities either as regards the setting of prices for
medicinal products or their inclusion in the scope of national health
insurance schemes, on the basis of health, economic and social
conditions.
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5. This Directive and all Regulations referred to therein shall not
affect the application of national legislation prohibiting or restricting
the use of any specific type of human or animal cells, or the sale,
supply or use of medicinal products containing, consisting of or
derived from these cells, on grounds not dealt with in the aforemen
tioned Community legislation. The Member States shall communicate
the national legislation concerned to the Commission. The Commission
shall make this information publicly available in a register.
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Article 5
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TITLE III
CHAPTER 1
Marketing authorization
Article 6
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1. ►M6 No medicinal product may be placed on the market of a
Member State unless a marketing authorisation has been issued by the
competent authorities of that Member State in accordance with this
Directive or an authorisation has been granted in accordance with Regu
lation (EC) No 726/2004, read in conjunction with Regulation (EC)
No 1394/2007. ◄
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When a medicinal product has been granted an initial marketing auth
orisation in accordance with the first subparagraph, any additional
strengths, pharmaceutical forms, administration routes, presentations,
as well as any variations and extensions shall also be granted an auth
orisation in accordance with the first subparagraph or be included in the
initial marketing authorisation. All these marketing authorisations shall
be considered as belonging to the same global marketing authorisation,
in particular for the purpose of the application of Article 10(1).
1a The marketing authorisation holder shall be responsible for
marketing the medicinal product. The designation of a representative
shall not relieve the marketing authorisation holder of his legal respon
sibility.
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2. The authorisation referred to in paragraph 1 shall also be required
for radionuclide generators, ►M4 kits ◄, radionuclide precursor
radiopharmaceuticals and industrially prepared radiopharmaceuticals.
Article 7
Article 8
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(c) Qualitative and quantitative particulars of all the constituents of the
medicinal product, including the reference to its international non-
proprietary name (INN) recommended by the WHO, where an INN
for the medicinal product exists, or a reference to the relevant
chemical name.
(ca) Evaluation of the potential environmental risks posed by the
medicinal product. This impact shall be assessed and, on a case-
by-case basis, specific arrangements to limit it shall be envisaged.
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(d) Description of the manufacturing method.
(e) Therapeutic indications, contra-indications and adverse reactions.
(f) Posology, pharmaceutical form, method and route of administration
and expected shelf life.
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(g) Reasons for any precautionary and safety measures to be taken for
the storage of the medicinal product, its administration to patients
and for the disposal of waste products, together with an indication
of potential risks presented by the medicinal product for the envi
ronment.
(h) Description of the control methods employed by the manufacturer.
(i) Results of:
— pharmaceutical (physico-chemical, biological or microbio
logical) tests,
— pre-clinical (toxicological and pharmacological) tests,
— clinical trials.
(ia) A detailed description of the pharmacovigilance and, where appro
priate, of the risk-management system which the applicant will
introduce.
(ib) A statement to the effect that clinical trials carried out outside the
European Union meet the ethical requirements of Directive
2001/20/EC.
(j) A summary, in accordance with Article 11, of the product charac
teristics, a mock-up of the outer packaging, containing the details
provided for in Article 54, and of the immediate packaging of the
medicinal product, containing the details provided for in Article 55,
together with a package leaflet in accordance with Article 59.
▼B
(k) A document showing that the manufacturer is authorised in his
own country to produce medicinal products.
(l) Copies of any authorisation obtained in another Member State or in
a third country to place the medicinal product on the market,
together with a list of those Member States in which an application
for authorisation submitted in accordance with this Directive is
under examination. Copies of the summary of the product charac
teristics proposed by the applicant in accordance with Article 11 or
approved by the competent authorities of the Member State in
accordance with Article 21. Copies of the package leaflet
proposed in accordance with Article 59 or approved by the
competent authorities of the Member State in accordance with
Article 61. Details of any decision to refuse authorization,
whether in the Community or in a third country, and the reasons
for such a decision.
This information shall be updated on a regular basis.
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(m) A copy of any designation of the medicinal product as an orphan
medicinal product under Regulation (EC) No 141/2000 of the
2001L0083 — EN — 30.12.2008 — 006.001 — 17
▼M4
European Parliament and of the Council of 16 December 1999 on
orphan medicinal products (1), accompanied by a copy of the
relevant Agency opinion.
(n) Proof that the applicant has the services of a qualified person
responsible for pharmacovigilance and has the necessary means
for the notification of any adverse reaction suspected of
occurring either in the Community or in a third country.
The documents and information concerning the results of the pharma
ceutical and pre-clinical tests and the clinical trials referred to in point
(i) of the first subparagraph shall be accompanied by detailed summaries
in accordance with Article 12.
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Article 9
▼M4
(b) ‘generic medicinal product’ shall mean a medicinal product which
has the same qualitative and quantitative composition in active
substances and the same pharmaceutical form as the reference
medicinal product, and whose bioequivalence with the reference
medicinal product has been demonstrated by appropriate bioavail
ability studies. The different salts, esters, ethers, isomers, mixtures
of isomers, complexes or derivatives of an active substance shall be
considered to be the same active substance, unless they differ signif
icantly in properties with regard to safety and/or efficacy. In such
cases, additional information providing proof of the safety and/or
efficacy of the various salts, esters or derivatives of an authorised
active substance must be supplied by the applicant. The various
immediate-release oral pharmaceutical forms shall be considered
to be one and the same pharmaceutical form. Bioavailability
studies need not be required of the applicant if he can demonstrate
that the generic medicinal product meets the relevant criteria as
defined in the appropriate detailed guidelines.
3. In cases where the medicinal product does not fall within the
definition of a generic medicinal product as provided in paragraph
2(b) or where the bioequivalence cannot be demonstrated through bioa
vailability studies or in case of changes in the active substance(s),
therapeutic indications, strength, pharmaceutical form or route of admi
nistration, vis-à-vis the reference medicinal product, the results of the
appropriate pre-clinical tests or clinical trials shall be provided.
4. Where a biological medicinal product which is similar to a
reference biological product does not meet the conditions in the defi
nition of generic medicinal products, owing to, in particular, differences
relating to raw materials or differences in manufacturing processes of
the biological medicinal product and the reference biological medicinal
product, the results of appropriate pre-clinical tests or clinical trials
relating to these conditions must be provided. The type and quantity
of supplementary data to be provided must comply with the relevant
criteria stated in Annex I and the related detailed guidelines. The results
of other tests and trials from the reference medicinal product's dossier
shall not be provided.
5. In addition to the provisions laid down in paragraph 1, where an
application is made for a new indication for a well-established
substance, a non-cumulative period of one year of data exclusivity
shall be granted, provided that significant pre-clinical or clinical
studies were carried out in relation to the new indication.
6. Conducting the necessary studies and trials with a view to the
application of paragraphs 1, 2, 3 and 4 and the consequential
practical requirements shall not be regarded as contrary to patent
rights or to supplementary protection certificates for medicinal products.
Article 10a
Article 10b
▼M4
tests or new clinical trials relating to that combination shall be provided
in accordance with Article 8(3)(i), but it shall not be necessary to
provide scientific references relating to each individual active substance.
Article 10c
Article 11
▼M4
6.5. nature and contents of container,
6.6. special precautions for disposal of a used medicinal product or
waste materials derived from such medicinal product, if appropriate.
7. marketing authorisation holder.
8. marketing authorisation number(s).
9. date of the first authorisation or renewal of the authorisation.
10. date of revision of the text.
11. for radiopharmaceuticals, full details of internal radiation dosimetry.
12. for radiopharmaceuticals, additional detailed instructions for extem
poraneous preparation and quality control of such preparation and,
where appropriate, maximum storage time during which any inter
mediate preparation such as an eluate or the ready-to-use pharma
ceutical will conform with its specifications.
For authorisations under Article 10, those parts of the summary of
product characteristics of the reference medicinal product referring to
indications or dosage forms which were still covered by patent law at
the time when a generic medicine was marketed need not be included.
Article 12
CHAPTER 2
Article 14
▼B
— they are administered orally or externally,
▼M7
If new scientific evidence so warrants, the Commission may amend the
third indent of the first subparagraph. That measure, designed to amend
non-essential elements of this Directive, shall be adopted in accordance
with the regulatory procedure with scrutiny referred to in
Article 121(2a).
▼B
At the time of registration, Member States shall determine the classifi
cation for the dispensing of the medicinal product.
▼M4
__________
▼B
Article 15
▼M4
— dossier describing how the homeopathic stock or stocks is/are
obtained and controlled, and justifying its/their homeopathic use,
on the basis of an adequate bibliography,
▼B
— manufacturing and control file for each pharmaceutical form and a
description of the method of dilution and potentization,
▼M4
— one or more mock-ups of the outer packaging and the immediate
packaging of the medicinal products to be registered,
▼B
— data concerning the stability of the medicinal product.
2001L0083 — EN — 30.12.2008 — 006.001 — 22
▼B
Article 16
In this case, the Member State concerned shall notify the Commission
of the specific rules in force.
▼M3
CHAPTER 2a
Article 16a
(d) the period of traditional use as laid down in Article 16c(1)(c) has
elapsed;
(e) the data on the traditional use of the medicinal product are
sufficient; in particular the product proves not to be harmful in
the specified conditions of use and the pharmacological effects or
efficacy of the medicinal product are plausible on the basis of long-
standing use and experience.
Article 16b
▼M3
2. In order to obtain traditional-use registration, the applicant shall
submit an application to the competent authority of the Member State
concerned.
Article 16c
▼M3
Committee considers it possible, it shall establish a Community herbal
monograph as referred to in Article 16h(3) which shall be taken into
account by the Member State when taking its final decision.
Article 16d
Article 16e
Article 16f
▼M3
Article 16g
1. Articles 3(1) and (2), 4(4), 6(1), 12, 17(1), 19, 20, 23, 24, 25, 40
to 52, 70 to 85, 101 to 108, 111(1) and (3), 112, 116 to 118, 122, 123,
125, 126, second subparagraph, and 127 of this Directive as well as
Commission Directive 91/356/EEC (1) shall apply, by analogy, to tradi
tional-use registration granted under this chapter.
2. In addition to the requirements of Articles 54 to 65, any labelling
and user package leaflet shall contain a statement to the effect that:
(a) the product is a traditional herbal medicinal product for use in
specified indication(s) exclusively based upon long-standing use;
and
(b) the user should consult a doctor or a qualified health care practi
tioner if the symptoms persist during the use of the medicinal
product or if adverse effects not mentioned in the package leaflet
occur.
A Member State may require that the labelling and the user package
leaflet shall also state the nature of the tradition in question.
3. In addition to the requirements of Articles 86 to 99, any adver
tisement for a medicinal product registered under this chapter shall
contain the following statement: Traditional herbal medicinal product
for use in specified indication(s) exclusively based upon long-standing
use.
Article 16h
▼M3
2. Each Member State shall appoint, for a three-year term which may
be renewed, one member and one alternate to the Committee for Herbal
Medicinal Products.
The alternates shall represent and vote for the members in their absence.
Members and alternates shall be chosen for their role and experience in
the evaluation of herbal medicinal products and shall represent the
competent national authorities.
The said Committee may coopt a maximum of five additional members
chosen on the basis of their specific scientific competence. These
members shall be appointed for a term of three years, which may be
renewed, and shall not have alternates.
With a view to the coopting of such members, the said Committee shall
identify the specific complementary scientific competence of the addi
tional member(s). Coopted members shall be chosen among experts
nominated by Member States or the Agency.
The members of the said Committee may be accompanied by experts in
specific scientific or technical fields.
3. The Committee for Herbal Medicinal Products shall establish
Community herbal monographs for herbal medicinal products with
regard to the application of Article 10(1)(a)(ii) as well as traditional
herbal medicinal products. The said Committee shall fulfil further
responsibilities conferred upon it by provisions of this chapter and
other Community law.
When Community herbal monographs within the meaning of this
paragraph have been established, they shall be taken into account by
the Member States when examining an application. Where no such
Community herbal monograph has yet been established, other appro
priate monographs, publications or data may be referred to.
When new Community herbal monographs are established, the regis
tration holder shall consider whether it is necessary to modify the regis
tration dossier accordingly. The registration holder shall notify any such
modification to the competent authority of the Member State concerned.
The herbal monographs shall be published.
4. The general provisions of Regulation (EEC) No 2309/93 relating
to the Committee for Human Medicinal Products shall apply by analogy
to the Committee for Herbal Medicinal Products.
Article 16i
CHAPTER 3
▼M4
Applications for marketing authorisations in two or more Member States
in respect of the same medicinal product shall be submitted in
accordance with Articles 27 to 39.
Article 18
▼B
Article 19
2. may submit the medicinal product, its starting materials and, if need
be, its intermediate products or other constituent materials, for testing
by ►M4 an Official Medicines Control Laboratory or a laboratory
that a Member State has designated for that purpose ◄ in order to
ensure that the control methods employed by the manufacturer and
described in the particulars accompanying the application in
accordance with Article 8(3)(h) are satisfactory.
Article 20
▼B
Article 21
Article 22
Article 23
▼M4
In order that the risk-benefit balance may be continuously assessed, the
competent authority may at any time ask the holder of the marketing
authorisation to forward data demonstrating that the risk-benefit balance
remains favourable.
Article 23a
The holder shall also notify the competent authority if the product
ceases to be placed on the market of the Member State, either
temporarily or permanently. Such notification shall, otherwise than in
exceptional circumstances, be made no less than 2 months before the
interruption in the placing on the market of the product.
Article 24
▼B
Article 25
Authorization shall not affect the civil and criminal liability of the
manufacturer and, where applicable, of the marketing authorization
holder.
2001L0083 — EN — 30.12.2008 — 006.001 — 30
▼M4
Article 26
CHAPTER 4
Article 27
Article 28
▼M4
summary of product characteristics and a draft of the labelling and
package leaflet. The reference Member State shall prepare these draft
documents within 120 days after receipt of a valid application and shall
send them to the concerned Member States and to the applicant.
4. Within 90 days of receipt of the documents referred to in para
graphs 2 and 3, the Member States concerned shall approve the
assessment report, the summary of product characteristics and the
labelling and package leaflet and shall inform the reference Member
State accordingly. The reference Member State shall record the
agreement of all parties, close the procedure and inform the applicant
accordingly.
5. Each Member State in which an application has been submitted in
accordance with paragraph 1 shall adopt a decision in conformity with
the approved assessment report, the summary of product characteristics
and the labelling and package leaflet as approved, within 30 days after
acknowledgement of the agreement.
Article 29
1. If, within the period laid down in Article 28(4), a Member State
cannot approve the assessment report, the summary of product charac
teristics, the labelling and the package leaflet on the grounds of potential
serious risk to public health, it shall give a detailed exposition of the
reasons for its position to the reference Member State, to the other
Member States concerned and to the applicant. The points of
disagreement shall be forthwith referred to the coordination group.
2. Guidelines to be adopted by the Commission shall define a
potential serious risk to public health.
3. Within the coordination group, all Member States referred to in
paragraph 1 shall use their best endeavours to reach agreement on the
action to be taken. They shall allow the applicant the opportunity to
make his point of view known orally or in writing. If, within 60 days of
the communication of the points of disagreement, the Member States
reach an agreement, the reference Member State shall record the
agreement, close the procedure and inform the applicant accordingly.
Article 28(5) shall apply.
4. If the Member States fail to reach an agreement within the 60-day
period laid down in paragraph 3, the Agency shall be immediately
informed, with a view to the application of the procedure under
Articles 32, 33 and 34. The Agency shall be provided with a detailed
statement of the matters on which the Member States have been unable
to reach agreement and the reasons for their disagreement. A copy shall
be forwarded to the applicant.
5. As soon as the applicant is informed that the matter has been
referred to the Agency, he shall forthwith forward to the Agency a
copy of the information and documents referred to in the first subpara
graph of Article 28(1).
6. In the circumstances referred to in paragraph 4, Member States
that have approved the assessment report, the draft summary of product
characteristics and the labelling and package leaflet of the reference
Member State may, at the request of the applicant, authorise the
medicinal product without waiting for the outcome of the procedure
laid down in Article 32. In that event, the authorisation granted shall
be without prejudice to the outcome of that procedure.
