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PHARMACOVIGILANCE: CURRENT SCENARIO & FUTURE
CHALLENGES IN INDIA
JANESHWAR VERMA
PRESENTATION CONTENTS
Introduction
Why Pharmacovigilance
ADR Reporting procedure
Aim of Pharmacovigilance
Pharmacovigilance: Future challenges, Need & issues
Outcome of a successful program in Pharmacovigilance
Summery and Conclusion2
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INCREDIBLE INDIA
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The zero and decimal system were developed.
38% Doctors in America are Indian
12% Scientist in America are Indian
36% NASA employees are Indian
World’s largest democracy
Clinical Research Hub
Fourth largest exporter by volume of drugs
USFDA office in Delhi, Mumbai & ….
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PHARMACOVIGILANCE
The science and activities relating to the detection, assessment, understanding and prevention of adverse effects or any other drug-related problem (WHO 2002). 4
Pharmakon vigilare
Greek Latin
Drug to be awake or alert,
to keep watch
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WHY PHARMACOVIGILANCE?
Patients affected by preventable harm.
Top ten causes of mortality.
>10% of hospital admissions.
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HISTORY OF PHARMACOVIGILANCE Ja
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BRIEF HISTORY OF PHARMACOVIGILANCE
The Thalidomide Disaster
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BRIEF HISTORY OF PHARMACOVIGILANCEJa
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BRIEF HISTORY OF PHARMACOVIGILANCEJa
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INDIA ?
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BRIEF HISTORY OF PHARMACOVIGILANCE
Pharmacovigilance in India
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PHARMACOVIGILANCE HIGHLIGHTS:GROWTH OF THE WHO GLOBAL ICSR DATABASE
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individual case safety reports
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WHAT TO REPORT?
All suspected reactions
Lack of effect
Resistance
Interaction
Dependence and abuse
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WHICH TO REPORT?
Allopathic medicines including OTC
Traditional Medicines
Biologicals like vaccines and sera
Herbals
Blood products
Medical devices
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WHERE TO REPORT ?
Patient Health
Professional
Regional Centre
Manufacturer
Hospital
National Centre
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MAJOR HEALTH PROFESSIONALS
Physicians
Dentists
Pharmacists
Nurses
Other health workers
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WHEN IS AN ADR SERIOUS?
Death / life-threatening (real risk of dying)
Hospitalization (initial or prolonged)
Disability (significant, persistent or permanent)
Congenital anomaly
Requires intervention to prevent
Permanent impairment or damage
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Reporting form
1. The patient
2. Adverse event
3. Suspected drug(s)
4. All other drugs used
5. Risk factors
6. Name and address of reporter
Reporting forms will be distributed.
Telephone, fax and email used to reporting ADR’s. 21
REPORTING OF ADVERSE DRUG REACTIONJa
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AIM OF PHARMACOVIGILANCE
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Improve patient care and safety
Improve public health and safety
Early detection of unknown safety problems
Identification of risk factors
Quantifying risks
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AIMS OF PHARMACOVIGILANCE
Janeshwar Verma ITS, Ghaziabad
Assessment of benefit, harm & effectiveness
Promote understanding, education in PV.
Encouraging safe, rational, and effective use
Preventing patients from being affected unnecessarily
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AIMS OF PHARMACOVIGILANCE
Janeshwar Verma ITS, Ghaziabad
PARTNERS IN PHARMACOVIGILANCE
Partners in the practice of drug safety monitoring.
Government
Industry
Hospitals and academia
Medical and pharmaceutical associations
Health professionals
Patients
Consumers
Media
WHO 25
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INDIA TODAY
PV is still in its infancy in INDIA
Major advancement are in western countries
More clinical research conducted in India
Immense need to understand the importance of PV
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PHARMACOVIGILANCE,CHALLENGES, NEEDS & ISSUES
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Population that is predominantly rural.
Use of traditional medicines.
Poor reporting.
Lake of physician and consumer awareness.
Inadequate post marketing surveillance.
Surfeit no. of licensed drug manufactures (>6,000)
Surfeit no. of branded formulations (>60,000).
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PHARMACOVIGILANCECHALLENGES, NEEDS AND ISSUES
Need to move toward more active Pharmacovigilance PSURs (Periodic Safety Update Reports)
Post marketing studies
Risk Management plans (periodicity driven by risk)
Improved communication
Need to Strengthen Safety Reporting Requirements for: Medical Devices,
Food Supplements and
Herbal products. 29
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PHARMACOVIGILANCECHALLENGES, NEEDS AND ISSUES
Each country should:
Establish a PV system and collect information
Training of HCPs and Health Authorities.
Promote Product Safety Awareness.
Encourage all HCPs to report suspected ADRs.
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PHARMACOVIGILANCECHALLENGES, NEEDS AND ISSUES
OUTCOME OF A SUCCESSFUL PROGRAM IN
PHARMACOVIGILANCE
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OUTCOME OF A SUCCESSFUL PROGRAM IN PHARMACOVIGILANCE
Assessment of benefit, harm, effectiveness & risk.
Improve patient care and safety.
Improve public health and safety.
Promote understanding, education & training in PV.
Effective communication to the public.
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SUMMARY & CONCLUSION
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To minimize the harm, medicine should have good:
Efficacy: Evaluated from clinical trials.Quality: Established standards by GMP.Safety : By toxicology, clinical trials.
In all, Pharmacovigilance will promote:
Systematic and rational use of medicines
Boost confidence for safety.34
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SUMMARY & CONCLUSIONS
KEY MESSAGES
The NPvP launched to improve the current state
Its basic purpose is to analyze ADR data
Healthcare team actively participate in the program
They should start reporting AE
Help to ensure that children’s safety
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THANK YOU
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‘People who are vigilant do not die; people who are negligent are as if dead’.
Shakyamuni Buddha
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