国家食品药品监督管理局药品审评中心启动实施《新药注册特殊审批管理规定》推动工作

为保证公众用药的可获得性,促进我国创新性药物的研发,国家食品药品监督管理局药品审评中心按照《药品注册管理办法》的要求,推动实施《新药注册特殊审批管理规定》,制定了技术审评程序、特殊审批资质申请和审批,信息公开内容和方式等实施细则,近日,发布了“特殊审批品种公示信息”、“特殊审批品种单独立卷资料撰写指导建议”、“特殊审批品种沟通交流工作机制实施细则”、“特殊审批品种沟通交流会会议纪要撰写格式”等信息。     

第三方对美国创新药首轮审评通过率影响因素评估的介绍

介绍了第三方机构对美国FDA创新药审评现状的评估结果,研究分析了FDA在创新性药品审评审批工作的实践和经验.总结归纳了制约FDA创新性药品审批效率的影响因素,进而提出对我国创新性药品审评审批管理的启示.     

我国药品和医疗器械关联审评审批制度对化妆品原料管理和产品安全评价的启示

目的：研究我国药品、医疗器械关联审评审批相关制度,为化妆品原料管理和产品安全评价提供参考。方法：对近年来国家药品监督管理部门发布的药品、医疗器械关联审评审批政策进行梳理总结,对相关监管要求和技术管理手段进行分析,并与化妆品监管要求和管理现状进行对比。结果与结论：在考虑行业差异和监管差异的基础之上,可参考借鉴我国药品和医疗器械关联审评审批相关制度和配套措施,优化我国化妆品审评审批流程、划清安全责任界限、加强原料信息管理、借助信息化支撑手段,探索“化妆品原料安全信息库”的科学应用,提高化妆品原料管理和产品安全评价的整体效率。     

我国药品优先审评审批制度的现状分析

目的 为推动我国优先审评审批制度形成稳定成熟的监管制度提供参考。方法 通过梳理近5年优先审评审批制度的演变及现状,整理归纳了纳入优先审评审批的不同情形,剖析了优先审评审批的范围调整,总结了优先审评审批的任务及占比。结果 同步申报、按与原研质量和疗效一致性完善后重新申报、专利到期和首仿这四类在每年的优先审评审批中比重大并占据了极大的审评资源。在新药品注册管理办法（2020年）实施后将这四类剔除优先审评审批的范围。结论 国家药品监管部门已将优先审评审批的资源向具有临床价值、市场急需的药物聚集。企业能充分利用优先审评审批制度将具有临床价值的药品快速推向市场。     

监管科学发展下药品审批提效的实践探讨

药品监管科学研究在最近10年取得了长足的发展.不管是从研究论文的产出,还是监管机构的法规以及指南文件的及时发布,均体现了顺应当前科技发展的需求.面对持续增长的审评压力,监管机构在资源有限的情况下,通过设置监管促进路径、开启共享审评模式等方式,提高审评效率,加速新药上市.展望未来的药品审评审批发展,将始终坚持以患者为中心...     

我国药品加快上市注册程序的注册情况分析

目的：对2020年新修订的《药品注册管理办法》颁布前后我国纳入药品加快上市注册程序并已批准上市的药品信息进行分析,为完善我国药品加快上市注册程序提供参考。方法：检索国家药品监督管理局药品审评中心发布的2019-2021年度药品审评报告,对通过优先审评和药品加快上市注册程序而上市的相关药品数据资料进行信息整理和汇总分析。结果：通过药品加快上市注册程序的上市药品数量逐年增多,优先审评审批资源向临床优势药品和创新药品倾斜。结论：药品加快上市注册程序可为临床价值显著的药品提高审批效率,在一定程度上激发制药企业研制热情,但药品加快上市注册审批体系仍需进一步完善配套政策,细化实施要求,加快专业指南出台,鼓励以临床价值为导向的药品的研发创制, 不断提升药品监管部门的服务和监管能力。     

国务院印发《关于改革药品医疗器械审评审批制度的意见》

<正>国务院日前印发《关于改革药品医疗器械审评审批制度的意见》(国发[2015]44号),明确药品医疗器械审评审批改革的目标、任务和具体措施。文件指出,近年来,我国医药产业快速发展,药品医疗器械质量和标准不断提高,较好地满足了公众用药需要。与此同时,药品医疗器械审评审批中存在的问题也日益突出,主要是药品注册申报积压严重,一些创新     

新形势下药品注册核查启动工作的实践和探索

药品注册核查作为药品注册上市监管不可或缺的重要环节,其启动工作模式和机制的调整一直以来受到业界的高度关注。2015年药品审评审批制度改革以来,有破有立,初步重建起全新的、与国际接轨的审评审批制度体系和工作程序。药品注册核查启动模式也随着审评审批制度改革的持续深入,处于不断探索和优化过程中,改革难度大、政策调整快、不确定性强,也使得其经历了“逢审必查”“基于技术审评工作需要”发起核查以及“基于风险”启动注册核查三重模式的变化。本文意在介绍近几来药品注册核查启动这3种工作模式的变化历程,并结合新版《药品注册管理办法》的落地实施、药品监管科学计划的持续推进,立足实际工作提出笔者对注册核查启动工作的新思考和新认识。     