Article 30
▼M4
divergent decisions concerning the authorisation of the medicinal
product or its suspension or revocation, a Member State, the
Commission or the applicant or the marketing authorisation holder
may refer the matter to the Committee for Medicinal Products for
Human Use, hereinafter referred to as ‘the Committee’, for the appli
cation of the procedure laid down in Articles 32, 33 and 34.
2. In order to promote harmonisation of authorisations for medicinal
products authorised in the Community, Member States shall, each year,
forward to the coordination group a list of medicinal products for which
a harmonised summary of product characteristics should be drawn up.
The coordination group shall lay down a list taking into account the
proposals from all Member States and shall forward this list to the
Commission.
The Commission or a Member State, in agreement with the Agency and
taking into account the views of interested parties, may refer these
products to the Committee in accordance with paragraph 1.
Article 31
Article 32
▼M4
3. Before issuing its opinion, the Committee shall provide the
applicant or the marketing authorisation holder with an opportunity to
present written or oral explanations within a time limit which it shall
specify.
The opinion of the Committee shall be accompanied by a draft summary
of product characteristics for the product and a draft text of the labelling
and package leaflet.
If necessary, the Committee may call upon any other person to provide
information relating to the matter before it.
The Committee may suspend the time-limits referred to in paragraph 1
in order to allow the applicant or the marketing authorisation holder to
prepare explanations.
4. The Agency shall forthwith inform the applicant or the marketing
authorisation holder where the opinion of the Committee is that:
(a) the application does not satisfy the criteria for authorisation; or
(b) the summary of the product characteristics proposed by the
applicant or the marketing authorisation holder in accordance with
Article 11 should be amended; or
(c) the authorisation should be granted subject to certain conditions, in
view of conditions considered essential for the safe and effective
use of the medicinal product including pharmacovigilance; or
(d) a marketing authorisation should be suspended, varied or revoked.
Within 15 days after receipt of the opinion, the applicant or the
marketing authorisation holder may notify the Agency in writing of
his intention to request a re-examination of the opinion. In that case,
he shall forward to the Agency the detailed grounds for the request
within 60 days after receipt of the opinion.
Within 60 days following receipt of the grounds for the request, the
Committee shall re-examine its opinion in accordance with the fourth
subparagraph of Article 62(1) of Regulation (EC) No 726/2004. The
reasons for the conclusion reached shall be annexed to the assessment
report referred to in paragraph 5 of this Article.
5. Within 15 days after its adoption, the Agency shall forward the
final opinion of the Committee to the Member States, to the
Commission and to the applicant or the marketing authorisation
holder, together with a report describing the assessment of the
medicinal product and stating the reasons for its conclusions.
In the event of an opinion in favour of granting or maintaining an
authorisation to place the medicinal product concerned on the market,
the following documents shall be annexed to the opinion:
(a) a draft summary of the product characteristics, as referred to in
Article 11;
(b) any conditions affecting the authorisation within the meaning of
paragraph 4(c);
(c) details of any recommended conditions or restrictions with regard to
the safe and effective use of the medicinal product;
(d) the proposed text of the labelling and leaflet.
▼B
Article 33
▼B
In the event of a draft decision which envisages the granting of
marketing authorization, the documents referred to in
►M4 Article 32(5), second subparagraph ◄ shall be annexed.
Where, exceptionally, the draft decision is not in accordance with the
opinion of the Agency, the Commission shall also annex a detailed
explanation of the reasons for the differences.
The draft decision shall be forwarded to the Member States and the
applicant►M4 or the marketing authorisation holder ◄.
▼M4
Article 34
Article 35
▼M4
__________
▼M7
These arrangements shall be adopted by the Commission in the form of
an implementing regulation. That measure, designed to amend non-
essential elements of this Directive by supplementing it, shall be
adopted in accordance with the regulatory procedure with scrutiny
referred to in Article 121(2a).
▼B
2. In case of arbitration submitted to the Commission, the procedure
laid down in Articles 32, 33 and 34 shall apply by analogy to variations
made to marketing authorizations.
Article 36
Article 37
Article 38
▼M4
2. At least every ten years the Commission shall publish a report on
the experience acquired on the basis of the procedures described in this
Chapter and shall propose any amendments which may be necessary to
improve those procedures. The Commission shall submit this report to
the European Parliament and to the Council.
Article 39
Article 29(4), (5) and (6) and Articles 30 to 34 shall not apply to the
homeopathic medicinal products referred to in Article 14.
▼B
TITLE IV
Article 40
Article 41
Article 42
▼B
3. The authorization shall apply only to the premises specified in the
application and to the medicinal products and pharmaceutical forms
specified in that same application.
Article 43
The Member States shall take all appropriate measures to ensure that the
time taken for the procedure for granting the manufacturing authori
zation does not exceed 90 days from the day on which the competent
authority receives the application.
Article 44
Article 45
The competent authority of the Member State may require from the
applicant further information concerning the particulars supplied
pursuant to Article 41 and concerning the qualified person referred to
in Article 48; where the competent authority concerned exercises this
right, application of the time-limits referred to in Article 43 and 44 shall
be suspended until the additional data required have been supplied.
Article 46
▼M7
with the regulatory procedure with scrutiny referred to in
Article 121(2a).
▼M4
Article 46a
▼M7
2. The Commission shall be empowered to adapt paragraph 1 to take
account of scientific and technical progress. That measure, designed to
amend non-essential elements of this Directive, shall be adopted in
accordance with the regulatory procedure with scrutiny referred to in
Article 121(2a).
▼B
Article 47
▼M7
The principles and guidelines of good manufacturing practices for
medicinal products referred to in Article 46(f) shall be adopted in the
form of a directive. That measure, designed to amend non-essential
elements of this Directive by supplementing it, shall be adopted in
accordance with the regulatory procedure with scrutiny referred to in
Article 121(2a).
▼B
Detailed guidelines in line with those principles will be published by the
Commission and revised necessary to take account of technical and
scientific progress.
▼M4
The principles of good manufacturing practice for active substances
used as starting materials referred to in point (f) of Article 46 shall
be adopted in the form of detailed guidelines.
The Commission shall also publish guidelines on the form and content
of the authorisation referred to in Article 40(1), on the reports referred
to in Article 111(3) and on the form and content of the certificate of
good manufacturing practice referred to in Article 111(5).
▼B
Article 48
▼B
Article 49
▼B
The duration of practical experience may be reduced by one year where
a university course lasts for at least five years and by a year and a half
where the course lasts for at least six years.
Article 50
Article 51
▼B
least equivalent to those laid down by the Community, and to ensure
that the controls referred to under point (b) of the first subparagraph of
paragraph 1 have been carried out in the exporting country, the qualified
person may be relieved of responsibility for carrying out those controls.
3. In all cases and particularly where the medicinal products are
released for sale, the qualified person must certify in a register or
equivalent document provided for that purpose, that each production
batch satisfies the provisions of this Article; the said register or
equivalent document must be kept up to date as operations are carried
out and must remain at the disposal of the agents of the competent
authority for the period specified in the provisions of the Member
State concerned and in any event for at least five years.
Article 52
Member States shall ensure that the duties of qualified persons referred
to in Article 48 are fulfilled, either by means of appropriate adminis
trative measures or by making such persons subject to a professional
code of conduct.
Member States may provide for the temporary suspension of such a
person upon the commencement of administrative or disciplinary
procedures against him for failure to fulfil his obligations.
Article 53
TITLE V
Article 54
▼M4
(f) a special warning that the medicinal product must be stored out of
the reach and sight of children;
▼B
(g) a special warning, if this is necessary for the medicinal product;
(h) the expiry date in clear terms (month/year);
(i) special storage precautions, if any;
▼M4
(j) specific precautions relating to the disposal of unused medicinal
products or waste derived from medicinal products, where appro
priate, as well as reference to any appropriate collection system in
place;
(k) the name and address of the marketing authorisation holder and,
where applicable, the name of the representative appointed by the
holder to represent him;
▼B
(l) the number of the authorization for placing the medicinal product
on the market;
(m) the manufacturer's batch number;
▼M4
(n) in the case of non-prescription medicinal products, instructions for
use.
▼B
Article 55
▼B
Article 56
Article 57
Article 58
▼M4
(iii) forms of interaction with other medicinal products and other
forms of interaction (e.g. alcohol, tobacco, foodstuffs) which
may affect the action of the medicinal product;
(iv) special warnings;
(d) the necessary and usual instructions for proper use, and in
particular:
(i) the dosage,
(ii) the method and, if necessary, route of administration;
(iii) the frequency of administration, specifying if necessary the
appropriate time at which the medicinal product may or must
be administered;
and, as appropriate, depending on the nature of the product:
(iv) the duration of treatment, where it should be limited;
(v) the action to be taken in case of an overdose (such as
symptoms, emergency procedures);
(vi) what to do when one or more doses have not been taken;
(vii) indication, if necessary, of the risk of withdrawal effects;
(viii) a specific recommendation to consult the doctor or the phar
macist, as appropriate, for any clarification on the use of the
product;
(e) a description of the adverse reactions which may occur under
normal use of the medicinal product and, if necessary, the action
to be taken in such a case; the patient should be expressly asked to
communicate any adverse reaction which is not mentioned in the
package leaflet to his doctor or pharmacist;
(f) a reference to the expiry date indicated on the label, with:
(i) a warning against using the product after that date;
(ii) where appropriate, special storage precautions;
(iii) if necessary, a warning concerning certain visible signs of
deterioration;
(iv) the full qualitative composition (in active substances and exci
pients) and the quantitative composition in active substances,
using common names, for each presentation of the medicinal
product;
(v) for each presentation of the product, the pharmaceutical form
and content in weight, volume or units of dosage;
(vi) the name and address of the marketing authorisation holder
and, where applicable, the name of his appointed represen
tatives in the Member States;
(vii) the name and address of the manufacturer;
(g) where the medicinal product is authorised in accordance with
Articles 28 to 39 under different names in the Member States
concerned, a list of the names authorised in each Member State;
(h) the date on which the package leaflet was last revised.
2. The list set out in point (c) of paragraph 1 shall:
(a) take into account the particular condition of certain categories of
users (children, pregnant or breastfeeding women, the elderly,
persons with specific pathological conditions);
(b) mention, if appropriate, possible effects on the ability to drive
vehicles or to operate machinery;
2001L0083 — EN — 30.12.2008 — 006.001 — 45
▼M4
(c) list those excipients knowledge of which is important for the safe
and effective use of the medicinal product and which are included
in the detailed guidance published pursuant to Article 65.
▼B
Article 60
Member States may not prohibit or impede the placing on the market of
medicinal products within their territory on grounds connected with
labelling or the package leaflet where these comply with the
requirements of this Title.
Article 61
▼M4
1. One or more mock-ups of the outer packaging and the immediate
packaging of a medicinal product, together with the draft package
leaflet, shall be submitted to the authorities competent for authorising
marketing when the marketing authorisation is requested. The results of
assessments carried out in cooperation with target patient groups shall
also be provided to the competent authority.
▼B
2. The competent authority shall refuse the marketing authorization if
the labelling or the package leaflet do not comply with the provisions of
this Title or if they are not in accordance with the particulars listed in
the summary of product characteristics.
Article 62
The outer packaging and the package leaflet may include symbols or
pictograms designed to clarify certain information mentioned in Articles
54 and 59(1) and other information compatible with the summary of the
product characteristics which is useful ►M4 to the patient ◄, to the
exclusion of any element of a promotional nature.
Article 63
The first subparagraph shall not prevent these particulars from being
indicated in several languages, provided that the same particulars appear
in all the languages used.
2001L0083 — EN — 30.12.2008 — 006.001 — 46
▼M4
In the case of certain orphan medicinal products, the particulars listed in
Article 54 may, on reasoned request, appear in only one of the official
languages of the Community.
2. The package leaflet must be written and designed to be clear and
understandable, enabling the users to act appropriately, when necessary
with the help of health professionals. The package leaflet must be
clearly legible in the official language or languages of the Member
State in which the medicinal product is placed on the market.
The first subparagraph shall not prevent the package leaflet from being
printed in several languages, provided that the same information is
given in all the languages used.
3. When the product is not intended to be delivered directly to the
patient, the competent authorities may grant an exemption to the obli
gation that certain particulars should appear on the labelling and in the
package leaflet and that the leaflet must be in the official language or
languages of the Member State in which the product is placed on the
market.
▼B
Article 64
Where the provisions of this Title are not complied with, and a notice
served on the person concerned has remained without effect, the
competent authorities of the Member States may suspend the
marketing authorization, until the labelling and the package leaflet of
the medicinal product in question have been made to comply with the
requirements of this Title.
▼M4
Article 65
In consultation with the Member States and the parties concerned, the
Commission shall draw up and publish detailed guidance concerning in
particular:
(a) the wording of certain special warnings for certain categories of
medicinal products;
(b) the particular information needs relating to non-prescription
medicinal products;
(c) the legibility of particulars on the labelling and package leaflet;
(d) the methods for the identification and authentication of medicinal
products;
(e) the list of excipients which must feature on the labelling of
medicinal products and the way in which these excipients must
be indicated;
(f) harmonised provisions for the implementation of Article 57.
▼B
Article 66
▼B
vial and the number of capsules, or, for liquids, the number of millilitres
in the container.
3. The vial shall be labelled with the following information:
— the name or code of the medicinal product, including the name or
chemical symbol of the radionuclide,
— the batch identification and expiry date,
— the international symbol for radioactivity,
▼M4
— the name and address of the manufacturer,
▼B
— the amount of radioactivity as specified in paragraph 2.
Article 67
Article 68
Article 69
▼B
— ‘homeopathic medicinal product without approved therapeutic indi
cations’,
▼M4
— a warning advising the user to consult a doctor if the symptoms
persist.
▼B
2. Notwithstanding paragraph 1, Member States may require the use
of certain types of labelling in order to show:
— the price of the medicinal product,
— the conditions for refunds by social security bodies.
TITLE VI
Article 70
Article 71
▼B
within the meaning of the international conventions in force, such as
the United Nations Conventions of 1961 and 1971, or
— the medicinal product is likely, if incorrectly used, to present a
substantial risk of medicinal abuse, to lead to addiction or be
misused for illegal purposes, or
— the medicinal product contains a substance which, by reason of its
novelty or properties, could be considered as belonging to the group
envisaged in the second indent as a precautionary measure.
3. Where Member States provide for the sub-category of medicinal
products subject to restricted prescription, they shall take account of the
following factors:
— the medicinal product, because of its pharmaceutical characteristics
or novelty or in the interests of public health, is reserved for
treatments which can only be followed in a hospital environment,
— the medicinal product is used in the treatment of conditions which
must be diagnosed in a hospital environment or in institutions with
adequate diagnostic facilities, although administration and follow-up
may be carried out elsewhere, or
— the medicinal product is intended for outpatients but its use may
produce very serious adverse reactions requiring a prescription
drawn up as required by a specialist and special supervision
throughout the treatment.
4. A competent authority may waive application of paragraphs 1, 2
and 3 having regard to:
(a) the maximum single dose, the maximum daily dose, the strength,
the pharmaceutical form, certain types of packaging; and/or
(b) other circumstances of use which it has specified.
5. If a competent authority does not designate medicinal products
into sub-categories referred to in Article 70(2), it shall nevertheless
take into account the criteria referred to in paragraphs 2 and 3 of this
Article in determining whether any medicinal product shall be classified
as a prescription-only medicine.
Article 72
Article 73
When new facts are brought to their attention, the competent authorities
shall examine and, as appropriate, amend the classification of a
medicinal product by applying the criteria listed in Article 71.
Article 74a
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tests or trials when examining an application by another applicant for or
holder of marketing authorisation for a change of classification of the
same substance for one year after the initial change was authorised.
▼B
Article 75
TITLE VII
Article 76
Article 77
▼B
shall be carried out under the responsibility of the Member State which
granted the authorization.
6. The Member State which granted the authorization referred to in
paragraph 1 shall suspend or revoke that authorization if the conditions
of authorization cease to be met. It shall forthwith inform the other
Member States and the Commission thereof.
7. Should a Member State consider that, in respect of a person
holding an authorization granted by another Member State under the
terms of paragraph 1, the conditions of authorization are not, or are no
longer met, it shall forthwith inform the Commission and the other
Member State involved. The latter shall take the measures necessary
and shall inform the Commission and the first Member State of the
decisions taken and the reasons for those decisions.
