Presentation on theme: "Compliance Considerations in Pharmaceutical Product Development Compliance Considerations in Pharmaceutical Product Development John C. (Jack) Garvey,"— Presentation transcript:
Compliance Considerations in Pharmaceutical Product Development Compliance Considerations in Pharmaceutical Product Development John C. (Jack) Garvey, Esq. THE WEINBERG GROUP INC. PRINCETON, NJ
Compliance in Drug Development The Drug Development Challenge A Sampling of Key Compliance Focus Areas Structuring Compliance for Sustainability Closing Thoughts
Business Climate Various sources estimate the current average drug approval costs between $900 million and $1.7 billion PHRMA member companies increased R&D spending 53.5% between 2000 and 2005 to $40 billion Goldman Sachs estimates that pharma R&D spending will increase 7% per year from 2004 to 2009 Estimates are that 1 FDA-approved drug results from 5-10,000 that enter the discovery phase Approval Cost
Snatched from the Headlines… The pharma industry is suffering a dearth of new drug approvals thanks to an increasingly stringent FDA…. From CNNMoney.com, 16 August 2007 The Food and Drug Administration approved 38 new drugs through July of this year, down 31 percent from 55 approvals during the same period in 2006 …. FDA spokesperson Susan Cruzan denied that her agency was getting tougher on drug applications. "There have been no systematic changes in how we are approaching the approval standards for new applications," wrote Cruzan in an to CNNMoney.com, adding that "each application is reviewed on its own merit.". …. [T]his year's approvals include only seven drugs that can be considered completely new, which is a 10- year low for the industry. ….
The TWO Main Goals of Drug Development Identifying a chemical entity / compound that has a specific, singular therapeutic impact on a broad population set with minimal adverse events. Developing a formulation and delivery system that consistently delivers the desired biological availability of the identified compound to the broadest possible population set. Then…
The Drug Development Cycle (Simplified) FDA REVIEW XFER TO MFG DISCOVERY PRE- CLINICAL Phase 1 Phase 2 Phase 3 IND FiledNDA Filed
FDA REVIEW XFER TO MFG DISCOVERY PRE- CLINICAL Phase 1 Phase 2 Phase 3 IND FiledNDA Filed Drug Development Compliance Touchpoints
Sampling of Traditional and Evolving Compliance Considerations Phase I GMP Guidances Clinical Trials Risk Communication Access for Investigational Drugs Early CMS Involvement in Clinical Requirements Data Integrity -- Traditional Data Integrity – Part 11 / CSV Considerations CMC Issues Pre-Approval Inspections Process Analytical Technology / Quality by Design Pharmacogenomic Data Submission Pediatric Studies Requirements Safety Reporting Requirements Third Party Services Current Hot-Button Areas New Guidances
The Changing Landscape of Development Compliance Guidance: Establishment and Operation of Clinical Trial Data Monitoring Committees (3/06) Guidance: Using a Centralized IRB Process in Multicenter Trials (3/06) Draft Guidance: Exception from Informed Consent Requirements for Emergency Research (9/06) Draft Guidance: Adverse Event Reporting – Improving Human Subject Protection (Out for Comment – 4/07) Draft Guidance: Approaches to Complying with CGMP During Phase I (12/06) Draft Guidance: Supervisory Responsibilities of Clinical Investigators (Out for Comment – 5/07) Guidance: Computerized Systems Used in Clinical Investigations (5/07) Guidance: ICH Q8 – Pharmaceutical Development (5/06) Guidance: Immunotoxicity Studies for Human Pharmaceuticals (4/06) Draft Guidance: ICH Q10 – Pharmaceutical Quality System (7/07)
Phase I GMP Guidance Not a new requirement – flows from original GMPs and heritage of 1991 Guidance Focus on Quality Control –Well controlled procedures –Adequately controlled equipment –Accurate and consistently recorded data Agency Recommendations: –Evaluate production environment for potential hazards –Appropriate actions to minimize risks and safeguard quality –In a phrase: Product Characterization And Risk Mitigation Specific Coverage: –Personnel –QC Function –Facility & Equipment –Control of Components Production & Documentation –Laboratory controls –Container closure and labeling –Distribution –Recordkeeping Other Coverage –Screening Studies/Microdose Producers –Multi-Product Facilities –Biological and Biotechnological Products –Sterile Products/Aseptically Processed Products
US Clinical Trial Regulatory Requirements IND – 21 CFR 312 Protection of Human Subjects CFR 50 Institutional Review Boards – 21 CFR 56 Financial Disclosure by Clinical Investigators – 21 CFR 54 FDA Guidance for Data Safety and Monitoring Boards NDA Regulations – 21 CFR CFR 11
FDA GCP Concerns A strong IRB system Protection of vulnerable populations Data Quality and Integrity Advancing Technology (5/10 FDA guidance) Personalized Medicine / Pharmacogenomics International Research Subject Safety (AE reporting/CI Training) –Two guidances in draft: AE reporting; Investigator Responsibilities
Clinical Investigator Inspections – 2006
Clinical Compliance Issues Investigator responsibilities – critical to clinical compliance outcomes –FDA Form 1572 – Provides information regarding the investigator, protocols, research facilities / labs, responsible IRB, sub-investigator – Commits investigator to responsibilities –FDAs focus on Investigators Personal investigator involvement Focus on Informed Consent (21 CFR 50) and IRB responsibilities (21 CFR 56) Timely, accurate adverse event reporting Focus on financial disclosure compliance rules
