Regulatory Open Forum

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  • 1.  Notified Body Opinion Report for a Combination Product

    Posted 15-Sep-2022 16:58

    For a medicinal/device combination product in the EU, if the action of a medicinal substance is primary and not ancillary to that of the device, the integral medicinal/device combination product shall be regulated by the Directive for Medicinal Products For Human Use (2001/83/EC). If the device component of a medicinal/ device combination product has not previously been issued a CE mark under the MDR, what is the procedure for a manufacturer to seek a NB Opinion (NBo) on the conformity of the device to the general safety and performance requirements set out in Annex I of the MDR in order that the NB can subsequently issue a NBo Report for inclusion in the Marketing Authorization Application(MAA) for the medicinal component of the medicinal/device combination product (Ref: MDR Article 117, Amendment to Directive 2001/83/EC, second paragraph)?

     

    Subsequently, does the post market surveillance requirements fall under the medicinal Pharmacovigilance system requirements (e.g., PSUR, medical literature monitoring, reporting of adverse events, etc.) or should the Technical Documentation of the device component contain the Post Marketing Surveillance (PMS) documents required by the MDR.

    Thanks in advance for your comments,



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    Bob Wilkinson
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  • 2.  RE: Notified Body Opinion Report for a Combination Product

    Posted 16-Sep-2022 01:05
    Dear Bob,

    This is correct. The Notified Body assesses the technical documentation of the manufacturer / MAH and, if all applicable requirements of Annex I (General Safety and Performance Requirements) are met, issues a Notified Body Opinion (NBOp). Unless there are significant changes, this is a one time event means, there is not surveillance. This NBOp is then included in the MAA as evidence that the device constituent part meets the requirements. The assessment is solely on the technical documentation and the quality management system will not be assessed and no audit / inspection is part of this. 

    BTW: the term "significant change" is currently controversely discussed between industry, Notified Bodies and Authorities but the positions are not yet aligned.

    You are correct that general post market surveillance requirements fall under the medicinal Pharmacovigilance system requirements. However, feedback will likely also influence the technical documentation of the device part (e.g. risk management file, human factors aspects, device changes etc.) and respective links should be built into the quality system to ensure this.

    Best regards
    Beat

    ------------------------------
    Beat U. Steffen, FRAPS
    confinis ag
    Founder & CEO
    Düdingen
    Switzerland
    www.confinis.com
    ------------------------------



  • 3.  RE: Notified Body Opinion Report for a Combination Product

    Posted 16-Sep-2022 05:46

    Bob,

    I concur with Beat's reply. Additionally, I'd note that this only applies to 'single integral' combination products ('single-entity' in US parlance) and, thus, an NBOp would only be issued for the combination product as a whole and not for the independent device part ('device constituent' in US terminology). It seems like you may have been alluding to this possibility in your initial message.

    Additionally, regarding postmarket activities, Beat is also correct - however there may be specific requirements in other jurisdictions if the same combination product is also marketed elsewhere (e.g. 21 CFR 4 Subpart B for Postmarket Safety Reporting if the combination product is also approved in the US).



    ------------------------------
    Jonathan Amaya-Hodges
    Director, Technical Services
    Sharon MA
    United States
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  • 4.  RE: Notified Body Opinion Report for a Combination Product

    Posted 16-Sep-2022 07:05
    Robert,

    Just to be clear, the integrated Product is fully regulated under Medicinal Product Directive (MPD) 2001/83/EC.  The MDR requires a NB opinion ONLY on the conformity of the device part with the relevant general safety and performance requirements (GSPRS) set out in Annex I for the type of device in question. No other section or requirements from the MDR apply to that product. 

    The procedure to request a NBOp is like any other process for contracting the services of a NB.  You must contact one or more Notified bodies that are authorized for your device part and ask about their process, costs, timing, procedures and forms necessary to initiate a contractual relationship for this service.

    Good Luck.

    ------------------------------
    Lee Leichter RAC
    President
    Fort Denaud FL
    United States
    ------------------------------



  • 5.  RE: Notified Body Opinion Report for a Combination Product

    Posted 19-Sep-2022 02:50
    Hello,

    All good comments so far.  Also just like to add if the device - medicinal product is NOT an integrated product, then the medical device needs to be reviewed by a Notified Body under EU MDR 2017/745 to obtain CE Mark as a medical device.  Examples of this would be syringes, inhalers, or pumps which are used to deliver medicinal products.  Products in the past like integrated syringes or inhalers maybe need to be reviewed against the current regulations as well, because it may not be so clear.

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    Richard Vincins ASQ-CQA, MTOPRA, RAC
    Vice President Global Regulatory Affairs
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  • 6.  RE: Notified Body Opinion Report for a Combination Product

    Posted 20-Sep-2022 00:30
    Hello Bob and Richard,

    Me again. Thanks to Richard for the additional input regarding standalone "non-integrated" drug delivery devies such as syringes and pumps. Just to be very clear: a syringe is only regulated as a medical device if it's placed on the market like that (empty syringe) - if it's a prefilled syringe (integrated) or simply sold as components to pharma / biotech companies to be filled, they are not medical devices as per the MDR.

    Furthermore, if the integrated drug-delivery device was already approved before May 26th, 2021 by the Health Authorities, an NBOp is only required in case of a significant change. Otherwise, no NBOp is needed.

    Hope this helps.

    Cheers, Beat


    ------------------------------
    Beat U. Steffen, FRAPS
    confinis ag
    Founder & CEO
    Düdingen
    Switzerland
    www.confinis.com
    ------------------------------



  • 7.  RE: Notified Body Opinion Report for a Combination Product

    Posted 19-Sep-2022 14:40

    Thanks Richard,

    Always look forward to your comments.

     

    Best regards,

    Bob

     

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