Article 78
Member States shall ensure that the time taken for the procedure for
examining the application for the distribution authorization does not
exceed 90 days from the day on which the competent authority of the
Member State concerned receives the application.
The competent authority may, if need be, require the applicant to supply
all necessary information concerning the conditions of authorization.
Where the authority exercises this option, the period laid down in the
first paragraph shall be suspended until the requisite additional data
have been supplied.
Article 79
Article 80
▼B
authorities or carried out in cooperation with the manufacturer or
marketing authorization holder for the medicinal product concerned;
(e) they must keep records either in the form of purchase/sales invoices,
or on computer, or in any other form, giving for any transaction in
medicinal products received or dispatched at least the following
information:
— date,
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— name of the medicinal product,
▼B
— quantity received or supplied,
— name and address of the supplier or consignee, as appropriate;
(f) they must keep the records referred to under (e) available to the
competent authorities, for inspection purposes, for a period of five
years;
(g) they must comply with the principles and guidelines of good distri
bution practice for medicinal products as laid down in Article 84.
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Article 81
Article 82
▼B
to provide information that makes it possible to trace the distribution
path of every medicinal product.
Article 83
The provisions of this Title shall not prevent the application of more
stringent requirements laid down by Member States in respect of the
wholesale distribution of:
— narcotic or psychotropic substances within their territory,
— medicinal products derived from blood,
— immunological medicinal products,
— radiopharmaceuticals.
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Article 84
Article 85
TITLE VIII
ADVERTISING
Article 86
▼B
— the labelling and the accompanying package leaflets, which are
subject to the provisions of Title V,
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— information relating to human health or diseases, provided that there
is no reference, even indirect, to medicinal products.
▼B
Article 87
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Article 88
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TITLE VIIIa
Article 88a
Within three years of the entry into force of Directive 2004/726/EC, the
Commission shall, following consultations with patients' and consumers'
organisations, doctors' and pharmacists' organisations, Member States
and other interested parties, present to the European Parliament and
the Council a report on current practice with regard to information
provision — particularly on the Internet — and its risks and benefits
for patients.
▼B
Article 89
(a) be set out in such a way that it is clear that the message is an
advertisement and that the product is clearly identified as a
medicinal product;
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2. Member States may decide that the advertising of a medicinal
product to the general public may, notwithstanding paragraph 1,
include only the name of the medicinal product or its international
non-proprietary name, where this exists, or the trademark if it is
intended solely as a reminder.
▼B
Article 90
(b) suggests that the effects of taking the medicine are guaranteed, are
unaccompanied by adverse reactions or are better than, or equivalent
to, those of another treatment or medicinal product;
(c) suggests that the health of the subject can be enhanced by taking the
medicine;
2001L0083 — EN — 30.12.2008 — 006.001 — 56
▼B
(d) suggests that the health of the subject could be affected by not
taking the medicine; this prohibition shall not apply to the vacci
nation campaigns referred to in Article 88(4);
(e) is directed exclusively or principally at children;
(f) refers to a recommendation by scientists, health professionals or
persons who are neither of the foregoing but who, because of
their celebrity, could encourage the consumption of medicinal
products;
(g) suggests that the medicinal product is a foodstuff, cosmetic or other
consumer product;
(h) suggests that the safety or efficacy of the medicinal product is due
to the fact that it is natural;
(i) could, by a description or detailed representation of a case history,
lead to erroneous self-diagnosis;
(j) refers, in improper, alarming or misleading terms, to claims of
recovery;
(k) uses, in improper, alarming or misleading terms, pictorial represen
tations of changes in the human body caused by disease or injury,
or of the action of a medicinal product on the human body or parts
thereof.
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__________
▼B
Article 91
Article 92
▼B
tation referred to in paragraph 1 shall be faithfully reproduced and the
precise sources indicated.
Article 93
Article 94
Article 96
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(d) each sample shall be no larger than the smallest presentation on the
market;
▼B
(e) each sample shall be marked ‘free medical sample — not for sale’
or shall show some other wording having the same meaning;
Article 97
1. Member States shall ensure that there are adequate and effective
methods to monitor the advertising of medicinal products. Such
methods, which may be based on a system of prior vetting, shall in
any event include legal provisions under which persons or organizations
regarded under national law as having a legitimate interest in prohibiting
any advertisement inconsistent with this Title, may take legal action
against such advertisement, or bring such advertisement before an
administrative authority competent either to decide on complaints or
to initiate appropriate legal proceedings.
It shall be for each Member State to decide which of the two options set
out in the first subparagraph to select.
▼B
Article 98
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3. The Member States shall not prohibit the co-promotion of a
medicinal product by the holder of the marketing authorisation and
one or more companies nominated by him.
▼B
Article 99
Member States shall take the appropriate measures to ensure that the
provisions of this Title are applied and shall determine in particular
what penalties shall be imposed should the provisions adopted in the
execution of Title be infringed.
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Article 100
▼B
TITLE IX
PHARMACOVIGILANCE
Article 101
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The Member States may impose specific requirements on doctors and
other health-care professionals in respect of the reporting of suspected
serious or unexpected adverse reactions.
Article 102
Article 102a
Article 103
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Article 104
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7. The Commission may amend paragraph 6 in view of experience
gained through its operation. That measure, designed to amend non-
essential elements of this Directive, shall be adopted in accordance
with the regulatory procedure with scrutiny referred to in
Article 121(2a).
2001L0083 — EN — 30.12.2008 — 006.001 — 62
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8. Following the granting of a marketing authorisation, the marketing
authorisation holder may request the amendment of the periods referred
to in paragraph 6 in accordance with the procedure laid down by
Commission Regulation (EC) No 1084/2003 (1).
In any case, the marketing authorisation holder shall ensure that such
information is presented objectively and is not misleading.
Article 105
Article 106
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Article 107
Article 108
TITLE X
For the collection and testing of human blood and human plasma,
Directive 2002/98/EC of the European Parliament and of the Council
of 27 January 2003 setting standards of quality and safety for the
collection, testing, processing, storage and distribution of human
blood and blood components and amending Directive 2001/83/EC (1)
shall apply.
▼B
Article 110
▼B
human plasma coming from voluntary unpaid donations. They shall
notify the Commission of such measures.
TITLE XI
Article 111
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1. The competent authority of the Member State concerned shall
ensure, by means of repeated inspections, and if necessary unannounced
inspections, and, where appropriate, by asking an Official Medicines
Control Laboratory or a laboratory designated for that purpose to
carry out tests on samples, that the legal requirements governing
medicinal products are complied with.
The competent authority may also carry out unannounced inspections at
the premises of manufacturers of active substances used as starting
materials, or at the premises of marketing authorisation holders
whenever it considers that there are grounds for suspecting non-
compliance with the principles and guidelines of good manufacturing
practice referred to in Article 47. These inspections may also be carried
out at the request of a Member State, the Commission or the Agency.
In order to verify whether the data submitted in order to obtain a
conformity certificate comply with the monographs of the European
Pharmacopoeia, the standardisation body of the nomenclatures and the
quality norms within the meaning of the Convention relating to the
elaboration of the European Pharmacopoeia (1) (European Directorate
for the quality of Medicinal Products) may ask the Commission or
the Agency to request such an inspection when the starting material
concerned is the subject of a European Pharmacopoeia monograph.
The competent authority of the Member State concerned may carry out
inspections of starting material manufacturers at the specific request of
the manufacturer himself.
Such inspections shall be carried out by officials representing the
competent authority who shall be empowered to:
(a) inspect the manufacturing or commercial establishments of manu
facturers of medicinal products or of active substances used as
starting materials, and any laboratories employed by the holder of
the manufacturing authorisation to carry out checks pursuant to
Article 20;
(b) take samples including with a view to independent tests being
carried out by an Official Medicines Control Laboratory or a
laboratory designated for that purpose by a Member State;
(c) examine any documents relating to the object of the inspection,
subject to the provisions in force in the Member States on
21 May 1975 placing restrictions on these powers with regard to
the description of the manufacturing method;
(d) inspect the premises, records and documents of marketing authoris
ation holders or any firms employed by the marketing authorisation
holder to perform the activities described in Title IX, and in
particular Articles 103 and 104.
▼B
2. Member States shall take all appropriate steps to ensure that the
manufacturing processes used in the manufacture of immunological
products are properly validated and attain batch-to-batch consistency.
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3. After every inspection as referred to in paragraph 1, the officials
representing the competent authority shall report on whether the manu
facturer complies with the principles and guidelines of good manufac
turing practice laid down in Article 47 or, where appropriate, with the
requirements laid down in Articles 101 to 108. The content of such
reports shall be communicated to the manufacturer or marketing auth
orisation holder who has undergone the inspection.
4. Without prejudice to any arrangements which may have been
concluded between the Community and third countries, a Member
State, the Commission or the Agency may require a manufacturer estab
lished in a third country to submit to an inspection as referred to in
paragraph 1.
5. Within 90 days of an inspection as referred to in paragraph 1, a
certificate of good manufacturing practice shall be issued to a manu
facturer if the outcome of the inspection shows that the manufacturer
complies with the principles and guidelines of good manufacturing
practice as provided for by Community legislation.
If inspections are performed as part of the certification procedure for the
monographs of the European Pharmacopoeia, a certificate shall be
drawn up.
6. Member States shall enter the certificates of good manufacturing
practice which they issue in a Community database managed by the
Agency on behalf of the Community.
7. If the outcome of the inspection as referred to in paragraph 1 is
that the manufacturer does not comply with the principles and
guidelines of good manufacturing practice as provided for by
Community legislation, the information shall be entered in the
Community database as referred to in paragraph 6.
▼B
Article 112
Member States shall take all appropriate measures to ensure that the
holder of the marketing authorization for a medicinal product and,
where appropriate, the holder of the manufacturing authorization,
furnish proof of the controls carried out on the medicinal product
and/or the ingredients and of the controls carried out at an intermediate
stage of the manufacturing process, in accordance with the methods laid
down in Article 8(3)(h).
Article 113
Article 114
▼B
new for a particular manufacturer, during a transitional period
normally specified in the marketing authorization,
to submit samples from each batch of the bulk and/or the medicinal
product for examination ►M4 by an Official Medicines Control
Laboratory or a laboratory that a Member State has designated for
that purpose ◄ before release on to the market unless, in the case of
a batch manufactured in another Member State, the competent authority
of that Member State has previously examined the batch in question and
declared it to be in conformity with the approved specifications.
Member States shall ensure that any such examination is completed
within 60 days of the receipt of the samples.
2. Where, in the interests of public health, the laws of a Member
State so provide, the competent authorities may require the marketing
authorization holder for medicinal products derived from human blood
or human plasma to submit samples from each batch of the bulk and/or
the medicinal product for testing ►M4 by an Official Medicines
Control Laboratory or a laboratory that a Member State has designated
for that purpose ◄ before being released into free circulation, unless
the competent authorities of another Member State have previously
examined the batch in question and declared it to be in conformity
with the approved specifications. Member States shall ensure that any
such examination is completed within 60 days of the receipt of the
samples.
Article 115
Member States shall take all necessary measures to ensure that the
manufacturing and purifying processes used in the preparation of
medicinal products derived from human blood or human plasma are
properly validated, attain batch-to-batch consistency and guarantee,
insofar as the state of technology permits, the absence of specific
viral contamination. To this end manufacturers shall notify the
competent authorities of the method used to reduce or eliminate
pathogenic viruses liable to be transmitted by medicinal products
derived from human blood or human plasma. The competent authority
may submit samples of the bulk and/or the medicinal product for testing
by a State laboratory or a laboratory designated for that purpose, either
during the examination of the application pursuant to Article 19, or after
a marketing authorization has been granted.
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Article 116
Article 117
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1. Without prejudice to the measures provided for in Article 116,
Member States shall take all appropriate steps to ensure that the
2001L0083 — EN — 30.12.2008 — 006.001 — 67
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supply of the medicinal product is prohibited and the medicinal product
withdrawn from the market, if the view is taken that:
(e) the controls on the medicinal product and/or on the ingredients and
the controls at an intermediate stage of the manufacturing process
have not been carried out or if some other requirement or obligation
relating to the grant of the manufacturing authorisation has not been
fulfilled.
▼B
2. The competent authority may limit the prohibition to supply the
product, or its withdrawal from the market, to those batches which are
the subject of dispute.
Article 118
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Article 119
▼B
TITLE XII
STANDING COMMITTEE
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Article 120
The Commission shall adopt any changes which are necessary in order
to adapt Annex I to take account of scientific and technical progress.
Those measures, designed to amend non-essential elements of this
2001L0083 — EN — 30.12.2008 — 006.001 — 68
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Directive, shall be adopted in accordance with the regulatory procedure
with scrutiny referred to in Article 121(2a).
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Article 121
GENERAL PROVISIONS
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Article 122
▼B
Article 123
Article 124
Article 125
Article 126
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health reasons authorise the placing on the market of the said medicinal
product.
2. When a Member State avails itself of this possibility, it shall adopt
the necessary measures in order to ensure that the requirements of this
Directive are complied with, in particular those referred to in Titles V,
VI, VIII, IX and XI.
3. Before granting such an authorisation a Member State shall:
(a) notify the marketing authorisation holder, in the Member State in
which the medicinal product concerned is authorised, of the
proposal to grant an authorisation under this Article in respect of
the product concerned; and
(b) request the competent authority in that State to furnish a copy of the
assessment report referred to in Article 21(4) and of the marketing
authorisation in force in respect of the said medicinal product.
4. The Commission shall set up a publicly accessible register of
medicinal products authorised under paragraph 1. Member States shall
notify the Commission if any medicinal product is authorised, or ceases
to be authorised, under paragraph 1, including the name or corporate
name and permanent address of the authorisation holder. The
Commission shall amend the register of medicinal products accordingly
and make this register available on their website.
5. No later than 30 April 2008, the Commission shall present a report
to the European Parliament and the Council concerning the application
of this provision with a view to proposing any necessary amendments.
Article 126b
Article 127
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Article 127a
Article 127b
TITLE XIV
FINAL PROVISIONS
Article 128
Article 129
This Directive shall enter into force on the twentieth day following that
of its publication in the Official Journal of the European Communities.
Article 130
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ANNEX I
ANALYTICAL, PHARMACOTOXICOLOGICAL AND CLINICAL STANDARDS AND PROTOCOLS IN
RESPECT OF THE TESTING OF MEDICINAL PRODUCTS
TABLE OF CONTENTS
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3.2.2.8. Stability of the finished medicinal product . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4. Module 4: Non-clinical reports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4.1. Format and Presentation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4.2. Content: basic principles and requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4.2.1. Pharmacology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4.2.2. Pharmaco-kinetics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4.2.3. Toxicology . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5. Module 5: Clinical study reports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5.1. Format and Presentation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5.2. Content: basic principles and requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5.2.1. Reports of bio-pharmaceutics studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5.2.2. Reports of studies pertinent to pharmaco-kinetics using human bio-materials . .. . . .. . . . .. . . ..
5.2.3. Reports of human pharmaco-kinetic studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5.2.4. Reports of human pharmaco-dynamic studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5.2.5. Reports of efficacy and safety studies . . . .. . . . .. . . .. . . .. . . . .. . . .. . . .. . . . .. . . ..
5.2.5.1. Study Reports of Controlled Clinical Studies Pertinent to the Claimed Indication . . . . . . . . . . . . . .
5.2.5.2. Study reports of uncontrolled clinical studies reports of analyses of data from more than one study and
other clinical study reports . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5.2.6. Reports of post-marketing experience . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5.2.7. Case reports forms and individual patient listings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Part II: Specific marketing authorisation dossiers and requirements
1. Well-established medicinal use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2. Essentially similar medicinal products. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3. Additional data required in specific situations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4. Similar biological medicinal products . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5. Fixed combination medicinal products . . . .. . . . .. . . .. . . .. . . . .. . . .. . . .. . . . .. . . ..
6. Documentation for applications in exceptional circumstances . . .. . . . .. . . .. . . .. . . . .. . . ..
7. Mixed marketing authorisation applications . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Part III: Particular medicinal products . . .. . . . .. . . .. . . . .. . . .. . . .. . . . .. . . .. . . .. . . . .. . . ..
