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Change Management System

US Market (Supplement):

Post approval drug manufacturing supplement for NDAs/ ANDA submitted to FDA for Major or Moderate manufacturing change.
Major change -
If a manufacturing change is considered to be major, an applicant must submit and receive FDA approval of a prior-approval supplement (PAS) before the drug product made with the change is distributed.
Moderate change-
If a manufacturing change is considered to be moderate, an applicant must submit a supplement at least 30 days before the drug product is distributed (a CBE-30 supplement) or, in some cases, submit a supplement at the time of distribution (a CBE-0 supplement).  “CBE” means “changes-being-effected”.
Post manufacturing supplement -
1. CBE 0 (Change being effected before 00 days):
2. CBE 30 (Change being effected before 30 days):
3. PAS (Prior approval supplement):

EUROPE Market (Variation):

A variation to the terms of a marketing authorization is an amendment to the contents of the documents of the approved dossier.

Variations are classified in following categories-
1. Minor variation
   A) Type-IA: Which have only a minimal impact or no impact at all. Do not require prior approval before implementation (Do and tell procedure).
       a) Type-IAIN: Requires immediate notification (within two weeks after implementation)- in order to ensure the continuous supervision of the medicinal product.
i.e. - Change in name and address of MAH.
       b) Type-IA: Do not requires immediate notification and may be submitted by MAH within 12 months after implementation.
i.e. - Addition of Physico- chemical tests.

   B) Type-IB: Should be notified to National competent authority/ EMA by the MAH before implementation. MAH must wait for 30 days to ensure that the notification is acceptable by the agency before implementing the change (tell, wait and do procedure).- Min to moderate impact on product quality.
i.e. - Change in storage condition.
2. Major variation: Variation which may have significant impact on the quality/safety and efficacy of the products.
i.e. - Relaxation of approved specification.
3. Extension (New application)
i.e. - Change in API, Strength, Dosage form, Route of administration etc.


Health Canada-

The following criteria are meant to provide guidance with respect to the classification of a quality related change. Specific change examples based on the application of these criteria are provided in Appendix 1 (Human Pharmaceuticals), Appendix 2 (Veterinary drugs), Appendix 3 (Biologics) and Appendix 4 (Schedule C drugs) that follow.

Management of Drug Submissions (drugs for human use)

Management of Regulatory Submissions (drugs for veterinary use).

 

1.      Level I ‐ Supplements (major quality changes)

Level I ‐ Supplements (Major Quality Changes) are changes that have a substantial potential to have an adverse effect on the identity, strength, quality, purity, or potency of a drug product as these factors may relate to the safety or effectiveness of the drug product.

 

In general, a change that is supported by extensive documentation and/or requiring extensive assessment of the supporting documentation would be considered a Level I ‐ Supplement (Major Quality Change) (e.g., a change supported by in vivo studies). This is to allow Health Canada the opportunity to apply the principles of risk management by having the necessary time for an appropriate assessment of the documentation. This assessment will take into consideration any potential impact upon market availability as well as the adverse effects on the identity, strength, quality, purity, or potency of the drug product.

 

The changes included in this reporting category shall be filed, along with the recommended

supporting data, to Health Canada as a Supplement to a New Drug Submission (SNDS) or a

Supplement to an Abbreviated New Drug Submission (SANDS). The change may not be

implemented by the sponsor until a NOC has been issued.

 

2.      Level II ‐ Notifiable Changes (moderate quality changes)

Level II ‐ Notifiable Changes (Moderate Quality Changes) are changes that have a moderate potential to have an adverse effect on the identity, strength, quality, purity, or potency of the drug product as these factors may relate to the safety or effectiveness of the drug product.

 

The changes included in this reporting category should be filed, along with the recommended supporting data, to Health Canada as a Notifiable Change.

 

All Level II changes should not be implemented by the sponsor until a No Objection Letter (NOL) has been issued.

 

3.      Level III ‐ Annual Notification (minor quality changes)

Level III ‐ Annual Notification (Minor Quality Changes) are changes that have minimal potential to have an adverse effect on the identity, strength, quality, purity, or potency of the drug product as these factors may relate to the safety or effectiveness of the drug product.

 

The changes included in this reporting category may be implemented by the sponsor without the prior review by Health Canada of the data supporting such a change. All Level III changes should be submitted using the Post‐Notice of Compliance Changes: Notices of Change (Level III) Form. Supporting data for the Level III changes recommended in this guidance document should not be submitted; however, the data should be available to Health Canada within thirty (30) calendar days, if requested at any time.

 

4.      Level IV Changes ‐ record of changes


Level IV (Quality only) changes are changes to a new drug that are not Level I, Level II or Level III and are not expected to have an adverse effect on the identity, strength, quality, purity, or potency of the drug product as these factors may relate to the safety or effectiveness of the drug product. The changes included in this reporting category may be implemented by the sponsor without prior review by Health Canada. The changes should be retained as part of the drug product’s record by either the sponsor or the manufacturer and comply with Good Manufacturing Practices (GMP) requirements of Division 2 of the Food and Drug Regulations. 


ICH Q12 - TECHNICAL AND REGULATORY CONSIDERATIONS FOR PHARMACEUTICAL PRODUCT LIFECYCLE MANAGEMENT

This guidance is part of other ICH guidelines based on quality evaluation of the drug product ICH Q8, Q9 and Q10. It describes the concepts and directives to use the pharmaceutical industry knowledge of the product to propose regulatory classification to the post approval changes. In this way the guidance is amplifying the scope described in the previous ICH guidance of the "quality by design" concept to the marketed products.