药品审评的改革实践和今后的工作思路

为了更好地把握药品审评科学规律,适应国家卫生体制改革和医药产业发展要求,近年来,药品审评中心始终围绕国家局党组提出“规范审评、严格审批、鼓励创新”的工作要求,不断深化改革,以机制建设落实科学监管,鼓励医药研发创新,加快药品技术审评国际化进程,确保公众用药安全有效可及。目前中心各项工作较好地沿着改革既定的目标逐步推进,并取得初步成效。     

信息技术对我国药品技术审评工作的保障作用

目的发挥信息技术在药品技术审评工作中的作用,构建药品技术评价信息化平台。方法固化审评流程,构建《技术审评系统》,加强组织管理,运用互联网实现药品技术审评的开放性,分析和调研药品技术评价信息需求,构建具有药品技术审评特性的信息支持体系。结果与结论通过信息技术在药品技术审评过程中的应用,保障了技术审评相关工作制度的落实,加大了信息公开的力度,为审评质量和效率的提高提供了信息保障平台。     

Human carcinogenic risk evaluation, Part III: Assessing cancer hazard and risk in human drug development.

Assessing cancer risk for human pharmaceuticals is important because drugs are taken at pharmacologically active doses and often on a chronic basis. Epidemiologic studies on patient populations have limited value because of the long latency period for most cancers and because these studies lack sensitivity. The Center for Drug Evaluation and Research (CDER) of the U.S. Food and Drug Administration relies on short-term surrogate assays (genetic toxicology studies) to assess risk to patients involved in clinical trials and on rodent carcinogenicity studies to assess cancer risk for drug approval. Unlike some other agencies that typically perform quantitative risk assessments on chemical pollutants or pesticide products, CDER does not perform such quantitative extrapolations. Rather, the evaluation of risk is the result of an integrated assessment of what is known about the drug, and risk is considered in the context of the clinical benefit. Mode of action of carcinogenesis and thresholds for effects are important considerations. The results of carcinogenicity studies of approved products are published in the drug labeling and individual clinicians balance risk and benefit in making prescribing decisions.     

美国食品药品监督管理局短缺药品信息平台对我国的启示

目的：借鉴美国短缺药品网站的成熟经验,为完善我国短缺药品信息平台提供参考。方法：采用文献研究法,介绍美国食品药品监督管理局（FDA）利用互联网络平台搜集和利用药品短缺相关信息的做法。结果：美国FDA网站的短缺药品信息平台,加强了药品短缺信息资源的搜集和利用,大大提高了政府解决药品短缺问题的效率,促进了公众对政府处理药品短缺问题的认知。结论：应当通过建立多主体参与的短缺药品信息沟通网络、强化生产企业上报潜在短缺药品信息的责任、定期发布药品短缺相关信息、建立药品短缺和临床必需药品数据库等方式,完善我国短缺药品信息平台的建设。     

美国化学仿制药立项调研及评估

目的 为拟在美国注册申报化学仿制药的中国企业提供立项指导和帮助,从目标产品的初步获得、产品具体信息的调研分析评估,到最终策略的制定,进行系统的介绍。方法 主要采用例证法。结果 获得美国仿制药立项信息收集及评估的途径和方法,形成并明确开发注册策略制定的思路和要素。结论 美国的药品信息比较透明公开,从公共途径基本可以获得产品开发所需要的相关信息。立项评估并不能做到百分百正确无误,企业可以设立自己的立项标准,只要在企业可接受范围内即可进行。     

Regulatory science: a special update from the United States Food and Drug Administration: Preclinical issues and status of investigation of botanical drug products in the United States

A recent survey was conducted across the therapeutic divisions within the CDER, U.S. FDA regarding the number of submissions related to botanical drug products over the past ten years. The overall number of botanical submissions as expressed in the parenthesis are as follows: 1990 (1), 1991 (4), 1992 (4), 1993 (5), 1994 (6), 1995 (5), 1996 (13), 1997 (16), 1998 (10). In the total of 64 counted, 50 of them are submitted in original IND and the rest (14) in pre-IND format. The therapeutic categories are focused on dermatological and topical (19), anti AIDS/antiviral (12), oncologic (13), neuropharmacologic (8), endocrine and metabolic (3), urologic (2), tobacco (2), and cardio-renal products (1). The regulatory actions taken on these submissions showed that 68% of them are evaluated as safe to proceed for the human trials, while the rest (32%) of submissions required agency's regulatory guidance. Among the submissions that required further guidance, 81% were deficient in preclinical pharmacology/toxicology information and the rest (19%) lacks information in other areas (chemistry, clinical protocols). Following agency's guidance, 93% of the submissions that were put on hold were allowed to proceed. In summary, a total of 94% of all the botanical INDs submitted to the agency were allowed to proceed without additional animal toxicity studies conducted. In conclusion, this survey indicates that the growing public interest in botanical supplements has prompted more formal evaluation of the efficacy/safety claims of these products.     