1. Biological medicinal products . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1.1. Plasma-derived medicinal product . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1.2. Vaccines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2. Radio-pharmaceuticals and precursors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2.1. Radio-pharmaceuticals .. . . . .. . . .. . . .. . . . .. . . .. . . .. . . . .. . . .. . . .. . . . .. . . ..
2.2. Radio-pharmaceutical precursors for radio-labelling purposes . . .. . . . .. . . .. . . .. . . . .. . . ..
3. Homeopathic medicinal products . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4. Herbal medicinal products . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
5. Orphan Medicinal Products . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Part IV: Advanced therapy medicinal products . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1. Gene therapy medicinal products (human and xenogeneic) . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1.1. Diversity of gene therapy medicinal products . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
1.2. Specific requirements regarding Module 3 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2. Somatic cell therapy medicinal products (human and xenogeneic) . . . . . . . . . . . . . . . . . . . . . . . .
3. Specific requirements for gene therapy and somatic cell therapy (human and xenogeneic) medicinal
products regarding Modules 4 and 5 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3.1. Module 4 . . . . .. . . .. . . . .. . . .. . . .. . . . .. . . .. . . .. . . . .. . . .. . . .. . . . .. . . ..
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3.2. Module 5 . . . . .. . . .. . . . .. . . .. . . .. . . . .. . . .. . . .. . . . .. . . .. . . .. . . . .. . . ..
3.2.1. Human pharmacology and efficacy studies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
3.2.2. Safety. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
4. Specific Statement on Xeno-transplantation Medicinal Products .. . . . .. . . .. . . .. . . . .. . . ..
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Introduction and general principles
(1) The particulars and documents accompanying an application for
marketing authorisation pursuant to Articles 8 and 10 (1) shall be
presented in accordance with the requirements set out in this Annex
and shall follow the guidance published by the Commission in The
rules governing medicinal products in the European Community,
Volume 2 B, Notice to applicants, Medicinal products for human
use, Presentation and content of the dossier, Common Technical
Document (CTD).
(2) The particulars and documents shall be presented as five modules:
Module 1 provides European Community specific administrative data;
Module 2 provides quality, non-clinical and clinical summaries,
Module 3 provides chemical, pharmaceutical and biological infor
mation, Module 4 provides non-clinical reports and Module 5
provides clinical study reports. This presentation implements a
common format for all ICH (1) regions (European Community,
United States of America, Japan). These five Modules shall be
presented in strict accordance with the format, content and
numbering system delineated in details in Volume 2 B of the Notice
to Applicants referred to above.
(3) The European Community-CTD-presentation is applicable for all types
of marketing authorisation applications irrespective of the procedure to
be applied (i.e. centralised, mutual recognition or national) and of
whether they are based on a full or abridged application. It is also
applicable for all types of products including new chemical entities
(NCE), radio-pharmaceuticals, plasma derivatives, vaccines, herbal
medicinal products, etc.
(4) In assembling the dossier for application for marketing authorisation,
applicants shall also take into account the scientific guidelines relating
to the quality, safety and efficacy of medicinal products for human use
as adopted by the Committee for Proprietary Medicinal Products
(CPMP) and published by the European Medicine Evaluation Agency
(EMEA) and the other pharmaceutical Community guidelines published
by the Commission in the different volumes of The rules governing
medicinal products in the European Community.
(5) With respect to the quality part (chemical, pharmaceutical and
biological) of the dossier, all monographs including general mono
graphs and general chapters of the European Pharmacopoeia are
applicable.
(6) The manufacturing process shall comply with the requirements of
Commission Directive 91/356/EEC laying down the principles and
guidelines of Good Manufacturing Practice (GMP) for medicinal
products for human use (2) and with the principles and guidelines on
GMP, published by the Commission in The rules governing medicinal
products in the European Community, Volume 4.
(7) All information, which is relevant to the evaluation of the medicinal
product concerned, shall be included in the application, whether
favourable or unfavourable to the product. In particular, all relevant
details shall be given of any incomplete or abandoned pharmaco-toxi
cological or clinical test or trial relating to the medicinal product and/or
completed trials concerning therapeutic indications not covered by the
application.
(8) All clinical trials, conducted within the European Community, must
comply with the requirements of Directive 2001/20/EC of the
European Parliament and of the Council on the approximation of the
laws, regulations and administrative provisions of the Member States
relating to the implementation of good clinical practice in the conduct
of clinical trials on medicinal products for human use (3). To be taken
into account during the assessment of an application, clinical trials,
conducted outside the European Community, which relate to
medicinal products intended to be used in the European Community,
shall be designed, implemented and reported on what good clinical
practice and ethical principles are concerned, on the basis of principles,
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which are equivalent to the provisions of Directive 2001/20/EC. They
shall be carried out in accordance with the ethical principles that are
reflected, for example, in the Declaration of Helsinki.
(9) Non-clinical (pharmaco-toxicological) studies shall be carried out in
conformity with the provisions related to Good Laboratory Practice
laid down in Council Directives 87/18/EEC on the harmonisation of
regulations and administrative provisions relating to the application of
the principles of good laboratory practice and the verification of their
application for tests in chemical substances (1) and 88/320/EEC on the
inspection and verification of good laboratory practice (GLP) (2).
(10) Member States shall also ensure that all tests on animals are conducted
in accordance with Council Directive 86/609/EEC of 24 November
1986 on the approximation of laws, regulation and administrative
provisions of the Member States regarding the protection of animals
for experimental and other scientific purposes.
(11) In order to monitor the benefit/risk assessment, any new information
not in the original application and all pharmaco-vigilance information
shall be submitted to the competent authority. After marketing author
isation has been granted, any change to the data in the dossier shall be
submitted to the competent authorities in accordance with the
requirements of Commission Regulations (EC) No 1084/2003 (3) and
(EC) No 1085/2003 (4) of the Commission or, if relevant, in accordance
with national provisions, as well as the requirements in Volume 9 of
Commission publication The rules governing medicinal products in the
European Community.
This Annex is divided in four different parts:
— Part I describes the application format, the summary of product
characteristics, the labelling, the leaflet and presentation
requirements for standard applications (Modules 1 to 5).
— Part II provides derogation for ‘Specific applications’, i.e. well-
established medicinal use, essentially similar products, fixed combi
nations, similar biological products, exceptional circumstances and
mixed applications (part bibliographic and part own studies).
— Part III deals with ‘Particular application requirements’ for
biological medicinal products (Plasma Master File; Vaccine
Antigen Master File), radio-pharmaceuticals, homeopathic
medicinal products, herbal medicinal products and orphan
medicinal products.
— Part IV deals with ‘Advanced therapy medicinal products’ and
concerns specific requirements for gene therapy medicinal
products (using human autologous or allogeneic system, or xeno
geneic system) and cell therapy medicinal products both of human
or animal origin and xenogeneic transplantation medicinal products.
PART I
STANDARDISED MARKETING AUTHORISATION DOSSIER
REQUIREMENTS
1. MODULE 1: ADMINISTRATIVE INFORMATION
1.1. Table of contents
A comprehensive table of contents of Modules 1 to 5 of the dossier
submitted for marketing authorisation application shall be presented.
1.2. Application form
The medicinal product, which is the subject of the application, shall be
identified by name and name of the active substance(s), together with
the pharmaceutical form, the route of administration, the strength and
the final presentation, including packaging.
The name and address of the applicant shall be given, together with the
name and address of the manufacturers and the sites involved in the
different stages of the manufacture (including the manufacturer of the
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finished product and the manufacturer(s) of the active substance(s)),
and where relevant the name and address of the importer.
The applicant shall identify the type of application and indicate what
samples, if any, are also provided.
Annexed to the administrative data shall be copies of the manufacturing
authorisation as defined in Article 40, together with a list of countries
in which authorisation has been granted, copies of all the summaries of
product characteristics in accordance with Article 11 as approved by
Member States and a list of countries in which an application has been
submitted.
As outlined in the application form, the applicants shall provide, inter
alia, details of the medicinal product subject of the application, the
legal basis of the application, the proposed marketing authorisation
holder and manufacture(s), information on orphan medicinal product
status, scientific advice and paediatric development program.
1.3. Summary of product characteristics, labelling and package leaflet
1.3.1. Summary of product characteristics
The applicant shall propose a summary of the product characteristics, in
accordance with Article 11.
1.3.2. Labelling and package leaflet
A proposed labelling text for immediate and outer packaging as well as
for the package leaflet shall be provided. These shall be in accordance
with all mandatory items listed in Title V on the labelling of medicinal
products for human use (Article 63) and on package leaflet
(Article 59).
1.3.3. Mock-ups and specimens
The applicant shall provide specimen and/or mock-ups of the
immediate and outer packaging, labels and package leaflets for the
medicinal product concerned.
1.3.4. Summaries of product characteristics already approved in the Member
States
Annexed to the administrative data of the application form shall be
copies of all the summaries of product characteristics in accordance
with Articles 11 and 21 as approved by Member States, where
applicable and a list of countries in which an application has been
submitted.
1.4. Information about the experts
In accordance with Article 12 (2) experts must provide detailed reports
of their observations on the documents and particulars which constitute
the marketing authorisation dossier and in particular on Modules 3, 4
and 5 (chemical, pharmaceutical and biological documentation, non-
clinical documentation and clinical documentation, respectively). The
experts are required to address the critical points related to the quality
of the medicinal product and of the investigations carried out on
animals and human beings and bring out all the data relevant for
evaluation.
These requirements shall be met by providing a quality overall
summary, a non-clinical overview (data from studies carried out in
animals) and a clinical overview that shall be located in Module 2 of
the marketing authorisation application dossier. A declaration signed by
the experts together with brief information on their educational back
ground, training and occupational experience shall be presented in
Module 1. The experts shall have suitable technical or professional
qualifications. The professional relationship of the expert to the
applicant shall be declared.
1.5. Specific requirements for different types of applications
Specific requirements for different types of applications are addressed
in Part II of the present Annex.
1.6. Environmental risk assessment
Where applicable, applications for marketing authorisations shall
include a risk assessment overview evaluating possible risks to the
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environment due to the use and/or disposal of the medicinal product
and make proposals for appropriate labelling provisions. Environmental
risk connected with the release of medicinal products containing or
consisting of GMOs (Genetically Modified Organisms) within the
meaning of Article 2 of Directive 2001/18/EC of the European
Parliament and of the Council of 12 March 2001 on the deliberate
release into the environment of modified organisms and repealing
Council Directive 90/220/EEC (1) shall be addressed.
— an introduction;
2. MODULE 2: SUMMARIES
This Module aims to summarise the chemical, pharmaceutical and
biological data, the non-clinical data and the clinical data presented
in Modules 3, 4 and 5 of the dossier for marketing authorisation,
and to provide the reports/overviews described in Article 12 of this
Directive.
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2.2. Introduction
Information on the pharmacological class, mode of action and proposed
clinical use of the medicinal product for which a marketing authoris
ation is requested shall be supplied.
— Introduction
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2.7. Clinical Summary
A detailed, factual summary of the clinical information on the
medicinal product included in Module 5 shall be provided. This shall
include the results of all bio-pharmaceutics studies, of clinical pharma
cology studies, and of clinical efficacy and safety studies. A synopsis
of the individual studies is required.
Summarised clinical information shall be presented in the following
order:
— Summary of Bio-pharmaceutics and Associated Analytical Methods
— Summary of Clinical Pharmacology Studies
— Summary of Clinical Efficacy
— Summary of Clinical Safety
— Synopses of Individual Studies
3. MODULE 3: CHEMICAL, PHARMACEUTICAL AND
BIOLOGICAL INFORMATION FOR MEDICINAL PRODUCTS
CONTAINING CHEMICAL AND/OR BIOLOGICAL ACTIVE
SUBSTANCES
3.1. Format and presentation
The general outline of Module 3 is as follows:
— Table of contents
— Body of data
— Active substance
General Information
— Nomenclature
— Structure
— General Properties
Manufacture
— Manufacturer(s)
— Description of Manufacturing Process and Process Controls
— Control of Materials
— Controls of Critical Steps and Intermediates
— Process Validation and/or Evaluation
— Manufacturing Process Development
Characterisation
— Elucidation of Structure and other Characteristics
— Impurities
Control of Active Substance
— Specification
— Analytical Procedures
— Validation of Analytical Procedures
— Batch Analyses
— Justification of Specification
Reference Standards or Materials
Container Closure System
Stability
— Stability Summary and Conclusions
— Post-approval Stability Protocol and Stability Commitment
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— Stability Data
— Finished Medicinal Product
Description and Composition of the
Medicinal Product
Pharmaceutical Development
— Components of the Medicinal Product
— Active Substance
— Excipients
— Medicinal Product
— Formulation Development
— Overages
— Physicochemical and Biological Properties
— Manufacturing Process Development
— Container Closure System
— Microbiological Attributes
— Compatibility
Manufacture
— Manufacturer(s)
— Batch Formula
— Description of Manufacturing Process and Process Controls
— Controls of Critical Steps and Intermediates
— Process Validation and/or Evaluation
Control of Excipients
— Specifications
— Analytical Procedures
— Validation of Analytical Procedures
— Justification of Specifications
— Excipients of Human or Animal Origin
— Novel Excipients
Control of Finished Medicinal Product
— Specification(s)
— Analytical Procedures
— Validation of Analytical Procedures
— Batch Analyses
— Characterisation of Impurities
— Justification of Specification(s)
Reference Standards or Materials
Container Closure System
Stability
— Stability Summary and Conclusion
— Post-approval Stability Protocol and Stability Commitment
— Stability Data
— Appendices
— Facilities and Equipment (Biological Medicinal Products
only)
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— Adventitious Agents Safety Evaluation
— Excipients
— European Community Additional Information
— Process Validation Scheme for the Medicinal Product
— Medical Device
— Certificate(s) of Suitability
— Medicinal products containing or using in the manufacturing
process materials of animal and/or human origin (TSE
procedure)
— Literature References
3.2. Content: basic principles and requirements
(1) The chemical, pharmaceutical and biological data that shall be
provided shall include for the active substance(s) and for the
finished medicinal product all of relevant information on: the
development, the manufacturing process, the characterisation
and properties, the quality control operations and requirements,
the stability as well as a description of the composition and
presentation of the finished medicinal product.
(2) Two main sets of information shall be provided, dealing with the
active substance(s) and with the finished medicinal product, re
spectively.
(3) This Module shall in addition supply detailed information on the
starting and raw materials used during the manufacturing
operations of the active substance(s) and on the excipients incor
porated in the formulation of the finished medicinal product.
(4) All the procedures and methods used for manufacturing and
controlling the active substance and the finished medicinal
product shall be described in sufficient details to enable them
to be repeated in control tests, carried out at the request of the
competent authority. All test procedures shall correspond to the
state of scientific progress at the time and shall be validated.
Results of the validation studies shall be provided. In the case of
test procedures included in the European Pharmacopoeia, this
description shall be replaced by the appropriate detailed
reference to the monograph(s) and general chapter(s).
(5) The monographs of the European Pharmacopoeia shall be
applicable to all substances, preparations and pharmaceutical
forms appearing in it. In respect of other substances, each
Member State may require observance of its own national phar
macopoeia.
However, where a material in the European Pharmacopoeia or in
the pharmacopoeia of a Member State has been prepared by a
method liable to leave impurities not controlled in the pharma
copoeia monograph, these impurities and their maximum
tolerance limits must be declared and a suitable test procedure
must be described. In cases where a specification contained in a
monograph of the European Pharmacopoeia or in the national
pharmacopoeia of a Member State might be insufficient to
ensure the quality of the substance, the competent authorities
may request more appropriate specifications from the
marketing authorisation holder. The competent authorities shall
inform the authorities responsible for the pharmacopoeia in
question. The marketing authorisation holder shall provide the
authorities of that pharmacopoeia with the details of the alleged
insufficiency and the additional specifications applied.
In the case of analytical procedures included in the European
Pharmacopoeia, this description shall be replaced in each
relevant section by the appropriate detailed reference to the
monograph(s) and general chapter(s).
