Literature DB >> 33604345

Paediatric Medicines in Europe: The Paediatric Regulation-Is It Time for Reform?

Maddalena Toma1, Mariagrazia Felisi2, Donato Bonifazi2, Fedele Bonifazi1, Viviana Giannuzzi1, Giorgio Reggiardo2, Saskia de Wildt3, Adriana Ceci1.   

Abstract

Objectives: In this paper, we investigated the effects of the European Paediatric Regulation (EC) N° 1901/2006 with respect to satisfying the paediatric therapeutic needs, assessed in terms of the increased number of paediatric medicinal products, new therapeutic indications in specific high-need conditions (neonates, oncology, rare disease, etc.) and increased number of paediatric clinical studies supporting the marketing authorisation.
Methods: We analysed the paediatric medicinal products approved by the European Medicines Agency in the period January 2007-December 2019, by collecting the following data: year of approval, active substance, legal basis for the marketing authorisation, type of medicinal product (i.e., chemical, biological, or ATMP), orphan drug status, paediatric indication, Anatomical Therapeutic Chemical code (first-level), number and type of paediatric studies. Data were compared with similar data collected in the period 1996-2006.
Results: In the period January 1996-December 2019, in a total of 1,190 medicinal products and 843 active substances, 34 and 38%, respectively, were paediatric. In the two periods, before and after the Paediatric Regulation implementation, the paediatric/total medicinal products ratio was constant while the paediatric/total active substances ratio decreased. Moreover, excluding generics and biosimilars, a total of 106 and 175 paediatric medicines were granted a new paediatric indication, dosage or age group in the two periods; out of 175, 128 paediatric medicines had an approved Paediatric Investigational Plan. The remaining 47 were approved without an approved Paediatric Investigational Plan, following the provisions of Directive 2001/83/EC and repurposing an off-patent drug. The analysis of the clinical studies revealed that drugs with a Paediatric Investigational Plan were supported by 3.5 studies/drug while drugs without a Paediatric Investigational Plan were supported by only 1.6 studies/drug. Discussion: This report confirms that the expectations of the European Paediatric Regulation (EC) N° 1901/2006 have been mainly satisfied. However, the reasons for the limited development of paediatric medicines in Europe, should be further discussed, taking advantage of recent initiatives in the regulatory field, such as the Action Plan on Paediatrics, and the open consultation on EU Pharmaceutical Strategy.
Copyright © 2021 Toma, Felisi, Bonifazi, Bonifazi, Giannuzzi, Reggiardo, de Wildt, Ceci and TEDDY European Network of Excellence for Paediatric Research.

Entities:  

Keywords:  EU paediatric regulation; orphan paediatric medicines; paediatric age; paediatric clinical studies; paediatric medicines; paediatric repurposing; therapeutic areas

Year:  2021        PMID: 33604345      PMCID: PMC7884470          DOI: 10.3389/fmed.2021.593281

Source DB:  PubMed          Journal:  Front Med (Lausanne)        ISSN: 2296-858X


  9 in total

1.  Medicines for children licensed by the European Agency for the Evaluation of Medicinal Products.

Authors:  A Ceci; M Felisi; M Catapano; P Baiardi; L Cipollina; S Ravera; S Bagnulo; S Reggio; G Rondini
Journal:  Eur J Clin Pharmacol       Date:  2002-09-25       Impact factor: 2.953

2.  Medicines for children licensed by the European Medicines Agency (EMEA): the balance after 10 years.

Authors:  A Ceci; M Felisi; P Baiardi; F Bonifazi; M Catapano; C Giaquinto; A Nicolosi; M Sturkenboom; A Neubert; I Wong
Journal:  Eur J Clin Pharmacol       Date:  2006-10-05       Impact factor: 2.953

3.  More medicines for children: impact of the EU paediatric regulation.

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Review 4.  Enabling Development of Paediatric Medicines in Europe: 10 Years of the EU Paediatric Regulation.

Authors:  Paolo A Tomasi; Gunter F Egger; Chrissi Pallidis; Agnes Saint-Raymond
Journal:  Paediatr Drugs       Date:  2017-12       Impact factor: 3.022

Review 5.  Modeling and simulation in pediatric drug therapy: Application of pharmacometrics to define the right dose for children.

Authors:  A A Vinks; C Emoto; T Fukuda
Journal:  Clin Pharmacol Ther       Date:  2015-07-20       Impact factor: 6.875

Review 6.  Pediatric drug-trial recruitment: enticement without coercion.

Authors:  Carl L Tishler; Natalie Staats Reiss
Journal:  Pediatrics       Date:  2011-04-04       Impact factor: 7.124

7.  Researchers', Regulators', and Sponsors' Views on Pediatric Clinical Trials: A Multinational Study.

Authors:  Pathma D Joseph; Jonathan C Craig; Allison Tong; Patrina H Y Caldwell
Journal:  Pediatrics       Date:  2016-10       Impact factor: 7.124

Review 8.  The Path to Perfect Pediatric Posology - Drug Development in Pediatrics.

Authors:  Joan M Korth-Bradley
Journal:  J Clin Pharmacol       Date:  2018-10       Impact factor: 3.126

9.  Unified approach for extrapolation and bridging of adult information in early-phase dose-finding paediatric studies.

Authors:  Caroline Petit; Adeline Samson; Satoshi Morita; Moreno Ursino; Jérémie Guedj; Vincent Jullien; Emmanuelle Comets; Sarah Zohar
Journal:  Stat Methods Med Res       Date:  2016-10-05       Impact factor: 3.021

  9 in total
  2 in total

1.  Patient attrition in Molecular Tumour Boards: a systematic review.

Authors:  Hannah Frost; Donna M Graham; Louise Carter; Paul O'Regan; Dónal Landers; André Freitas
Journal:  Br J Cancer       Date:  2022-08-08       Impact factor: 9.075

Review 2.  Recommendations by the European Network of Paediatric Research at the European Medicines Agency (Enpr-EMA) Working Group on preparedness of clinical trials about paediatric medicines process.

Authors:  Angeliki Siapkara; Claudio Fracasso; Gunter F Egger; Carmelo Rizzari; Cristina Serén Trasorras; Dimitrios Athanasiou; Mark A Turner
Journal:  Arch Dis Child       Date:  2021-04-15       Impact factor: 3.791

  2 in total

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