17th ASEAN Consultative Committee on Standards & Quality - Medical Device Product Working Group (ACCSQ-MDPWG) UPDATES from MLIG-SMF May Ng Awareness Seminar for Medical Device III (15 May 2013) Organised by: Supported by: Copyright 2013, by May Ng CONTENT Background of ASEAN & ACCSQ-MDPWG 17th ACCSQ-MDPWG Meeting - Pre-meeting training (for regulators by US-TATF) - Medical Device Industry seminar (Malaysia) - Country updates in Public-Private Forum - 10th ACCSQ-MDPWG Technical Committee Meeting Report - 17th ACCSQ-MDPWG Meeting Report Copyright 2013, by May Ng CONTENT Background of ASEAN & ACCSQ-MDPWG 17th ACCSQ-MDPWG Meeting - Pre-meeting training (for regulators by US-TATF) - Medical Device Industry seminar (Malaysia) - Country updates in Public-Private Forum - 10th ACCSQ-MDPWG Technical Committee Meeting Report - 17th ACCSQ-MDPWG Meeting Report Copyright 2013, by May Ng ASSOCIATION OF SOUTHEAST ASIAN NATIONS 10 countries (Singapore, Malaysia, Thailand, Brunei, Indonesia, Philippines, Cambodia, Laos, Myanmar, Vietnam) ASEAN Land Area: 4,464,322 sq km ASEAN Population: 564,986,000 Copyright 2013, by May Ng ASEAN Economic Community (AEC) & ACCSQ-MDPWG ASEAN Summit ASEAN Economic Ministers Meeting (AEM) ASEAN Senior Economic Officials Meeting (SEOM) Dec 97 ASEAN Vision 2020 Oct 03 AEC 2020 Jan 07 AEC 2015 (a) (b) (c) (d) Single Market & Production Base eg Free flow Competitive Economic Region eg IP Equitable Economic Development eg IAI Integration into the Global Economy eg IBP ASEAN Consultative Committee on Standards and Quality (ACCSQ) since 1992 • Medical Device Product Working Group (MDPWG) since 3 - 4 Aug 2004 • Pharmaceutical Product Working Group (PPWG) • Traditional Medicines and Health Supplements Product Working Group (PPWG) • ASEAN Cosmetics Committee (ACC) Healthcare & e-ASEAN sectors Wood-based product & Automotives Rubber-based products & Textiles & apparels Agro-based products & Fisheries Electronics Air Travel & Tourism Logistics Copyright 2013, by May Ng 5 ASEAN Medical Device Directive ACCSQ-MDPWG Aim: • To standardize the regulatory framework for regulating medical device among member states, with a set of principles in the AMDD. • AMDD will help improve patient safety standards across the region and ensuring citizens of each of the ASEAN Member States have timely access to safe and effective medical devices, as well as providing a more straightforward path to market in the region for manufacturers of medical devices. • AMDD targeted for implementation by Dec 2014. Philosophies tools from the Global Harmonization Task Force Copyright 2013, by May Ng 6 ASEAN Medical Device Directive Article 1 General provisions Article 2 Definition and scope of medical device Article 3 Essential principles of safety and performance of medical device Article 4 Classification of medical devices Article 5 Conformity assessment Article 6 Registration and placement on the market Article 7 Registration of persons responsible for placing medical devices on the markets of member states Article 8 Technical documents for medical devices Article 9 Reference to standards and relevant documents Article 10 Labelling Article 11 Product claims Article 12 Post-marketing alert system Article 13 Clinical investigation Article 14 Institutional arrangements Article 15 Safe guard clauses Article 16 Confidentiality Article 17 Special cases Article 18 Implementation Article 19 Dispute Settlement Article 20 Final provisions Annex 1 Essential Principles of Safety and Performance of Medical Devices Annex 2 Risk Classification Rules for Medical Devices other than in-vitro diagnostic products Annex 3 Risk Classification Rules for In-Vitro Diagnostic Products Annex 4 ASEAN Common Submission Dossier Template (CSDT) Annex 5 Post Marketing Alerts System (PMAS) Requirements Annex 6 Harmonized set of elements for a Product Owner’s or Physical Manufacturer’s Declaration of Conformity (DoC) Annex 7 Component