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Our International Partnerships in Medicines Regulation Murray M. Lumpkin, M.D., M.Sc. Deputy Commissioner International and Special Programs U.S. Food and Drug Administration

Our International Partnerships in Medicines Regulation Murray M. Lumpkin, M.D., M.Sc. Deputy Commissioner International and Special Programs U.S. Food

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21 st Century Reality The world in which we operate has radically changed, and continues to do so. Promote and protect public health in the globalized world in which our regulated products are discovered, developed, manufactured, authorized, promoted, marketed, and used by consumers, practitioners and patients.

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Page 1: Our International Partnerships in Medicines Regulation Murray M. Lumpkin, M.D., M.Sc. Deputy Commissioner International and Special Programs U.S. Food

Our International Partnerships

in Medicines RegulationMurray M. Lumpkin, M.D., M.Sc.

Deputy CommissionerInternational and Special ProgramsU.S. Food and Drug Administration

Page 2: Our International Partnerships in Medicines Regulation Murray M. Lumpkin, M.D., M.Sc. Deputy Commissioner International and Special Programs U.S. Food

International Regulatory Cooperation

• No longer discretionary

• Integral and pivotal part of the work we and our counterpart agencies perform

• Only way to accomplish our domestic mission

Page 3: Our International Partnerships in Medicines Regulation Murray M. Lumpkin, M.D., M.Sc. Deputy Commissioner International and Special Programs U.S. Food

21st Century Reality• The world in which we operate has

radically changed, and continues to do so.

• Promote and protect public health in the globalized world in which our regulated products are discovered, developed, manufactured, authorized, promoted, marketed, and used by consumers, practitioners and patients.

Page 4: Our International Partnerships in Medicines Regulation Murray M. Lumpkin, M.D., M.Sc. Deputy Commissioner International and Special Programs U.S. Food

21st Century Reality• Our borders are now boundaries, • NOT barriers

– Not barriers to disease– Not barriers to information flow– Not barriers to product acquisition

– Are boundaries to our jurisdiction

Page 5: Our International Partnerships in Medicines Regulation Murray M. Lumpkin, M.D., M.Sc. Deputy Commissioner International and Special Programs U.S. Food

21st Century Reality• None of us have the financial, human,

or scientific resources to do all that our parliaments and people ask and expect of us

• Cannot meet our mission by only looking within one’s own borders

Page 6: Our International Partnerships in Medicines Regulation Murray M. Lumpkin, M.D., M.Sc. Deputy Commissioner International and Special Programs U.S. Food

21st Century Reality• Borders can no longer be the first line of

defense – Import Safety Working Group Action Plan; Food Protection Plan

• We can no longer “inspect” out bad products at the border

• Borders must be places where we “audit” that indeed quality has been built in at the point of manufacture

Page 7: Our International Partnerships in Medicines Regulation Murray M. Lumpkin, M.D., M.Sc. Deputy Commissioner International and Special Programs U.S. Food

21st Century Reality• No national or regional regulatory

authority has a monopoly on good science or good regulatory practices.

• The sum of our parts is clearly superior to their individual value.

Page 8: Our International Partnerships in Medicines Regulation Murray M. Lumpkin, M.D., M.Sc. Deputy Commissioner International and Special Programs U.S. Food

21st Century Reality• Regulatory cooperation is no longer

discretionary.

• Regulatory cooperation must become a standard operating procedure of 21st century flagship medicinal products regulatory authorities

Page 9: Our International Partnerships in Medicines Regulation Murray M. Lumpkin, M.D., M.Sc. Deputy Commissioner International and Special Programs U.S. Food

21st Century Reality• We must still respect the great diversity

in, and the richness it brings to, the legal, societal, and medical practice foundations upon which each regulatory authority must act within its own jurisdiction.

