Wednesday, August 26, 2015

European Commission publishes draft text for the Falsified Medicines Directive Delegated Act


The European Commission has published the long-awaited draft text of the 'Delegated Act', setting out the requirements for the future system of medicines verification that must operate in all EU countries by a 2018 deadline.

EAHP EU Monitor - 25 August 2015 indicates 5 key points to note from the text:
1) The Unique Identifier and its components
The system of medicines verification will be underpinned by the placing of a 'unique identifier' on every package of medicine produced in the EU.
The Delegated Act mandates that the unique identifier take the form of a 2D barcode containing:
  • the product code;
  • a serial number;
  • the batch number;
  • the expiry date; and,
  • the national reimbursement number (if requested by the EU Member State)
2) An end-to-end verification system, not full track-and-trace
The Delegated Act describes the requirement for the future medicines verification systems in Europe to be "an end-to-end verification system supplemented by risk-based verifications by wholesalers".
This means the critical points in the verification system are at the production stage (when the unique identifier is placed on the outer packaging) and at the point that the medicine is "being supplied to the public" (which the Commission describes as meaning "at pharmacy level") when the unique identifier will be scanned to ensure authenticity, and thereafter the unique identifier will be marked in the data repository as "checked out". This is aimed to prevent any further unscrupulous use of the packaging by counterfeiters.
In very practical terms, it means that the system requires pharmacists in both community and hospital settings to ensure medicines are verified for their authenticity and 'checked out' of the repository system before the medicine is provided to patients. The check out will be conducted via a scan of the 2D barcode on the outer packaging containing the unique identifier.
3) A verification system operated by 'stakeholders'
As set out in the explanatory memorandum of the Delegated Act, the Commission expects that "The repositories system containing the unique identifiers should be set up and managed by stakeholders. National competent authorities should however be able to access and supervise the repositories system".
More specifically, the Delegated Act goes on to state: "The repositories system should be established and managed by the marketing authorisation holders, since they are responsible for placing the product on the market, and by the manufacturers of medicinal products bearing the safety features, since they bear the costs of the repositories system".
In practical terms, this means that the verification system will almost certainly be operated by the European Medicines Verification Organisation (EMVO), a collaboration of the European pharmaceutical industry (represented by the European Federation of Pharmaceutical Industry and Associations as well as the European Generic and Biosimilar Medicines Association), wholesalers (represented by the European Association of Pharmaceutical Full-line Wholesalers, and the European Association of Euro-Pharmaceutical Companies), and pharmacists (represented by the Pharmaceutical Group of the European Union).
4) Flexibility provided to healthcare institutions in respect of when to perform verification
The text of the draft Delegated Act states:
"In order to avoid an excessive impact on the daily operations of healthcare institutions, it should be possible for Member States to allow persons authorized or entitled to supply medicinal products to the public operating within healthcare institutions to perform the verification of the authenticity and the decommissioning of a unique identifier earlier than the time the medicinal products is supplied to the public, or exempt them from this obligation, subject to certain conditions."
This is an important flexibility for hospital pharmacists to have awareness of. In practical terms, it should enable each hospital to determine at what stage they wish to conduct their verification responsibilities, including the choice between verification on arrival to the hospital, or at a later stage, such as departure from the dispensary.
A 'healthcare institution' is defined in the Delegated Act as meaning "a hospital, in- or out-patient clinic or health centre.
5) A 10 day limit between a medicine being checked out, and still being able to return the medicine
Article 13 1 (b) of the draft Delegated Act means that after a period of ten days has passed since a pharmacy checked out a medicine, the status of the unique identifier on the outer packaging can no longer be reverted to active.
In the following months this issue will be a key area of EAHP investigation with the Commission, system operators and others. EAHP has consistently expressed its view that the 10 day limit could have damaging unintended impacts for medicines waste and potentially medicines shortage.
Documents

Full notification form text

EN FR FR

Full text of the announced text or any other relevant text

New   Draft Text 1 is available for download in the following languages:
EN 

New   Draft Text 2 is available for download in the following languages:
EN 


Sources

EAHP Monitor

Europa

Friday, August 07, 2015

EU Recognizes IHE Profiles for Procurement


On July 28, the European Commission announced its decision to identify 27 IHE profiles that should be referenced in public procurement documents for health IT systems throughout the European Union (EU) as part of its eHealth European Interoperability Framework (eEIF). 

