Divided by a Common Language: PV Differences Between the UK and the US – Notes for Ambitious Biotechs

International Biopharma - Extracts - September, 2021

ln the modern market, small and nimble biotechs possess many great advantages in terms of their ability to bring new innovation to market quickly, unhindered by legacy ways of operating. Yet the smallest startups share the same obligations as large pharma companies when it cornes to safety and pharmacovigilance, which means they are likely to face a steep learning curve.

lt doesn’t help that requirements vary from region to region, from authority to authority, around the world. Relying on an individual CRO partner to manage all PV requirements internationally may be appealing, but is a risky strategy- unless there is experienced CR0 oversight to ensure that the regulatory requirements are met in all countries where a compound is studied and/or marketed. A far better approach is for biotech companies to grasp for themselves the complexity of the task they face.

Before going to market
Most pre-market PV requirements are the same across the European and US markets, in line with agreements and guidance on standardisation via the ICH – the International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use. But there are some small, noteworthy variations.

Companies tend to favour filing in the US first, because on top of the market’s vast size the US benefits from being one country, governed by one main agency – the United States Food and Drug Administration (FDA}. ln Europe, marketing authorisation can take much longer because beyond the central European Medicines Agency (EMA) each EU member state has its own unique requirements to navigate.

Even at a central Level, EMA submissions have a different look and format to US dossiers so require different handling. For instance the Summary of Product Characteristics (SmPC} and labelling in relation to side effects are not presented in the same way in Europe. Differences exist too between the risk management approaches – the FDA’s Risk Evaluation and Mitigation Strategies (REMS} and EMA’s Risk Management Plan (RMP} – one cannot be substituted for the other. Failure to factor in these differences could present an issue at the time of filing. ln addition, national EU-specific requirements may be requested in certain countries, on top of the RMP EU requirements, even for centralised procedures.

Get any of this wrong, and companies risk their dossiers being rejected, or authorisation being delayed as requests for amendments or additional information go back and forth.

Keep it together
All of this means that biotechs need a clear strategy and timeline for how they will file to their target markets. Leaving Europe to one side until sales in the US are up and running is inadvisable, given the additional time that is likely to be required to prepare for EMA’s differing requirements – and those of each EU country beyond that. And of course the UI< must now be treated as its own market, following Bre>

lt isn’t just European information and formatting require­ ments that differ and are more involved than in the US. Standard operating procedures (S0Ps)/process requirements can be more complex in Europe too.

Real-world monitoring
The post-marketing regulatory environment is highly regulated and inspection driven, and it is here that biotechs are likely to find the greatest challenges in managing their PV obligations. Here, the differences between US and European requirements differ more significantly.

ln the early 2000s, Europe revised its post-marketing PV requirements, making these very clear and prescriptive. ln the US, equivalent post-marketing safety requirements are considerably older and quite vague in their language, leaving much to interpretation. For post-marketing safety studies, for instance, Europe has done quite a nice job of breaking down the requirements for interventional versus non-interventional studies and what needs to be reported – or not – for each. ln the US, companies tend to tread a much more cautious path, interpreting the requirements more conservatively because precise guidance is lacking.}.

If studies are used to support a product daim, and the right data hasn’t been collected in the right way for the given market, this could pose problems. So the different requirements do need to be well understood – and designed into post-marketing and market research studies – to avoid potential problems later.

Differences in definition
A further variable in all of this is that categorisation and treatment of different products types by the authorities can differ between regions. A ‘device’ or ‘combination product’ (device plus medicine} may carry different definitions and requirements from one region to another, for instance. Being aware ofthis, and buildingthis into PV processes and planning, is another international regulatory imperative then.

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