Elements of a “Dear Healthcare Professional” Letter Annex 8 Sample Template of Letter of Authorisation Annex 9 Labelling Requirements Annex 10 Clinical Investigation – Pre-market Clinical Investigation to Support Marketing Authorisation Application AMDD Version 11, Draft for National consultation, 8 May 12. Copyright 2013, by May Ng 7 CONTENT Background of ASEAN & ACCSQ-MDPWG 17th ACCSQ-MDPWG Meeting - Pre-meeting training (for regulators by US-TATF) - Medical Device Industry seminar (Malaysia) - Country updates in Public-Private Forum - 10th ACCSQ-MDPWG Technical Committee Meeting Report - 17th ACCSQ-MDPWG Meeting Report Copyright 2013, by May Ng 8 S/N 1 AGENDA ITEMS ADOPTION OF AGENDA DISCUSSED ITEMS • Annex 1 List of delegates • Annex 2 Provisional annotated agenda 2 3 BUSINESS ARRANGEMENT UPDATES ON THE RECENT DEVELOPMENTS IN ASEAN ECONOMIC INTEGRATION INITIATIVES ~ • ASEAN harmonization is on technical requirements in ASEAN countries. It is not a single approval for ASEAN market. MATTERS ARISING FROM THE 16th MDPWG MEETING • Annex 5 MDPWG 16th Meeting on follow-up actions taken 4 • SEOM, AEC Deliverables for 2015 (ie 2013) • AEM, AMDD 2015 implementation roadmap • AEM, Non-Tariff measures in ASEAN Trade in Goods Agmt (ATIGA), AMS feedback if impacted AMDD. • Annex 3 AEC deliverables for 2015 • Annex 4 AEC deliverables for 2013 Copyright 2013, by May Ng S/N AGENDA ITEMS DISCUSSED ITEMS 5 DEVELOPMENT OF THE ASEAN MEDICAL DEVICE DIRECTIVE 5.1 AMDD Finalization 5.2 Risk Classification of MD Guidelines • Annex 10 Risk classification, feedback by 30 Jun 13 5.3 Agreement on a Framework for Disseminating and Sharing of Information Relating to Adverse Events Associated with Medical Devices among ASEAN Member States • Annex 11 Agreement, AMS to comment after AMDD legal scrubbed. •AMDD legal scrubbing & endorsement (see table) • AMDD public consultation - categorised as AMDD legal scrub by AMS 31 May 13 recommendations (excl. LOA, Dear HCP letter) AMDD legal scrub by Alegal 1 Jun 13 clarifications, general or personal and typos. AMDD endorse by ACCSQ 4-5 Jul 13 • IMDRF changes will be revised to AMDD if impacted AMDD endorse by SEOM 16 Sep 13 patient safety th • Annex 6 AMDD AMDD endorse in ASEAN Summit 24 • Annex 7 AMDD public consultation presentation • Annex 8 Country updates to AMDD and timeline • Annex 9 AMDD roadmap's priority activities • CLMV under Initiative for ASEAN Integration (IAI) • AFMDI, entity associated with ASEAN ie ID, MY, PH, SG, TH & soon VN Copyright 2013, by May Ng S/N 6 AGENDA ITEMS 8th MEDICAL DEVICE TECHNICAL COMMITTEE REPORT DISCUSSED ITEMS • ACSDT implementation in AMS (see table) • Standards, final feedback from TH & VN by 3 May 2013 • Post market activities Annex 12 AE form Annex 13 FSCA form Annex 14 8th MD Technical Committee report ACSDT Singapore Since 2010 Indonesia Since 2010 (partial English & local language) Thailand Since 2012 (partial English & local language) Cambodia Targeted 2013 Malaysia Targeted Jul 2013 PhilippinesTargeted end 2013 Brunei Not yet Laos Not yet 7 7.1 NEW AREAS Refurbished Medical Devices 7.2 In-vitro Diagnostic Medical Devices (IVDs) • ACSDT IVD differ from MD on the pre-clinical testing, feedback by 30 June 2013 8 NOMENCLATURE OF MEDICAL DEVICES • Annex 17 Nomenclatures by MIMOS. Noted GMDN, UMDNS, SNOMED, ICD-10, LOINC correlated. Continue to share eg ID using HS code in INSW, TH not yet • Malaysia's GRPMD based on COCIR, JIRA and MITA sharing • PH guide in progress SG allowed and ID not regulated. Copyright 2013, by May Ng S/N 9 9.1 AGENDA ITEMS DISCUSSED ITEMS COOPERATION WITH INTERNATIONAL AND REGIONAL ORGANISATIONS • Annex 18 IMDRF 3rd meeting (5 GHTF, Brazil, Canada, AHWP Cooperation with the IMDRF affiliated organization, Russia and Mexico observer) - NCAR, UDI, SAP, Std, Pdt Submission. IMDRF 12-14 Nov 13 Brussels. 