Snatched from the Headlines… From THE WALL STREET JOURNAL, 6 August 2007 Drug: Experimnetal Gene Therapy Company: Targeted Genetics Subject: 36 year old woman Issue: Informed consent process Outcomes: Patient death; Negative media exposure of company Drug: Experimnetal Gene Therapy Company: Targeted Genetics Subject: 36 year old woman Issue: Informed consent process Outcomes: Patient death; Negative media exposure of company What happened: Trial investigator introduced study to patient during routine treatment Allegations of mixed signals with warnings due to doctor patient relationship If a patients doctor is an investigator, there should be additional counsel for the patient about study participation What happened: Trial investigator introduced study to patient during routine treatment Allegations of mixed signals with warnings due to doctor patient relationship If a patients doctor is an investigator, there should be additional counsel for the patient about study participation
Clinical Compliance Issues FDA Oversees Clinical Research through –Agency central review – primarily through safety reports and submissions –Bioresearch Monitoring Program (BIMO) Site inspections A few FDA Challenges with Clinical Trials –Large, multicenter studies –Data integrity (ALCOA - Attributable, Legible, Contemporaneous, Organized, and Accurate) –Ex-US studies –Oversight with Limited Resources
Clinical Compliance Issues Other Compliance Issues –Documentation practices – appropriateness of delegations of responsibility, attribution, and accuracy Preparation of Regulatory Binder –Product Compliance – dispensing, accountability, reconciliation –ICF accuracy – proper versions –Failure to maintain proper case histories –Investigation not done pursuant to signed investigation plan or investigator statement –Ensuring accurate AE reporting
Expanded Access for Investigational Drugs Abigail Alliance v. von Eschenbach –Issues involve 21 CFR – should terminally ill patients have access to purchase post-phase-I drugs?? –Impacts on the sponsor – liability, cost, etc. Oral argument on 3/1/07 – Decision Pending December 14, 06 – FDA issues proposed rule on Expanded Access to Investigational Drugs for Treatment Use (71 FR 240, 75147) UPDATE: August 7 th – U.S. Court of Appeals, DC Circuit, reverses District Court and denies right to expanded access. U P D A T E : A u g u s t 7 t h – U. S. C o u r t o f A p p e a l s, D C C i r c u i t, r e v e r s e s D i s t r i c t C o u r t a n d d e n i e s r i g h t t o e x p a n d e d a c c e s s.
CMS Draft Requirements for Clinical Research For drugs, biologics or devices that treat Medicare reimbursable diseases or injuries Provides what deemed studies are and outlines requirements and criteria –Protocol –Linkage of results in protocol to Medicare population –Inclusion criteria and consideration of subpopulations –Study results must be published
Compliance & Use of Third Party Services Continually increasing trend towards use of third parties for development activities –CROs / CRAs –AE Reporting –Bioanalytical Services / Testing –Services added all the time Some services being moved overseas, particularly those with IT components –Complaint, AE, Pharmacovigilence handling / reporting –Clinical studies –Clinical trials data analysis When its hard enough to keep operations in compliance with domestic oversight, how do we do this when operations are entrusted with another entity, halfway across the world?
FDA Letter to Sponsors of Approved ANDAs (1/07): [S]erious questions remain about the validity of bioequivalence data generated by MDS in studies during this time period that have not been inspected by FDA, including the studies you have submitted in support of your applications. In view of these findings, FDA is informing holders of approved ANDA(s) of these issues and would like to know what steps are being taken by you to assure the accuracy of data submitted in these applications and confirm the validity of MDS's analytical studies that were conducted from January 2000 through December 2004 and subsequently submitted to the FDA.. FDA Letter to Sponsors of Approved ANDAs (1/07): [S]erious questions remain about the validity of bioequivalence data generated by MDS in studies during this time period that have not been inspected by FDA, including the studies you have submitted in support of your applications. In view of these findings, FDA is informing holders of approved ANDA(s) of these issues and would like to know what steps are being taken by you to assure the accuracy of data submitted in these applications and confirm the validity of MDS's analytical studies that were conducted from January 2000 through December 2004 and subsequently submitted to the FDA.. Case Study: MDS Pharma Warning Letter: 12/04 A systematic problem of inadequate analysis and investigation of anomalous results across multiple studies for multiple sponsors. Warning Letter: 12/04 A systematic problem of inadequate analysis and investigation of anomalous results across multiple studies for multiple sponsors. Warning Letter: 8/06 [F]ailure to demonstrate the accuracy of your analytical methods in more than thirty studies for six different drugs confirm that there are widespread problems at your facilities…. Warning Letter: 8/06 [F]ailure to demonstrate the accuracy of your analytical methods in more than thirty studies for six different drugs confirm that there are widespread problems at your facilities…. Warning Letter: 12/04 FDA has concerns about the validity of other bioequivalence data generated by MDS, including data submitted in support of currently-approved applications. Warning Letter: 12/04 FDA has concerns about the validity of other bioequivalence data generated by MDS, including data submitted in support of currently-approved applications.