(6) In case where starting and raw materials, active substance(s) or
excipient(s) are described neither in the European Pharma
copoeia nor in the pharmacopoeia of a Member State,
compliance with the monograph of a third country pharma
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copoeia can be accepted. In such cases, the applicant shall
submit a copy of the monograph accompanied by the validation
of the analytical procedures contained in the monograph and by
a translation where appropriate.
(7) Where the active substance and/or a raw and starting material or
excipient(s) are the subject of a monograph of the European
Pharmacopoeia, the applicant can apply for a certificate of suit
ability that, where granted by the European Directorate for the
Quality of Medicines, shall be presented in the relevant section
of this Module. Those certificates of suitability of the monograph
of the European Pharmacopoeia are deemed to replace the
relevant data of the corresponding sections described in this
Module. The manufacturer shall give the assurance in writing
to the applicant that the manufacturing process has not been
modified since the granting of the certificate of suitability by
the European Directorate for the Quality of Medicines.
(11) Any special apparatus and equipment, which may be used at any
stage of the manufacturing process and control operations of the
medicinal product, shall be described in adequate details.
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3.2.1. Active substance(s)
3.2.1.1. G e n e r a l i n f o r m a t i o n a n d i n f o r m a t i o n r e l a t e d t o t h e
starting and raw materials
a) Information on the nomenclature of the active substance shall be
provided, including recommended International Non-proprietary
Name (INN), European Pharmacopoeia name if relevant,
chemical name(s).
The structural formula, including relative and absolute stereo-
chemistry, the molecular formula, and the relative molecular
mass shall be provided. For biotechnological medicinal products
if appropriate, the schematic amino acid sequence and relative
molecular mass shall be provided.
A list shall be provided of physicochemical and other relevant
properties of the active substance, including biological activity
for biological medicinal products.
b) For the purposes of this Annex, starting materials shall mean all
the materials from which the active substance is manufactured or
extracted.
For biological medicinal products, starting materials shall mean
any substance of biological origin such as micro-organisms,
organs and tissues of either plant or animal origin, cells or fluids
(including blood or plasma) of human or animal origin, and
biotechnological cell constructs (cell substrates, whether they are
recombinant or not, including primary cells).
A biological medicinal product is a product, the active substance of
which is a biological substance. A biological substance is a
substance that is produced by or extracted from a biological
source and that needs for its characterisation and the determination
of its quality a combination of physico-chemical-biological testing,
together with the production process and its control. The following
shall be considered as biological medicinal products: immuno
logical medicinal products and medicinal products derived from
human blood and human plasma as defined, respectively in para
graphs (4) and (10) of Article 1; medicinal products falling within
the scope of Part A of the Annex to Regulation (EEC) No 2309/93;
advanced therapy medicinal products as defined in Part IV of this
Annex.
Any other substances used for manufacturing or extracting the
active substance(s) but from which this active substance is not
directly derived, such as reagents, culture media, foetal calf
serum, additives, and buffers involved in chromatography, etc.
are known as raw materials.
3.2.1.2. M a n u f a c t u r i n g p r o c e s s o f t h e a c t i v e s u b s t a n c e ( s )
a) The description of the active substance manufacturing process
represents the applicant's commitment for the manufacture of the
active substance. To adequately describe the manufacturing process
and process controls, appropriate information as laid down in
guidelines published by the Agency shall be provided.
b) All materials needed in order to manufacture the active
substance(s) shall be listed, identifying where each material is
used in the process. Information on the quality and control of
these materials shall be provided. Information demonstrating that
materials meet standards appropriate for their intended use shall be
provided.
Raw materials shall be listed and their quality and controls shall
also be documented.
The name, address, and responsibility of each manufacturer,
including contractors, and each proposed production site or
facility involved in manufacturing and testing shall be provided.
c) For biological medicinal products, the following additional
requirements shall apply.
The origin and history of starting materials shall be described and
documented.
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Regarding the specific measures for the prevention of the Trans
mission of animal Spongiform Encephalopathies, the applicant
must demonstrate that the active substance complies with the
Note for Guidance on Minimising the Risk of Transmitting
Animal Spongiform Encephalopathy Agents via Medicinal
Products and its updates, published by the Commission in the
Official Journal of the European Union.
When cell banks are used, the cell characteristics shall be shown to
have remained unchanged at the passage level used for the
production and beyond.
3.2.1.3. C h a r a c t e r i s a t i o n o f t h e a c t i v e s u b s t a n c e ( s )
Data highlighting the structure and other characteristics of the active
substance(s) shall be provided.
3.2.1.4. C o n t r o l o f a c t i v e s u b s t a n c e ( s )
Detailed information on the specifications used for routine control of
active substance(s), justification for the choice of these specifications,
methods of analysis and their validation shall be provided.
3.2.1.5. R e f e r e n c e s t a n d a r d s o r m a t e r i a l s
Reference preparations and standards shall be identified and described
in detail. Where relevant, chemical and biological reference material of
the European Pharmacopoeia shall be used.
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3.2.1.6. C o n t a i n e r and closure system of the active
substance
A description of the container and the closure system(s) and their
specifications shall be provided.
3.2.1.7. S t a b i l i t y o f t h e a c t i v e s u b s t a n c e ( s )
a) The types of studies conducted, protocols used, and the results of
the studies shall be summarised
b) Detailed results of the stability studies, including information on
the analytical procedures used to generate the data and validation
of these procedures shall be presented in an appropriate format
c) The post authorisation stability protocol and stability commitment
shall be provided
3.2.2. Finished medicinal product
3.2.2.1. D e s c r i p t i o n a n d c o m p o s i t i o n of the finished
medicinal product
A description of the finished medicinal product and its composition
shall be provided. The information shall include the description of the
pharmaceutical form and composition with all the constituents of the
finished medicinal product, their amount on a per-unit basis, the
function of the constituents of:
— the active substance(s),
— the constituent(s) of the excipients, whatever their nature or the
quantity used, including colouring matter, preservatives,
adjuvants, stabilisers, thickeners, emulsifiers, flavouring and
aromatic substances, etc.,
— the constituents, intended to be ingested or otherwise administered
to the patient, of the outer covering of the medicinal products (hard
capsules, soft capsules, rectal capsules, coated tablets, films-coated
tablets, etc.),
— these particulars shall be supplemented by any relevant data
concerning the type of container and, where appropriate, its
manner of closure, together with details of devices with which
the medicinal product will be used or administered and which
will be delivered with the medicinal product.
The ‘usual terminology’, to be used in describing the constituents of
medicinal products, shall mean, notwithstanding the application of the
other provisions in Article 8 (3) (c):
— in respect of substances which appear in the European Pharma
copoeia or, failing this, in the national pharmacopoeia of one of
the Member States, the main title at the head of the monograph in
question, with reference to the pharmacopoeia concerned,
— in respect of other substances, the international non-proprietary
name (INN) recommended by the World Health Organisation, or,
failing this, the exact scientific designation; substances not having
an international non-proprietary name or an exact scientific desig
nation shall be described by a statement of how and from what they
were prepared, supplemented, where appropriate, by any other
relevant details,
— in respect of colouring matter, designation by the ‘E’ code assigned
to them in Council Directive 78/25/EEC of 12 December 1977 on
the approximation of the rules of the Member States concerning the
colouring matters authorised for use in medicinal products (1)
and/or European Parliament and Council Directive 94/36/EC of
30 June 1994 on colours for use in foodstuffs (2).
In order to give the ‘quantitative composition’ of the active
substance(s) of the finished medicinal products, it is necessary,
depending on the pharmaceutical form concerned, to specify the
mass, or the number of units of biological activity, either per dosage-
unit or per unit of mass or volume, of each active substance.
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Active substances present in the form of compounds or derivatives
shall be designated quantitatively by their total mass, and if
necessary or relevant, by the mass of active entity or entities of the
molecule.
3.2.2.2. P h a r m a c e u t i c a l d e v e l o p m e n t
This chapter shall be devoted to information on the development
studies conducted to establish that the dosage form, the formulation,
manufacturing process, container closure system, microbiological
attributes and usage instructions are appropriate for the intended use
specified in the marketing authorisation application dossier.
The studies described in this chapter are distinct from routine control
tests conducted according to specifications. Critical parameters of the
formulation and process attributes that can influence batch reproduci
bility, medicinal product performance and medicinal product quality
shall be identified and described. Additional supportive data, where
appropriate, shall be referenced to the relevant chapters of Module 4
(Non Clinical Study Reports) and Module 5 (Clinical Study Reports) of
the marketing authorisation application dossier.
g) The suitability of the container and closure system used for the
storage, shipping and use of the finished product shall be docu
mented. A possible interaction between medicinal product and
container may need to be considered.
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3.2.2.3. M a n u f a c t u r i n g p r o c e s s o f t h e f i n i s h e d m e d i c i n a l
product
a) The description of the manufacturing method accompanying the
application for Marketing Authorisation pursuant to
Article 8 (3) (d), shall be drafted in such a way as to give an
adequate synopsis of the nature of the operations employed.
The same applies where the quality control of the finished product
depends on in-process control tests, particularly if the medicinal
product is essentially defined by its method of preparation.
3.2.2.4. C o n t r o l o f e x c i p i e n t s
a) All the materials needed in order to manufacture the excipient(s)
shall be listed identifying where each material is used in the
process. Information on the quality and control of these materials
shall be provided. Information demonstrating that materials meet
standards appropriate for their intended use shall be provided.
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lopathy Agents via Medicinal Products and its updates, published
by the Commission in the Official Journal of the European Union.
Demonstration of compliance with the aforementioned Note for
Guidance can be done by submitting either preferably a certificate
of suitability to the relevant monograph on Transmissible Spon
giform Encephalopathies of the European Pharmacopoeia, or by the
supply of scientific data to substantiate this compliance.
d) Novel excipients:
For excipient(s) used for the first time in a medicinal product or by
a new route of administration, full details of manufacture, charac
terisation, and controls, with cross references to supporting safety
data, both non-clinical and clinical, shall be provided according to
the active substance format previously described.
A document containing the detailed chemical, pharmaceutical and
biological information shall be presented. This information shall be
formatted in the same order as the chapter devoted to Active
Substance(s) of Module 3.
Information on novel excipient(s) may be presented as a stand-
alone document following the format described in the former para
graphs. Where the applicant differs from the novel excipient manu
facturer the said stand-alone document shall be made available to
the applicant for submission to the competent authority.
Additional information on toxicity studies with the novel excipient
shall be provided in Module 4 of the dossier.
Clinical studies shall be provided in Module 5.
3.2.2.5. C o n t r o l o f t h e f i n i s h e d m e d i c i n a l p r o d u c t
For the control of the finished medicinal product, a batch of a
medicinal product is an entity which comprises all the units of a
pharmaceutical form which are made from the same initial quantity
of material and have undergone the same series of manufacturing
and/or sterilisation operations or, in the case of a continuous production
process, all the units manufactured in a given period of time.
Unless there is appropriate justification, the maximum acceptable
deviation in the active substance content of the finished product shall
not exceed ± 5 % at the time of manufacture.
Detailed information on the specifications, (release and shelf life) justi
fication for their choice, methods of analysis and their validation shall
be provided.
3.2.2.6. R e f e r e n c e s t a n d a r d s o r m a t e r i a l s
Reference preparations and standards used for testing of the finished
medicinal product shall be identified and described in detail, if not
previously provided in the section related to the active substance.
3.2.2.7. C o n t a i n e r a n d c l o s u r e o f t h e f i n i s h e d m e d i c i n a l
product
A description of the container and the closure system(s) including the
identity of each immediate packaging material and their specifications
shall be provided. The specifications shall include description and
identification. Non-pharmacopoeial methods (with validation) shall be
included where appropriate.
For non-functional outer packaging materials only a brief description
shall be provided. For functional outer packaging materials additional
information shall be provided.
3.2.2.8. S t a b i l i t y o f t h e f i n i s h e d m e d i c i n a l p r o d u c t
a) The types of studies conducted, protocols used, and the results of
the studies shall be summarised;
b) Detailed results of the stability studies, including information on
the analytical procedures used to generate the data and validation
of these procedures shall be presented in an appropriate format; in
case of vaccines, information on cumulative stability shall be
provided where appropriate;
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c) The post authorisation stability protocol and stability commitment
shall be provided.
4. MODULE 4: NON-CLINICAL REPORTS
4.1. Format and Presentation
The general outline of Module 4 is as follows:
— Table of contents
— Study reports
— Pharmacology
— Primary Pharmaco-dynamics
— Secondary Pharmaco-dynamics
— Safety Pharmacology
— Pharmaco-dynamic Interactions
— Pharmaco-kinetics
— Analytical Methods and Validation Reports
— Absorption
— Distribution
— Metabolism
— Excretion
— Pharmaco-kinetic Interactions (non-clinical)
— Other Pharmaco-kinetic Studies
— Toxicology
— Single-Dose Toxicity
— Repeat-Dose Toxicity
— Genotoxicity
— In vitro
— In vivo (including supportive toxico-kinetics
evaluations)
— Carcinogenicity
— Long-term studies
— Short- or medium-term studies
— Other studies
— Reproductive and Developmental Toxicity
— Fertility and early embryonic development
— Embryo-fetal development
— Prenatal and postnatal development
— Studies in which the offspring (juvenile animals) are
dosed and/or further evaluated
— Local Tolerance
— Other Toxicity Studies
— Antigenicity
— Immuno-toxicity
— Mechanistic studies
— Dependence
— Metabolites
— Impurities
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— Other
— Literature references
4.2. Content: basic principles and requirements
Special attention shall be paid to the following selected elements.
(1) The pharmacological and toxicological tests must show:
a) the potential toxicity of the product and any dangerous or unde
sirable toxic effects that may occur under the proposed
conditions of use in human beings; these should be evaluated
in relation to the pathological condition concerned;
b) the pharmacological properties of the product, in both qualitative
and quantitative relationship to the proposed use in human
beings. All results must be reliable and of general applicability.
Whenever appropriate, mathematical and statistical procedures
shall be used in designing the experimental methods and in
evaluating the results.
Additionally, it is necessary for clinicians to be given infor
mation about the therapeutic and toxicological potential of the
product.
(2) For biological medicinal products such as immunological medicinal
products and medicinal products derived from human blood or
plasma, the requirements of this Module may have to be adapted
for individual products; therefore the testing program carried out
shall be justified by the applicant.
In establishing the testing program, the following shall be taken
into consideration:
all tests requiring repeated administration of the product shall be
designed to take account of the possible induction of, and inter
ference by, antibodies;
examination of reproductive function, of embryo/foetal and peri-
natal toxicity, of mutagenic potential and of carcinogenic
potential shall be considered. Where constituents other than the
active substance(s) are incriminated, validation of their removal
may replace the study.
(3) The toxicology and pharmaco-kinetics of an excipient used for the
first time in the pharmaceutical field shall be investigated.
(4) Where there is a possibility of significant degradation during
storage of the medicinal product, the toxicology of degradation
products must be considered.
4.2.1. Pharmacology
Pharmacology study shall follow two distinct lines of approach.
— Firstly, the actions relating to the proposed therapeutic use shall be
adequately investigated and described. Where possible, recognised
and validated assays, both in vivo and in vitro, shall be used. Novel
experimental techniques must be described in such detail as to
allow them to be reproduced. The results shall be expressed in
quantitative terms using, for example, dose-effect curves, time-
effect curves, etc. Wherever possible, comparisons shall be made
with data relating to a substance or substances with a similar ther
apeutic action.
— Secondly, the applicant shall investigate the potential undesirable
pharmaco-dynamic effects of the substance on physiological
functions. These investigations shall be performed at exposures in
the anticipated therapeutic range and above. The experimental tech
niques, unless they are standard procedures, must be described in
such detail as to allow them to be reproduced, and the investigator
must establish their validity. Any suspected modification of
responses resulting from repeated administration of the substance
shall be investigated.
For the pharmaco-dynamic medicinal product interaction, tests on
combinations of active substances may be prompted either by pharma
cological premises or by indications of therapeutic effect. In the first
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case, the pharmaco-dynamic study shall demonstrate those interactions,
which might make the combination of value in therapeutic use. In the
second case, where scientific justification for the combination is sought
through therapeutic experimentation, the investigation shall determine
whether the effects expected from the combination can be demonstrated
in animals, and the importance of any collateral effects shall at least be
investigated.