9.2 Cooperation with WHO • Continue follow-up regional office of WHO SEARO-WPR, WHO-US 10 Technical assistance and cooperation with dialogue partners • Annex 19 Concept note on US-funded training prioritized based on AMDD roadmap - Indonesia (26-27 Aug regulators & 28-29 Industry) - Thailand (21-23 Aug regulators & industry, ie CLM) -Vietnam (late Jul regulators & industry) 11 OTHER MATTERS • MDPWG Trust Fund closure, after funded Myanmar delegates to 16th meeting. 12 WORK PROGRAMME Annex 20 MDPWG Work programme 13 NEXT MEETING Annex 21 MDPWG List of Meetings 14 ADOPTION OF REPORT Adopted for next meeting in October, Brunei. Copyright 2013, by May Ng CONTENT Background of ASEAN & ACCSQ-MDPWG 17th ACCSQ-MDPWG Meeting - Pre-meeting training (for regulators by US-TATF) - Medical Device Industry seminar (Malaysia) - Country updates in Public-Private Forum - 10th ACCSQ-MDPWG Technical Committee Meeting Report - 17th ACCSQ-MDPWG Meeting Report Excl. Copyright 2013, by May Ng Philippines Regulatory Authority Center for Device Regulation, Radiation Health, and Research (CDRRHR) Food and Drug Administration, Department of Health MD regulation • • • • Republik Act 3720 in June 1963, 'Food, Drug and Cosmetic Act' - regulated manufacture and distribution of food, drugs and cosmetics Executive Order No. 175 amended RA3720, add regulation of MD to BFAD Executive Order No. 102, created BHDT but not enacted to regulated MD Republic Act No. 9711 in Aug 2009 created FDA, DOH strengthen regulatory in food, drug, cosmetics, MD and other health devices (BFAD & BHDT in FDA) Copyright 2013, by May Ng Philippines Regulatory control 1) Establishment License • Manufacturer, Distributor/importer, Distributor/wholesaler, Retailer • Leadtime : 90 days ie inspection 2) Product registration • Class 1, 2, 3,4; per product/brand/model excl. size and shape • Leadtime: 180 days • e-copy dossier and hardcopy returning for co. record since 2011 3) AE & Recall reporting 4) PMS Copyright 2013, by May Ng Philippines Class 1 Class 2 Class 3 Class 4 Legal requirements • Application form, notarized • Medical device establishment license issued by the CDRRHR • Agreement with licensed local manufacturer and distributor, notarized • Registration of product issued by the health authority from the country of origin and foreign agency agreement, both notarized and duly authenticated by the Philippine Consulate (for imported product) Technical Requirements, based on the ACSDT •Device description •Description of the sterilization method and the packaging used, the sterility level and the validation of the sterilization process (if applicable) •Certificate of Conformity to the aspect of manufacture relating to metrology for devices with measuring functions •Declaration of Conformity with product standards (if applicable) •Sample of labels on the device and its packaging and other labeling materials to be used for the device that includes user’s or instruction manuals •Government certificate attesting to the status of the Manufacturer ‘s competency and reliability of the personnel and facilities or QS Certificate of approval or compliance certificate with ISO 9000 series or ISO 13485. (for imported product, Certificate to be duly authenticated by the territorial Philippine Consulate) •Stability studies (if applicable) •Picture of the product and representative sample or commercial presentation of the product (when needed) •Executive Summary •Relevant essential principles and method/s used to demonstrate conformity (if applicable •Device description* •Design Verification and Validation Documents* •Risk assessment consisting of risk analysis, evaluation and reduction measures, (if applicable)* •Manufacturer information including the process, quality assurance* •Clinical evidence (if applicable)* •Software validation studies (if applicable) •Biological evaluation (if applicable)* * varies depend on device class •List of countries where the device has been soldCopyright 2013, by May Ng Thailand Regulatory