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Sithole T, Mahlangu G, Capote V, Sitoie T, Shifotoka S, Gaeseb J, Danks L, Nkambule P, Juma A, Fimbo A, Munkombwe Z, Mwale B, Salek S, Walker S. Evaluation of the Review Models and Approval Timelines of Countries Participating in the Southern African Development Community: Alignment and Strategies for Moving Forward. Front Med (Lausanne) 2021; 8:742200. [PMID: 34513894 PMCID: PMC8429484 DOI: 10.3389/fmed.2021.742200] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 08/06/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Regulatory reliance, harmonization and work sharing have grown over the last few years, resulting in greater sharing of work and information among regulators, enabling efficient use of limited resources and preventing duplication of work. Various initiatives on the African continent include ZaZiBoNa, the Southern African Development Community (SADC) collaborative medicines registration initiative. ZaZiBoNa has resulted in great savings in time and resources; however, identified challenges include lack of clear information regarding the participating countries registration processes and requirements as well as lengthy registration times. The aim of this study, therefore, was to compare the data requirements and review models employed in the assessment of applications for registration, the target timelines for key milestones and the metrics of applications received and approved in 2019 and 2020 by Mozambique, Namibia, South Africa, Tanzania, Zambia, and Zimbabwe. Methods: A senior member of the division responsible for issuing marketing authorisations completed an established and validated questionnaire, which standardizes the review process, allowing key milestones, activities and practices of the six regulatory authorities to be identified and compared. The completed questionnaires were validated by the heads of the respective agencies. Results: The majority of applications received and approved by all six agencies in 2019 and 2020 were for generics. The mean approval times for generics varied across the countries, with ranges of 218-890 calendar days in 2019 and 158-696 calendar days in 2020. All three types of scientific assessment review models were used by the six agencies and data requirements and extent of scientific assessment were similar for five countries, while one conducted full reviews for new active substances. A large variation was observed in the targets set by the six agencies for the different milestones as well as overall approval times. Conclusions: The study identified the strengths of the countries as well as opportunities for improvement and alignment. Implementation of the recommendations made as in this study will enhance the countries' individual systems, enabling them to efficiently support the ZaZiBoNa initiative.
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Affiliation(s)
- Tariro Sithole
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
- Medicines Control Authority of Zimbabwe (MCAZ), Harare, Zimbabwe
| | - Gugu Mahlangu
- Medicines Control Authority of Zimbabwe (MCAZ), Harare, Zimbabwe
| | - Velma Capote
- National Directorate of Pharmacy in the Mozambique Ministry of Health, Maputo, Mozambique
| | - Tania Sitoie
- National Directorate of Pharmacy in the Mozambique Ministry of Health, Maputo, Mozambique
| | - Saren Shifotoka
- Namibia Medicines Regulatory Council (NMRC) in the Namibia Ministry of Health and Social Services, Windhoek, Namibia
| | - Johannes Gaeseb
- Namibia Medicines Regulatory Council (NMRC) in the Namibia Ministry of Health and Social Services, Windhoek, Namibia
| | - Lorraine Danks
- South African Health Products Regulatory Authority (SAHPRA), Pretoria, South Africa
| | - Portia Nkambule
- South African Health Products Regulatory Authority (SAHPRA), Pretoria, South Africa
| | - Alex Juma
- Tanzania Medicines and Medical Devices Authority (TMDA), Dar es Salaam, Tanzania
| | - Adam Fimbo
- Tanzania Medicines and Medical Devices Authority (TMDA), Dar es Salaam, Tanzania
| | - Zuma Munkombwe
- Zambia Medicines Regulatory Authority (ZAMRA), Lusaka, Zambia
| | - Bernice Mwale
- Zambia Medicines Regulatory Authority (ZAMRA), Lusaka, Zambia
| | - Sam Salek
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
- Institute for Medicines Development, Cardiff, United Kingdom
| | - Stuart Walker
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
- Centre for Innovation in Regulatory Science, London, United Kingdom
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Sithole T, Mahlangu G, Capote V, Sitoie T, Shifotoka S, Gaeseb J, Padayachee S, Sehloho T, Khea A, Fimbo A, Munkombwe Z, Mwale B, Salek S, Walker S. Evaluation of the Good Review Practices of Countries Participating in the Southern African Development Community: Alignment and Strategies for Moving Forward. Front Med (Lausanne) 2021; 8:742181. [PMID: 34513893 PMCID: PMC8429788 DOI: 10.3389/fmed.2021.742181] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 08/06/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: National medicines regulatory agencies are faced with challenges including limited resources and technical capacity, resulting in countries collaborating and sharing resources to improve efficiency of the review process to facilitate access to quality-assured medicines by their populations. One such collaboration is the Southern African Development Community (SADC) medicines registration collaborative initiative, ZaZiBoNa. Countries participate in the initiative by contributing to regulatory reviews and good manufacturing practices inspections. The aim of this study was to review and compare the registration processes of regulatory authorities of Mozambique, Namibia, South Africa, Tanzania, Zambia, and Zimbabwe to identify strategies for better alignment. Methods: A senior member of the division responsible for issuing marketing authorisations completed an established and validated questionnaire, which standardises the review process, allowing key milestones, activities and practices of the six regulatory authorities to be identified and compared. The completed questionnaires were validated by the heads of the respective agencies. Results: The six countries vary in population and in the size of their respective regulatory agency and the resources allocated to regulatory reviews. The review processes of the six agencies were similar; however, differences were noted in the milestones recorded; for example, two of the countries did not record the start of the scientific assessment. Additionally, decisions for marketing authorisation were made by an expert committee in four of the countries and by the head of the agency and the Minister of Health in two countries. All six agencies implemented the majority of good review practices; however, the need for improvement in the areas of transparency and communication and quality decision making practices was a common finding for all six countries. Conclusions: Participation in the ZaZiBoNa initiative has improved the way in which the six agencies perform regulatory reviews in their countries, highlighting the realisation of one of the key objectives of the initiative, which was building the expert capacity of member countries. Other agencies in the SADC region and beyond can use the results of this study to identify best practices, which in turn, could improve their regulatory performance.