How Has CDER Prepared for the Nano Revolution? A Review of Risk Assessment,Regulatory Research,and Guidance Activities

The Nanotechnology Risk Assessment Working Group in the Center for Drug Evaluation and Research (CDER) within the United States Food and Drug Administration (FDA) was established to assess the potential impact of nanotechnology on drug products. One of the working group’s major initiatives has been to conduct a comprehensive risk management exercise regarding the potential impact of nanomaterial pharmaceutical ingredients and excipients on drug product quality, safety, and efficacy. This exercise concluded that current review practices and regulatory guidance are capable of detecting and managing the potential risks to quality, safety, and efficacy when a drug product incorporates a nanomaterial. However, three risk management areas were identified for continued focus during the review of drug products containing nanomaterials: (1) the understanding of how to perform the characterization of nanomaterial properties and the analytical methods used for this characterization, (2) the adequacy of in vitro tests to evaluate drug product performance for drug products containing nanomaterials, and (3) the understanding of properties arising from nanomaterials that may result in different toxicity and biodistribution profiles for drug products containing nanomaterials. CDER continues to actively track the incorporation of nanomaterials in drug products and the methodologies used to characterize them, in order to continuously improve the readiness of our science- and risk-based review approaches. In parallel to the risk management exercise, CDER has also been supporting regulatory research in the area of nanotechnology, specifically focused on characterization, safety, and equivalence (between reference and new product) considerations. This article provides a comprehensive summary of regulatory and research efforts supported by CDER in the area of drug products containing nanomaterials and other activities supporting the development of this emerging technology.     

Advanced science education in the regulatory arena: the Center for Drug Evaluation and Research Experience at the Food and Drug Administration

A challenge faced by the Center for Drug Evaluation and Research (CDER) in effectively carrying out its mission requires it to integrate the disciplines of science, medicine, law, and public policy. One way to do that is by ensuring a highly trained multidisciplinary staff. The CDER has been able to meet this requirement by identifying the core competencies needed to accomplish its mission. The use of a competency-based training model in the planning, development, and delivery of its advanced scientific education program allows CDER staff to maintain current knowledge as well as prepare for future scientific education needs. The CDER educational model could be readily adapted to meet the educational needs of other organizations.     

美国FDA“动物(效应)法规”在生物防御药物开发中的应用及启示

目的:在应对重大公共卫生事件中,为我国相关生物防御药物的上市审批和应用储备提供参考依据和解决思路。方法:结合审批实例,对美国FDA"动物(效应)法规"的主要内容、应用范围和实施状况进行综述,针对美国和我国现阶段应对重大公共卫生事件的药品审批机制进行讨论。结果与结论:在针对可能发生的生物恐怖袭击事件及重大疫情开展的药物研发中,评价尺度可以与普通药物有所区别,应视情做好相应生物防御药物的战略储备,为应对突发重大公共卫生事件提供系统性支持。     

Public drug use in eight U.S. cities: Health risks and other factors associated with place of drug use

BackgroundDrug overdose is the leading cause of accidental death in the United States (U.S.). Previous studies have found that place of drug use is associated with risks including overdose, sharing of drug use equipment, and arrest, but the research on this subject in the U.S. is limited.MethodsOur study describes the relationship between place of drug use and health outcomes through the analysis of associations between frequent public drug use and drug-related arrest, overdose, and reuse of injection equipment. We analysed data from a cross-sectional, observational study of individuals who utilize syringe exchange services in 8 U.S. cities. Using regression analysis, we assessed associations between public drug use, demographic characteristics, and health risks.ResultsHalf (48%) of the respondents (N = 575) reported that at least one of their top two most frequent places of drug use is a public place. Street homelessness (AOR = 17.44), unstable housing (AOR = 3.43) and being under age 30 (AOR = 1.85) were independently associated with increased odds of frequent public drug use. Frequent public drug use was associated with increased odds of past-year arrest for drug-related offenses (AOR = 1.87).ConclusionPublic drug use is associated with negative health and social outcomes. Increased access to harm reduction services, housing, and supervised consumption sites (SCS) interventions and a shift away from punitive approaches to drug use may reduce the some of the harms associated with public drug use.     

A regulatory perspective on issues and approaches in characterizing human metabolites

This document captures the current thinking within FDA/CDER on the non-clinical safety assessment of human drug metabolites in new drug products. Examples are provided, which define a scientific based approach to the safety evaluation of human metabolites in new drug candidates. A discussion of the need for, and the adequacy of, the assessment of human drug metabolites with specific regard to their potential as mediators of toxicity is presented from a regulatory perspective.