Authority Medical Devices Control Division, Food and Drug Administration MD regulation • • • • Drug Act, bfr 1988 Medical Device Act 1988 & MDCD, FDA since June 1990 Ministerial Notification: Requiements on recording & reporting of manufacturing/importing/selling of MD, 7 June 2011 Ministerial Regulations & FDA notifications: Application & Issuing of Manufacturing/Importing MD Licenses & Notifications (CSDT), 28 May 2012 Copyright 2013, by May Ng Thailand Regulatory control 1) Establishment License • Manufacturing, Importing • Leadtime : 90 days ie inspection 2) Selling Licence (some device) • Licensed (condoms, surgical gloves, HIV IVD, contact lens ie cosmetic use, blood bag ie with anti-coagulant); Notified (physical therapy, alcohol detector, breast implants, breast enhancer external use, etc); General • Class 1, 2, 3,4 Leadtime: 180 days, per product/brand/model excl. size and shape 3) Post-Marketing - check premises, sampling, vigilance, AE, One Stop Service Center – Pre-market, pre-advertisement, cert issuance; One Stop Complaint Center – Post- market, post-advertisement, enforcement Network of control - provincial, port, police, lab/standard, healthcare professional/expertise Copyright 2013, by May Ng Thailand Regulatory control - updates • MD definition ie animal use, IVD, software, accessories, components or parts, any announced by minister • MD reclassification • National single window/licence per invoice (targeted Sep/Dec 2013) • Database: Importer Co. Reg. No. ID code, Product License/Notification/Import permit letter No., HS code, Product code, City & Country of Origin • Outsource program • AMDD & AEC 2015 Copyright 2013, by May Ng Indonesia Regulatory Authority Medical Device Production and Distribution Service, Pharmaceutical & Medical Device Service, MOH MD regulation and policy • • • • • • • Act on health Gov regulation Production, Distribution, registration of medical devices & household National Medical Device Policy Product under regulation - Premarket control & Postmarket control Use under Health Technology Management - Assessment, Procurement, User, Maintenance Risk based, ASEAN harmonization, International std, transparency & excellent service reformation Copyright 2013, by May Ng Indonesia Regulatory control Pre-market control •CSDT, QMS ISO 13485 , National & International Std •Registration no., product name, product generic name, type/size (all accessories in attached licence), Manufacturer name & Address, Distributor name & address, HS code, release date, expired date, country of origin, •Validity 5 years Post-market control •Sampling, monitoring production and distribution facilities to QS standard, vigilance eg AE report, PMS (MOH with civil police investigator working with healthcare facilities, police, customs, health province officer Copyright 2013, by May Ng e-Monitoring Indonesia e-Registration (http://regalkes.depkes.go.id) - Registration no. - Production License - Distributor License (GDP) Indonesia National Single Window (http://eservice.insw.go.id) National system that integrates all entities which related to customs clearance to accelerate the process of import-export services and traffic. - National Trade Repository - Single sign on e-Planning e-Catalogue (http://inaproc.lkpp.go.id/v3/public/ekatalog/ek atalog.htm) - Government procurement for goods and services, President decree No. 70/2012 - transparent, accountable, effective, efficient, decrease MD less 40%, decrease healthcare expenditure f0or Social Security program & MDGs - Name, type, specification, price , service guarantee Copyright 2013, by M Regulatory Authority Lao PDR Drug Control Division, Food and Drug Department, MOH MD regulation and policy • • • • • • The National Drug Policy was endorsed in 1993, and revised in 2003 Drug and Medical Product Law enacted since April 2000, 2nd and ie risk class A,B,C,D, endorsed by National Assembly last year (2012) Regulation