Prequalification of Medicines Overview & update

1. Prequalification of Medicines Overview & update Wondiyfraw Z. Worku WHO Prequalification of Medicines Programme Assessment training, Copenhagen January 2012 PQP-overview & update January 2012

2. Agenda • PQP and its activities • PQ process flow • Some numbers and achievements • The Assessment team PQP-overview & update January 2012

3. UN Prequalification Programme for Priority Essential Medicines • A UN action plan since 2001 to expand access to priority essential medicines for • HIV, Malaria, TB, • RH, NTD, selected Influenza products, Zinc products for Acute diarrhoea • To ensure quality, safety and efficacy of medicines procured using international funds • Propose a list of prequalified products and APIs and manufacturers meeting international norms and standards PQP-overview & update January 2012

4. UN Prequalification Programme for Priority Essential Medicines • Help the national medicine regulatory authorities to build up capacity in assessment, inspection and quality control meeting international norms and standards. • Develop local possibilities of manufacturing and clinical studies by offering customized technical assistance. PQP-overview & update January 2012

5. Only for essential priority medicines • Mostly for generic products • Open only to dossiers for invited medicines (Expression of interest) • Based on inclusion in treatment guidelines and/or WHO model list of essential medicines PQP-overview & update January 2012

6. Why PQ? • Many of the UN and other procurement agencies lack sufficient means to ensure safety, efficacy and quality of procured medicines and other medical items. • Many of the receiving and exporting countries do not have/did not have well established regulatory system. • Increasing demand for generic medicines-several players- substandard products • A number of reports on sub standard Anti Tb and Malaria products • Need for common-international standard. PQP-overview & update January 2012

7. Prequalification activities • Prequalification of medicinal products and APIs • Review of quality and safety/efficacy documentation • Inspection of manufacturing sites and CROs • Prequalification of quality control laboratories • To identify suitable laboratories for quality testing of products procured using international funds • Also for quality survey of products • Technical assistance and capacity building • Help manufacturers to meet dossier and GMP requirements • To build capacity of national medicine regulatory authorities PQP-overview & update January 2012

8. Similarities with NMRAs • Like NMRAs, PQP performs - Dossier assessments - Inspections - Quality control testing (mostly through post approval sampling) - Also post approval pharmacovigilance activities (through sister units within EMP/QSM) PQP-overview & update January 2012

9. Differences from NMRAs • Priority therapeutic areas • Assessments and inspections by international experts • Marketing authorization is not issued. • Prequalification of APIs • Prequalification of quality control laboratories • Provides technical assistance to applicants • No fees PQP-overview & update January 2012

10. Expression of interest (EOI) Process flow Application for prequalification Dossier, Samples & SMF Information requested Applicant Screening Application accepted for assessment GMP Review of GMP Certification, Inspection reports, Site Master Files (SMF). Information requested Information requested Corrective and preventative actions Assessment Applicant Inspection Manufacturer Accepted Accepted WHOPIR Final decision on prequalification Variations Complaints Random sampling Requalification WHOPAR Listing on WHO website PQP-overview & update January 2012

11. Major achievements in 2011 • The revised CTD based main guideline for multi source generic products is being implemented • Another product from Sub-Saharan Africa manufacturer prequalified. • 35 FPPs including 7 second line anti-TB products were prequalified • First two generic RH products were prequalified • First ICH generic product was prequalified • First Active Pharmaceutical Ingredients were prequalified • Two new APIs included in the biowaiver list • Revised variation guide soon ready for public comment PQP-overview & update January 2012

12. List of products included in WHO prequalified products list • Prequalified generics and innovators as of December 31st 2011: 274 products (assessed and inspected by PQ) • Total listed as of December 31st 2011 (including those listed based on USFDA/EMA/HCnda approvals): 366 products PQP-overview & update January 2012

13. Inspections PQP-overview & update January 2012

14. Prequalified / interested laboratoriesDecember 2011 Prequalified QCLs: • South Africa, RIIP+CENQAM (2005) • Algeria, LNCPP (2005) • South Africa, Adcock Ingram (2007) • Morocco, LNCM (2008) • Kenya, NQCL (2008) • India, Vimta Labs (2008) • France, CHMP (2008) • Vietnam, NIDQC (2008) • Kenya, MEDS (2009) • Singapore, HSA (2009) • Singapore, TÜV (2009) • Canada, K.A.B.S. Laboratories (2010) • Ukraine, CLQCM (2010) • Ukraine, LPA (2010) • Peru, CNCC (2010) • Uruguay, CCCM (2010) • Bolivia CONCAMYT (2010) • TFDA, Tanzania (2011) • SGS, India (2011) • SGS, Belgium (2011) • Proxy, Netherlands (2011) • INFARMED, Portugal (2011) • FUNED, Brazil (2011) PQP-overview & update January 2012 14

15. Technical assistance to applicants • More than 80 technical assistance missions have been organized and delivered PQP-overview & update January 2012

16. Trainings • More than 95 trainings have been delivered PQP-overview & update January 2012

17. The assessment process in more detail PQP-overview & update January 2012

18. The assessment team - More than 50 temporary advisors (pool of external assessors) - Six full time in-house and one rotational assessor. PQP-overview & update January 2012

19. The Assessment process • Six sessions per annum (every other month) here in CPH. • More than 30 assessors per session • At least two assessors for every dossier assessment • A final QA process when the dossier is close to PQ PQP-overview & update January 2012

20. Assessors tools • WHO and other guidelines • Pharmacopoeias • Internal guides (alerts) • Previous assessment reports • Discussion with colleague assessors PQP-overview & update January 2012

21. The ideal place to learn • Extensive discussion with experienced assessors coming from all corners of the world • A mix of ICH and non-ICH assessors • Access to full dossier as compiled for stringent regulatory authorities • Access to full previous assessment and inspection reports • Adequate time for assessment • A chance to join the PQP team for a three months rotational position in Geneva PQP-overview & update January 2012

22. Assessors working PQP-overview & update January 2012

23. Notice of concerns & related info • Prequalification lists • Procedures & Guidelines • Prequalification of APIs • Inspection info • Trainings and meetings • Public assessment and inspection reports www.who.int/prequal PQP-overview & update January 2012

24. Thank you PQP-overview & update January 2012