2. ???WHAT IS IT
???HOW IS IT
???WHY IS IT
.REGULATION VERSUS PHARMACEUTICAL COMP
3.
4.
5. Generic Drug product: Definition
• Same active ingredient (s)
• Same strength
• Same dosage form
• Same route of administration
• Same indications
6.
7. NDA vs. ANDA Review Process
Original Drug
NDA Requirements
1. Chemistry
2. Manufacturing
3. Controls
4. Labeling
5. Testing
6. Animal Studies
7. Clinical Studies
(Bioavailability)
Generic Drug
ANDA Requirements
1. Chemistry
2. Manufacturing
3. Controls
4. Labeling
5. Testing
6. Bioequivalence Study (In Vivo, In
vitro)
Note: Generic drug applications are termed "abbreviated" because they are generally
not required to include preclinical (animal) and clinical (human) data to establish safety and effectiveness.
Instead, generic applicants must scientifically demonstrate that their product is bioequivalent
(i.e., performs in the same manner as the origina; drug).
9. FDA Determinations of Bioequivalence
Main Terms
• Pharmaceutical equivalents
• Pharmaceutical alternatives
• Therapeutic equivalents
• Bioavailability
• Bioequivalence
Approved Drug Products With Therapeutic Equivalence Evaluations. 23rd ed. 2003. FDA/CDER Web site. Available at:
http://www.fda.gov/cder/ob/docs/preface/ecpreface.htm#Therapeutic Equivalence-Related Terms. Accessed September
29, 2003.
10. Pharmaceutical Equivalents
• Drug products are considered pharmaceutical
equivalents if they contain the same active
ingredient(s), have the same dosage form and route
of administration, and are identical in strength or
concentration
• Equivalent products contain the same amount of
ingredient in the same dosage form but may differ in
characteristics, such as shape, release mechanisms,
and packaging
Approved Drug Products With Therapeutic Equivalence Evaluations. 23rd ed. 2003. FDA/CDER Web site.
Available at: http://www.fda.gov/cder/ob/docs/preface/ecpreface.htm. Accessed September 29, 2003.
11. Pharmaceutical Alternatives
• Drug products are considered pharmaceutical alternatives if
they contain the same therapeutic moiety, are different
salts, esters, or complexes of the same moiety, are different
dosage forms, or are different strengths
• Other pharmaceutical alternatives
– Different dosage forms and strengths within a single product line by a
single manufacturer
– Extended-release formulations when compared with immediate- or
standard-release formulations
Approved Drug Products With Therapeutic Equivalence Evaluations. 23rd ed. 2003. FDA/CDER Web site. Available at:
http://www.fda.gov/cder/ob/docs/preface/ecpreface.htm#Therapeutic Equivalence-Related Terms. Accessed September
29, 2003.
12. Therapeutic Equivalents
• Drug products are considered therapeutic equivalents if
they are all of the following
– Pharmaceutical equivalents
– Bioequivalent
– Approved as safe and effective
– Adequately labeled
– Manufactured in compliance with current Good Manufacturing Practice
regulations
• Therapeutic equivalents are expected to have the same
clinical effect and safety profile
Approved Drug Products With Therapeutic Equivalence Evaluations. 23rd ed. 2003. FDA/CDER Web site. Available at:
http://www.fda.gov/cder/ob/docs/preface/ecpreface.htm#Therapeutic Equivalence-Related Terms. Accessed September
29, 2003.
13. Bioavailability
(quantifies ABSORPTION = ?, Reasons for poor F)
• The extent and rate at which its active moiety is
delivered from pharmaceutical form and becomes
available in the systemic circulation
Pharmacokinetics
conc. vs time
(Conc.(mg/L
0 25
(Time (h
0.0
14. Why do ? we care about BIOAVAILABILITY
The “true dose” is not the drug swallowed;
BUT is the drug available to exert its effect.
•„ Dissolution
•„ Absorption
•„ Survive metabolism
May have a drug with very low bioavailability
•„ Dosage form or drug may not dissolve readily
•„ Drug may not be readily pass across biological
membranes (i.e. be absorbed)
•„ Drug may be extensively metabolized during
absorption process (first-pass, gut wall, liver)
Important component of overall variability
•„ Variable bioavailability may produce variable exposure
15.
16.
17. Rate versus Extent of Absorption
Extent of absorption is reflected by AUC
Rate of absorption, ka, is reflected by Tmax
Both Rate and Extent of absorption affect Cmax
Leads to : 4 possible relative scenarios
„ (R) Rapid, (E) Complete Absorption •
yields a short Tmax, high Cmax, high AUC
„ (R) Rapid, (E) incomplete absorption •
yields a short Tmax, low Cmax, low AUC
„ (R) Slow, (E) complete absorption •
yields a long Tmax, high Cmax, high AUC
„ (R) Slow, (E) incomplete absorption •
yields a long Tmax, low Cmax, low AUC
18.
19.
20. :FACTORS INFLUENCING BIOAVAILABILITY
Three distinct factors are involved to influencing bioavailability. These are:
1.Pharmaceutical factors:
• physicochemical properties of the drug.
