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Essentials of US FDA Biosimilar Guidance 2012
   - Impact and Opportunities for Chinese
            BioPharma Companies

         FDA2012
        -



                    (Jim Wei), MD, PhD


                     June 30, 2012

                     Taizhou, China
Background
   Public Health Service Act
     • The Biologics Price Competition and Innovation Act (BPCI
       Act) was passed as part of the Affordable Care Act that
       President Obama signed into law on March 23, 2010.
     • BPCI Act creates an abbreviated licensure pathway for
       biological products shown to be biosimilar to or
       interchangeable with an FDA-licensed reference product
       [section 351(k) of the Public Health Service Act].

   Federal Food Drug and Cosmetic Act (FFDCA)
     • The Abbreviated New Drug Application process in section
       505(j) was established through the 1984 Hatch-Waxman
       Amendments to the FFDCA thus creating the generic drug
       program for “small molecule” drugs
Background                                           cont’d
   “Biological Product” in the Public Health Service Act (PHS Act)
    now includes “protein”:
     • . . . a virus, therapeutic serum, toxin, antitoxin, vaccine,
        blood, blood component or derivative, allergenic product,
        protein (except any chemically synthesized polypeptide),
        or analogous product …applicable to the prevention,
        treatment, or cure of a disease or condition of human
        beings…
   Historically, some proteins have been approved as drugs
    under section 505 of the FD&C Act and other proteins have
    been licensed as biologics under section 351 of the PHS Act.
    • Growth hormone
   Under the BPCI Act, a protein, except any chemically
    synthesized polypeptide, will be regulated as a biological
    product.
Biologics Price Competition and
Innovation Act (BPCI Act)
   The Biologics Price Competition and Innovation Act (BPCI Act) was passed as
    part of the Affordable Care Act that President Obama signed into law on
    March 23, 2010. BPCI Act creates an abbreviated licensure pathway for
    biological products shown to be biosimilar to or interchangeable with an FDA-
    licensed reference product [section 351(k) of the Public Health Service Act].

   “Biological Product” in the Public Health Service Act (PHS Act) now includes
    “protein”:. . . a virus, therapeutic serum, toxin, antitoxin, vaccine, blood, blood
    component or derivative, allergenic product, protein (except any chemically
    synthesized polypeptide), or analogous product …applicable to the
    prevention, treatment, or cure of a disease or condition of human beings…

   Historically, some proteins have been approved as drugs under section 505 of
    the FD&C Act and other proteins have been licensed as biologics under
    section 351 of the PHS Act. Under the BPCI Act, a protein, except any
    chemically synthesized polypeptide, will be regulated as a biological product.
Biologics Price Competition and
Innovation Act (BPCI Act)       cont’d
   A 351(k) application must include information demonstrating that the
    biological product:
     • Is biosimilar to a reference product;
     • Utilizes the same mechanism(s) of action for the proposed
        condition(s) of use -- only to the extent known for the reference
        product;
     • Condition(s) of use proposed in labeling have been previously
        approved for the reference product; and
     • Has the same route of administration, dosage form, and strength
        as the reference product.
     • That the biological product is highly similar to the reference
        product notwithstanding minor differences in clinically inactive
        components; and
     • There are no clinically meaningful differences between the
        biological product and the reference product in terms of the
        safety, purity, and potency of the product.
FDA Biosimilar Guidance
-February 2012
   Scientific Considerations in Demonstrating
    Biosimilarity to a Reference product

   Quality Considerations in Demonstrating Biosimilarity
    to a Reference Product

   Biosimilars: Questions and Answers Regarding
    Implementation of Biologics Price Competition and
    Innovation Act of 2009
FDA Biosimilar Guidance
-February 2012                                           cont’d
   The guidance reflects public input and questions received by
    FDA.
   The initial draft guidance is targeted to the highest priority
    issues and directed to clarifying expectations and providing
    predictability to sponsors initiating biosimilar development
    programs.
   The initial scope of the guidance includes
      • Characterization of the proposed biosimilar product and
        the reference product (Scientific Considerations; Quality
        Considerations)
      • Data needed, such as PK/PD, preclinical, clinical (Scientific
        Considerations; Q&A)
      • Common questions regarding FDA’s initial interpretation of
        certain statutory terms and requirements (Q&A)
FDA Biosimilar Guidance
-February 2012                                         cont’d
   Definition
    • Protein means any alpha amino acid polymer with a
      specific defined sequence that is greater than 40 amino
      acids in size.

    • Chemically synthesized polypeptide means any alpha
      amino acid polymer that is (a) made entirely by chemical
      synthesis, and (b) is less than 100 amino acids in size.

   FDA Biosimilar guidance only applied to “protein products”
FDA Biosimilar Guidance
-Quality Considerations Draft Guidance
   This guidance focuses on analytical studies that may be
    relevant to assessing the similarity between a proposed
    biosimilar protein product and a reference product.