The extensive list includes profiles that define standards-based interoperability for laboratory, pharmacy, radiology and enterprise information and communication systems, as well as health information exchanges. 

The Commission's announcement states, "The 27 IHE profiles have the potential to increase interoperability of eHealth services and applications to the benefit of patients and medical community."

 The full announcement and list of profiles, as published in the Official Journal of the European Union, are available here.

Source

http://eur-lex.europa.eu/legal-content/EN/TXT/?uri=OJ:JOL_2015_199_R_0011

Thursday, July 23, 2015

European Union logo for online sale of medicines

Legal background

EU logoThe common logo for legally operating online pharmacies/retailers in the EU Member States was introduced by Directive 2011/62/EU (the Falsified Medicines Directive) as one of the measures to fight against falsified medicines.
The Directive gave the Commission a legal basis to establish the design of a common logo as well as the technical, electronic and cryptographic requirements for verification of its authenticity. It is however up to the Member States to determine the specific conditions for the retail supply of medicinal products to the public. Member States may impose certain conditions and limitations, e.g. by not allowing online sale of prescription medicines.
On 24 June 2014 the European Commission adopted the new common logo through the Implementing Regulation 699/2014. Member States had one year from this date to ensure that the provisions on the common logo are applied. Therefore, as of 1st of July 2015, all online pharmacies or retailers legally operating in the EU should display the logo.
The Implementing Regulation was prepared taking into account the results of a public consultation. [A concept paperpdf(52 KB), replies to the consultation]

What is the purpose of the logo?

Falsified medicines are a major threat to public health and safety. The illegal sale of medicinal products to the public via the Internet by retailers operating outside the law is a serious danger as falsified medicinal products may easily reach the public in this way. The logo helps identify the websites which are operating legally. Buying from a legally operating pharmacy or retailer guarantees the safety of the products.

How does the logo look like?

EU logo
The national flag and the text are an integral part of the logo. The flag in the middle left side of the logo corresponds to the Member State where the pharmacy or retailer is registered or authorised. Only national flags of the EU Member States as well as those of Norway, Iceland and Lichtenstein are allowed. Therefore, a logo displaying the EU flag, for example, will not be authentic.

How does the logo work?

The logo links to the website of the national competent authority listing all legally operating online pharmacies/retailers. National websites are listed with the European Medicines Agency. By simply clicking on the logo a purchaser of the medicines online will be sent to the entry of the pharmacy on that national list, thus completing the verification process.
The logo can be trusted only if a purchaser, after clicking, is redirected to the entry of that pharmacy on the list of legally operating on-line pharmacies and retailers registered in that Member State on the national authority web-page.

Communication material

Source

Wednesday, June 24, 2015

Early dialogue to support development of medicines for children


EMA’s early interaction meetings encourage consideration of paediatric needs in the early phases of medicine development.

The European Medicines Agency (EMA) has launched an initiative that offers free-of-charge early paediatric interaction meetings with medicines developers to stimulate early dialogue on the development of their medicines for use in children. A one-year pilot phase is starting today.
The new initiative aims to encourage discussions on the paediatric needs that could be addressed with a specific medicine well before the submission of a paediatric investigation plan (PIP).

Medicines developers that wish to participate in the pilot phase are invited to provide information on their medicine using a specific form and send it topaediatrics@ema.europa.eu.

