proof of interchangeability of pharmaceutical products and ......pharmaceuticals are generic (73% in...

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Proof of interchangeability of Proof of interchangeability of pharmaceutical products and assurance pharmaceutical products and assurance of their quality in Ukraine of their quality in Ukraine е е - - mail: mail: baula baula @ @ pharma pharma - - center. center. kiev kiev . . ua ua site: site: www. www. pharma pharma - - center. center. kiev kiev . . ua ua phone: phone: +38 (044) 498 4303 +38 (044) 498 4303 Olga Olga Baula Baula State Pharmacological Center State Pharmacological Center MoH MoH Ukraine Ukraine ICDRA Berne, 16 September, 2008

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Page 1: Proof of interchangeability of pharmaceutical products and ......Pharmaceuticals are Generic (73% in Ukraine) Innovator (13% in Ukraine) equivalent (therapeutically Interchangeability

Proof of interchangeability of Proof of interchangeability of pharmaceutical products and assurance pharmaceutical products and assurance

of their quality in Ukraineof their quality in Ukraine

ее--mail: mail: baulabaula@@pharmapharma--center.center.kievkiev..uauasite: site: www.www.pharmapharma--center.center.kievkiev..uauaphone:phone: +38 (044) 498 4303+38 (044) 498 4303

OlgaOlga BaulaBaulaState Pharmacological CenterState Pharmacological Center MoHMoH UkraineUkraine

ICDRABerne, 16 September, 2008

Page 2: Proof of interchangeability of pharmaceutical products and ......Pharmaceuticals are Generic (73% in Ukraine) Innovator (13% in Ukraine) equivalent (therapeutically Interchangeability

Population = 46.3 millionPopulation = 46.3 million

The geographical center of Europe is situated on The geographical center of Europe is situated on the territory of Ukrainethe territory of Ukraine

•• Area Area –– 603,700 km2603,700 km2(5,7 % area of Europe)(5,7 % area of Europe)

•• 2nd in Europe by area size2nd in Europe by area size

UkraineUkraineCapital Capital –– KievKiev

Situated in the SouthSituated in the South--East East of Eastof East--European Valley European Valley (Central(Central--Eastern Europe)Eastern Europe)

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Page 3: Proof of interchangeability of pharmaceutical products and ......Pharmaceuticals are Generic (73% in Ukraine) Innovator (13% in Ukraine) equivalent (therapeutically Interchangeability

Pharmaceutical Sector of UkrainePharmaceutical Sector of UkraineIn

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Registration certificatesRegistration certificates1297212972

Finished pharmaceutical Finished pharmaceutical products (FPP)products (FPP)

1086910869 FFP packaging from in bulkFFP packaging from in bulk872872

Active pharmaceutical Active pharmaceutical ingredients (API)ingredients (API)

12411241Domestic Domestic –– 3322 (3322 (25,625,6%)%)

Imported Imported –– 75477547 (58,1%)(58,1%) Domestic Domestic –– 101101 (0,8%)(0,8%)

Imported Imported –– 761761 (5,9%)(5,9%)

DoemsticDoemstic –– 192192 (1,5%)(1,5%)

Imported Imported –– 10491049 (8,1%)(8,1%)

Share in money Share in money –– $2 billion$2 billion

Increase of market shareIncrease of market share–– at least 20% per yearat least 20% per year

ManufactureManufacture– 147 domestic enterprises147 domestic enterprises

Page 4: Proof of interchangeability of pharmaceutical products and ......Pharmaceuticals are Generic (73% in Ukraine) Innovator (13% in Ukraine) equivalent (therapeutically Interchangeability

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BackgroundBackground

19931993 –– registration process for pharmaceuticals was launched in registration process for pharmaceuticals was launched in UkraineUkraine

19961996 –– adoption of the Law of Ukraine adoption of the Law of Ukraine ““On MedicinesOn Medicines””

20012001 –– alignment of rules governing pharmaceuticals in Ukraine with alignment of rules governing pharmaceuticals in Ukraine with EU principlesEU principles

20052005 –– adoption of a set of regulations related to generic adoption of a set of regulations related to generic interchangeabilityinterchangeability