   General principles include:
     • Importance of extensive analytical, physico- chemical and
       biological characterization
     • Advances in manufacturing science and Quality by Design
       approaches may facilitate “fingerprint”-like analysis
     • Identification of lots used in the various analyses for
       biosimilarity determination
FDA Biosimilar Guidance
-Quality Considerations Draft Guidance cont’d
   Factors for consideration in assessing whether
    products are highly similar:
    •   Expression system
    •   Manufacturing process
    •   Assessment of physicochemical properties
    •   Functional activities
    •   Receptor binding and immunochemical properties
    •   Impurities
    •   Reference product and reference standards
    •   Finished drug product
    •   Stability
FDA Biosimilar Guidance:
-Scientific Considerations Draft Guidance
   FDA intends to consider the totality of the evidence to support a
    demonstration of biosimilarity,
   FDA recommends to use a stepwise approach in their development
    of biosimilar products.
   Scope of this guidance in demonstrating biosimilarity, including:
     • A stepwise approach to demonstrating biosimilarity, which can
        include a comparison of the proposed product and the
        reference product with respect to structure, function, animal
        toxicity, human pharmacokinetics (PK) and pharmacodynamics
        (PD), clinical immunogenicity, and clinical safety and
        effectiveness
     • The totality-of-the-evidence approach that FDA will use to review
        applications for biosimilar products
     • General scientific principles in conducting comparative studies
FDA Biosimilar Guidance:
-Scientific Considerations Draft Guidance                   cont’d

   Complexities of protein products
     • Nature of Protein Products and Related Scientific
       Considerations
        - Proteins are typically more complex and are unlikely to
          be shown to be structurally identical to a reference
          product.

    • Manufacturing Process Considerations
       - Different manufacturing processes may alter a protein
       product in a way that could affect the safety or
       effectiveness of the product.
FDA Biosimilar Guidance:
-Scientific Considerations Draft Guidance                           cont’d

   U.S.-licensed reference product and other comparators
     • To obtain licensure of a proposed product under section 351(k) of
        the PHS Act, a sponsor must demonstrate that the proposed
        product is biosimilar to a single reference product that previously
        has been licensed by FDA.

     • Under certain circumstances, a sponsor may seek to use data
       derived from animal or clinical studies comparing a proposed
       product with a non-U.S.-licensed product to address, in part, the
       requirements under section 351(k)(2)(A) of the PHS Act.

         - to scientifically justify the relevance of this comparative data
         to an assessment of biosimilarity and to establish an acceptable
         bridge to the U.S.-licensed reference product.
FDA Biosimilar Guidance:
-Scientific Considerations Draft Guidance           cont’d

   Demonstrating biosimilarity
     • Structural Analysis
     • Functional Assays
     • Animal Data
         - Animal Toxicity Studies
         - Inclusion of Animal PK and PD Measures
         - Animal Immunogenicity Studies
     • Clinical Studies
         - Human Pharmacology Data
              • Pharmacokinetics
              • pharmacodynamics
         - Clinical Immunogenicity Assessment
         - Clinical Safety and Effectiveness Data
FDA Biosimilar Guidance:
-Scientific Considerations Draft Guidance                                    cont’d

   Clinical studies – general considerations
     • Clinical Immunogenicity Assessment
          - Extent and timing:
                • If the immune response to the reference product is rare, two
                  separate studies may be sufficient to evaluate immunogenicity:
                  (1) a premarket study powered to detect major differences in
                  immune responses between the two products and (2) a post-
                  market study designed to detect more subtle differences in
                  immunogenicity.
          - Study design:
                • FDA recommends use of a comparative parallel design (i.e., a
                  head-to-head study)
          - Study population:
                • If a sponsor is seeking to extrapolate immunogenicity findings for
                  one indication to other indications, the sponsor should consider
                  using the study population and treatment regimen that are the
                  most sensitive for detecting a difference in immune responses.
FDA Biosimilar Guidance:
-Scientific Considerations Draft Guidance                                     cont’d

   Clinical Immunogenicity Assessment (cont’d)
     • Selection endpoints: prospectively define the clinical immune response
        criteria (e.g., definitions of significant clinical events), using established
        criteria where available, for each type of potential immune response and
        obtain agreement from FDA on these criteria before initiating the study.
     • Follow-up period: based on
          - (1) the time course for the generation of immune responses (such as
          the development of neutralizing antibodies, cell-mediated immune
          responses), and expected clinical sequelae (informed by experience
          with the reference product),
          - (2) the time course of disappearance of the immune responses and
          clinical sequelae following cessation of therapy, and
          - (3) the length of administration of the product.