1. Particle size
2. Crystalline structure
3. Salt form
• Formulation and manufacturing variables.
1.Disintegration and dissolution time
2.Pharmaceutical ingredients
3.Special coatings
4.Nature and type of dosage form
21. :Patient related factors. 2 • Physiologic factors.
1.Variations in pH of GI fluids
2.Gastric emptying rate
3. Intestinal motility
4. Presystemic and first-pass metabolism
5. Age, sex
6. Disease states
• Interactions with other substances.
1. Food
2. Fluid volume
3. Other drugs
3. Route of administration:
1.Parentral administration
2.Oral administration
3.Rectal administration
4.Topical administration
22. Bioequivalence
• A comparison of the bioavailability of two or more
• drug products.
• Two products or formulations containing the same
• active ingredient are bioequivalent if their rates
• and extents of absorption are the same
• Bioequivalence may be demonstrated through in vivo or
in vitro test methods, comparative clinical trials, or
pharmacodynamic studies
Approved Drug Products With Therapeutic Equivalence Evaluations. 23rd ed. 2003. FDA/CDER Web site. Available
at: http://www.fda.gov/cder/ob/docs/preface/ecpreface.htm#Therapeutic Equivalence-Related Terms. Accessed
September 29, 2003.
24. Regulatory Bioequivalence: An Overview
Solutions
Suspensions
.Chewable, etc
Conventional
Tablets
Capsules
MR Products
Self-evident” - Biowaivers granted“
Condition- excipients do not alter absorption
(historical data)
Pre-1962 DESI Drugs: In Vivo
”evaluation for “bio-problem
(drugs (TI, PK, P-Chem
Post-1962 Drugs: Generally
In Vivo - some exceptions
..(IVIVC)
(SUPAC-IR (1995
Dissolution-IR
BCS
(pre-/post approval)
In VIVO
SUPAC-MR
IVIVC
25. Bioequivalence: IR Products
Pharmaceutical Equivalent
Products
Reference Test
Possible Differences
, ..Drug particle size
Excipients
Manufacturing process
Equipment
Site of manufacture
. …Batch size
Documented Bioequivalence
Therapeutic Equivalence=
Ajaz Hussain, FDA
.(Note: Generally, same dissolution spec)
Normal healthy subjects
Crossover design
Overnight fast
Glass of water
CI within 80-125% 90%
(of Ref. (Cmax & AUC
26. FDA Methods to Determine
Bioequivalence
• Generic drug manufacturers must demonstrate
that a drug is bioequivalent to a reference drug
product
• In order of FDA preference, methods used to
define bioequivalence
– Pharmacokinetic studies
– Pharmacodynamic studies
– Comparative clinical trials
– In vitro studies
Food and Drug Administration. Code of Federal Regulations. Title 21, Part 320: Bioavailability and Bioequivalence
Requirements. Section 320.24. 2003. Available at: http://www.accessdata.fda.gov. Accessed September 29, 2003.
27. Pharmacokinetic Studies
Key Measurements
• AUC
– Area under the concentration- time curve
• Cmax
– Maximum concentration
– A difference of greater than 20% in Cmax or
the AUC represents a significant difference
between the study and reference
compounds
• Tmax
– Time to maximum concentration
Study Compound
Reference Compound
Cmax
Time Concentration
Tmax
AUC
Approved Drug Products With Therapeutic Equivalence Evaluations. 23rd ed. 2003. FDA/CDER Web site. Available at:
http://www.fda.gov/cder/ob/docs/preface/ecpreface.htm#Therapeutic Equivalence-Related Terms. Accessed September 29, 2003.
28. Comparative Pharmacodynamic Studies
• Not recommended when:
– active ingredient is absorbed into the systemic
circulation
– pharmacokinetic study can be conducted
• Local action / no systemic absorption
• eg. : Topical Corticosteroid
28 Hanoi, 2006-19-01
29. Comparative Clinical Studies
• Pharmacokinetic profile not possible
• Lack of suitable pharmacodynamic endpoint
• eg . : (Nasal suspensions)
29 Hanoi, 2006-19-01
30. Study Designs
-Single-dose, two-way crossover design
- Single-dose, parallel design
-Multiple-dose studies( in case of :
-Drugs too potent/toxic
Extended/modified release products
31.
32. Crossover vs. Parallel Designs
• Crossover design preferred
– Intra-subject comparison
– Lower variability
– Generally fewer subjects required
• Parallel design may be useful
– Drug with very long half-life
– Crossover design not practical
32 Hanoi, 2006-19-01
33. Disadv. of cross over design
• The main problem with the cross over design is :
The carry over effect………!?