4.2.2. Pharmaco-kinetics
Pharmaco-kinetics means the study of the fate of the active substance,
and its metabolites, within the organism, and covers the study of the
absorption, distribution, metabolism (bio-transformation) and excretion
of these substances.
The study of these different phases may be carried mainly by means of
physical, chemical or possibly by biological methods, and by obser
vation of the actual pharmaco-dynamic activity of the substance itself.
Information on distribution and elimination shall be necessary in all
cases where such data are indispensable to determine the dosage for
humans, and in respect of chemo-therapeutic substances (antibiotics,
etc.) and substances whose use depends on their non-pharmaco-
dynamic effects (e.g. numerous diagnostic agents, etc.).
In vitro studies also can be carried out with the advantage of using
human material for comparison with animal material (i.e. protein
binding, metabolism, drug-drug interaction).
Pharmaco-kinetic investigation of all pharmacologically active
substances is necessary. In the case of new combinations of known
substances, which have been investigated in accordance with the
provisions of this Directive, pharmaco-kinetic studies may not be
required, if the toxicity tests and therapeutic experimentation justify
their omission.
The pharmaco-kinetic program shall be design to allow comparison and
extrapolation between animal and human.
4.2.3. Toxicology
a) Single-dose toxicity
A single-dose toxicity test shall mean a qualitative and quantitative
study of the toxic reactions, which may result from a single admi
nistration of the active substance or substances contained in the
medicinal product, in the proportions and physico-chemical state
in which they are present in the actual product.
The single-dose toxicity test must be carried out in accordance with
the relevant guidelines published by the Agency.
b) Repeat-dose toxicity
Repeated dose toxicity tests are intended to reveal any physiological
and/or anatomo-pathological changes induced by repeated adminis
tration of the active substance or combination of active substances
under examination, and to determine how these changes are related
to dosage.
Generally, it is desirable that two tests be performed: one short
term, lasting two to four weeks, the other long-term. The duration
of the latter shall depend on the conditions of clinical use. Its
purpose is to describe potential adverse effects to which attention
should be paid in clinical studies. The duration is defined in the
relevant guidelines published by the Agency.
c) Geno-toxicity
The purposes of the study of mutagenic and clastogenic potential is
to reveal the changes which a substance may cause in the genetic
material of individuals or cells. Mutagenic substances may present a
hazard to health since exposure to a mutagen carries the risk of
inducing germ-line mutation, with the possibility of inherited
disorders, and the risk of somatic mutations including those
leading to cancer. These studies are obligatory for any new
substance.
d) Carcino-genicity
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Tests to reveal carcinogenic effects shall normally be required:
f) Local tolerance
For chemicals applied to the skin (e.g. dermal, rectal, vaginal) the
sensitising potential shall be evaluated in at least one of the test
systems currently available (the guinea pig assay or the local lymph
node assay).
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5. MODULE 5: CLINICAL STUDY REPORTS
5.1. Format and Presentation
The general outline of Module 5 is as follows:
— Table of contents for clinical study reports
— Tabular listing of all clinical studies
— Clinical study reports
— Reports of Bio-pharmaceutical Studies
— Bio-availability Study Reports
— Comparative Bio-availability and Bio-equivalence Study
Reports
— In vitro — In vivo Correlation Study Report
— Reports of Bio-analytical and Analytical Methods
— Reports of Studies Pertinent to Pharmaco-kinetics Using
Human Bio-materials
— Plasma Protein Binding Study Reports
— Reports of Hepatic Metabolism and Interaction Studies
— Reports of Studies Using Other Human Bio-materials
— Reports of Human Pharmaco-kinetic Studies
— Healthy subjects Pharmaco-kinetics and Initial Tolerability
Study Reports
— Patient Pharmaco-kinetics and Initial Tolerability Study
Reports
— Intrinsic Factor Pharmaco-kinetics Study Reports
— Extrinsic Factor Pharmaco-kinetics Study Reports
— Population Pharmaco-kinetics Study Reports
— Reports of Human Pharmaco-dynamic Studies
— Healthy Subject Pharmaco-dynamic and Pharmaco-kinetic
s/Pharmaco-dynamic Study Reports
— Patient Pharmaco-dynamic and Pharmaco-kinetic
s/Pharmaco-dynamic Studies Study Reports
— Reports of Efficacy and Safety Studies
— Study Reports of Controlled Clinical Studies Pertinent to the
Claimed Indication
— Study Reports of Uncontrolled Clinical Studies
— Reports of Analyses of Data from More than One Study
including any formal integrated analyses, meta-analyses
and bridging analyses
— Other Study Reports
— Reports of Post-marketing Experience
— Literature references
5.2. Content: basic principles and requirements
Special attention shall be paid to the following selected elements.
a) The clinical particulars to be provided pursuant to Articles 8 (3) (i)
and 10 (1) must enable a sufficiently well-founded and scientifically
valid opinion to be formed as to whether the medicinal product
satisfies the criteria governing the granting of a marketing author
isation. Consequently, an essential requirement is that the results of
all clinical trials should be communicated, both favourable and
unfavourable.
b) Clinical trials must always be preceded by adequate pharmaco
logical and toxicological tests, carried out on animals in accordance
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with the requirements of Module 4 of this Annex. The investigator
must acquaint himself with the conclusions drawn from the phar
macological and toxicological studies and hence the applicant must
provide him at least with the investigator's brochure, consisting of
all the relevant information known prior to the onset of a clinical
trial including chemical, pharmaceutical and biological data, toxi
cological, pharmaco-kinetic and pharmaco-dynamic data in animals
and the results of earlier clinical trials, with adequate data to justify
the nature, scale and duration of the proposed trial; the complete
pharmacological and toxicological reports shall be provided on
request. For materials of human or animal origin, all available
means shall be employed to ensure safety from transmission of
infectious agents prior to the commencement of the trial.
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mation in respect of each patient individually, including case
report forms on each trial subject
— final report signed by the investigator and for multi-centre trials,
by all the investigators or the co-ordinating (principal) inves
tigator.
e) The particulars of clinical trials referred to above shall be forwarded
to the competent authorities. However, in agreement with the
competent authorities, the applicant may omit part of this infor
mation. Complete documentation shall be provided forthwith
upon request.
The investigator shall, in his conclusions on the experimental
evidence, express an opinion on the safety of the product under
normal conditions of use, its tolerance, its efficacy and any useful
information relating to indications and contra-indications, dosage
and average duration of treatment as well as any special precautions
to be taken during treatment and the clinical symptoms of over
dosage. In reporting the results of a multi-centre study, the
principal investigator shall, in his conclusions, express an opinion
on the safety and efficacy of the investigational medicinal product
on behalf of all centres.
f) The clinical observations shall be summarised for each trial indi
cating:
1) the number and sex of subjects treated;
2) the selection and age-distribution of the groups of patients being
investigated and the comparative tests;
3) the number of patients withdrawn prematurely from the trials
and the reasons for such withdrawal;
4) where controlled trials were carried out under the above
conditions, whether the control group:
— received no treatment
— received a placebo
— received another medicinal product of known effect
— received treatment other than therapy using medicinal
products
5) the frequency of observed adverse reactions;
6) details concerning patients who may be at increased risk, e.g.
elderly people, children, women during pregnancy or
menstruation, or whose physiological or pathological condition
requires special consideration;
7) parameters or evaluation criteria of efficacy and the results in
terms of these parameters;
8) a statistical evaluation of the results when this is called for by
the design of the trials and the variable factors involved.
g) In addition, the investigator shall always indicate his observations
on:
1) any signs of habituation, addiction or difficulty in weaning
patients from the medicinal product;
2) any interactions that have been observed with other medicinal
products administered concomitantly;
3) the criteria determining exclusion of certain patients from the
trials;
4) any deaths which occurred during the trial or within the follow-
up period.
h) Particulars concerning a new combination of medicinal substances
must be identical to those required for new medicinal products and
must substantiate the safety and efficacy of the combination.
i) Total or partial omission of data must be explained. Should unex
pected results occur during the course of the trials, further pre
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clinical toxicological and pharmacological tests must be undertaken
and reviewed.
— distribution,
— metabolism,
— excretion.
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The demonstration of pharmaco-dynamic effects in human beings
shall not in itself be sufficient to justify conclusions regarding any
particular potential therapeutic effect.
b) If the medicinal product is normally to be administered concomi
tantly with other medicinal products, particulars shall be given of
joint administration tests performed to demonstrate possible modi
fication of the pharmacological action.
Pharmaco-dynamic interactions between the active substance and
other medicinal products or substances shall be investigated.
5.2.5. Reports of efficacy and safety studies
5.2.5.1. S t u d y R e p o r t s o f C o n t r o l l e d C l i n i c a l Studies
Pertinent to the Claimed Indication
In general, clinical trials shall be done as ‘controlled clinical trials’ if
possible, randomised and as appropriate versus placebo and versus an
established medicinal product of proven therapeutic value; any other
design shall be justified. The treatment of the control groups will vary
from case to case and also will depend on ethical considerations and
therapeutic area; thus it may, in some instances, be more pertinent to
compare the efficacy of a new medicinal product with that of an
established medicinal product of proven therapeutic value rather than
with the effect of a placebo.
(1) As far as possible, and particularly in trials where the effect of the
product cannot be objectively measured, steps shall be taken to
avoid bias, including methods of randomisation and blinding.
(2) The protocol of the trial must include a thorough description of the
statistical methods to be employed, the number and reasons for
inclusion of patients (including calculations of the power of the
trial), the level of significance to be used and a description of
the statistical unit. Measures taken to avoid bias, particularly
methods of randomisation, shall be documented. Inclusion of a
large number of subjects in a trial must not be regarded as an
adequate substitute for a properly controlled trial.
The safety data shall be reviewed taking into account guidelines
published by the Commission, with particular attention to events
resulting in changes of dose or need for concomitant medication,
serious adverse events, events resulting in withdrawal, and deaths.
Any patients or patient groups at increased risk shall be identified
and particular attention paid to potentially vulnerable patients who
may be present in small numbers, e.g., children, pregnant women,
frail elderly, people with marked abnormalities of metabolism or
excretion etc. The implication of the safety evaluation for the
possible uses of the medicinal product shall be described.
5.2.5.2. S t u d y r e p o r t s o f u n c o n t r o l l e d c l i n i c a l s t u d i e s
reports of analyses of data from more than one
study and other clinical study reports
These reports shall be provided.
5.2.6. Reports of post-marketing experience
If the medicinal product is already authorised in third countries, infor
mation shall be given in respect of adverse reactions of the medicinal
product concerned and medicinal products containing the same active
substance(s), in relation to the usage rates if possible.
5.2.7. Case reports forms and individual patient listings
When submitted in accordance with the relevant Guideline published
by the Agency, case report forms and individual patient data listings
shall be provided and presented in the same order as the clinical study
reports and indexed by study.
PART II
SPECIFIC MARKETING AUTHORISATION DOSSIERS AND
REQUIREMENTS
Some medicinal products present specific features which are such that all the
requirements of the marketing authorisation application dossier as laid down in
Part I of this Annex need to be adapted. To take account of these particular
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situations, an appropriate and adapted presentation of the dossier shall be
followed by applicants.
1. WELL-ESTABLISHED MEDICINAL USE
For medicinal products the active substance(s) of which has/have a
‘well-established medicinal use’ as referred to Article 10(1)(a)(ii),
with recognised efficacy and an acceptable level of safety, the
following specific rules shall apply.
The applicant shall submit Modules 1, 2 and 3 as described in part I of
this Annex.
For Modules 4 and 5, a detailed scientific bibliography shall address
non-clinical and clinical characteristics.
The following specific rules shall apply in order to demonstrate the
well-established medicinal use:
a) Factors which have to be taken into account in order to establish a
well-established medicinal use of constituents of medicinal
products are:
— the time over which a substance has been used,
— quantitative aspects of the use of the substance,
— the degree of scientific interest in the use of the substance
(reflected in the published scientific literature) and
— the coherence of scientific assessments.
Therefore different periods of time may be necessary for estab
lishing well-established use of different substances. In any case,
however, the period of time required for establishing a well estab
lished medicinal use of a constituent of a medicinal product must
not be less than one decade from the first systematic and docu
mented use of that substance as a medicinal product in the
Community.
b) The documentation submitted by the applicant should cover all
aspects of the safety and/or efficacy assessment and must include
or refer to a review of the relevant literature, taking into account
pre- and post-marketing studies and published scientific literature
concerning experience in the form of epidemiological studies and
in particular of comparative epidemiological studies. All documen
tation, both favourable and unfavourable, must be communicated.
With respect to the provisions on ‘well-established medicinal use’
it is in particular necessary to clarify that ‘bibliographic reference’
to other sources of evidence (post marketing studies, epidemio
logical studies, etc.) and not just data related to tests and trials
may serve as a valid proof of safety and efficacy of a product if
an application explains and justifies the use of these sources of
information satisfactorily.
c) Particular attention must be paid to any missing information and
justification must be given why demonstration of an acceptable
level of safety and/or efficacy can be supported although some
studies are lacking.
d) The non-clinical and/or clinical overviews must explain the
relevance of any data submitted which concern a product
different from the product intended for marketing. A judgement
must be made whether the product studied can be considered as
similar to the product, for which application for a marketing auth
orisation has been made in spite of the existing differences.
e) Post-marketing experience with other products containing the same
constituents is of particular importance and applicants should put a
special emphasis on this issue.
2. ESSENTIALLY SIMILAR MEDICINAL PRODUCTS
a) Applications based upon Article 10(1) (a) (i) (essentially similar
products) shall contain the data described in Modules 1, 2 and 3
of Part I of this Annex provided the applicant has been granted the
consent of the holder of the original marketing authorisation to cross
refer to the content of his Modules 4 and 5.
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b) Applications based upon Article 10(1) (a) (iii) (essentially similar
products i.e. generics) shall contain the data described in Modules 1,
2 and 3 of Part I of this Annex together with data showing bio-
availability and bio-equivalence with the original medicinal product
provided the latter is not a biological medicinal product (see Part II,
4 Similar biological medicinal products).
For these products the non-clinical/clinical overviews/summaries shall
particularly focus on the following elements:
— the grounds for claiming essential similarity;
— a summary of impurities present in batches of the active
substance(s) as well as those of the finished medicinal product
(and where relevant decomposition products arising during
storage) as proposed for use in the product to be marketed
together with an evaluation of these impurities;
— an evaluation of the bio-equivalence studies or a justification why
studies were not performed with respect to the guideline on ‘Inves
tigation of Bio-availability and Bio-equivalence’;
— an update of published literature relevant to the substance and the
present application. It may be acceptable for articles in ‘peer
review’ journals to be annotated for this purpose;
— every claim in the summary of product characteristics not known
from or inferred from the properties of the medicinal product and/or
its therapeutic group should be discussed in the non clinical/clinical
overviews/summaries and substantiated by published literature
and/or additional studies.
— if applicable, additional data in order to demonstrate evidence on
the equivalence of safety and efficacy properties of different salts,
esters or derivatives of an authorised active substance should be
provided by the applicant when he claims essential similarity.
3. ADDITIONAL DATA REQUIRED IN SPECIFIC SITUATIONS
Where the active substance of an essentially similar medicinal product
contains the same therapeutic moiety as the original authorised product
associated with a different salt/ester complex/derivative evidence that
there is no change in the pharmaco-kinetics of the moiety, pharmaco-
dynamics and/or in toxicity which could change the safety/efficacy
profile shall be demonstrated. Should this not be the case, this associ
ation shall be considered as a new active substance.
Where a medicinal product is intended for a different therapeutic use or
presented in a different pharmaceutical form or to be administered by
different routes or in different doses or with a different posology, the
results of appropriate toxicological and pharmacological tests and/or of
clinical trials shall be provided.
4. SIMILAR BIOLOGICAL MEDICINAL PRODUCTS
The provisions of Article 10(1)(a) (iii) may not be sufficient in the case
of biological medicinal products. If the information required in the case
of essentially similar products (generics) does not permit the demon
stration of the similar nature of two biological medicinal products,
additional data, in particular, the toxicological and clinical profile
shall be provided.
