Regulation of Pharmaceuticals in Kenya Anthony Toroitich, Pharmacy and Poisons Board (PPB) Directorate of Product Evaluation & Registration Presentation Overview Introduction Regulatory Framework and Principles Scope of Health Product Regulation Regulation of Clinical trials Marketing Authorization Process Comparative Overview of Current Pharmaceutical Laws in EAC Areas for Legal Harmonization Introduction (1) 3 Medical Products and Health Technologies (MPHT’s) is an integral part of the health system in Kenya An effective healthcare system should Provide the public with access to medicines that are of good quality, safety and efficacy and that are economically affordable. Must be captured clearly in the national health and pharmaceutical policies. Access to medicines becomes even more critical given that majority of our population live below poverty line and face serious pandemics such as HIV/AIDS, malaria, drought and famine. Introduction (2) Regulation of Medical Products and Health Technologies (MHPT’s) has developed over the past 50 years in response to crises. The initial regulatory standards were primarily related to ensuring the supply of quality of MHPT’s Current regulatory developments involve development of standards for quality, efficacy and safety . Future EAC Harmonization initiatives Introduction (3) Pharmaceutical and Health Policy Goal and Objective: Universal access to essential health products and technologies by ensuring availability and rational use of safe, good quality, efficacious/effective and affordable health products and technologies through appropriate regulation A key strategy: Pharmaceutical Sector Regulation Requires a harmonized regulatory system based on sound science and evidence Should cover: human Medicines; vaccines, blood & biologics; diagnostics, medical devices & technologies; animal & veterinary Medicines; food products, cosmetics and emerging health technologies. Regulatory Principles and Framework (2) 6 Pharmacy and Poisons Board was established in 1957 under the Pharmacy and Poisons Act- Cap 244 of the Laws of Kenya, with the mandate: “to make better provision for the practice and profession of pharmacy and the trade in pharmaceutical products.” Principles of Regulation Law (CAP 244): are usually written in fairly general terms to meet present and possibly future needs. Passing new laws is a lengthy process hence enforced by regulation. Rules (Regulation): Requiring approval by Cabinet Secretary, more rapidly to respond to changes and can be altered more easily. PPB Gazette notices: Public Information for operationalisation of rules Guidelines: Do not carry the force of law, can be more easily modified and updated and offer informal information on PPB’s thinking in regard to implementation of regulations. Guidelines help avoid misinterpretation of and facilitate compliance with laws and regulations. Regulatory Principles and Framework (3) Critical elements for regulation depend on Product, usage and presentation to user. Stages of regulatory control Pre-market control ensure that the product to be placed on the market complies with regulatory requirements i.e. Quality, Safety and Efficacy/Effectiveness. Post-market Control Conception & Development Manufacture Pre-market Control Labeling Advertising Ethical Marketing Use Post-Market Control Disposal Key Regulatory Functions of PPB Premarket of Medical Products Clinical Trials Marketing Authorization Medical Products Evaluation & Registration Inspection (+ GMP) Good Distribution Practice Licensing of pharmaceutical manufacturers, importers and distributors Post-market of Medical Products Control of importation of pharmaceuticals Post Market Surveillance and Enforcement Quality Control Laboratory testing Pharmacovigilance (Adverse Drugs Reactions) Scope of MPHTs Regulated Medicines Convectional medicines (Human, Veterinary and Biological products) Complementary/Alternative/Herbal medicines Dietary Supplements Medical devices and Borderline products Legal Framework and Policies Required National Policies Development & issuance of guidelines Pre-market evaluation & approval Regulation of Clinical trials Done during medicine discovery process To determine whether indications, dosage or even the age group. To provide data that support the registration of medicines All clinical trials need to be carried out according to the approved protocols Monitored to ensure the integrity of the data generated. Conducted in accordance with Good Clinical Practice GCP standards: ethical principles from Helsinki Declaration List of PPB Approved clinical trials @ www.ctr.pharmacyboardkenya.org Marketing Authorization 11 Marketing authorisation (MA) or Registration: Permission for a medicinal product to be marketed or distributed in a country Requires pre-market evaluation of Dossier Entry in a register and gazetting in a government Gazette Objective: Protection of consumers against effects of unsafe and ineffective products Availability of the drug is in the public interest safety, efficacious and of acceptable quality The site and manufacturing operations complies with current GMP (adapted WHO guidelines) Marketing Authorization Process Submission Yes No Screening No Yes Scheduling Yes Review Yes Approval Yes Queries No Yes Post Marketing Actions Receipt of application and administrative data recording Scheduling of Dossiers on First In-First Out (FIFO) basis. Evaluation of dossier – First and Second or Review by technical committee/Peer Review Re-submission for reevaluation. Inspection of manufacturers. Good Distribution Practice Manufacturers, importers and distributors of MPHTs in must be licensed. All medicines released onto the market into Kenya are certified both for quality and GMP compliance. Inspectors are available for enforcement and inspection of premises Emerging Experts A specialized pool of experts in regulatory science is growing in Kenya, thereby enhancing regulation MPHTs. They allow best possible scientific decision for the regulation of MPHTs in Kenya Experts are chosen on the basis of their scientific expertise Experts participate as members of its scientific advisory committees or as members of the assessment teams carrying out the evaluation of medicines. Pharmacovigilance and Post market Surveillance of MPHTs All suspected side effects that are reported by patients and healthcare professionals must be entered into PPB PV portal, PPB web-based information system that collects, manages reports of suspected side effects of medicines. These data are continuously monitored in order to identify any new safety information. PPB has a committee dedicated to the safety of MPHTs. If there is a safety issue with an MPHTs that is authorised, patients and healthcare professionals are given guidance by the committee and regulatory action taken. In addition to its role in risk assessment, advice and recommendations to risk management planning and postmarketing surveillance for MPHTs. Harmonization Update 16 The future: we hope to have common legislation, common procedures for inspection, technical support, meetings, trainings in EAC. Pharmaceutical Policy: Different among partner states Pre-Market: Clinical Trials regulation Product Registration and Inspection esp. API/FPP manufacturer regulation and Inspection; Pre-market Laboratory for Quality Testing Product Information and scheduling: Legal Categories for Products, POM adverts, Internet and electronic media Post-Market Pharmacovigilance and Post market Surveillance National Formulary Development Price control Regulatory Actions for non compliance EAC Harmonization Update 17 Harmonized Technical Requirements Developed: MER, GMP, IMS & QMS. Capacity Building for Assessors, GMP ad QMS; - # of Regional Training: GMP inspectors (1), Dossier Assessment (1) & QMS (1). - Joint Assessments - Joint Inspections in collaboration between WHO and NMRA NMRA Adoption of Risk Based review approaches: Mutual recognition for access of essential medicines. Other Parallel Regional Activities - FPP focused PIC/S certification inspections of local manufacturers. - GIZ/PTB project improvement of GMP for local manufacturers. - Future Harmonized EAC Pharmaceutical Policy, Law, Mutual Recognition Framework and Information Sharing Agreements for NMRA. - Future Establishment of EAC Medicine & Food Safety Commission Questions/Comments Contacts Pharmacy and Poisons Board; Directorate of Product Evaluation and Registration Thank you