Page 10: Our International Partnerships in Medicines Regulation Murray M. Lumpkin, M.D., M.Sc. Deputy Commissioner International and Special Programs U.S. Food

FDA’s Statutory Mission• SEC. 903. [ 21 U.S.C. 393] FOOD AND DRUG ADMINISTRATION. • (b) MISSION.—The Administration shall—• (1) promote the public health by promptly and efficiently reviewing

clinical research and taking appropriate action on the marketing of regulated products in a timely manner;

• (2) with respect to such products, protect the public health by ensuring that—

• (A) foods are safe, wholesome, sanitary, and properly labeled;• (B) human and veterinary drugs are safe and effective;• (C) there is reasonable assurance of the safety and effectiveness of

devices intended for human use;• (D) cosmetics are safe and properly labeled; and• (E) public health and safety are protected from electronic product

radiation;

Page 11: Our International Partnerships in Medicines Regulation Murray M. Lumpkin, M.D., M.Sc. Deputy Commissioner International and Special Programs U.S. Food

FDA’s Statutory Mission

• (3) participate through appropriate processes with representatives of other countries to reduce the burden of regulation, harmonize regulatory requirements, and achieve appropriate reciprocal arrangements;

Page 12: Our International Partnerships in Medicines Regulation Murray M. Lumpkin, M.D., M.Sc. Deputy Commissioner International and Special Programs U.S. Food

International Cooperative Activities• Bilateral and multilateral efforts to

leverage the human, scientific, and financial resources of and the knowledge and experience of other key trusted regulatory authorities so as to avoid duplication of effort, to make our activities more efficient, and to allow us to focus our limited resources on higher-risk areas of concern.

Page 13: Our International Partnerships in Medicines Regulation Murray M. Lumpkin, M.D., M.Sc. Deputy Commissioner International and Special Programs U.S. Food

Increased Bilateral Cooperation• Increase the efficiency and impact of

information and human resource exchange– Focus on specific information – Focus of timing of exchange– Institutionalize the processes

• Formal• Informal - Peer sounding boards

Page 14: Our International Partnerships in Medicines Regulation Murray M. Lumpkin, M.D., M.Sc. Deputy Commissioner International and Special Programs U.S. Food

“The Pyramid”

CONFIDENTIALITY ARRANGEMENTS

IMPLEMENTATION PLAN

TOOLS FOR CLOSER BILATERAL COOPERATION

SPECIFIC POINTS OF CONTACT FOR PUBLIC INFO

Page 15: Our International Partnerships in Medicines Regulation Murray M. Lumpkin, M.D., M.Sc. Deputy Commissioner International and Special Programs U.S. Food

Confidentiality Arrangements:Key Counterpart Agencies

• Japan• Mexico• Netherlands• New Zealand• Singapore• South Africa• Sweden• Switzerland• United Kingdom

• Australia• Belgium• Canada• Denmark• EU/EMEA• EU/EFSA• France• Germany• Ireland• Israel

Page 16: Our International Partnerships in Medicines Regulation Murray M. Lumpkin, M.D., M.Sc. Deputy Commissioner International and Special Programs U.S. Food

Confidentiality Arrangements

• Legal Framework – Commercial confidential– Pre-decisional– Investigative – compliance– NOT Trade Secret

– NO requirement to exchange anything

Page 17: Our International Partnerships in Medicines Regulation Murray M. Lumpkin, M.D., M.Sc. Deputy Commissioner International and Special Programs U.S. Food

Implementation Plans• Depends on country and issues being

addressed – level of capability, history of interactions, level of confidence

• None is more robust or active than ours with the EU and EMEA on medicinal products

• Work in many arenas – multilaterally– ICH, VICH, GHTF, ICRR, WHO

Page 18: Our International Partnerships in Medicines Regulation Murray M. Lumpkin, M.D., M.Sc. Deputy Commissioner International and Special Programs U.S. Food

Implementation Plans• The European Commission and the

EMEA are two of our most important counterpart agencies and the ones with whom we feel we have one of the most developed, most bilaterally productive relationships – personally, professionally, and organizationally.

Page 19: Our International Partnerships in Medicines Regulation Murray M. Lumpkin, M.D., M.Sc. Deputy Commissioner International and Special Programs U.S. Food

Implementation Plans• These arrangements form the

framework for our almost daily interactions with our European counterparts on these products, and they help focus attention on those areas we have agreed for more intense work during the year.

Page 20: Our International Partnerships in Medicines Regulation Murray M. Lumpkin, M.D., M.Sc. Deputy Commissioner International and Special Programs U.S. Food

Implementation Plans• We meet formally with our European

colleagues at least once a year (at which the work plan for the next year is agreed), and we meet with them informally innumerable times each year in person, on the telephone, or in cyberspace.