In the European Union, pharmaceutical companies are obliged to develop all new medicines also for use in children. The paediatric development is detailed in a PIP that needs to be agreed with EMA’s Paediatric Committee (PDCO).
While assessing PIPs submitted by medicines developers, EMA identified a number of issues which often delay the paediatric development and consequently children’s access to the medicine. Often, development programmes for adults and children are not sufficiently integrated and the possibility to extrapolate the results of studies in adults to children is not always explored to its full extent.
Early discussion between developers, EMA and its PDCO on the overall paediatric development strategy is expected to help medicines developers optimise the development plan for their medicine and ultimately speed up access to the medicine for children.

About the initiative

Following receipt of a request for an early paediatric interaction meeting, an EMA paediatric coordinator and a PDCO representative will be appointed as well as additional participants from other EMA departments or national competent authorities as required. A date for a teleconference with the applicant will then be arranged.
EMA can only consider a limited number of applications during the pilot phase and the Agency will give priority to medicines that address major public health needs.
The procedure will be reviewed at the end of the pilot and may be modified based on the experience gained.

For further information on the early paediatric interaction meetings, see the last question within the section 'Applying for a PIP, waiver or deferral' on Paediatric investigation plans: questions and answers.

Source

http://www.ema.europa.eu/

Thursday, May 28, 2015

What happened at eHealth Week 2015 in Riga?


A total of 1334 eHealth experts and 81 exhibitors from across Europe gathered in Riga to exchange knowledge and share best practices as part of the annual eHealth Week conference and exhibition. The presentation slides, photo's and Commissioner Andriukaitis' speech are now available.

The event kicked off with a VIP Exhibition Tour and a Press Conference, led by three representatives: Dr. Guntis Belēvičs, Minister for Health of Latvia, Commissioner Vytenis Andriukaitis and H. Stephen Lieber, CEO of HIMSS. Afterwards they opened the conference together with keynote speaker Toomas H.Ilves, President of the Republic of Estonia.
In his speech, Commissioner Andriukaitis highlighted the timely release of the Digital Single Market: "We must seize the Digital Single Market opportunities to fulfill a vision for healthcare in the 21st century – a vision of a single, universally accessible, sustainable and high quality, eHealth single market for the benefit of all European citizens and healthcare professionals".
He also highlighted the importance of eHealth Week: "By coming together at events such as this and by sharing experiences in the Member States and at EU level, we will drive forward the case for eHealth".

eHealth frontrunner

According to President Ilves, Estonia has been a frontrunner in eHealth: Nearly all prescriptions are issued electronically, and two-thirds of hospitals use eHealth technologies in some way.
Politico magazine wrote that Ilves touted Estonia as a model of how IT in preventive and treatment services can "improve both the welfare of patients and the healthcare system in general." But more widely across Europe, "healthcare is lagging ten years behind when compared to other industries," he said.

Increasing dynamism of EU economy

Head of Unit for eHealth & Wellbeing Pēteris Zilgalvis (European Commission), who was also in Riga, said: "Digital solutions can increase the dynamism of the European economy and deliver benefits to EU citizens." For him, the conference offered the chance to explore how mobile health and eHealth can help EU citizens manage their own health by empowering them, as well "ensuring the sustainability of our health care systems."
During the event, the Nordic countries revealed interesting findings and next steps for them in terms of eHealth. Finland, for instance, announced they will be switching off paper-based prescriptions by 2017, as they “have reached nearly 100% coverage with electronic prescriptions now”, according to Maritta Korhonen, Head of Development in the Finnish Ministry of Social Affairs and Health.

Real impact

Paul Timmers, Director for Digital Society, Trust and Security (DG CONNECT, European Commission), who spoke during the closing plenary said he was rooting for a European eHealth Community which can turn actions into tangible results with real impact for patients. He said: "I am glad to see that the eHealth community is committed to deliver results with real influence in terms of healthier citizens, more efficient and better healthcare services and economic growth and jobs. By joining up forces and learning from each other we can deliver a social and economic return on digital investment in health and social care".

