Vaccines assessment overview

Transcription

1 Vaccines assessment overview 1

2 PQT WHO uses the same scientific principles to assess the products safety, quality and efficacy/performance as well-resourced national regulators: - scientific assessment of documentary evidence for quality, safety and efficacy - site inspections for GMP, GLP and GCP - control of variations to products and their manufacturing processes - post-approval monitoring of quality and safety - where possible cooperating and relying on other regulators decisions avoiding duplication 2

3 Prequalification is NOT stand alone activity Many other technical work areas support and link to prequalification (medicines, vaccines, diagnostics and medical devices) Outside EMP Disease oriented departments/programs, IVB Department, Strategic Advisory Group of Experts (SAGE) on Immunization; Regional and Country Offices Inside EMP Norms and standards work/quality Assurance, Safety/Vigilance, Activities to combat SFFC medical products, NRA strengthening, Policy, Innovation and technology transfer /index.html 3

4 Structure of the new WHO/HQ regulatory unit Regulation of Medicines and other Health Technologies Lembit Rägo Norms and Standards David Wood Regulatory systems strengthening Nora Dellepiane Prequalification Lembit Rägo a.i. Safety and Vigilance Clive Ondari Medicines - Lembit Rägo Vaccines David Wood Diagnostics Irena Prat Medical devices Adriana Velazquez 4

5 New prequalification team: five functional groups PQT Coordinator Inspections services Deus Mubangizi Technical assistance and laboratory services Milan Smid Medicines assessment Matthias Stahl Vaccines assessment Carmen Rodriquez Diagnostics assessment Irena Prat 5

6 Purpose of WHO vaccines prequalification programme A service provided to UN purchasing agencies. Provides independent opinion/advice on the quality, safety and efficacy of vaccines for purchase Ensures that candidate vaccines are suitable for the target population and meet the needs of the programme Ensures continuing compliance with specifications and established standards of quality

7 NRA registration and WHO prequalification Aspects considered Exporting Country NRA WHO prequalification procedure Chemico pharmaceutical and biological Exhaustive review Review of summary information Non-clinical data Exhaustive review Usually not reviewed Clinical data GMP Relevance of data exporting country Compliance with National standard Relevance of data to UN target population Compliance with WHO standard Consistency testing Sometimes Always Schedule, co-administration Stability profile & shelf life Applicability of multidose vial policy Relevance to exporting country Suitability for exporting country --- Assessed Relevance to UN population Suitability for developing countries + VVM Presentation Highly flexible Critical: vials and AD syringes Shipping boxes --- Validation assessed

8 Principles GMP Clinical data Consistency of final product characteristics Meeting WHO requirements and tender specifications Reliance on NRA 8

9 Pre-conditions for PQ evaluation > Reliance on the National Regulatory Authority (NRA) of the exporting country NRA must be assessed as functional as a result of successful evaluation using the WHO NRA assessment tool NRA s functional status needs to be sustained over time Continued regulatory oversight by NRA is required as well as communication with WHO about potential problems with the vaccine Agreements are established with the NRAs for information exchange when a vaccine is about to be prequalified 9

10 Pre- conditions for PQ evaluation Vaccine is licensed/registered by the responsible NRA (Scientific opinion by EMA accepted) WHO guidelines/recommendations approved by the ECBS are available (published in the WHO Technical Report Series) Listed in the vaccine priority list (low priority vaccines may be postponed depending on workload and no priority vaccines will not be reviewed) 10

11 Prequalification process Scientific review of quality dossier Scientific review of clinical data Testing of samples Consultation with responsible NRA Site audit to manufacturing facilities Revised procedure in place from January

12 Role of NRA during PQ process > As part of the evaluation procedure, consultation with NRA To discuss regulatory status of the concerned vaccine/s Clinical performance in country of manufacture if used Quality evaluation, outcome of recent GMP inspections Compliance with specifications (trends from lot release data) Regulatory actions Informal agreement for information sharing with WHO recorded in Consultation report 12

13 Monitoring performance of PQd vaccines > Targeted testing (contracted labs worldwide) Once a year testing of samples of lots shipped to the field to ensure continuing compliance with specifications > Monitoring and resolution of complaints and reports of AEFIs (with collaboration of the responsible NRA) > Reassessments frequency defined on risk analysis basis 13

14 Why is Vaccines PQ important for user countries and its NRAs? > It represents a source of vaccines of "assured quality" > In addition the evaluation is focused on programmatic needs > WHO follows up on complaints and reports of AEFIs and publishes the outcome of investigations > WHO monitors the quality of prequalified vaccines on a continuing basis, through testing of samples, reassessment of the products, targeted audits, and delists vaccines if they do not meet the established specifications and/or standard > Opportunity for NRAs in user countries to save resources to focus on other priorities, since registration can be granted through a facilitated and shortened procedure 14

15 Added value of the PQ evaluation > Ensures that the vaccine has been reviewed and licensed by a functional NRA compliance with WHO recommended requirements for quality, safety and efficacy (i.e. WHO GMP standards) compliance with UN tender specifications Ensures that available clinical data are relevant to the target population and compatible with immunization schedules in developing countries Feasibility of co-administration with other vaccines included in the NIPs Reviews product characteristics to ensure these are the desirable ones for developing countries International transportation conditions Vaccine carries VVMs if required by procuring agency 15

16 Australia Belgium Canada Vaccines prequalified by WHO: Status July 2014 (assured quality) 15 industrialized country mfrs 8 emerging economy country mfrs 29 manufacturers Denmark France The Netherlands Germany Hungary Italy Japan Rep. of Korea Switzerland Brazil Bulgaria Cuba India Indonesia Russia Senegal Thailand 130 pre-qualified vaccines used in 124 countries Sweden United Kingdom USA 64% total population 16

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