regarding drug and medical product company establishment No. 1442 dated 13 August 2003 (Importer or Distributor authorization) Supervision and monitoring tools based on the Good Wholesaling Practice (GWP) Regulatory control • MD control committee, AMDD, guideline in progress, MD list and it use in health care facility has been established by Medical Product Supply Centre with FDD; Medical equipments in central and provincial hospitals in ID Copyright 2013, by May Ng system Cambodia Regulatory Authority Medical Device Section, Registration Bureau, Department of Drugs, Food, Cosmetics and Medical Devices, MOH MD regulation and policy • • • • • • • • Constitution of the Kingdom of Cambodia Reach Kret No ns/rkt 0908/1055 dated 25 September 2008 establishing the Royal Government of Cambodia. Reach Kram No ns/rkm/ 0196/06 dated 24 January 1996 establishing the MOH Reach Kram No Cs/rkm/ 0696/02 approval of the Drug law dated 17 June 1996 Sub‐Decree No 67 GnRk/kt dated 22 October 1997 empowering the Ministry of Health to undertake activities related to Health Service. Sub‐Decree No 44 GnRk/kt dated 10 August 1994 Pharmaceutical Registration Prakas No 145 Gbs dated 14 / 03 / 2001 consumable device registration Prakas No Gbs dated 2000 reagent registration Copyright 2013, by May Ng Regulatory control • • • Cambodia Flow: Licensing of Manufacturer, importer; Product registration no.; Imported license of registered products Process: submit dossier, evaluation and computerised system, complete document, payment, passed committe meeting, licensing. new regulation Nov 2012: definition, 4 classes, CSDT (excl. Class A) Class A ‐ Application form ‐ GMP or ISO Certificate (ISO 13485) ‐ FSC issued by Health Authority ‐ Letter of Authorization Class B, C and D ‐ Application form ‐ GMP or ISO Certificate (ISO 13485) ‐ FSC issued by Health Authority ‐ Letter of Authorization - Registration Certificates in other countries (if available) ‐ Testing Report ‐ Technical documents: CSDT (requirement increase with risk) Leadtime: 90 days, Validity: 3 years renewal 6mths bfr expired. Copyright 2013, by May Ng Regulatory Authority Brunei Healthcare Technology Department , MOH MD regulation and legal framework Legal Framework • • • Drafting MD regulations & policies Voluntary implementation to be carry out No mandatory control Regulatory control – Premarket & Postmarket Technical capacity Building Medical device Regulation Pre-market control Post-market control Pre-market control • Business Establishment Licensing • Development of QMS certification procedures, specifications and guidance • Product registration • AMDD technical requirements, ACSDT Post-market control • MDPWG forms and develop procedures and forms, strengthen surveillance Copyright 2013, by May Ng Regulatory Authority Malaysia Medical Device Authority, MOH MD regulation and policy • • • • • • • Medical device regulatory program proposal approval by Cabinet, 16 Feb 2005 Medical Devices Control Division established in Aug 2005, for MD bill and legislation, program, registration & surveillance/vigilance system MEDICAL DEVICE AUTHORITY ACT 2012 (ACT 738), Gazetted 9 Feb 2012 & Effective 15 Mar 2012 MEDICAL DEVICE ACT 2012 (ACT 737), Gazetted 9 Feb 2012 & Effective 30 Jun 2013 MEDICAL DEVICE REGULATIONS 2012, Gazetted Dec 2012 & Effective 1 Jul 2013 Orders, other legislative tool - Permit for designated medical device - Others to be determined, post market requirements, advertising and usage (ie maintenance, installation, T&C and disposal) Guidance Documents, Standards Device definition..i(b) any instrument, apparatus, implement, machine, appliance, implant, in-vitro reagent or calibrator, software, material or other similar or related article, to be used on the human body, which the Minister may, after taking into consideration issues of public safety, public health or public risk, declare to be a MEDICAL DEVICE by order published in the Copyright 