When a biological medicinal product as defined in Part I, paragraph 3.2
of this Annex, which refers to an original medicinal product having
been granted a marketing authorisation in the Community, is submitted
for a marketing authorisation by an independent applicant after the
expiry of data protection period, the following approach shall be
applied.
— Information to be supplied shall not be limited to Modules 1, 2
and 3 (pharmaceutical, chemical and biological data), supplemented
with bio-equivalence and bio-availability data. The type and amount
of additional data (i.e. toxicological and other non-clinical and
appropriate clinical data) shall be determined on a case by case
basis in accordance with relevant scientific guidelines.
— Due to the diversity of biological medicinal products, the need for
identified studies foreseen in Modules 4 and 5, shall be required by
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the competent authority, taking into account the specific charac
teristic of each individual medicinal product.
— the package leaflet and any medical information shall draw the
attention of the medical practitioner to the fact that the particulars
available concerning the medicinal product in question are as yet
inadequate in certain specified respects.
PART III
PARTICULAR MEDICINAL PRODUCTS
This Part lays down specific requirements related to the nature of identified
medicinal products.
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1. BIOLOGICAL MEDICINAL PRODUCTS
1.1. Plasma-derived medicinal product
For medicinal products derived from human blood or plasma and by
derogation from the provisions of Module 3, the dossier requirements
mentioned in ‘Information related to the starting and raw materials’, for
starting materials made of human blood/plasma may be replaced by a
Plasma Master File certified in accordance with this Part.
a) P r i n c i p l e s
For the purposes of this Annex:
b) C o n t e n t
In accordance with the provisions of Article 109, as amended by
Directive 2002/98/EC, which refers to the requirements for donors
and the testing of donations, the Plasma Master File shall include
information on the plasma used as starting/raw material, in particular:
(iv) system in place which enables the path taken by each donation
to be traced from the blood/plasma collection establishment
through to finished products and vice versa.
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(ii) testing of blood/plasma donations and pools for infectious
agents, including information on test methods and, in the
case of plasma pools, validation data on the tests used.
c) E v a l u a t i o n a n d C e r t i f i c a t i o n
— For medicinal products not yet authorised, the marketing authoris
ation applicant shall submit a full dossier to a competent authority,
which shall be accompanied by a separate Plasma Master File
where one does not already exist.
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1.2. Vaccines
For vaccines for human use and by derogation from the provisions of
Module 3 on ‘Active substance(s)’, the following requirements when
based on the use of a Vaccine Antigen Master File system shall apply.
The marketing authorisation application dossier of a vaccine other than
human influenza vaccine, shall be required to include a Vaccine
Antigen Master File for every vaccine antigen that is an active
substance of this vaccine.
a) P r i n c i p l e s
For the purposes of this Annex:
— Vaccine Antigen Master File shall mean a stand-alone part of the
marketing authorisation application dossier for a vaccine, which
contains all relevant information of biological, pharmaceutical and
chemical nature concerning each of the active substances, which are
part of this medicinal product. The stand-alone part may be
common to one or more monovalent and/or combined vaccines
presented by the same applicant or marketing authorisation holder.
— A vaccine may contain one or several distinct vaccine antigens.
There are as many active substance(s) as vaccine antigen(s)
present in a vaccine.
— A combined vaccine contains at least two distinct vaccine antigens
aimed at preventing a single or several infectious diseases.
— A monovalent vaccine is a vaccine, which contains one vaccine
antigen aimed at preventing a single infectious disease.
b) C o n t e n t
The Vaccine Antigen Master File shall contain the following infor
mation extracted from the relevant part (Active substance) of
Module 3 on ‘Quality Data’ as delineated in Part I of this Annex:
Active Substance
1. General Information, including compliance with the relevant mono
graph(s) of the European Pharmacopoeia.
2. Information on the manufacture of the active substance: this heading
must cover the manufacturing process, information on the starting
and raw materials, specific measures on TSEs and adventitious
agents safety evaluation and facilities and equipment.
3. Characterisation of the active substance
4. Quality control of the active substance
5. Reference standard and materials
6. Container and closure system of the active substance
7. Stability of the active substance.
c) E v a l u a t i o n a n d C e r t i f i c a t i o n
— For novel vaccines, which contain a novel vaccine antigen, the
applicant shall submit to a competent authority a full marketing-
authorisation application dossier including all the Vaccine Antigen
Master Files corresponding to each single vaccine antigen that is
part of the novel vaccine where no master file already exists for the
single vaccine antigen. A scientific and technical evaluation of each
Vaccine Antigen Master File shall be carried out by the Agency. A
positive evaluation shall result in a certificate of compliance to the
European legislation for each Vaccine Antigen Master File, which
shall be accompanied by the evaluation report. The certificate shall
apply throughout the Community.
— The provisions of the first indent shall also apply to every vaccine,
which consists of a novel combination of vaccine antigens, irre
spective of whether or not one or more of these vaccine antigens
are part of vaccines already authorised in the Community.
— Changes to the content of a Vaccine Antigen Master File for a
vaccine authorised in the Community shall be subject to a scientific
and technical evaluation carried out by the Agency in accordance
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with the procedure laid down in Commission Regulation (EC)
No 1085/2003. In the case of a positive evaluation the Agency
shall issue a certificate of compliance with Community legislation
for the Vaccine Antigen Master File. The certificate issued shall
apply throughout the Community.
— By derogation from the provisions of the first, second and third
indents of the present point (evaluation and certification), where a
Vaccine Antigen Master File corresponds only to a vaccine which
is the subject of a marketing authorisation which has not been/will
not be granted according to a Community procedure, and, provided
the authorised vaccine includes vaccine antigens which have not
been evaluated through a Community procedure, the scientific and
technical evaluation of the said Vaccine Antigen Master File and its
subsequent changes, shall be carried out by the national competent
authority that has granted the marketing authorisation.
— As a second step to the provisions in the first, second, third and
fourth indents, the competent authority that will grant or has
granted the marketing authorisation shall take into account the
certification, re-certification or variation of the Vaccine Antigen
Master File on the concerned medicinal product(s).
2. RADIO-PHARMACEUTICALS AND PRECURSORS
2.1. Radio-pharmaceuticals
For the purposes of this chapter, applications based upon Articles 6 (2)
and 9 shall provide a full dossier in which the following specific details
shall be included:
Module 3
a) In the context of a radio-pharmaceutical kit, which is to be radio-
labelled after supply by the manufacturer, the active substance is
considered to be that part of the formulation which is intended to
carry or bind the radio-nuclide. The description of the manufac
turing method of radio-pharmaceutical kits shall include details of
the manufacture of the kit and details of its recommended final
processing to produce the radioactive medicinal product. The
necessary specifications of the radio-nuclide shall be described in
accordance, where relevant, with the general monograph or specific
monographs of the European Pharmacopoeia . In addition, any
compounds essential for the radio-labelling shall be described.
The structure of the radio-labelled compound shall also be
described.
For radio-nuclides, the nuclear reactions involved shall be
discussed.
In a generator, both mother and daughter radio-nuclides shall be
considered as active substances.
b) Details of the nature of the radio-nuclide, the identity of the isotope,
likely impurities, the carrier, the use and the specific activity shall
be provided.
c) Starting materials include irradiation target materials.
d) Considerations on chemical/radiochemical purity and its rela
tionship to bio-distribution shall be provided.
e) Radio-nuclide purity, radiochemical purity and specific activity
shall be described.
f) For generators, details on the testing for mother and daughter radio-
nuclides are required. For generator-eluates, tests for mother radio-
nuclides and for other constituents of the generator system shall be
provided.
g) The requirement to express the content of active substances in
terms of the mass of active entities shall onlyapply to radio-phar
maceutical kits. For radio-nuclides, radioactivity shall be expressed
in Becquerels at a given date and, if necessary, time with reference
to time zone. The type of radiation shall be indicated.
h) For kits, the specifications of the finished product shall include tests
on performance of products after radio-labelling. Appropriate
controls on radiochemical and radio-nuclidic purity of the radio-
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labelled compound shall be included. Any material essential for
radio-labelling shall be identified and assayed.
Module 4
It is appreciated that toxicity may be associated with a radiation dose.
In diagnosis, this is a consequence of the use of radio-pharmaceuticals;
in therapy, it is the property desired. The evaluation of safety and
efficacy of radio-pharmaceuticals shall, therefore, address requirements
for medicinal products and radiation dosimetry aspects. Organ/tissue
exposure to radiation shall be documented. Absorbed radiation dose
estimates shall be calculated according to a specified, internationally
recognised system by a particular route of administration.
Module 5
The results of clinical trials shall be provided where applicable
otherwise justified in the clinical overviews.
Module 3
The provisions of Module 3 shall apply to the registration of radio-
pharmaceutical precursors as define above (indents a) to i)), where
applicable.
Module 4
Concerning single dose and repeat dose toxicity, the results of studies
carried out in conformity with the provisions related to good laboratory
practice laid down in Council Directives 87/18/EEC and 88/320/EEC
shall be provided, unless otherwise justified.
Module 5
Clinical information generated from clinical studies using on the
precursor itself is not considered to be relevant in the specific case
of a radio-pharmaceutical precursor intended solely for radio-labelling
purposes.
Module 3
The provisions of Module 3 shall apply to the documents submitted in
accordance with Article 15 in the simplified registration of homeo
pathic medicinal products referred to in Article 14(1) as well as to
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the documents for authorisation of other homeopathic medicinal
products referred to in Article 16(1) with the following modifications.
a) Terminology
The Latin name of the homeopathic stock described in the
marketing authorisation application dossier must be in accordance
with the Latin title of the European Pharmacopoeia or, in absence
thereof, by an official pharmacopoeia of a Member State. Where
relevant the traditional name(s) used in each Member State shall be
provided.
b) Control of starting materials
The particulars and documents on the starting materials, i.e. all of
the materials used including raw materials and intermediates up to
the final dilution to be incorporated into the finished medicinal
product, accompanying the application shall be supplemented by
additional data on the homeopathic stock.
The general quality requirements shall apply to all of the starting
and raw materials as well as intermediate steps of the manufac
turing process up to the final dilution to be incorporated into the
finished medicinal product. If possible, an assay is required if toxic
components are present and if the quality cannot be controlled on
final dilution to be incorporated because of the high dilution degree.
Every step of the manufacturing process from the starting materials
up to the final dilution to be incorporated into the finished
medicinal product must be fully described.
In case dilutions are involved, these dilution steps should be done
in accordance with the homeopathicmanufacturing methods laid
down in the relevant monograph of the European Pharmacopoeia
or, in absence thereof, by an official pharmacopoeia of a Member
State.
c) Control tests on the finished medicinal product
The general quality requirements shall apply to the homeopathic
finished medicinal products, any exception needs to be duly
justified by the applicant.
Identification and assay of all the toxicologically relevant consti
tuents shall be carried out. If it can be justified that an identification
and/or an assay on all the toxicologically relevant constituents is
not possible e.g. due to their dilution in the finished medicinal
product the quality shall be demonstrated by complete validation
of the manufacturing and dilution process.
d) Stability tests
The stability of the finished medicinal product must be demon
strated. Stability data from the homeopathic stocks are generally
transferable to dilutions/triturations obtained thereof. If no identifi
cation or assay of the active substance is possible due to the degree
of dilution, stability data of the pharmaceutical form may be
considered.
Module 4
The provisions of Module 4 shall apply to the simplified registration of
homeopathic medicinal products referred to in Article 14(1) with the
following specifications.
Any missing information must be justified, e.g., justification must be
given why demonstration of an acceptable level of safety can be
supported although some studies are lacking.
4. HERBAL MEDICINAL PRODUCTS
Applications for herbal medicinal products shall provide a full dossier
in which the following specific details shall be included.
Module 3
The provisions of Module 3, including compliance with monograph(s)
of the European Pharmacopoeia, shall apply to the authorisation of
herbal medicinal products. The state of scientific knowledge at the
time when the application is lodged shall be taken into account.
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The following aspects specific to herbal medicinal products shall be
considered:
(1) Herbal substances and herbal preparations
For the purposes of this Annex the terms ‘herbal substances and
preparations’ shall be considered equivalent to the terms ‘herbal
drugs and herbal drug preparations’, as defined in the European Phar
macopoeia.
With respect to the nomencRlature of the herbal substance, the
binomial scientific name of plant (genus, species, variety and author),
and chemotype (where applicable), the parts of the plants, the definition
of the herbal substance, the other names (synonyms mentioned in other
Pharmacopoeias) and the laboratory code shall be provided.
With respect to the nomenclature of the herbal preparation, the
binomial scientific name of plant (genus, species, variety and author),
and chemotype (where applicable), the parts of the plants, the definition
of the herbal preparation, the ratio of the herbal substance to the herbal
preparation, the extraction solvent(s), the other names (synonyms
mentioned in other Pharmacopoeias) and the laboratory code shall be
provided.
To document the section of the structure for herbal substance(s) and
herbal preparation(s) where applicable, the physical form, the
description of the constituents with known therapeutic activity or
markers (molecular formula, relative molecular mass, structural
formula, including relative and absolute stereo-chemistry, the
molecular formula, and the relative molecular mass) as well as other
constituent(s) shall be provided.
To document the section on the manufacturer of the herbal substance,
the name, address, and responsibility of each supplier, including
contractors, and each proposed site or facility involved in production/
collection and testing of the herbal substance shall be provided, where
appropriate.
To document the section on the manufacturer of the herbal preparation,
the name, address, and responsibility of each manufacturer, including
contractors, and each proposed manufacturing site or facility involved
in manufacturing and testing of the herbal preparation shall be
provided, where appropriate.
With respect to the description of manufacturing process and process
controls for the herbal substance, information shall be provided to
adequately describe the plant production and plant collection,
including the geographical source of the medicinal plant and culti
vation, harvesting, drying and storage conditions.
With respect to the description of manufacturing process and process
controls for the herbal preparation, information shall be provided to
adequately describe the manufacturing process of the herbal
preparation, including description of the processing, solvents and
reagents, purification stages and standardisation.
With respect to the manufacturing process development, a brief
summary describing the development of the herbal substance(s) and
herbal preparation(s) where applicable shall be provided, taking into
consideration the proposed route of administration and usage. Results
comparing the phyto-chemical composition of the herbal substance(s)
and herbal preparation(s) where applicable used in supporting biblio
graphic data and the herbal substance(s) and herbal preparation(s),
where applicable, contained as active substance(s) in the herbal
medicinal product applied for shall be discussed, where appropriate.
With respect to the elucidation of the structure and other characteristics
of the herbal substance, information on the botanical, macroscopical,
microscopical, phyto-chemical characterisation, and biological activity
if necessary, shall be provided.
With respect to the elucidation of the structure and other characteristics
of the herbal preparation, information on the phyto- and physico
chemical characterisation, and biological activity if necessary, shall
be provided.
The specifications for the herbal substance(s) and herbal preparation(s)
where applicable shall be provided.
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The analytical procedures used for testing the herbal substance(s) and
herbal preparation(s) where applicable shall be provided.
With respect to the validation of analytical procedures, analytical vali
dation information, including experimental data for the analytical
procedures used for testing the herbal substance(s) and herbal
preparation(s) where applicable shall be provided.
With respect to batch analyses, description of batches and results of
batch analyses for the herbal substance(s) and herbal preparation(s)
where applicable shall be provided, including those for pharmacopoeial
substances.
Justification for the specifications of the herbal substance(s) and herbal
preparation(s) where applicable shall be provided.
Information on the reference standards or reference materials used for
testing of the herbal substance(s) and herbal preparation(s) where
applicable shall be provided.
Where the herbal substance or the herbal preparation is the subject of a
monograph, the applicant can apply for a certificate of suitability that
was granted by the European Directorate for the Quality of Medicines.
(2) Herbal Medicinal Products
With respect to the formulation development, a brief summary
describing the development of the herbal medicinal product should
be provided, taking into consideration the proposed route of adminis
tration and usage. Results comparing the phyto-chemical composition
of the products used in supporting bibliographic data and the herbal
medicinal product applied for shall be discussed, where appropriate.
5. ORPHAN MEDICINAL PRODUCTS
— In the case of an orphan medicinal product in the meaning of
Regulation (EC) No 141/2000, general provisions of Part II-6
(exceptional circumstances) can be applied. The applicant shall
then justify in the non-clinical and clinical summaries the reasons
for which it is not possible to provide the complete information and
shall provide a justification of the benefit/risk balance for the
orphan medicinal product concerned.