2016: Amsterdam

eHealth Week 2015 concluded with an invitation to join next year’s edition in Amsterdam, during the week of 6 June, in The Netherlands, the country which at that time will be holding the Presidency of the Council of the European Union.

More information:


Source

Digital-agenda for Europe

Saturday, May 09, 2015

Cannabidiol Given Orphan Drug Designation for NHIE by the FDA


The drug Cannabidiol was recently granted orphan drug designation by the US Food and Drug Administration (FDA) for the treatment of children with neonatal hypoxic-ischemic encephalopathy (NHIE).1
 
Neonatal deprivation of oxygen during the birth process can lead to the acute or sub-acute brain injury known as NHIE.1 In the US, the incidence of NHIE is 1.5 to 2.8 per 1,000 births.1   Inflammatory cytokines, oxidative stress, and cell death all play a role in the disease pathology.2 Affected infants may show loss muscle tone, seizures, poor feeding, and a depressed level of consciousness.2  Around 35% of these infants to die in early life, and 30% may suffer from permanent disability.1  Currently, there are no effective FDA-approved medications to treat the condition.1
 
Cannabidiol is a non-psychoactive ingredient in cannabis. It is one of a group of compounds, the cannabinoids, which mediate their effects through the cannabinoid receptors. 3 Several studies have highlighted the potential of cannabinoids as neuroprotective treatments in ischemic brain damage, perhaps partly because of their anti-inflammatory and antioxidant properties.4
 
Since 2008, GW has been researching the neuroprotective effects of Cannabidiol in animal models of NHIE. This work has shown that Cannabidiol reduces neurologic disability in several models of newborn animal brain hypoxia. GW expects to submit an Investigational New Drug Application (IND) in mid-2015 for their intravenous formulation of CBD. The company expects to begin a Phase 1 trial in the second half of this year.1

"This orphan drug designation for Cannabidiol for the treatment of newborn children with neonatal hypoxic-ischemic encephalopathy follows several years of pre-clinical evaluation," GW’s Chief Executive Officer, Justin Gover, stated in a press release.1 Potentially, Cannabidiol might be approved for orphan drug status for other uncommon medical conditions, especially those with an inflammatory component.3 Mr. Grover also noted, “GW continues to explore the opportunity for the development of cannabinoids in rare pediatric conditions characterized by significant unmet need.”1

References

  1. GW Pharmaceuticals receives orphan drug designation from FDA for Cannabidiol for the treatment of neonatal hypoxic-ischemic encephalopathy [press release]. http://www.globenewswire.com/news-release/2015/04/24/728108/10130593/en/GW-Pharmaceuticals-Receives-Orphan-Drug-Designation-From-FDA-for-Cannabidiol-for-the-Treatment-of-Neonatal-Hypoxic-Ischemic-Encephalopathy.html. Published April 24, 2015. Accessed May 3, 2015.
  2. Fatemi A, Wilson MA, Johnston MV. Hypoxic ischemia encephalopathy in the term infant. Clin Perinatol. 2009;36(4):834-838. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2849741/. Accessed May 3, 2015.
  3. Nagarkatti P, Pandey R, Rieder SA, Hegde V, Nagarkatti M. Cannabinoids as novel anti-inflammatory drugs. Future Med Chem. 2009;1(7):1333-1349. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2828614/. Accessed May 3, 2015.
  4. Alvarez FJ, Lafuente H, Rey-Santano MC, et al. Neuroprotective effects of the nonpsychoactive cannabinoid cannabidiol in hypoxic-ischemic newborn piglets. Pediatr Res. 2008;64:653-658. http://www.nature.com/pr/journal/v64/n6/full/pr2008260a.html. Accessed May 3, 2015.

Source

http://www.raredr.com/articles/Cannabidiol-Orphan-Drug-Designation-NHIE