1. Regulatory Update Ellen Leinfuss SVP, Life Sciences

2. Topics Covered Today US FDA Update -6 Steps Outlined by New FDA Administrator European Medicines Agency (EMA) Update Medical Device Directives Update Trends in Warning Letters

3. US FDA Update Set Post-Inspection Deadlines -Once issue found, company to have 15 days to respond -Goal is to issue warning letters on a timely basis and facilitate prompt corrective action Take Responsible Steps to Speed the Warning Letter Process -New policy limiting the review of warning letters by the FDA’s Office of Chief Counsel to “significant” or “novel” legal issues -Goal to streamline process Work More Closely with FDA’s Regulatory Partners -To develop effective risk controls and enforcement strategies

4. US FDA Update Prioritize Follow-up on Warning Letters and Other Enforcement Actions -A Warning Letter or recall will trigger enforcement follow up -Cases will no longer be allowed to languish or remain open with uncertain resolution. Firms will get a knock on the door and an inspection Be Prepared to Take Immediate Action in Response to Public Health Risks -No multiple warning letters. The second warning letter to a firm will trigger increased scrutiny and follow up actions Develop and Implement a Formal Warning Letter “Close-out” Process -For firms that have taken the necessary corrective actions -It could play “an important motivating role” in spurring corrective actions

5. European Medicines Agency Update Changed acronym from EMEA to EMA Priority areas for 2010 -Improve safety monitoring (pharmacovigilance) -Focus on counterfeit medicines legislation and supply chain integrity -Work closely with international partners and activities -Provide more information to patients Incorporation of ICH Q9 and Q10 -ICH Q9 (Quality Risk Management) is a systematic process for the assessment, control and review of risk to the quality of a drug across its life cycle -ICH Q10 (Pharmaceutical Quality System) ccis a model for a pharmaceutical quality system that can be implemented throughout the different stages of a product lifecycle.

6. Medical Device Directive Update Directive 2007/47/EC comes into effect 21 March 2010 Key impact: Device Classification -Software now considered active medical device, whether integral to device or stand-alone product. Software validation required -Clarification on borderline products; active implantables; products that incorporate human tissue, blood or plasma; reusable surgical instruments; combination products Key impact: Clinical Evaluation -Clinical investigation of devices seen as continuous process to identify, generate, document and evaluate clinical data -All devices, including Class I now require clinical data -All side effects must now be reported -Clinical investigation requirements now extend to include post-market surveillance

7. Medical Device Directive Update Key Impact: Technical Knowledge -Level of technical knowledge, experience, education or training of intended user is now explicitly a relevant factor in the evaluation of the safety of a device -Manufacturers must now provide a summary of characteristics for Class II and III products -Goals are safety of device usage Key Impact: Increased Transparency -More information on product information and clinical data will be publicly available Key Impact: European Database -Clinical data to be collected in common database and shared among Competent Authorities

8. Most Frequent FDA 483 Observations DeficiencyNumber of Observations Quality Control Unit responsibilities 887 Adherence to production procedures 709 Production procedures (validation) 618 Laboratory controls 553 Written procedures for production 518 Investigations 506 Testing and release 478 Personnel qualification and testing 456 Batch record preparation and review 449 Equipment cleaning and maintenance 397

9. Compliance v.3.0 – Driving Behavior Change  Product Seizure  Not able to Execute Govt. Contracts  Failure to Issue Export Certifications  Refusals for Export  Increased Regulatory Intervention  Legal Injunctions  Holds on Pending New Drug Applications 483 Observations Can Escalate Most Warning Letters Issued because Company Responses Failed to Adequately Address FDA Concerns

10. Compliance v.3.0 – Driving Behavior Change Summary The Cornerstone for the Quality Organization is the Site Compliance Program. Companies should take a risk-based approach and employ internal audits and established audit management practices to remain “inspection-ready” at all times. If issues are found, the company should respond promptly with a detail corrective action program.