          For example, the minimal follow-up period for chronically administered
          agents should be one year, unless a shorter duration can be justified by
          the sponsor.
FDA Biosimilar Guidance:
-Scientific Considerations Draft Guidance                        cont’d

   Clinical Immunogenicity Assessment (cont’d):
     As a scientific matter, it is expected that the following will be
     assessed in clinical immunogenicity studies:

     • Binding antibody: titer, specificity, relevant isotype
       distribution, time course of development, persistence,
       disappearance, and association with clinical sequelae

     • Neutralizing antibody: all of the above, plus neutralizing
       capacity to all relevant functions (e.g., uptake and
       catalytic activity, neutralization for replacement enzyme
       therapeutics)
FDA Biosimilar Guidance:
-Scientific Considerations Draft Guidance                     cont’d

   Clinical Immunogenicity Assessment (cont’d):
     • To develop assays capable of sensitively detecting
        immune responses, even in the presence of circulating
        drug product (proposed product and reference product)
          - The proposed product and reference product should be
          assessed in the same assay with the same patient sera
          whenever possible.
          - FDA recommends that immunogenicity assays be
          developed and validated with respect to both the
          proposed product and reference product early in
          development.
          - Sponsors should consult with FDA on the sufficiency of
          assays before initiating any clinical immunogenicity study.
FDA Review Process of Biosimilar Applications
   FDA traditionally relies on integrating various kinds of evidence
    in making regulatory decisions; a “totality of the evidence”
    approach can be applied to assessing biosimilars.
     • It is possible to exceed a current state-of-the-art analysis by
        evaluating more attributes and combination of attributes
        at greater sensitivities with multiple complementary
        methods;
     • such fingerprint-like characterization may reduce further
        the scope and extent of additional animal and clinical
        studies.
   To provide the best advice on the scope of any required
    animal and human studies, FDA should already have
    completed a thorough review of data from structural and
    functional analyses.
FDA “Totality of the Evidence” Approach
- No “one size fits all” assessment

                             FDA will evaluate an overall assessment
               Clinical      that a biological product is (or is not)
                             biosimilar to an approved reference product
               Animal
               Studies

              Clinical
           Immunogenicity                               Biosimilar

       Clinical Knowledge e.g.
       post-market Experience

     Human Pharmacokinetics and
      Pharmacodynamics (PK/PD)
                                                       Highly Similar
       Structural and Functional
           Characterization
Pediatric Study Requirements
   Under the Pediatric Research Equity Act (PREA), all
    applications for new active ingredients, new indications, new
    dosage forms, new dosing regimens, or new routes of
    administration are required to contain a pediatric assessment
    to support dosing, safety, and effectiveness of the product for
    the claimed indication unless this requirement is waived,
    deferred, or inapplicable (see section 505B of FD&C Act).

   For purposes of PREA, a biological product determined to be:
    biosimilar is considered to have a “new active ingredient”;
    interchangeable is not considered to have a “new active
    ingredient.” FDA however, encourages applicants to submit
    plans for pediatric studies during the IND stage of product
    development.
Interchangeable or Interchangeability
   Definition: The interchangeable product may be substituted for the
    reference product without the authorization of the health care
    provider.

   How to meet:
     • The biological product is biosimilar to the reference product.

     • It can be expected to produce the same clinical result as the
       reference product in any given patient;

     • and for a product administered more than once, the safety and
       reduced efficacy risks of alternating or switching are not greater
       than with repeated use of the reference product without
       alternating or switching.
Exclusivity
   First Interchangeable Biosimilar Product
     • The first biosimilar product to be licensed as
         interchangeable is granted a period of exclusivity.
     • During the exclusivity period, a subsequent biosimilar
         product relying on the same reference product cannot be
         licensed as interchangeable.
     • Exclusivity calculus is based on date of approval, date of
         first commercial marketing, and patent litigation
         milestones.
   Reference Product
     • A 351(k) application may not be submitted until 4 years
         after the date of first licensure of the reference product.
     • A 351(k) application may not be approved until 12 years
         after the date of first licensure of reference product.
Regulatory Pathways for Biosimilars
   351(a) or 505(b)(2)              351(k)
    • User Fee paid at                • User Fee paid earlier and
      BLA/NDA filing in lump            in increments
      sum                             • Labeled as “biosimilar”
    • Labeling contains results         or “interchangeable”
      of clinical studies             • Exclusivity for first
    • No exclusivity                    interchangeable
    • No demonstration of               product
      “highly similar” or             • FDA unsure of
      “sameness in any given            requirements for
      patient”                          interchangeability
    • Substitution not                • Allows for substitution
      prohibited
Transition Provisions
   An application for a “biological product” must be submitted
    under section 351 of the PHS Act.
     • Exception: An application for a biological product may be
       submitted under the FD&C Act through March 23, 2020, if
       the product is in a product class for which there is already
       an approved application under the FD&C Act,
         » unless there is another biological product licensed
           under section 351(a) of the PHS Act that could serve as
           its reference product.