ICH Q12 describes that the change being proposed could be summarized in a post approval management protocol (PACMP) that is applied to the evaluation of the regulatory agency. This protocol needs also to describe the established conditions (EC).

 

The EC can be described as the summary of the important characteristics of the product that, when changed, could cause an impact to its quality and/or safety. The PACMP in this context, is a document that will summarize the change itself as well as the evaluation of each EC when applying the proposed change, evaluating the risk of the change. Depending on the knowledge of the product and the impact of the proposed change, the company could propose a regulatory classification different from described in previous post approval guidance. So, a change that previously was being classified as type II variation could be classified even as a notification depending on the PACMP information.

The PACMP has two steps: one is the application of the protocol itself and the evaluation of the overall strategy by the regulatory agency. In this step regulatory agency could agree (or not) with the strategy, studies and the proposed regulatory classification. The second step is the application of the results obtained following the PACMP. The results could corroborate the initial protocol and, in this case, the change could be implemented as defined in the protocol, or can be against what was initially assumed. In this last case the change needs to be applied as a post approval change to be evaluated by the Agency.

A last document is the product lifecycle management (PLCM). This documents poses as a "live" information of the product characteristics and the history of the changes. It must be updated when a post approval or a PACMP is submitted or evaluated and needs to reflect the actual regulatory status of the product within the Agency. Is part of the quality system of the MAH.

The knowledge of the product not only serves as an important part of the process to have a lower regulatory classification but also serves to change the EC of the product. Depending on the knowledge of the product an EC could be included, changed or excluded. This changes on EC needs to be applied and approved by the Agency as well.

How this proposal fits to the Brazilian regulation on post approval changes?

ANVISA is the regulatory Agency in Brazil. The post approval change process in Brazil was totally changed by the new regulation, RDC 73/2016, that replaced RDC 48/2009. Different from other post approval changes regulation in high regulated countries as FDA and EMA, the major changes are described in RDC 73/2016 and the document list for this changes are also described in details within the regulation.

RDC 73/2016 describes categories of variation that could range from an Annual reports to a post approval change but all them are described and categorized. There is little to no room for discussion in respect of regulatory classification for the proposed the change.

Also RDC 73/2016 brought a document called "PATE" that is similar to the "AF" in Japan and the PACMP described in ICH Q12. It needs to be filled in each post approval change application and the company should describe the product characteristics according to the last approval by the Agency (similar to the EC) and the change itself evaluating how the change impacts the controls, quality and efficacy of the drug product, very similar to the PACMP process described in ICHQ12. The difference relies on the fact that, in Brazil, no matter how do you know your product, there is little chance on classifying it differently than described in RDC 73/2016. There is some room to apply to a different classification when the change is related to the manufacturing process and the company has process validation showing that the proposed change does not affect the quality of the product, in this case the change could be classified as minor and the regulatory classification will be by immediate implementation. For other changes there is no space for discussion on regulatory classification of the variation.

There is also no evaluation of this PATE prior to the conduction of the studies. The company is responsible for regulatory classification and the studies to be conducted according to it. Once the documents for post approval application are finalized, the company should apply them to ANVISA´s evaluation. If the company applied by wrong regulatory classification (especially a minor instead of major change), the company could be punished with the withdrawal of the application by immediate implementation for all products within an year. This could make the companies always apply for the worst scenario (post approval application) instead of encourage them to use the knowledge to have a lower regulatory classification.

PATE could works as a PLCM described in ICH because the company should have the PATE updated with the change and ANVISA´s approval history.

As a member of ICH ANVISA will need to comply at some time to the ICH Q12 guidance and the process of evaluation is being conducted by the industry.

Personally I think that it is a great opportunity to start using PATE as a tool for previous evaluation of the change proposal and to give the companies power for evaluation of the risk for the variations in quality and safety of the products. This could speed up the post approval evaluation time and make the companies more aligned and close to the Agency. By the end of the day this will give the company celerity to apply the changes and the population better and improved medicines.


ICH Q10-
Objective:
Implementation of the Q10 model should result in achievement of three main objectives which complement or enhance regional GMP requirements.
1. Achieve Product Realisation-
To establish, implement and maintain a system that allows the delivery of products with the quality attributes appropriate to meet the needs of patients, health care professionals, regulatory authorities (including compliance with approved regulatory filings) and other internal and external customers.
2. Establish and Maintain a State of Control-
To develop and use effective monitoring and control systems for process performance and product quality, thereby providing assurance of continued suitability and capability of processes. Quality risk management can be useful in identifying the monitoring and control systems.
3. Facilitate Continual Improvement-
To identify and implement appropriate product quality improvements, process
improvements, variability reduction, innovations and pharmaceutical quality system enhancements, thereby increasing the ability to fulfil quality needs consistently. Quality risk management can be useful for identifying and prioritising areas for continual improvement.

ICH Q9-
Additionally, the pharmaceutical industry and regulators can assess and manage risk using recognized risk management tools and/ or internal procedures (e.g., standard operating procedures). Below is a non-exhaustive list of some of these tools (further details in Annex 1 and chapter 8):
• Basic risk management facilitation methods
(flowcharts, check sheets etc.);
• Failure Mode Effects Analysis (FMEA);
• Failure Mode, Effects and Criticality Analysis (FMECA);
• Fault Tree Analysis (FTA);
• Hazard Analysis and Critical Control Points (HACCP);
• Hazard Operability Analysis (HAZOP);
• Preliminary Hazard Analysis (PHA);
• Risk ranking and filtering;
• Supporting statistical tools.

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