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FieldInvestigators:
ADEDetectives學(xué)分網(wǎng)SectionOneIntroductiontotheTeamandTheirRolesFDA’sPostmarketingAdverseDrugExperienceInspectionalProgram…”promoteandprotectpublichealthbyassuringthatsafeandeffectivedrugsareavailabletoAmericans.”…”providepharmacovigilanceresourcestotheCenterforDrugEvaluationandResearchtoensurethesafetyofmarketeddrugs.”
FieldInvestigations
OfficeofDrugSafety
OfficeofCompliance
RegulatoryPolicyStaff
OfficeofChiefCounsel…”serveasindustrywatchdog,performinginspectionsorinvestigationsthathelpprotectthesafetyofallourcitizens.”
Afterapproval,drugsareusedinmany
typesofpatients--includingolder,sicker
orthosetakingmedications---
thatwerenotstudiedduringthepre-approval
period.
Rare,seriousadversereactionsareoften
notdiscovereduntilmanythousands
ofpatientshavetakenthedrug.
Labelingchangesrelatedtoprescribing
informationarecompleteandup-to-date.
Drugrisksarequicklyandappropriately
managed.
Regulations
Guidance
Informationonhowtoconductan
inspection
HelpfultipsandinformationSectionTwoTheRegulationsSafetyreportingrequirements
coverallpersonswhomarket
over-the-counterdrugswith
approvedapplicationsand
prescriptionsdrugs
Applicants
Manufacturers
Packers
Distributors
Title21oftheCodeofFederalRegulationsSection314.80-PostmarketingSafety
ReportingRegulationsforHumanDrugs
withApprovedNewDrugApplicationsSection314.98-PostmarketingSafety
ReportingRegulationsforHumanDrugs
withApprovedAbbreviatedNewDrug
ApplicationsSection211.198-RequiresIndustry
toEstablishWrittenProceduresfor
HandlingComplaints,IncludingADEs
Anadverseevent
occurringinthecourseof
theuseofadrugproductin
professionalpractice;
fromadrugoverdose,whether
accidentalorintentional;
fromdrugabuse;
fromdrugwithdrawal;
andfromanyfailureofexpected
pharmacologicalaction
Death
Alife-threateningADE
Inpatienthospitalizationor
prolongationofexisting
hospitalization
Apersistentorsignificantdisability
orincapacity
Acongenitalanomalyorbirthdefect
Otherimportantmedicalevents
Whatmustbereported?
Anyspontaneousadverseevent
occurringwithintheU.S.
Anyforeignreports,literatureand
studyreportsthatinvolveserious
andunexpectedevents.3TypesofRequiredReports?
Expeditedor15-dayalertreports
Periodicreports
Follow-upreportsFourBasicElements:
identifiablepatient
Identifiablereporter
Suspectdrug
Anadverseexperienceorfatal
outcomeForm3500AorCIOMS1Form-From
thecouncilforInternationalOrganizations
ofMedicalSciences
Surveillance
Receipt
Evaluation
Reporting
Firmsshouldcollect
qualityinformation
Identifyandconfirmdrug
safetyissuesassoonaspossible
Communicatedrugsafety
informationtoFDAandtothe
publicefficientlyandeffectively
MaintainallADErecords,including
allrawdata,for10years
/medwatch/how.htm
ByMail:Usethepostage-paid
MedWatchform
ByPhone:1-800-FDA-1088
ByFAX:1-800-FDA-0178
AndbyInternetSectionThreeComplianceProgramGuidanceYourjobasaninvestigatorwilldependmore
oncomputersandtelecommunications.TypesofInspections:
For-causeordirectedinspections
RoutinesurveillanceinspectionsSelectionCriteria:
AreviewoftheAdverseEventReporting
Systemdatabase
Firmsthathaveahistoryofviolations,are
ontheApplicationIntegrityPolicyList,or
thathaveahistoryofrecalls
Routinesurveillance
ThedrugisanewmolecularentityorIson
theTOP200List
SelectionCriteria:
Safetyissues
Bioequivalenceissuesand
Specialsituations
Timelinessreports
Directreportsvs.Mandatoryreports
Completenessreports
GettingReadyforanInspectionReviewpreviousestablishmentinspectionreportsReviewinformationprovidedwiththeassignment,
whichmayinclude3500Aforms,current
approvedlabelingandAERS-generatedADElistsReviewapplicableCFRsections,Compliance
ProgramInformation,andFDAguidelinesContactthestaffmemberwhoinitiatedyour
assignment
Allofthefirm’swrittenproceduresthatdescribe
receipt,evaluation,andsubmissionsofADEs
duringthetimeperiodunderinvestigation.
Organizationalchartsshowingwhichpersonswere
orareresponsibleforallcomplianthandlingduring
thetimeperiodunderinvestigation.
Allwrittenproceduresdescribingwhoisresponsible
forchangingcomplainthandlingproceduresduring
thetimeperiodunderinvestigation.
Allcorrespondence,meetingminutes,anddocuments
relatingtoallADEs.
Listofallthecompany’sdrugproductsandapproval
dates.
Packageinsertsforproductscoveredunderthe
inspection.
AlistingofallADEcomplaintsreceivedoveraspecific
timeframe,suchas2years,includingforeignand
domesticevents.
Periodicreports,specific3500Aforms,andassociated
rawdata.
Listsofcollectionsites,processingcenters,and
reportingunits.
Copiesofallcontractualagreementsrelatedtocollection,
evaluationandreportingADEs.SectionFourHowtoConductanInspectionIsthereadifferencebetweenaGMPinspection
andapost-marketingADEinspection?WhatisthemainobjectiveoftheseADE
inspections?Whataresomethequestionsyoutypicallyask
whileinterviewingrepresentativesofthe
company?
Howdotheydotheirjobwheneachtypeof
ADEcomesintothecompany?
AretheremeetingsonADEs?Whopresides;
howoften;whattopicsarediscussed?
Whichpersonsinthecompanyareresponsible
forlabelingandmakingsurethelabelingreflects
theADEscomingintothecompany?
Howdoestheprocessworkforassuring
labelingreflectsADEs?
Whofirstreceivestheincomingmailorcalls
relatingtoADEs?
WhereareandhowareADEsloggedin?
Whoperformsthemedicalevaluations?
Whoperformsfollow-up?
Whoassessesseriousness?
WhodeterminesiftheADEisalabeledoran
unlabeledevent?
WhodeterminesiftheADEisa15-dayora
periodicreport?
Whotransmitsorsendsthe3500AFormtoFDA?
Howisinformationsharedamong
departments?Beawarethatthelegal
departmentmightbereceivingandmaintaining
ADEstoo.
WhodeterminesiftheADEisalabeledoran
unlabeledevent?
HowareADEstracked?
Howarecontrolnumbersassigned?
Doesthefirmuseacomputerizeddatabasefor
tracking
Isthisdatabasenationalorglobal?What
informationiskeptinthedatabase?
Isthereanaudittrail?Howdoesthe
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