   As of March 23, 2020, an application for a biological product
    approved under section 505 of the FD&C Act will be deemed
    a biologics license application (“BLA”) licensed under section
    351 of the PHS Act.
Biosimilar User Fees
   Starting October 1, 2012:
     • User Fee for Biosimilars is the same as for an 505(b)(1) or
         (b)(2) product
   Initial Biosimilar Biological Product Development Fee
     • It will trigger at the time:
          - A request for a biosimilar biological product
          development meeting or
          - An IND that contains a clinical protocol
     • Within 5 days of granting the request for the meeting or
         upon submission of the IND
     • 10% of the fee established for a BLA that year
Biosimilar User Fees                                   cont’d
   Annual fee
      • 10% of the fee established for a BLA that year
   Remainder due when file the 351(k) BLA
   Discontinuation of fee
      • No intention of further developing the product
   If don’t pay - will not be granted meeting or will not consider
    IND or BLA as received
   No refunds, waivers, exemptions, or reductions
      • Waiver for first biosimilar BLA for a small business
User Fees Performance Goals
   Biosimilar Initial Advisory Meeting
     • General discussion on whether licensure under 351(k) is
       feasible and general advice on the development program

   Biological Product Development (BPD) Meetings
     • Type 1 – otherwise stalled development program
     • Type 2 – discuss a specific issue or questions
     • Type 3 - in depth data review and advice
     • Type 4 – format and content of BLA or sBLA

   Meeting minutes available within 30 days of meeting date
User Fees Performance Goals                     cont’d
   Response to meeting request and date of meeting
    based on receipt of meeting request:


             Type    Response (days)   Date (days)
        Advisory           21              90
        BPD Type 1         14              30
        BPD Type 2         21              75
        BPD Type 3         21             120
        BPD Type 4         21              60
Status of Biosimilar Applications at FDA
   As of February 2012 at US FDA:
     • 35 Pre-IND meeting requests for proposed biosimilar
       products to 11 reference products
     • 21 Pre-IND sponsor meetings held to date
         - Development programs include:
                -Prospective development programs
                         -“Global” programs
                – “Retrospective” development programs
                         - Programs seeking licensure in US for
                similar biological products licensed outside the US
     • 9 INDs received
EU versus US Biosimilar Products
   EU has approved 14 biosimilar products, with
    reference products being:
     • Filgrastim
     • Epoetin
     • Somatropin

   FDA approved 1 biosimilar product in 2006 under
    505(b)(2) pathway:
     • Omnitrope by Sandoz
Opportunities for China Pharma Industry
   The development of a biosimilar is cheaper, faster
    and less risk than an innovative product
   Huge market and profit
   Can have a different formulation or delivery system
    as long as there are no clinically meaningful
    differences
   Select the right talent
   Regulatory pathways are well defined with FDA
Challenges
   When to meet with FDA
   User Fees
   Product differentiation
      • 351(a) versus 351(k)
   How much difference is still treated as “highly
    biosimilar”
   How to meet requirements for interchangeability
   Bridging studies for U.S. licensed versus non-U.S.
    licensed reference product
   cGMP requirements on facilities/manufacturing
    • More costly than small molecules
References
   Biologics Price Competition and Innovation Act
     •   http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/UCM216146.
         pdf
   FDA Guidance for Industry: Scientific Considerations in Demonstrating
    Biosimilarity to a Reference Product, February 2012.
     •   http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/U
         CM291128.pdf
   FDA Guidance for Industry: Quality Considerations in Demonstrating
    Biosimilarity to a Reference Product , February 2012.
     •   http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/U
         CM291134.pdf
   FDA Guidance for Industry: Biosimilars: Questions and Answers Regarding
    Implementation of the Biologics Price Competition and Innovation Act of
    2009, February 2012.
     •   http://www.fda.gov/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/ucm259797.h
         tm
   Proposed PDUFA V Reauthorization Performance Goals and Procedures; Fiscal
    Years 2013 through 2017 http://pharma.about.com/od/FDA/a/2012-Renewal-Of-The-
    Prescription-Drug-User-Fee-Act-Pdufa.htm
Medpace China
   Medpace China’s office was established in 2007,
    supported by experienced and trained teams who
    have excellent relationships with investigators and
    site staff. China does not allow import or export of
    specimens so this ability is critical to conducting
    studies requiring central laboratory services.
    Medpace has an advantage of a central
    laboratory facility on campus for efficient conduct
    of all trials in China.
Contact Us: Medpace Beijing

Beijing Medpace Medical Science &

                                         谢谢!
Technology Ltd.
No 23, East Business Tower
Sheng Shi Long Yuan
No 1005, Gao Bei Dian Xiang Xi Dian.
Chaoyang District
Beijing 100022 China                   weijim@yahoo.com
Tel: +86 10 87706500
Fax: +86 10 87706422
E-mail: info.cn@medpace.com
About Medpace Beijing Central Lab
   600 square meters in laboratory area, including main laboratory, logistics,
    and archive area
   Equipments and instruments: Olympus AU2700 analyzer, Dade Behring BN
    II system, Beckman LH750, Clinitek Atlas Urinalysis analyzer, Roche cobas
    e411, Sysmex CA- 1500 coagulation analyzer, Tosoh G7 HbA1c analyzer,
    Eppendorf 5810R centrifuge, and Millipore Elix 70 clinical water
    purification system
   Industry-appropriate quality assurance and accreditation: certificate of
    lipid standardization program and NGSP (level I) laboratory certification
   Secure on-site archival storage of specimens
   Process samples related to hematology, biochemistry, lipid profile,
    urinalysis, immunoassays, and thyroid function
Contact Us: Medpace Beijing MRL
   Medpace Reference Laboratories
    No 23, East Business Tower
    Sheng Shi Long Yuan
    No 1005, Gao Bei Dian Xiang Xi Dian
    Chaoyang District
    Beijing 100022
    China
    Tel: +86 10 87706877, ext. 3450
    Fax: +86 10 87706411
    E-mail: info@medpacelab.com

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Us biosimilar guidance jim wei-june 2012 (3)

  • 1. Essentials of US FDA Biosimilar Guidance 2012 - Impact and Opportunities for Chinese BioPharma Companies FDA2012 - (Jim Wei), MD, PhD June 30, 2012 Taizhou, China
  • 2. Background  Public Health Service Act • The Biologics Price Competition and Innovation Act (BPCI Act) was passed as part of the Affordable Care Act that President Obama signed into law on March 23, 2010. • BPCI Act creates an abbreviated licensure pathway for biological products shown to be biosimilar to or interchangeable with an FDA-licensed reference product [section 351(k) of the Public Health Service Act].  Federal Food Drug and Cosmetic Act (FFDCA) • The Abbreviated New Drug Application process in section 505(j) was established through the 1984 Hatch-Waxman Amendments to the FFDCA thus creating the generic drug program for “small molecule” drugs
  • 3. Background cont’d  “Biological Product” in the Public Health Service Act (PHS Act) now includes “protein”: • . . . a virus, therapeutic serum, toxin, antitoxin, vaccine, blood, blood component or derivative, allergenic product, protein (except any chemically synthesized polypeptide), or analogous product …applicable to the prevention, treatment, or cure of a disease or condition of human beings…  Historically, some proteins have been approved as drugs under section 505 of the FD&C Act and other proteins have been licensed as biologics under section 351 of the PHS Act. • Growth hormone  Under the BPCI Act, a protein, except any chemically synthesized polypeptide, will be regulated as a biological product.
  • 4. Biologics Price Competition and Innovation Act (BPCI Act)  The Biologics Price Competition and Innovation Act (BPCI Act) was passed as part of the Affordable Care Act that President Obama signed into law on March 23, 2010. BPCI Act creates an abbreviated licensure pathway for biological products shown to be biosimilar to or interchangeable with an FDA- licensed reference product [section 351(k) of the Public Health Service Act].  “Biological Product” in the Public Health Service Act (PHS Act) now includes “protein”:. . . a virus, therapeutic serum, toxin, antitoxin, vaccine, blood, blood component or derivative, allergenic product, protein (except any chemically synthesized polypeptide), or analogous product …applicable to the prevention, treatment, or cure of a disease or condition of human beings…  Historically, some proteins have been approved as drugs under section 505 of the FD&C Act and other proteins have been licensed as biologics under section 351 of the PHS Act. Under the BPCI Act, a protein, except any chemically synthesized polypeptide, will be regulated as a biological product.
  • 5. Biologics Price Competition and Innovation Act (BPCI Act) cont’d  A 351(k) application must include information demonstrating that the biological product: • Is biosimilar to a reference product; • Utilizes the same mechanism(s) of action for the proposed condition(s) of use -- only to the extent known for the reference product; • Condition(s) of use proposed in labeling have been previously approved for the reference product; and • Has the same route of administration, dosage form, and strength as the reference product. • That the biological product is highly similar to the reference product notwithstanding minor differences in clinically inactive components; and • There are no clinically meaningful differences between the biological product and the reference product in terms of the safety, purity, and potency of the product.
  • 6. FDA Biosimilar Guidance -February 2012  Scientific Considerations in Demonstrating Biosimilarity to a Reference product  Quality Considerations in Demonstrating Biosimilarity to a Reference Product  Biosimilars: Questions and Answers Regarding Implementation of Biologics Price Competition and Innovation Act of 2009
  • 7. FDA Biosimilar Guidance -February 2012 cont’d  The guidance reflects public input and questions received by FDA.  The initial draft guidance is targeted to the highest priority issues and directed to clarifying expectations and providing predictability to sponsors initiating biosimilar development programs.  The initial scope of the guidance includes • Characterization of the proposed biosimilar product and the reference product (Scientific Considerations; Quality Considerations) • Data needed, such as PK/PD, preclinical, clinical (Scientific Considerations; Q&A) • Common questions regarding FDA’s initial interpretation of certain statutory terms and requirements (Q&A)
  • 8. FDA Biosimilar Guidance -February 2012 cont’d  Definition • Protein means any alpha amino acid polymer with a specific defined sequence that is greater than 40 amino acids in size. • Chemically synthesized polypeptide means any alpha amino acid polymer that is (a) made entirely by chemical synthesis, and (b) is less than 100 amino acids in size.  FDA Biosimilar guidance only applied to “protein products”
  • 9. FDA Biosimilar Guidance -Quality Considerations Draft Guidance  This guidance focuses on analytical studies that may be relevant to assessing the similarity between a proposed biosimilar protein product and a reference product.  General principles include: • Importance of extensive analytical, physico- chemical and biological characterization • Advances in manufacturing science and Quality by Design approaches may facilitate “fingerprint”-like analysis • Identification of lots used in the various analyses for biosimilarity determination
  • 10. FDA Biosimilar Guidance -Quality Considerations Draft Guidance cont’d  Factors for consideration in assessing whether products are highly similar: • Expression system • Manufacturing process • Assessment of physicochemical properties • Functional activities • Receptor binding and immunochemical properties • Impurities • Reference product and reference standards • Finished drug product • Stability
  • 11. FDA Biosimilar Guidance: -Scientific Considerations Draft Guidance  FDA intends to consider the totality of the evidence to support a demonstration of biosimilarity,  FDA recommends to use a stepwise approach in their development of biosimilar products.  Scope of this guidance in demonstrating biosimilarity, including: • A stepwise approach to demonstrating biosimilarity, which can include a comparison of the proposed product and the reference product with respect to structure, function, animal toxicity, human pharmacokinetics (PK) and pharmacodynamics (PD), clinical immunogenicity, and clinical safety and effectiveness • The totality-of-the-evidence approach that FDA will use to review applications for biosimilar products • General scientific principles in conducting comparative studies
  • 12. FDA Biosimilar Guidance: -Scientific Considerations Draft Guidance cont’d  Complexities of protein products • Nature of Protein Products and Related Scientific Considerations - Proteins are typically more complex and are unlikely to be shown to be structurally identical to a reference product. • Manufacturing Process Considerations - Different manufacturing processes may alter a protein product in a way that could affect the safety or effectiveness of the product.