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Affiliation(s)
- Tariro Sithole
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
- Medicines Control Authority of Zimbabwe, Harare, Zimbabwe
| | - Gugu Mahlangu
- Medicines Control Authority of Zimbabwe, Harare, Zimbabwe
| | - Velma Capote
- National Directorate of Pharmacy, Mozambique Ministry of Health, Maputo, Mozambique
| | - Tania Sitoie
- National Directorate of Pharmacy, Mozambique Ministry of Health, Maputo, Mozambique
| | - Saren Shifotoka
- Namibia Medicines Regulatory Council, Namibia Ministry of Health and Social Services, Windhoek, Namibia
| | - Johannes Gaeseb
- Namibia Medicines Regulatory Council, Namibia Ministry of Health and Social Services, Windhoek, Namibia
| | | | - Tohlang Sehloho
- South African Health Products Regulatory Authority, Pretoria, South Africa
| | - Akida Khea
- Tanzania Medicines and Medical Devices Authority, Dodoma, Tanzania
| | - Adam Fimbo
- Tanzania Medicines and Medical Devices Authority, Dodoma, Tanzania
| | | | - Bernice Mwale
- Zambia Medicines Regulatory Authority, Lusaka, Zambia
| | - Sam Salek
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
- Institute for Medicines Development, Cardiff, United Kingdom
| | - Stuart Walker
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
- Centre for Innovation in Regulatory Science, London, United Kingdom
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Wadhwa M, Kang HN, Jivapaisarnpong T, Andalucia LR, Blades CDRZ, Casas Levano M, Chang W, Chew JY, Chilufya MB, Chirachanakul P, Cho HG, Cho YO, Choi KM, Chong S, Chua HM, Farahani AV, Gencoglu M, Ghobrial MRW, Guha P, Gutierrez Lugo MT, Ha SB, Habahbeh S, Hamel H, Hong Y, Iarutkin A, Jang H, Jayachandran R, Jivapaisarnpong T, Kang HN, Kim DY, Kim GH, Kim Y, Kwon HS, Larsen J, Lee AH, Lee J, Medvedeva K, Munkombwe Z, Oh I, Park J, Park J, Putri DE, Rodgers J, Ryu S, Savkina M, Schreitmueller T, Semeniuk O, Seo M, Shin YI, Shin J, Srivastava S, Song H, Song S, Tavares Neto J, Wadhwa M, Yamaguchi T, Youn HJD, Yun M. WHO implementation workshop on guidelines on procedures and data requirements for changes to approved biotherapeutic products, Seoul, Republic of Korea, 25-26 June 2019. Biologicals 2020; 65:50-59. [PMID: 31959504 DOI: 10.1016/j.biologicals.2019.12.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 12/20/2019] [Indexed: 10/25/2022] Open
Abstract
The first global workshop on implementation of the WHO guidelines on procedures and data requirements for changes to approved biotherapeutic products adopted by the WHO Expert Committee in 2018 was held in June 2019. The workshop participants recognized that the principles based on sound science and the potential for risk, as described in the WHO Guidelines on post-approval changes, which constitute the global standard for product life-cycle management are providing clarity and helping national regulatory authorities in establishing guidance while improving time-lines for an efficient regulation of products. Consequently, the regulatory situation for post-approval changes and guideline implementation is changing but there is a disparity between different countries. While the guidelines are gradually being implemented in some countries and also being considered in other countries, the need for regional workshops and further training on post-approval changes was a common theme reiterated by many participants. Given the complexities relating to post-approval changes in different regions/countries, there was a clear understanding among all participants that an efficient approach for product life-cycle management at a national level is needed to ensure faster availability of high standard, safe and efficacious medicines to patients as per the World Health Assembly Resolution 67.21.
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Affiliation(s)
- Meenu Wadhwa
- National Institute for Biological Standards and Control, Medicines and Healthcare Products Regulatory Agency, Potters Bar, United Kingdom.
| | - Hye-Na Kang
- World Health Organization, Avenue Appia 20, CH-1211, Geneva, Switzerland.
| | - Teeranart Jivapaisarnpong
- National Biopharmaceutical Facility, King Mongkut's University of Technology Thonburi, Bangkhuntian, Bangkok, 10150, Thailand.
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- International MSD International GmbH, Singapore
| | | | | | - Mary Casas Levano
- General Directorate of Medicines Supplies and Drugs (DIGEMID), San Miguel, Peru
| | | | | | | | | | | | | | - Kyung Min Choi
- Ministry of Food and Drug Safety (MFDS), Republic of Korea
| | | | | | | | - Mumun Gencoglu
- International Federation of Pharmaceutical Manufacturers Association, Switzerland
| | | | | | | | | | | | | | | | - Aleksei Iarutkin
- Federal Service for Surveillance in Healthcare (Roszdravnadzor), Russian Federation
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Desi Eka Putri
- National Agency of Drug and Food Control (NADFC), Indonesia
| | | | | | - Maria Savkina
- The FSBI "SCEEMP of the Ministry of Health of the Russian Federation, Russian Federation
| | | | | | | | | | | | | | - HyeonHo Song
- ILDONG Pharmaceutical Co., Ltd, Republic of Korea
| | | | | | - Meenu Wadhwa
- National Institute for Biological Standards and Control, United Kingdom
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