The EMA is the regulatory body with responsibility for all EU member states. It coordinates a network of some 4,000 pharmacovigilance experts from the national regulatory authorities of 31 countries from the EU and European Economic Area (EEA). Its activities include publishing the guidelines which inform Marketing Authorisation Holders (MAHs) and EU clinical trial sponsors on safety, efficacy and quality for both human and veterinary products. The Committee for Medicinal Human Products (CHMP) has been established as the body through which all pharmacovigilance activities for drugs intended for people takes place on behalf of the EMA.
When pharmaceutical companies aim to place any new drug onto an EU market, they must apply for a Marketing Authorisation (MA). There are 4 routes via which this can be done: the National, Centralised, De-centralised and Mutual Recognition procedures. The application for the centralised route must be made directly to the EMA, and evaluation of the quality, efficacy and safety are carried out by an appointed Rapporteur and co-Rapporteur assessor from two of the EU Member State regulatory authorities. Their assessments are then considered by the CHMP which makes a recommendation to the European Commission. Should the application be successful, the European Commission grants a Marketing Authorisation and the product may then be sold in any or all of the 28 EU member states. Many MA applications now take this route, in particular for any medicinal product derived from biotechnology as well as medicines intended for the treatment of:
As distinct from the Centralised procedure, individual EU countries may issue National marketing authorisations for medicinal products based on a local assessment of quality, efficacy and safety. Sometimes, a company will use one such National MA as the basis for a Mutual Recognition procedure: that country acts as the Reference Member State and its assessment is evaluated by other EU countries – the Concerned Member States – so that the product can then be marketed in the countries that accept the assessment. The Decentralised procedure is similar – mostly used for generic medicines – it involves a synchronised submission followed by assessment by several EU countries.
Medicinal products intended for the treatment of rare diseases are termed ‘Orphan Drugs. The Committee for Orphan Medicinal Products (COMP) is responsible for processing any application for an MA for such products.
The Committee on Herbal Medicinal Products (HMPC) reviews applications for marketing of herbal medicinal products intended for sale within the EU.
From November 2017, all marketed product serious and non-serious Individual Case Safety Reports (ICSRs) occurring within the EEA will be reported directly to EudraVigilance by MAHs and other stakeholders under simplified centralised reporting.
Regulatory authorities or, in some instances such as the Netherlands, independent national pharmacovigilance centres, hold databases on post-marketing spontaneous and clinical trial adverse reactions.
The EMA manages the Eudravigilance database which is a repository for adverse reaction data from post-marketing spontaneous reports and of serious adverse reactions from clinical trials from across the EU.
Reports of Adverse Reactions may be generated by individual doctors, nurses, other healthcare professionals, pharmacists or patients themselves or their friends, relatives or others. They may be submitted to national regulatory authorities, where appropriate, the independent national pharmacovigilance centres, to regional centres in various countries or to the pharmaceutical company.
Pharmaceutical companies must operate a suitable safety database to allow for timely and accurate reporting in the correct format to the national authorities and EMA.
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