  • 13. FDA Biosimilar Guidance: -Scientific Considerations Draft Guidance cont’d  U.S.-licensed reference product and other comparators • To obtain licensure of a proposed product under section 351(k) of the PHS Act, a sponsor must demonstrate that the proposed product is biosimilar to a single reference product that previously has been licensed by FDA. • Under certain circumstances, a sponsor may seek to use data derived from animal or clinical studies comparing a proposed product with a non-U.S.-licensed product to address, in part, the requirements under section 351(k)(2)(A) of the PHS Act. - to scientifically justify the relevance of this comparative data to an assessment of biosimilarity and to establish an acceptable bridge to the U.S.-licensed reference product.
  • 14. FDA Biosimilar Guidance: -Scientific Considerations Draft Guidance cont’d  Demonstrating biosimilarity • Structural Analysis • Functional Assays • Animal Data - Animal Toxicity Studies - Inclusion of Animal PK and PD Measures - Animal Immunogenicity Studies • Clinical Studies - Human Pharmacology Data • Pharmacokinetics • pharmacodynamics - Clinical Immunogenicity Assessment - Clinical Safety and Effectiveness Data
  • 15. FDA Biosimilar Guidance: -Scientific Considerations Draft Guidance cont’d  Clinical studies – general considerations • Clinical Immunogenicity Assessment - Extent and timing: • If the immune response to the reference product is rare, two separate studies may be sufficient to evaluate immunogenicity: (1) a premarket study powered to detect major differences in immune responses between the two products and (2) a post- market study designed to detect more subtle differences in immunogenicity. - Study design: • FDA recommends use of a comparative parallel design (i.e., a head-to-head study) - Study population: • If a sponsor is seeking to extrapolate immunogenicity findings for one indication to other indications, the sponsor should consider using the study population and treatment regimen that are the most sensitive for detecting a difference in immune responses.
  • 16. FDA Biosimilar Guidance: -Scientific Considerations Draft Guidance cont’d  Clinical Immunogenicity Assessment (cont’d) • Selection endpoints: prospectively define the clinical immune response criteria (e.g., definitions of significant clinical events), using established criteria where available, for each type of potential immune response and obtain agreement from FDA on these criteria before initiating the study. • Follow-up period: based on - (1) the time course for the generation of immune responses (such as the development of neutralizing antibodies, cell-mediated immune responses), and expected clinical sequelae (informed by experience with the reference product), - (2) the time course of disappearance of the immune responses and clinical sequelae following cessation of therapy, and - (3) the length of administration of the product. For example, the minimal follow-up period for chronically administered agents should be one year, unless a shorter duration can be justified by the sponsor.
  • 17. FDA Biosimilar Guidance: -Scientific Considerations Draft Guidance cont’d  Clinical Immunogenicity Assessment (cont’d): As a scientific matter, it is expected that the following will be assessed in clinical immunogenicity studies: • Binding antibody: titer, specificity, relevant isotype distribution, time course of development, persistence, disappearance, and association with clinical sequelae • Neutralizing antibody: all of the above, plus neutralizing capacity to all relevant functions (e.g., uptake and catalytic activity, neutralization for replacement enzyme therapeutics)
  • 18. FDA Biosimilar Guidance: -Scientific Considerations Draft Guidance cont’d  Clinical Immunogenicity Assessment (cont’d): • To develop assays capable of sensitively detecting immune responses, even in the presence of circulating drug product (proposed product and reference product) - The proposed product and reference product should be assessed in the same assay with the same patient sera whenever possible. - FDA recommends that immunogenicity assays be developed and validated with respect to both the proposed product and reference product early in development. - Sponsors should consult with FDA on the sufficiency of assays before initiating any clinical immunogenicity study.
  • 19. FDA Review Process of Biosimilar Applications  FDA traditionally relies on integrating various kinds of evidence in making regulatory decisions; a “totality of the evidence” approach can be applied to assessing biosimilars. • It is possible to exceed a current state-of-the-art analysis by evaluating more attributes and combination of attributes at greater sensitivities with multiple complementary methods; • such fingerprint-like characterization may reduce further the scope and extent of additional animal and clinical studies.  To provide the best advice on the scope of any required animal and human studies, FDA should already have completed a thorough review of data from structural and functional analyses.
  • 20. FDA “Totality of the Evidence” Approach - No “one size fits all” assessment FDA will evaluate an overall assessment Clinical that a biological product is (or is not) biosimilar to an approved reference product Animal Studies Clinical Immunogenicity Biosimilar Clinical Knowledge e.g. post-market Experience Human Pharmacokinetics and Pharmacodynamics (PK/PD) Highly Similar Structural and Functional Characterization
  • 21. Pediatric Study Requirements  Under the Pediatric Research Equity Act (PREA), all applications for new active ingredients, new indications, new dosage forms, new dosing regimens, or new routes of administration are required to contain a pediatric assessment to support dosing, safety, and effectiveness of the product for the claimed indication unless this requirement is waived, deferred, or inapplicable (see section 505B of FD&C Act).  For purposes of PREA, a biological product determined to be: biosimilar is considered to have a “new active ingredient”; interchangeable is not considered to have a “new active ingredient.” FDA however, encourages applicants to submit plans for pediatric studies during the IND stage of product development.
  • 22. Interchangeable or Interchangeability  Definition: The interchangeable product may be substituted for the reference product without the authorization of the health care provider.  How to meet: • The biological product is biosimilar to the reference product. • It can be expected to produce the same clinical result as the reference product in any given patient; • and for a product administered more than once, the safety and reduced efficacy risks of alternating or switching are not greater than with repeated use of the reference product without alternating or switching.
  • 23. Exclusivity  First Interchangeable Biosimilar Product • The first biosimilar product to be licensed as interchangeable is granted a period of exclusivity. • During the exclusivity period, a subsequent biosimilar product relying on the same reference product cannot be licensed as interchangeable. • Exclusivity calculus is based on date of approval, date of first commercial marketing, and patent litigation milestones.  Reference Product • A 351(k) application may not be submitted until 4 years after the date of first licensure of the reference product. • A 351(k) application may not be approved until 12 years after the date of first licensure of reference product.