Case Study: MDS Pharma (Contd.) Lesson 1: You dont want to have submissions or approved products at risk due to third-party compliance issues. Lesson 2: FDA expectations change. Are your service providers keeping up? How do you know? Lesson 3: Sponsors maintain responsibility for their products – Responsibility is NOT able to be outsourced! Lesson 4: Continual oversight for 3-P services is essential.
Late Stage Development – CMC Issues Q7, Q8, Q9 & Q10 are big drivers in late stage development issues Risk-based focuses are now the desired end-state Cannot do enough product and process characterization –essential product requirements –critical to quality attributes –design space (multivariate analysis & modeling) –critical control points (HACCP & like methodologies) –Linearity and linkage from IND product through final formulation (including clinical impacts)
Preapproval Inspections Purpose: Insure application, data and sponsor operational integrity Joint Center/District activity with Office of Compliance Focus on: –cGMP compliance –Authenticity, integrity of data in the applications –Adherence to application commitments –Other factors potentially impacting whether Agency should approve application
Focus on Data Integrity – Examples Cutting and pasting of chromatographic data to change OOS results Manipulations of sample outcomes to force passing results Modifying weights of samples in analytical calculations Selective inclusion of raw data into final records Disconnect between results obtained and approved methods filed with Agency
Dont mess with data integrity…
Data Integrity – According to FDA… Issues with data integrity and fraud appear to be increasing Cuts across regulated product classes, and is occurring in clinical trials and elsewhere in the development process FDA is increasing staff focus on data integrity, data manipulation and fraud Increasing focus on PAIs and on the data integrity issues Focus on following up on tips or information provided regarding data integrity failures or fraud issues What they are seeing…What they are doing about it…
Four Quadrant Compliance Program Framework Process Management Process definition Process characterization Process execution Process Management Process definition Process characterization Process execution Governance Reporting & Management Review Metrics Executive Linkage Governance Reporting & Management Review Metrics Executive Linkage Compliance Systems Policies, Procedures, Work Instructions, etc. Personnel and organizational structures Audits, QA activities, etc. Compliance Systems Policies, Procedures, Work Instructions, etc. Personnel and organizational structures Audits, QA activities, etc. Knowledge & Environment Organizational Culture Regulatory Intelligence Training & Education Knowledge & Environment Organizational Culture Regulatory Intelligence Training & Education
Application of the 4Q Compliance Model to Pharmaceutical Development Look at compliance end to end – should track to end-to-end quality considerations Establish an overall Pre-Marketing Compliance Leadership – Ensures executive involvement Focus on ensuring no substantive gaps across the development cycle –Application of substantive requirements to company business processes / development models –Linkage from requirements to infrastructure elements
Application of the 4Q Compliance Model to Pharmaceutical Development (Contd.) Break down development cycle or substantive requirements into areas of compliance responsibility –Discovery / pre-clinical –GCP –Data assurance –Late stage / product transfer Incorporate compliance metrics into development cycle metrics – Create regular compliance Management Review Use third party (internal or external) compliance reviews for formal assessments -- No spin feedback is essential
Applied Regulatory Intelligence And remember… SystemsProcesses Research & Development Statutes, Regulations, Guidances, 483 / WL observations, Agency Statements, Case Law, etc. Application SystemsProcesses &
Clearly below legal requirements and enforcement expectations Clearly above legal requirements and enforcement expectations The Rolling the Dice Zone – How much risk do you want to take? Zones of Compliance Certainty
Closing Thoughts Is compliance a companys biggest challenge in pharmaceutical product development? Based on all this … will drug development get less complex? Less Risky? How will you manage this? Do you know where in the Zone of Compliance Certainty your organization is? By system? By process? Does executive management understand this material? Are you proactive or reactive in your approach to compliance? Why? What will you do differently when you get back to your company?
Thank you. Questions? For More Information, Contact: John C. (Jack) Garvey, Esq. THE WEINBERG GROUP INC. Office: Mobile: For More Information, Contact: John C. (Jack) Garvey, Esq. THE WEINBERG GROUP INC. Office: Mobile: