Post-marketing sampling and testing programs for licensed medicinal products

a narrative review

Authors

  • Edvaldo Oliveira Neves Brazilian Health Regulatory Agency (ANVISA), Brasilia, DF, Brazil; Faculty of Health Sciences, University of Brasilia (UnB), Brasilia, DF, Brazil https://orcid.org/0000-0002-1220-9675
  • Paloma Michelle Sales Faculty of Health Sciences, University of Brasilia (UnB), Brasilia, DF, Brazil; Central Laboratory of Public Health of the Federal District (LACEN-DF), Brasilia, DF, Brazil
  • Damaris Silveira Faculty of Health Sciences, University of Brasilia (UnB), Brasilia, DF, Brazil https://orcid.org/0000-0003-1851-5224

DOI:

https://doi.org/10.1590/s2175-97902022e19538

Keywords:

Medicines, Quality control, Post-marketing, Pharmaceutical products, Harmonization, Pharmacopeia

Abstract

The globalization of the pharmaceutical market has enabled access to a considerable number of new medicinal products. Consequently, the circulation of substandard medicinal products has also increased. To minimize this problem, post-marketing quality sampling and testing programs are performed to monitor and confirm that the medicinal products available in the market meet appropriate quality requirements. In this review, the post-approval sampling and testing procedures of six regulatory authorities were compared with the goal of strengthening these market surveillance systems. Similarities were observed between the procedures adopted by different regulatory authorities. However, the agencies were not always transparent about the results of these monitoring procedures. A probable mismatch between the registration procedures and the quality requirements listed in official compendiums was observed, which resulted in dissonance and contradiction between the specifications approved by the regulatory authorities and those required in the pharmacopeias. Therefore, strengthening harmonization projects related to these activities can help minimize such difficulties.

Downloads

Download data is not yet available.

References

Anvisa. Brazilian Health Regulatory Agency (Brazil). Resolution of the Collegiate Board of Officers RDC nº 37 of July 06, 2009, which deals with the admissibility of foreign pharmacopoeias. Brazilian Federal Register, Jul 08, 2009, p. 40, Section 1.

Anvisa. Brazilian Health Regulatory Agency (Brazil). Resolution of the Collegiate Board of Officers RDC nº 49 of November 23, 2010. It approves Brazilian Pharmacopoeia, 5th edition and provides further remedies. Brazilian Federal Register , Nov 24 2010, p. 80, Section 1.

Anvisa. Brazilian Health Regulatory Agency (Brazil). Ordinance nº 452 of February 25, 2013. Approves the Internal Regulations of the Brazilian Pharmacopoeia Commission, revokes Ordinance nº 1015 of July 20, 2011 and gives other provisions. Brazilian Federal Register , Feb 26 2013, p. 102-103, Section 1.

Anvisa. Brazilian Health Regulatory Agency. Anvisa launches drug and device monitoring program: 1,800 samples will be tested [Internet]. 2016 [cited 2018 Dec 12]. Available from: Available from: https://bit.ly/2HwFYKw

» https://bit.ly/2HwFYKw

Anvisa. Brazilian Health Regulatory Agency. Brazilian Pharmacopoeia [Internet]. 2018a [cited 2018 Sep 17]. Available from: Available from: http://portal.anvisa.gov.br/farmacopeia

» http://portal.anvisa.gov.br/farmacopeia

Anvisa. Brazilian Health Regulatory Agency. Generic drugs: 18 years in the Brazil [Internet]. 2018b [cited 2019 May 09]. Available from: Available from: https://bit.ly/2Ju2THW

» https://bit.ly/2Ju2THW

Anvisa. Brazilian Health Regulatory Agency. Home Page for the Brazilian Health Regulatory Agency (ANVISA) 2019 [cited 2019 Apr 09]. Available from: Available from: http://portal.anvisa.gov.br/

» http://portal.anvisa.gov.br/

Bouin A-S, Wierer M. Quality standards of the European Pharmacopoeia. J Ethnopharmacol. 2014; 158:454-457.

Brazil. Law nº 5991 of December 17, 1973. Provides for the sanitary control for sale of medicines, drugs, pharmaceutical inputs and correlates, and give other provisions. Brazilian Federal Register , Dec 19, 1973, p. 13049-, Section 1.

Brazil. Law nº 6360 of September 23, 1976. Provides for the Health Surveillance that the medicines, drugs, and the pharmaceutical inputs, cosmetics & sanitizing and other products are subjected, and gives other provisions. Brazilian Federal Register , Sep 24, 1976, p. 12647-, Section 1.

Brazil. Decree nº 8077 of August 14, 2013. Regulates the registro, control, and monitoring of the products addressed by Law nº 6360 of September 23, 1976, and the conditions for the operation of companies subject to sanitary licensing, within the scope of health. Brazilian Federal Register , Aug 15, 2013, p. 18-19, Section 1.

Brazil. Law nº 13097 of January 19, 2015. Amends the Law nº 6360 of September 23, 1976, and give other provisions Brazilian Federal Register , Jan 20, 2015, p. 01-12, Section 1.

Brazil. Consolidation Ordinance nº 4 of September 28, 2017. Consolidation of the rules on health actions and services of Unified Health System (SUS). Brazilian Federal Register , Out 03, 2017, p. 288-360, Section 1 supplement.

Burdick RK, LeBlond DJ, Pfahler LB, Quiroz J, Sidor L, Vukovinsky K, et al. Specifications. Statistical applications for Chemistry, Manufacturing and Controls (CMC) in the pharmaceutical industry. Cham, Switzerland: Springer International Publishing; 2017. p. 227-267.

Calam DH. Design and international harmonization of pharmacopoeial standards. J Pharm Biomed Anal. 1995;14(1):1-5.

Colombia. Decree nº 677 of April 26, 1995. Regulates the conditions of registration and licensing, quality control and the health surveillance system for pharmaceuticals, cosmetics, pharmaceutical preparations of natural resources, grooming products, household care and other products of “domestic use”. Colombian Federal Register, Apr 28, 1995, p. 20.

Colombia. Resolution nº 1619 of May 15, 2015. Implementing rules for the national laboratories network. Colombian Federal Register , May 20, 2015, p. 1-2.

Conceição J, Pita JR, Cabral-Marques HM, Sousa Lobo JM. The European Pharmacopoeia: an official book with fifty years. Acta Farm Port. 2019;8(1):17-38.

Conceição J, Pita JR, Estanqueiro M, Lobo JS. Portuguese pharmacopoeias and public health. Acta Farm Port . 2014;3(1):47-65.

Dong X, Tsong Y, Shen M. Statistical considerations in setting product specifications. J Biopharm Stat. 2015;25(2):280-294.

EDQM. European Directorate for the Quality of Medicines and HealthCare. General procedure for sampling and testing of generic Centrally-Authorised products PA/PH/CAP (12) 32 11R [Internet]. 2014 [cited 2018 Aug 09]. Available from: Available from: https://www.edqm.eu/medias/fichiers/general_procedure_ for_sampling _and_testing _of_ generic_centrally _ authorised_products_paphcap_12_32.pdf

» https://www.edqm.eu/medias/fichiers/general_procedure_ for_sampling _and_testing _of_ generic_centrally _ authorised_products_paphcap_12_32.pdf

EDQM. European Directorate for the Quality of Medicines and HealthCare. Annex 7 to the GEON Terms of reference: Mutual recognition of test results PA/PH/OMCL (16) 49 R [Internet]. 2016a [cited 2018 Aug 08]. Available from: Available from: https://www.edqm.eu/sites/default/files/geon-tor-annex7-mutualrecognition-test-results.pdf

» https://www.edqm.eu/sites/default/files/geon-tor-annex7-mutualrecognition-test-results.pdf

EDQM. European Directorate for the Quality of Medicines and HealthCare. Incorporation of a risk based approach in Market Surveillance testing at OMCLs PA/PH/OMCL (06) 3 9R [Internet]. 2016b [cited 2018 Sep 11]. Available from: Available from: https://www.edqm.eu/sites/default/files/omcl_incorporation_of_a_rb_approach_in_ms_testing_at_omcls.pdf

» https://www.edqm.eu/sites/default/files/omcl_incorporation_of_a_rb_approach_in_ms_testing_at_omcls.pdf

EDQM. European Directorate for the Quality of Medicines and HealthCare. Annual Report 2017 European Directorate for the Quality of Medicines & HealthCare (EDQM) 2017 [cited 2018 Set 11]. Available from: Available from: https://www.edqm.eu/sites/default/files/annual-report-edqm-2017.pdf

» https://www.edqm.eu/sites/default/files/annual-report-edqm-2017.pdf

EMA. European Medicines Agency. Connecting the dots-Towards global knowledge of the international medicine regulatory landscape: mapping of international initiatives [Internet]. 2016a [cited 2018 Nov 10]. Available from: Available from: https://www.ema.europa.eu/documents/leaflet/connecting-dots-towards-global-knowledge-international-medicineregulatory-landscape-mapping_en.pdf

» https://www.ema.europa.eu/documents/leaflet/connecting-dots-towards-global-knowledge-international-medicineregulatory-landscape-mapping_en.pdf

EMA. European Medicines Agency. The European regulatory system for medicines: A consistent approach to medicines regulation across the European Union [Internet]. 2016b [cited 2018 Sep 24]. Available from: Available from: http://www.ema.europa.eu/docs/en_GB/document_library/Leaflet/2014/08/ WC500171674.pdf

» http://www.ema.europa.eu/docs/en_GB/document_library/Leaflet/2014/08/ WC500171674.pdf

EMA. European Medicines Agency. Results of the sampling and testing programme for the year 2014 Human and veterinary products [Internet]. 2016c [cited 2018 Aug 13]. Available from: http://www.ema.europa.eu/docs/en_GB/document_library/Report/2016/07/WC500211428.pdf

» http://www.ema.europa.eu/docs/en_GB/document_library/Report/2016/07/WC500211428.pdf

EU. European Union. Directive 2001/83/EC of the European Parliament and of the Council of 6 November 2001 on the Community code relating to medicinal products for human use. Official Journal European Union, L311, 2001, p. 67-128.

FDA. Food and Drug Administration. Guideline for submitting supporting documentation in drug applications for the manufacture of drug products [Internet]. 1987 [cited 2018 Nov 10]. Available from: Available from: https://www.fda.gov/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/ucm149499.htm

» https://www.fda.gov/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/ucm149499.htm

FDA. Food and Drug Administration. Guidance for industry ANDA submissions - Content and format of Abbreviated New Drug Applications [Internet]. 2014 [cited 2018 Sep 20]. Available from: Available from: https://www.fda.gov/downloads/drugs/guidances/ucm400630.pdf

» https://www.fda.gov/downloads/drugs/guidances/ucm400630.pdf

FDA. Food and Drug Administration. Drug quality sampling and testing (DQST) Human drugs Program 7356.008 [Internet]. 2015 [cited 2018 Sep 10]. Available from: Available from: https://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/UCM273078.pdf

» https://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/UCM273078.pdf

FDA. Food and Drug Administration. Drug quality sampling and testing programs [Internet]. 2018 [cited 2018 Aug 28]. Available from: Available from: https://www.fda.gov/Drugs/ScienceResearch/ucm407277.htm

» https://www.fda.gov/Drugs/ScienceResearch/ucm407277.htm

Hajjou M, Krech L, Lane-Barlow C, Roth L, Pribluda VS, Phanouvong S, et al. Monitoring the quality of medicines: Results from Africa, Asia, and South America. Am J Trop Med Hyg. 2015;92(Suppl 6):68-74.

Heyward J, Padula W, Tierce JC, Alexander GC. The value of U.S. Pharmacopeial Standards: A review of the literature. J Pharm Sci. 2018;107(10):2611-2617.

ICH. Specifications: Test procedures and acceptance criteria for new drug substances and new drug products: Chemical substances Q6A. International conference on harmonisation of technical requirements for registration of pharmaceuticals for human use; 1999 Oct 6; Geneva, Switzerland: ICH; 1999.

Infarmed. National Authority of Medicines and Health Products. Supervisão do mercado [Internet]. 2017 [cited 2018 Sep 08]. Available from: Available from: http://www.infarmed.pt/web/infarmed/entidades/medicamentos-uso-humano/contrololaboratorial-de-medicamentos/supervisao-do-mercado

» http://www.infarmed.pt/web/infarmed/entidades/medicamentos-uso-humano/contrololaboratorial-de-medicamentos/supervisao-do-mercado

Infarmed. National Authority of Medicines and Health Products. Laboratory Drug Control [Internet]. 2018 [cited 2018 Aug 09]. Available from: Available from: http://www.infarmed.pt/web/infarmed/entidades/medicamentos-uso-humano/contrololaboratorial-de-medicamentos

» http://www.infarmed.pt/web/infarmed/entidades/medicamentos-uso-humano/contrololaboratorial-de-medicamentos

Invima. National Food and Drug Surveillance Institute. Demonstrate Quality Program Drug Products (DeMuestra La Calidad) [Internet]. 2017 [cited 2018 Dec 20]. Available from: Available from: https://www.invima.gov.co/images/pdf/farmacovigilancia_alertas/ INFORME-PROGRAMADEMUESTRA-LA-CALIDAD-2016.pdf

» https://www.invima.gov.co/images/pdf/farmacovigilancia_alertas/ INFORME-PROGRAMADEMUESTRA-LA-CALIDAD-2016.pdf

IQVIA Institute. The global use of medicine in 2019 and outlook to 2023: Forecasts and areas to watch [Internet]. 2019 [cited 2019 Mar 15]. Available from: Available from: https://www.iqvia.com/-/media/iqvia/pdfs/institute-reports/the-global-use-ofmedicine-in-2019-and-outlook-to-2023.pdf

» https://www.iqvia.com/-/media/iqvia/pdfs/institute-reports/the-global-use-ofmedicine-in-2019-and-outlook-to-2023.pdf

Lima LMTR. Pharmacopeia and ANVISA: A Necessary Symbiosis. Rev Bras Farm Hosp Serv Saúde. 2017; 8(4):4-7.

Lybecker KM. Social, ethical, and legal issues in drug development, marketing, and pricing policies setting priorities: pharmaceuticals as private organizations and the duty to make money/maximize profits. The Power of Pills. Social, Ethical and Legal Issues in Drug Development, Marketing and Pricing. London: Pluto Press; 2006. p. 25-31.

Neves EO, de Sales PM, Silveira D. Pharmacopeial specifications and analytical data from post-marketing quality sampling and testing programs: a perspective beyond out-of-specification results. J Pharm Biomed Anal . 2019:112935.

Newton PN, Green MD, Fernández FM. Impact of poorquality medicines in the ‘developing’ world. Trends Pharmacol Sci. 2010;31(3):99-101.

Ozawa S, Evans DR, Bessias S, Haynie DG, Yemeke TT, Laing SK, et al. Prevalence and estimated economic burden of substandard and falsified medicines in lowand middleincome countries: A systematic review and meta-analysis. JAMA Netw Open. 2018;1(4):e181662-e181662.

Portugal. Decree-Law nº 176 of August 30, 2006. Establishes the legal system of the medicinal products for human use and is usually referred as Medicinal Products Statute. Official Journal, Aug 30, 2006, p. 6297-6383, Section I.

Portugal. Decree-Law nº 46 of February 24, 2012. Approves the organic statute of INFARMED National Authority of Medicines and Health Products, I.P. Official Journal, Feb 24, 2012, p. 884-890, Section I

Pribluda VS, Barojas A, Coignez V, Bradby S, Dijiba Y, ElHadri L, et al. The three-level approach: a framework for ensuring medicines quality in limited-resource countries. Pharm Regul Aff. 2014;3(1):117.

Priyanka P, Jayshree D. In vitro Comparison of Generic and Branded Preparations of Amoxicillin with Potassium Clavulanate. J Clin Diagn Res. 2016;10(9):FC07-FC09.

Rägo L, Santoso B. Drug regulation: history, present and future. In: Van Boxtel CJ, Santoso B, Edwards IR, editors. Drug benefits and risks: International textbook of clinical pharmacology. Amsterdam and Washington, DC: IOS Press; 2008. p. 65-77.

Ratanawijitrasin S, Wondemagegnehu E. Effective drug regulation: A multicountry study. Geneva, Switzerland: World Health Organization; 2002.

Sindusfarma. Association of the Pharmaceutical Industry in the State of São Paulo. Lecture of ANVISA at Sindusfarma: Brazilian Health Regulatory Agency starts its programmed tests on 1.800 drug samples - São Paulo on December 19, 2016 [Internet]. 2016 [cited 2018 Aug 08]. Available from: Available from: http://sindusfarma.org.br/arquivos/Apresentacao2_19dez2016. pptx

» http://sindusfarma.org.br/arquivos/Apresentacao2_19dez2016. pptx

Sousa VD, Ramalho PI, Silveira D. Sharing regulatory data as tools for strengthening health systems in the Region of the Americas. Rev Panam Salud Publica. 2016;39(5):245-254.

Teixeira T, Kweder SL, Saint-Raymond A. Are EMA, FDA and other international regulators talking to each other? Clin Pharmacol Ther. 2019;107(3):7p.

USP. United States Pharmacopeia. USP Guideline for submitting requests for revision to the USP-NF: General information for all submissions [Internet]. 2016 [cited 2018 Dec 10]. Available from: Available from: http://www.usp.org/sites/default/files/usp/document/get-involved/submission-guidelines/general-information-for-all-submissions.pdf

» http://www.usp.org/sites/default/files/usp/document/get-involved/submission-guidelines/general-information-for-all-submissions.pdf

USP. United States Pharmacopeia. Pending Monograph Guideline [Internet]. 2017 [cited 2019 Jan 20]. Available from: Available from: https://www.uspnf.com/sites/default/files/usp_pdf/ EN/USPNF/pending-monograph-guideline.pdf

» https://www.uspnf.com/sites/default/files/usp_pdf/ EN/USPNF/pending-monograph-guideline.pdf

USP. United States Pharmacopeia. United States Pharmacopeia (USP 41-NF 36) [Internet]. 2018 [cited 2018 Aug 23]. Available from: Available from: https://www.uspnf.com/ Subscription required.

» https://www.uspnf.com/

Van Norman GA. Drugs and devices: Comparison of European and U.S. approval processes. JACC Basic Transl Sci. 2016;1(5):399-412.

Vickers S, Bernier M, Zambrzycki S, Fernandez FM, Newton PN, Caillet C. Field detection devices for screening the quality of medicines: a systematic review. BMJ Glob Health. 2018;3(4):e000725.

Wechsler J. Harmonizing Standards and Specifications. Pharm Tech. 2002;26(5):14-22.

Weyer K. Concept paper for discussion: A stepwise approach for pharmaceutical companies in developing countries to attain WHO GMP standards. WHO Drug Information. 2016;30(2):186-198.

WHO. World Health Organization. Effective medicines regulation: ensuring safety, efficacy and quality. WHO Policy Perspectives on Medicines. Geneva, Switzerland: WHO Press; 2003.

WHO. World Health Organization. WHO good practices for pharmaceutical quality control laboratories. Forty-fourth report of the WHO Expert Committee on Specifications for Pharmaceutical Preparations. Geneva, Switzerland: WHO Press ; 2010.

WHO. World Health Organization. WHO Procedure for the development of monographs and other texts for The International Pharmacopoeia. Forty-ninth report of the WHO Expert Committee on Specifications for Pharmaceutical Preparations. Geneva, Switzerland: WHO Press ; 2015.

WHO. World Health Organization. Guidelines on the conduct of surveys of the quality of medicines. Fiftieth report of the WHO Expert Committee on Specifications for Pharmaceutical Preparations. Geneva, Switzerland: WHO Press ; 2016.

WHO. World Health Organization. A study on the public health and socioeconomic impact of substandard and falsified medical products [Internet]. 2017a [cited 2019 Mar 02]. Available from: Available from: https://www.who.int/medicines/regulation/ssffc/publications/SE-Study_EN_web.pdf?ua=1

» https://www.who.int/medicines/regulation/ssffc/publications/SE-Study_EN_web.pdf?ua=1

WHO. World Health Organization. WHO Global Surveillance and Monitoring System for substandard and falsified medical products [Internet]. 2017b [cited 2019 Mar 02]. Available from: Available from: https://www.who.int/medicines/regulation/ssffc/publications/GSMS_Report_layout.pdf?ua=1

» https://www.who.int/medicines/regulation/ssffc/publications/GSMS_Report_layout.pdf?ua=1

WHO. World Health Organization. Considerations for requesting analysis of medicines samples. Fifty-second report of the WHO Expert Committee on Specifications for Pharmaceutical Preparations. Geneva, Switzerland: WHO Press ; 2018a.

WHO. World Health Organization. Index of world pharmacopoeias and pharmacopoeial authorities Working document QAS/11.453/Rev.10 [Internet]. 2018b [cited 2018 Aug 02]. Available from: Available from: http://www.who.int/medicines/publications/pharmacopoeia/indexofpharmacopoeias_17012018.pdf?ua=1&ua=1

» http://www.who.int/medicines/publications/pharmacopoeia/indexofpharmacopoeias_17012018.pdf?ua=1&ua=1

Downloads

Published

2022-11-23

Issue

Section

Review

How to Cite

Post-marketing sampling and testing programs for licensed medicinal products: a narrative review. (2022). Brazilian Journal of Pharmaceutical Sciences, 58. https://doi.org/10.1590/s2175-97902022e19538