— When an applicant for an marketing authorisation for an orphan
medicinal product invokes the provisions of Article 10 (1)(a)(ii) and
Part II-1 of this Annex (well-established medicinal use), the
systematic and documented use of the concerned substance can
refer — as way of derogation — to the use of that substance in
accordance with the provisions of Article 5 of this Directive.
PART IV
ADVANCED THERAPY MEDICINAL PRODUCTS
Advanced therapy medicinal products are based on manufacturing processes
focussed on various gene transfer-produced bio-molecules, and/or biologically
advanced therapeutic modified cells as active substances or part of active
substances.
For those medicinal products the presentation of the Marketing Authorisation
application dossier shall fulfil the format requirements as described in Part I of
this Annex.
Modules 1 to 5 shall apply. For Genetically Modified Organisms deliberate
release in the environment, attention shall be paid to the persistence of the
Genetically Modified Organisms in the recipient and to the possible replication
and/or modification of the Genetically Modified Organisms when released in the
environment. The information concerning the environmental risk should appear
in the Annex to Module 1.
1. GENE THERAPY MEDICINAL PRODUCTS (HUMAN AND
XENOGENEIC)
For the purposes of this Annex, gene therapy medicinal product shall
mean a product obtained through a set of manufacturing processes
aimed at the transfer, to be performed either in vivo or ex vivo, of a
prophylactic, diagnostic or therapeutic gene (i.e. a piece of nucleic
acid), to human/animal cells and its subsequent expression in vivo.
The gene transfer involves an expression system contained in a
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delivery system known as a vector, which can be of viral, as well as
non-viral origin. The vector can also be included in a human or animal
cell.
1.1. Diversity of gene therapy medicinal products
a) Gene therapy medicinal products based on allogeneic or xeno
geneic cells
The vector is ready-prepared and stored before its transfer into the
host cells.
The cells have been obtained previously and may be processed as a
cell bank (bank collection or bank established from procurement of
primary cells) with a limited viability.
The cells genetically modified by the vector represent an active
substance.
Additional steps may be carried out in order to obtain the finished
product. By essence, such a medicinal product is intended to be
administered to a certain number of patients.
b) Gene therapy medicinal products using autologous human cells
The active substance is a batch of ready-prepared vector stored
before its transfer into the autologous cells.
Additional steps may be carried out in order to obtain the finished
medicinal product.
Those products are prepared from cells obtained from an individual
patient. The cells are then genetically modified using a ready-
prepared vector containing the appropriate gene that has been
prepared in advance and that constitutes the active substance.
The preparation is re-injected into the patient and is by definition
intended to a single patient. The whole manufacturing process from
the collection of the cells from the patient up to the re-injection to
the patient shall be considered as one intervention.
c) Administration of ready-prepared vectors with inserted (prophy
lactic, diagnostic or therapeutic) genetic material
The active substance is a batch of ready-prepared vector.
Additional steps may be carried out in order to obtain the finished
medicinal product. This type of medicinal product is intended to be
administered to several patients.
Transfer of genetic material may be carried out by direct injection
of the ready-prepared vector to the recipients.
1.2. Specific requirements regarding Module 3
Gene therapy medicinal products include:
— naked nucleic acid
— complex nucleic acid or non viral vectors
— viral vectors
— genetically modified cells
As for other medicinal products, one can identify the three main
elements of the manufacturing process, i.e.:
— starting materials: materials from which the active substance is
manufactured such as, gene of interest, expression plasmids, cell
banks and virus stocks or non viral vector;
— active substance: recombinant vector, virus, naked or complex
plasmids, virus producing cells, in vitro genetically modified cells;
— finished medicinal product: active substance formulated in its final
immediate container for the intended medical use. Depending on
the type of gene therapy medicinal product, the route of adminis
tration and conditions of use may necessitate an ex vivo treatment
of the cells of the patient (see 1.1.b).
A special attention shall be paid to the following items:
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a) Information shall be provided on the relevant characteristics of the
gene therapy medicinal product including its expression in the target
cell population. Information concerning the source, construction,
characterisation and verification of the encoding gene sequence
including its integrity and stability shall be provided. Apart from
therapeutic gene, the complete sequence of other genes, regulatory
elements and the vector backbone shall be provided.
b) Information concerning the characterisation of the vector used to
transfer and deliver the gene shall be provided. This must include
its physico-chemical characterisation and/or biological/immuno
logical characterisation.
For medicinal products that utilise a micro-organism such as
bacteria or viruses to facilitate gene transfer (biological gene
transfer), data on the pathogenesis of the parental strain and on
its tropism for specific tissues and cell types as well as the cell
cycle-dependence of the interaction shall be provided.
For medicinal products that utilise non-biological means to facilitate
gene transfer, the physico-chemical properties of the constituents
individually and in combination shall be provided.
c) The principles for cell banking or seed lot establishment and char
acterisation shall apply to gene transfer medicinal products as appro
priate.
d) The source of the cells hosting the recombinant vector shall be
provided.
The characteristics of the human source such as age, sex, results of
microbiological and viral testing, exclusion criteria and country of
origin shall be documented.
For cells of animal origin, detailed information related to the
following items shall be provided:
— Sourcing of the animals
— Animal husbandry and care
— Transgenic animals (methods of creation, characterisation of
transgenic cells, nature of the inserted gene)
— Measures to prevent and monitor infections in the source/donor
animals
— Testing for infectious agents
— Facilities
— Control of starting and raw materials.
Description of cell collection methodology including location, type
of tissue, operating process, transportation, storage and traceability
as well as controls carried out during the collection process shall be
documented.
e) The evaluation of the viral safety as well as the traceability of the
products from the donor to the finished medicinal product, are an
essential part of the documentation to be supplied. E.g., the presence
of replication competent virus in stocks of non-replication
competent viral vectors must be excluded.
2. SOMATIC CELL THERAPY MEDICINAL PRODUCTS (HUMAN
AND XENOGENEIC)
For the purposes of this Annex, somatic cell therapy medicinal
products shall mean the use in humans of autologous (emanating
from the patient himself), allogeneic (coming from another human
being) or xenogeneic (coming from animals) somatic living cells, the
biological characteristics of which have been substantially altered as a
result of their manipulation to obtain a therapeutic, diagnostic or
preventive effect through metabolic, pharmacological and immuno
logical means. This manipulation includes the expansion or activation
of autologous cell populations ex vivo (e.g., adoptive immuno-therapy),
the use of allogeneic and xenogeneic cells associated with medical
devices used ex vivo or in vivo (e.g., micro-capsules, intrinsic matrix
scaffolds, bio-degradable or not).
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Specific requirements for cell therapy medicinal products regarding
Module 3
Somatic cell therapy medicinal products include:
— Cells manipulated to modify their immunological, metabolic or
other functional properties in qualitative or quantitative aspects;
— Cells sorted, selected and manipulated and subsequently undergoing
a manufacturing process in order to obtain the finished medicinal
product;
— Cells manipulated and combined with non-cellular components (e.g.
biological or inert matrixes or medical devices) and exerting the
principle intended action in the finished product;
— Autologous cell derivatives expressed in vitro under specific culture
conditions;
— Cells genetically modified or otherwise manipulated to express
previously unexpressed homologous or non-homologous functional
properties.
The whole manufacturing process from the collection of the cells from
the patient (autologous situation) up to the re-injection to the patient
shall be considered as one single intervention.
As for other medicinal products, the three elements of the manufac
turing process are identified:
— starting materials: materials from which the active substance is
manufactured, i.e., organs, tissues, body fluids or cells;
— active substance: manipulated cells, cell lysates, proliferating cells
and cells used in conjunction with inert matrixes and medical
devices;
— finished medicinal products: active substance formulated in its final
immediate container for the intended medical use.
a) General information on active substance(s)
The active substances of cell therapy medicinal products consist of
cells which as a consequence of in vitro processing display
prophylactic, diagnostic or therapeutic properties different from
the original physiological and biological one.
This section shall describe the type of cells and culture concerned.
Tissues, organs or biological fluids from which cells are derived as
well as the autologous, allogeneic, or xenogeneic nature of the
donation and its geographical origin shall be documented.
Collection of the cells, sampling and storage prior further
processing shall be detailed. For allogeneic cells, special
attention shall be paid to the very first step of the process,
which covers selection of donors. The type of manipulation
carried out and the physiological function of the cells that are
used as active substance shall be provided.
b) Information related to the starting materials of active substance(s)
1. Human somatic cells
Human somatic cell therapy medicinal products are made of a
defined number (pool) of viable cells, which are derived from a
manufacturing process starting either at the level of organs or
tissues retrieved from a human being, or, at the level of a well
defined cell bank system where the pool of cells relies on
continuous cell lines. For the purposes of this chapter, active
substance shall mean the seed pool of human cells and finished
medicinal product shall mean seed pool of human cells formulated
for the intended medical use.
Starting materials and each step of the manufacturing process shall
be fully documented including viral safety aspects.
(1) Organs, tissues, body fluids and cells of human origin
The characteristics of the human source such as age, sex, micro
biological status, exclusion criteria and country of origin shall be
documented.
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Description of sampling including site, type, operating process,
pooling, transportation, storage and traceability as well as
controls carried out on sampling shall be documented.
(2) Cell banking systems
Relevant requirements depicted in part I shall apply for the
preparation and quality control of cell banking systems. This
may essentially be the case for allogeneic or xenogeneic cells.
(3) Ancillary materials or ancillary medical devices
Information shall be provided on the use of any raw materials
(e.g., cytokines, growth factors, culture media) or of possible
ancillary products and medical devices e.g., cell sorting devices,
biocompatible polymers, matrix, fibres, beads in terms of bio-com
patibility, functionality as well as the risk of infectious agents.
2. Animal somatic cells (xenogeneic)
Detailed information related to the following items shall be
provided:
— Sourcing of the animals
— Animal husbandry and care
— Genetically modified animals (methods of creation, character
isation of transgenic cells, nature of the inserted or excised
(knock out) gene)
— Measures to prevent and monitor infections in the source/donor
animals
— Testing for infectious agents including vertically transmitted
micro-organisms (also endogenous retro viruses)
— Facilities
— Cell banking systems
— Control of starting and raw materials.
a) Information on the manufacturing process of the active
substance(s) and the finished product
The different steps of the manufacturing process such as organ/
tissue dissociation, selection of the cell population of interest, in
vitro cell culture, cell transformation either by physico-chemical
agents or gene transfer shall be documented.
b) Characterisation of active substance(s)
All of the relevant information on the characterisation of the cell
population of interest in terms of identity (species of origin,
banding cytogenetics, morphological analysis), purity (adventitious
microbial agents and cellular contaminants), potency (defined
biological activity), and suitability (karyology and tumorigenicity
tests) for the intended medicinal use shall be provided.
c) Pharmaceutical development of finished medicinal product
Apart from the specific method of administration used (intravenous
infusion, site-injection, transplantation surgery), information shall
also be provided on the use of possible ancillary medical devices
(bio-compatible polymers, matrix, fibres, beads) in terms of bio-
compatibility and durability.
d) Traceability
A detailed flow chart shall be provided insuring the traceability of
the products from the donor to the finished medicinal product.
3. SPECIFIC REQUIREMENTS FOR GENE THERAPY AND
SOMATIC CELL THERAPY (HUMAN AND XENOGENEIC)
MEDICINAL PRODUCTS REGARDING MODULES 4 AND 5
3.1. Module 4
For gene and somatic cell therapy medicinal products, it is recognised
that conventional requirements as laid down in Module 4 for non-
clinical testing of medicinal products may not always be appropriate
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due to unique and diverse structural and biological properties of the
products in question, including high degree of species specificity,
subject specificity, immunological barriers and differences in pleio
tropic responses.
3.2. Module 5
The efficacy of advanced therapy medicinal products must be demon
strated as described in Module 5. For some products and for some
therapeutic indications, however, it may not be possible to perform
conventional clinical trials. Any deviation from the existing guidelines
shall be justified in Module 2.
Special risks associated with such products arising from potential con
tamination with infectious agents must be addressed in the application
for marketing authorisation for advanced therapy medicinal products.
Special emphasis should be put on both the early stages of develop
ment in one hand, including the choice of donors in the case of cell
therapy medicinal products, and on the therapeutic intervention as a
whole, including the proper handling and administration of the product
on the other hand.
▼M2
3.2.2. Safety
Safety issues arising from immune response to the medicinal products
or to the expressed proteins, immune rejection, immuno-suppression,
and breakdown of immuno-isolation devices shall be considered.
Certain advanced gene therapy and somatic cell therapy medicinal
products (e.g. xenogeneic cell therapy and certain gene transfer
products) may contain replication-competent particles and/or infectious
agents. The patient may have to be monitored for the development of
possible infections and/or their pathological sequelae during pre- and/or
post-authorisation phases; this surveillance may have to be extended to
close contacts of the patient including health-care workers.
The risk of contamination with potentially transmissible agents cannot
be totally eliminated in the use of certain somatic cell therapy
medicinal products and certain gene transfer medicinal products. The
risk can be minimised, however, by appropriate measures as described
in Module 3.
The measures included in the production process must be complemen
ted with accompanied testing methods, quality control processes and by
appropriate surveillance methods that must be described in Module 5.
The use of certain advanced somatic cell therapy medicinal products
may have to be limited, temporarily or permanently, to establishments
that have documented expertise and facilities for assuring a specific
follow up of the safety of the patients. A similar approach may be
relevant for certain gene therapy medicinal products that are associated
with a potential risk of replication-competent infectious agents.
The long term monitoring aspects for the development of late compli
cations shall also be considered and addressed in the submission, where
relevant.
Where appropriate, the applicant has to submit a detailed risk
management plan covering clinical and laboratory data of the patient,
emerging epidemiological data, and, if relevant, data from archives of
tissue samples from the donor and the recipient. Such a system is
needed to ensure the traceability of the medicinal product and the
rapid response to suspicious patterns of adverse events.
4. SPECIFIC STATEMENT ON XENO-TRANSPLANTATION
MEDICINAL PRODUCTS
For the purposes of this Annex, xeno-transplantation shall mean any
procedure that involves the transplantation, implantation, or infusion
into a human recipient of either live tissues or organs retrieved from
animals, or, human body fluids, cells, tissues or organs that have
undergone ex vivo contact with live non-human animal cells, tissues
or organs.
Specific emphasis shall be paid to the starting materials.
In this respect, detailed information related to the following items shall
be provided according to specific guidelines:
— Sourcing of the animals
— Animal husbandry and care
— Genetically modified animals (methods of creation, characterisation
of transgenic cells, nature of the inserted or excised (knock out)
gene)
— Measures to prevent and monitor infections in the source/donor
animals
— Testing for infectious agents
— Facilities
— Control of starting and raw materials
— Traceability.
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ANNEX II
PART A
▼B
PART B
Directive 66/454/EEC —
Directive 78/420/EEC —
This Dir. 65/65/EEC 75/318/EEC 75/319/EEC 89/342/EEC 89/343/EEC 89/381/EEC 92/25/EEC 92/26/EEC 92/27/EEC 92/28/EEC 92/73/EEC
Art. 87 Art. 2
Art. 88 Art. 3(1) to
(6)
Art. 89 Art. 4
Art. 90 Art. 5
Art. 91 Art. 6
Art. 92 Art. 7
Art. 93 Art. 8
Art. 94 Art. 9
Art. 95 Art. 10
Art. 96 Art. 11
Art. 97(1) to Art. 12(1)
(4) and (2)
Art. 97(5) Art. 12(4)
Art. 98 Art. 13
Art. 99 Art. 14
Art. 100 Art. 6(3)
Art. 101 Art. 29e
Art. 102 Art. 29a
Art. 103 Art. 29c
Art. 104 Art. 29d
Art. 105 Art. 29f
Art. 106(1) Art. 29g
Art. 106(2) Art. 29b, 2nd
paragraph
Art. 107 Art. 29h
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This Dir. 65/65/EEC 75/318/EEC 75/319/EEC 89/342/EEC 89/343/EEC 89/381/EEC 92/25/EEC 92/26/EEC 92/27/EEC 92/28/EEC 92/73/EEC