  • 24. Regulatory Pathways for Biosimilars  351(a) or 505(b)(2)  351(k) • User Fee paid at • User Fee paid earlier and BLA/NDA filing in lump in increments sum • Labeled as “biosimilar” • Labeling contains results or “interchangeable” of clinical studies • Exclusivity for first • No exclusivity interchangeable • No demonstration of product “highly similar” or • FDA unsure of “sameness in any given requirements for patient” interchangeability • Substitution not • Allows for substitution prohibited
  • 25. Transition Provisions  An application for a “biological product” must be submitted under section 351 of the PHS Act. • Exception: An application for a biological product may be submitted under the FD&C Act through March 23, 2020, if the product is in a product class for which there is already an approved application under the FD&C Act, » unless there is another biological product licensed under section 351(a) of the PHS Act that could serve as its reference product.  As of March 23, 2020, an application for a biological product approved under section 505 of the FD&C Act will be deemed a biologics license application (“BLA”) licensed under section 351 of the PHS Act.
  • 26. Biosimilar User Fees  Starting October 1, 2012: • User Fee for Biosimilars is the same as for an 505(b)(1) or (b)(2) product  Initial Biosimilar Biological Product Development Fee • It will trigger at the time: - A request for a biosimilar biological product development meeting or - An IND that contains a clinical protocol • Within 5 days of granting the request for the meeting or upon submission of the IND • 10% of the fee established for a BLA that year
  • 27. Biosimilar User Fees cont’d  Annual fee • 10% of the fee established for a BLA that year  Remainder due when file the 351(k) BLA  Discontinuation of fee • No intention of further developing the product  If don’t pay - will not be granted meeting or will not consider IND or BLA as received  No refunds, waivers, exemptions, or reductions • Waiver for first biosimilar BLA for a small business
  • 28. User Fees Performance Goals  Biosimilar Initial Advisory Meeting • General discussion on whether licensure under 351(k) is feasible and general advice on the development program  Biological Product Development (BPD) Meetings • Type 1 – otherwise stalled development program • Type 2 – discuss a specific issue or questions • Type 3 - in depth data review and advice • Type 4 – format and content of BLA or sBLA  Meeting minutes available within 30 days of meeting date
  • 29. User Fees Performance Goals cont’d  Response to meeting request and date of meeting based on receipt of meeting request: Type Response (days) Date (days) Advisory 21 90 BPD Type 1 14 30 BPD Type 2 21 75 BPD Type 3 21 120 BPD Type 4 21 60
  • 30. Status of Biosimilar Applications at FDA  As of February 2012 at US FDA: • 35 Pre-IND meeting requests for proposed biosimilar products to 11 reference products • 21 Pre-IND sponsor meetings held to date - Development programs include: -Prospective development programs -“Global” programs – “Retrospective” development programs - Programs seeking licensure in US for similar biological products licensed outside the US • 9 INDs received
  • 31. EU versus US Biosimilar Products  EU has approved 14 biosimilar products, with reference products being: • Filgrastim • Epoetin • Somatropin  FDA approved 1 biosimilar product in 2006 under 505(b)(2) pathway: • Omnitrope by Sandoz
  • 32. Opportunities for China Pharma Industry  The development of a biosimilar is cheaper, faster and less risk than an innovative product  Huge market and profit  Can have a different formulation or delivery system as long as there are no clinically meaningful differences  Select the right talent  Regulatory pathways are well defined with FDA
  • 33. Challenges  When to meet with FDA  User Fees  Product differentiation • 351(a) versus 351(k)  How much difference is still treated as “highly biosimilar”  How to meet requirements for interchangeability  Bridging studies for U.S. licensed versus non-U.S. licensed reference product  cGMP requirements on facilities/manufacturing • More costly than small molecules
  • 34. References  Biologics Price Competition and Innovation Act • http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/UCM216146. pdf  FDA Guidance for Industry: Scientific Considerations in Demonstrating Biosimilarity to a Reference Product, February 2012. • http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/U CM291128.pdf  FDA Guidance for Industry: Quality Considerations in Demonstrating Biosimilarity to a Reference Product , February 2012. • http://www.fda.gov/downloads/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/U CM291134.pdf  FDA Guidance for Industry: Biosimilars: Questions and Answers Regarding Implementation of the Biologics Price Competition and Innovation Act of 2009, February 2012. • http://www.fda.gov/Drugs/GuidanceComplianceRegulatoryInformation/Guidances/ucm259797.h tm  Proposed PDUFA V Reauthorization Performance Goals and Procedures; Fiscal Years 2013 through 2017 http://pharma.about.com/od/FDA/a/2012-Renewal-Of-The- Prescription-Drug-User-Fee-Act-Pdufa.htm
  • 35. Medpace China  Medpace China’s office was established in 2007, supported by experienced and trained teams who have excellent relationships with investigators and site staff. China does not allow import or export of specimens so this ability is critical to conducting studies requiring central laboratory services. Medpace has an advantage of a central laboratory facility on campus for efficient conduct of all trials in China.
  • 36. Contact Us: Medpace Beijing Beijing Medpace Medical Science & 谢谢! Technology Ltd. No 23, East Business Tower Sheng Shi Long Yuan No 1005, Gao Bei Dian Xiang Xi Dian. Chaoyang District Beijing 100022 China weijim@yahoo.com Tel: +86 10 87706500 Fax: +86 10 87706422 E-mail: info.cn@medpace.com
  • 37. About Medpace Beijing Central Lab  600 square meters in laboratory area, including main laboratory, logistics, and archive area  Equipments and instruments: Olympus AU2700 analyzer, Dade Behring BN II system, Beckman LH750, Clinitek Atlas Urinalysis analyzer, Roche cobas e411, Sysmex CA- 1500 coagulation analyzer, Tosoh G7 HbA1c analyzer, Eppendorf 5810R centrifuge, and Millipore Elix 70 clinical water purification system  Industry-appropriate quality assurance and accreditation: certificate of lipid standardization program and NGSP (level I) laboratory certification  Secure on-site archival storage of specimens  Process samples related to hematology, biochemistry, lipid profile, urinalysis, immunoassays, and thyroid function
  • 38. Contact Us: Medpace Beijing MRL  Medpace Reference Laboratories No 23, East Business Tower Sheng Shi Long Yuan No 1005, Gao Bei Dian Xiang Xi Dian Chaoyang District Beijing 100022 China Tel: +86 10 87706877, ext. 3450 Fax: +86 10 87706411 E-mail: info@medpacelab.com