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Page 5: Proof of interchangeability of pharmaceutical products and ......Pharmaceuticals are Generic (73% in Ukraine) Innovator (13% in Ukraine) equivalent (therapeutically Interchangeability

Regulatory requirements for equivalence assessment of generic products in Ukraine

Decree of the Cabinet of Ministers of Ukraine of May 26, 2005 № 376 (as amended)

Order of the Ministry of Health of Ukraine of 26.08.2005 №426 (as amended)

Order of the Ministry of Health of Ukraine of 17.04.2007 №190

Guidelines 42 – 7.1.2005 “Guidelines on clinical trials. Bioavailability and bioequivalence studies”

State Pharmacopoeia of Ukraine – 1st edition –Supplement 2 2008. 5.14.2 “Bioavailability and bioequivalence studies of generic products”

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Page 6: Proof of interchangeability of pharmaceutical products and ......Pharmaceuticals are Generic (73% in Ukraine) Innovator (13% in Ukraine) equivalent (therapeutically Interchangeability

Harmonization

Regulatory requirements adopted in Ukraine concerning bioavailability and bioequivalence studies of generic products have beendeveloped in compliance developed in compliance withwith EMEA guidelines EMEA guidelines andandWHO recommendationsWHO recommendations

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Page 7: Proof of interchangeability of pharmaceutical products and ......Pharmaceuticals are Generic (73% in Ukraine) Innovator (13% in Ukraine) equivalent (therapeutically Interchangeability

Pharmaceuticals are

Generic (73% in Ukraine)

Innovator (13% in Ukraine)

equivalentequivalent(therapeutically (therapeutically

interchangeable)interchangeable)

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Quality

Efficacy

Safety

Has reliable evidence Has reliable evidence of efficacy, safety and of efficacy, safety and quality, is originally quality, is originally registered based on full registered based on full registration dossier and registration dossier and is/was under the patent is/was under the patent protectionprotection

Meets the same Meets the same quality, efficacy and quality, efficacy and safety standards as an safety standards as an innovation product,innovation product,

designed for its designed for its therapeutic therapeutic

interchangeabilityinterchangeabilityand marketed after and marketed after expiry of the patent or expiry of the patent or exclusivity right to an exclusivity right to an innovation productinnovation product

Page 8: Proof of interchangeability of pharmaceutical products and ......Pharmaceuticals are Generic (73% in Ukraine) Innovator (13% in Ukraine) equivalent (therapeutically Interchangeability

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Bioequivalence

Pharmaceutical alternatives

InterchangeabilityInterchangeability

Pharmaceutical equivalence

Identity of qualitative and quantitative parameters of active ingredientIdentity of dosage formIdentity or similarity ofexcipient’s contentEquivalence of pharmaceutical developmentEquivalence of quality specifications and requirements to manufacture (GMP)

Same molar amount of the same active pharmaceutical moietyActive pharmaceutical ingredient has different chemical form (other salts or ethers) Different pharmaceutical form (tablets, capsules) Equivalence of pharmaceutical developmentEquivalence of quality specifications and requirements to manufacture (GMP)

Two products are bioequivalent if they are:Pharmaceutically equivalent or pharmaceutically alternativesHave similar bioavailabilityProvide the same efficacy and safety after administration in thesame molar dose

InterchangeabilityMain feature of generic is a therapeutic interchangeabilityMain feature of generic is a therapeutic interchangeability

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Page 9: Proof of interchangeability of pharmaceutical products and ......Pharmaceuticals are Generic (73% in Ukraine) Innovator (13% in Ukraine) equivalent (therapeutically Interchangeability

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Structure of pharmaceuticals registered in UkraineStructure of pharmaceuticals registered in Ukraine

7%

13%

73%

2%

3%

2%

GenericInnovatorOther pharmaceuticalsBiologicalHomeopathicTraditional herbal / products of well-established use

3% 2%5%5%

9%

19%

57%

Solid oralParenteralTopicalLiquid oralNasal, ophthalmic, aerosolBiologicalHomeopathic

About 5500 generic products which interchangeability to be justiAbout 5500 generic products which interchangeability to be justified including:fied including:

35%35% -- registered based on BE/BA documented evidenceregistered based on BE/BA documented evidence

AboutAbout 1,5%1,5% -- pharmaceutical products registered for pharmaceutical products registered for ««historical reasonshistorical reasons»»

63%63% -- generic productsgeneric products ??????