Page 21: Our International Partnerships in Medicines Regulation Murray M. Lumpkin, M.D., M.Sc. Deputy Commissioner International and Special Programs U.S. Food

Implementation Plans• “Clusters”

– Pediatrics, vaccines, pharmacogenomics, oncology, orphans, product safety

– Monthly (if not more often) telephone conferences about specific issues and products during which they leverage each other's scientific perspective and insight and regulatory resources.

Page 22: Our International Partnerships in Medicines Regulation Murray M. Lumpkin, M.D., M.Sc. Deputy Commissioner International and Special Programs U.S. Food

History• 12 Sept 2003 – Confidentiality Arrangements• 16 Sept 2004 – Implementation Plan• 17 Sept 2004 – Guidance on Parallel Scientific Advice• 12 Sept 2005 – Confidentiality Arrangements

extended to 2010• 21 May 2006 – Voluntary Genomics Data

Submissions Guidance• 02 July 2007 – Arrangements on medical devices and

cosmetics • 02 July 2007 – Implementation Plan Updated• October 2007 – Joint Orphan Products Designation

Form

Page 23: Our International Partnerships in Medicines Regulation Murray M. Lumpkin, M.D., M.Sc. Deputy Commissioner International and Special Programs U.S. Food

Regulatory Cooperation between EC and US FDA

• Ad-hoc upstream regulatory cooperation– Non papers on regulatory issues prior to the

drafting of new legislation or regulations– Advance drafts of legislation in the EU and

advance drafts of regulations in the US– Implementing technical texts such as guidelines– Staff exchanges– Bilateral meetings and workshops

Page 24: Our International Partnerships in Medicines Regulation Murray M. Lumpkin, M.D., M.Sc. Deputy Commissioner International and Special Programs U.S. Food

Regulatory Cooperation between EMEA and the US FDA

• Regular information exchanges– Quarterly: newly submitted MAAs, MAAs

still undergoing review, MAAs on which a marketing decision has been made that quarter and what the decision was (for post-authorization applications, limited to major public health interest such as new indications or important safety concerns

Page 25: Our International Partnerships in Medicines Regulation Murray M. Lumpkin, M.D., M.Sc. Deputy Commissioner International and Special Programs U.S. Food

Regulatory Cooperation between EMEA and the US FDA

• Regular information exchanges– Listings of GCP inspections performed

since last report and likely to be performed– As requested, pharmacovigilance

inspection reports– GMP – access to COMSTAT and EudraGMP

Page 26: Our International Partnerships in Medicines Regulation Murray M. Lumpkin, M.D., M.Sc. Deputy Commissioner International and Special Programs U.S. Food

Regulatory Cooperation between EMEA and the US FDA

• Ad-hoc exchanges– Emergency information (usually related to

safety/public health or major news impact)

– Urgent Requests (data to be provided in 24 hours)– Expedited Requests (4 working days)– Standard Requests (2 weeks)

Page 27: Our International Partnerships in Medicines Regulation Murray M. Lumpkin, M.D., M.Sc. Deputy Commissioner International and Special Programs U.S. Food

Regulatory Cooperation between EMEA and the US FDA

• Ad-hoc exchanges– Parallel Scientific Advice Programme– Issues with specific MAAs not covered by the

regular exchanges– Product-specific pharmacovigilance issues

(especially black boxes or more stringent regulatory actions / changes affecting product licensing status and resulting in public information)

Page 28: Our International Partnerships in Medicines Regulation Murray M. Lumpkin, M.D., M.Sc. Deputy Commissioner International and Special Programs U.S. Food

Regulatory Cooperation between EMEA and the US FDA

• Ad-hoc exchanges– Actions to restrict distribution that may

have an impact on each other’s market – Issues of general public interest (BSE,

counterterrorism)

Page 29: Our International Partnerships in Medicines Regulation Murray M. Lumpkin, M.D., M.Sc. Deputy Commissioner International and Special Programs U.S. Food

FDA Presence outside USA• Believe it is necessary to help make our

interactions with counterparts more useful

• Full time focus on these relationships• Bilaterally helpful – a win/win• China, India, Europe, Middle East, Latin

America

Page 30: Our International Partnerships in Medicines Regulation Murray M. Lumpkin, M.D., M.Sc. Deputy Commissioner International and Special Programs U.S. Food

THANK YOU!