2013, by May Ng Gazette. Act & Regulations (ACT 737 - 6 Parts, 80 Sections) Part I : Preliminary Part II: Registration of Medical Device and Conformity Assessment Body Chapter 1: Registration of medical device Chapter 2: Registration of conformity assessment body Part III: Licence and Permit Chapter 1: Establishment licence Chapter 2: Designated medical device permit Chapter 3: Duties and obligations of licensees or permit holders Chapter 4: General duty Chapter 5: Export permit Part IV: Appeal Part V: Enforcement Malaysia (MDR 2012 - 14 Parts, 61 Sections) Part I : Preliminary Part II: Conformity Assessment Procedures Part III: Registration of Medical Device Part IV: Registration of Conformity Assessment Body Part V: Establishment Licence Part VI: Export Permit Part VII: Labelling Requirements Part VII: Duties and Obligation of Licensees Part IX: Exemption of any person or medical device from any provision of this Act Part X: Usage, Operation, Maintenance Part XI: Requirements for provision of auditing, consulting or Training related to medical device regulatory matters Part XII: Appeal Part XIII: Register Part XIV: Prescribed fees Copyright 2013, by May Ng Act & Regulations timeline Cabinet approve d proposal to develop MD regulator y system 16 Feb05 Medical Device Control Division establishe d 09 Feb12 Act 737. Act 738 gazetted Act 738 comes into operation 09 Feb12 15 Mar12 Medical Device Control Division (MDCD) Appointment of members of the Authority Malaysia Medical Device Authority (MDA) establishe d Medical Device Regulations (MDR) 2012 gazetted 14 Jun12 31 Dec12 Act 737 comes into operation 30 Jun13 Effective date of MDR 2012 Enforcem ent of establish ment license Enforce ment of medical device registrati on 30 Jun14 30 Jun15 01 Jul13 Medical Device Authority (MDA) Cessation of MDCD Transition – establishment license Transition – MD registration Act 737 Part VI: General, Section 80: Savings and transitional – 80(1): A person who has imported, exported or place in the market any medical device prior to appointed date of the Act shall apply for registration of medical device within 24 months from the appointed date – 80(2): A person who has imported, exported or place in the market any medical device and intend to continue shall apply for establishment licence within 12 months from the appointed date – 80(3): A person in 80(1) or 80(2) may continue to import, export or place in the market the medical device pending determination of application Copyright 2013, by May Ng CAB verifies evidence of conformity PRE-MARKET ASSESSMENT Manufacturers of medical devices shall • ensure their products conform to Essential Principles for Safety & Performance (EPSP) of Medical Device • establish appropriate quality system for manufacturing • collect evidence of conformity MEDICAL DEVICE REGISTRATION • Manufacturer (or authorized representative) apply to register medical devices & establishment license ESTABLISHMENT LICENSING • Importers/distributors shall ensure compliance to GDP & advertising requirements • apply for establishment license to import/distribute medical devices MDA issues licenses, registers medical devices and monitors compliance to requirements & takes appropriate actions in accordance with the law SURVEILLANCE & VIGILANCE • Establishments shall monitor safety & performance of products • carry out postmarket obligations, eg complaint handling, FSCA, recall USAGE & MAINTENANCE • Users shall use, maintain & dispose off medical devices appropriately • Users shall apply for permit to use/operate designated medical devices Copyright 2013, by May Ng THANK YOU Acknowledgement to: BIOSENSORS INTERNATIONAL GROUP SINGAPORE HQ • Health Products Act - www.agc.gov.sg • Global Harmonization Task Force (GHTF) - www.ghtf.org • Asian Harmonization Working Party (AHWP) - www.asiahwp.org • ACCSQ Medical Device Product Working Group - www.accsq-mdpwg.org Copyright 2013, by May Ng