Page 10: Proof of interchangeability of pharmaceutical products and ......Pharmaceuticals are Generic (73% in Ukraine) Innovator (13% in Ukraine) equivalent (therapeutically Interchangeability

Equivalence assessment procedure

ComparatorComparator GenericGeneric

At least 3 bathes from which one with interim results of dissolution

testing is selected

At least 1/10 manufacturing batch or manufacturing batch

(<100 000 items)

Pharmaceutical equivalence or alternatives

In vitro comparative studies using dissolution testing

In vivo comparative studies

In vitro/in vivo correlation (IVIVC)

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Page 11: Proof of interchangeability of pharmaceutical products and ......Pharmaceuticals are Generic (73% in Ukraine) Innovator (13% in Ukraine) equivalent (therapeutically Interchangeability

In vitro comparative studies

Biowaiver –is a procedure for registration of solid dosage forms based onBiopharmaceutics Classification System (BCS) and results of in vitrocomparative studies using dissolution testing

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FPP dissolution

(FPP)

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API solubility API solubility

(API)(API)

API permeability API permeability

(API)(API)

Products registered throughbiowaiver procedure

• Diazepam

• ASA

• Letrozole

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Applications for registration rejectedApplications for registration rejected

Lack of pharmaceutical equivalenceLack of pharmaceutical equivalence

Inadequate quality of APIInadequate quality of API

Improper selection of a comparator productImproper selection of a comparator product

NonNon--evident BE/BAevident BE/BA

In 2007 each fifth application for registration was rejectedIn 2007 each fifth application for registration was rejected

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Page 13: Proof of interchangeability of pharmaceutical products and ......Pharmaceuticals are Generic (73% in Ukraine) Innovator (13% in Ukraine) equivalent (therapeutically Interchangeability

Example of comparative pharmacokinetic studies ofFluconazole

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112.802398.3170AUCinf

109.787096.6373AUClast

98.674089.5639Cmax

Upper 90%Lower 90%Parameter

Reference product

Test product

Mean values of plasma concentration (R and T) Substance – Fluconazole

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Example of comparative pharmacokinetic studies ofRiluzole

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109.089386.5047AUCinf

108.811986.6426AUClast

103.515170.5435Cmax

Upper 90%Lower 90%Parameter

Mean values of plasma concentration (R and T) Substance – Riluzole

Reference product

Test product

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Page 15: Proof of interchangeability of pharmaceutical products and ......Pharmaceuticals are Generic (73% in Ukraine) Innovator (13% in Ukraine) equivalent (therapeutically Interchangeability

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Stages of quality assurance of generic productStages of quality assurance of generic product

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Stages of quality assurance of generic productStages of quality assurance of generic product

Established and justified during pharmaceutical development

Justified by the bioequivalence

assessment using in vivo and/or in vitro

methods

Provision at manufacturing

processEvaluation and improvement

throughout the product lifecycle

Page 16: Proof of interchangeability of pharmaceutical products and ......Pharmaceuticals are Generic (73% in Ukraine) Innovator (13% in Ukraine) equivalent (therapeutically Interchangeability

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Ensuring GMP of pharmaceutical production of finished and investigational products prior to registration

Conducting all clinical trials only in compliance with GCP

Enforcement of post-marketing drug monitoring

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Page 17: Proof of interchangeability of pharmaceutical products and ......Pharmaceuticals are Generic (73% in Ukraine) Innovator (13% in Ukraine) equivalent (therapeutically Interchangeability

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WHO External assessment of regulatory functions in Ukraine

To address medium term update of BE/BA status of previously registered

Improved coordination of regulatory functions

Capacity building

NextNext ststepseps

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OlgaOlga BaulaBaula

State Pharmacological CenterState Pharmacological Center MoHMoH UkraineUkraine

е-mail: [email protected]: www.pharma-center.kiev.uaphone: +38 (044) 498 4303