34. Fasted vs. Fed Designs
• Fasted study design preferred
–Minimize variability not attributable to formulation
– Better able to detect formulation differences
34 Hanoi, 2006-19-01
35. Fed Study Designs may be employed when:
• Significant gastrointestinal (GI) disturbance caused
by fasted administration
• Product labeling restricts administration to fed
state
35 Hanoi, 2006-19-01
36. When equivalence studies are NOT
(necessary (Biowaivers
•
• Aqueous parenteral solutions
• Solutions for oral use ( syrups, elixirs, tinctures & other
soluble forms but not suspensions)
• Pdrs for reconstitution as a solution
• Otic or ophthalmic aqueous solutions
• Topical aqueous solutions
• Aqueous nebulizing inhalations or nasal sprays
37. • B. For some products bioequivalence may be
demonstrated by evidence obtained in vitro instead
of in vivo data:
– The drug product is in the same dosage form, but in a
different strength, and is proportionally similar in its
active and inactive ingredients to another product by
the same manufacturer that was found to be
bioequivalent.
38. • For high potency drug substances, the same
inactive ingredients are used for all strengths, and
the change in any strength is obtained by altering
the amount of the active ingredients and one or
more of the inactive ingerdients are within the
limits defined by the SUPAC guidances (up to level
II).
39. Waiver of Bioavailability and
Bioequivalence Studies for Immediate-
Release Solid Oral Dosage Forms Based on
a Biopharmaceutics Classification System
((B.C.S
40. BCS Classifications
According to the BCS, drug substances
are classified as follows:
Class I - High Permeability, High Solubility
Class II - High Permeability, Low Solubility
Class III - Low Permeability, High Solubility
Class IV - Low Permeability, Low Solubility
41. Solubility
• A drug substance is considered highly soluble when
the highest dose strength is soluble in 250 ml or
less of aqueous media over the pH range of 1 - 7.5
(WHO , pH: 1.2 – 6.8)
42. Permeability
• A drug substance is considered to be highly
permeable when the extent of absorption in
humans is determined to be 90% or more of an
administered dose ( WHO, 85% ).
43. Conditions for BCS Bio-waivers
Firms can request waivers of in vivo testing for Class
1 drug substances
Drug products must meet these criteria:
Immediate-release solid oral dosage forms
Highly soluble, highly permeable drug
substance
Rapid in vitro dissolution
Note: Waivers not applicable for narrow therapeutic range therapeutic
range (Digoxin, Lithium, phenytoin, warfarin) drugs
44. A drug product is considered to be
RAPIDLY DISSOLVING when > 85% of
the labeled amount of drug substance
dissolves within 30 minutes using USP
apparatus I or II in a volume of < 900 ml
buffer solutions.
45. BCS Class I: Dissolution
USP Apparatus I (100 rpm) or II (50 rpm)
Three media
0.1 N HCl or SGF USP without enzymes 0.1 N
HCl or SGF USP without enzymes
pH 4.5 buffer pH 4.5 buffer
pH 6.8 buffer or SIF USP without enzymes
NLT 85% dissolves within 30 minutes
Similarity factor (f2) for test (T) v. reference
(R) profile comparisons should > 50
Notes de l'éditeur
FDA Determinations of Bioequivalence. Main Terms.
The Orange Book defines 5 terms that describe the most important concepts for discussing product substitution.1 These terms are:
Pharmaceutical equivalents
Pharmaceutical alternatives
Therapeutic equivalents
Bioequivalence
Bioavailability
Reference
1. Approved Drug Products With Therapeutic Equivalence Evaluations. 23rd ed. 2003. FDA/CDER Web site. Available at: http://www.fda.gov/cder/ob/docs/preface/ecpreface.htm#Therapeutic Equivalence-Related Terms. Accessed September 29, 2003.
Pharmaceutical Equivalents.
The FDA considers 2 drug products pharmaceutical equivalents if they contain the same active ingredient(s), have the same dosage form and route of administration, and are identical in strength or concentration.1
Pharmaceutically equivalent drug products are formulated to contain the same amount of active ingredient in the same dosage form and to meet the same or other applicable standards (eg, strength, quality, purity, and identity). However, these drug products may differ in characteristics, such as shape, release mechanisms, and packaging.
Reference
1. Approved Drug Products With Therapeutic Equivalence Evaluations. 23rd ed. 2003. FDA/CDER Web site. Available at: http://www.fda.gov/cder/ob/docs/preface/ecpreface.htm. Accessed September 29, 2003.
Pharmaceutical Alternatives.
The FDA considers 2 products to be pharmaceutical alternatives if they contain the same therapeutic moiety, but are different salts, esters, or complexes of that moiety, or if they have different dosages or strengths, such as quinidine sulfate 200-mg tablets versus quinidine sulfate 200-mg capsules. Other products considered to be pharmaceutical alternatives include different dosage forms and strengths within a product line by a single manufacturer, and extended-release (ER) products when compared with immediate- or standard-release formulations of the same active ingredient.1
Reference
1. Approved Drug Products With Therapeutic Equivalence Evaluations. 23rd ed. 2003. FDA/CDER Web site. Available at: http://www.fda.gov/cder/ob/docs/preface/ecpreface.htm#Therapeutic Equivalence-Related Terms. Accessed September 29, 2003.
Therapeutic Equivalents.
Drug products are considered therapeutic equivalents if they meet the following criteria:1
They are approved as safe and effective and are pharmaceutical equivalents;
They are bioequivalent in that
They do not present a known or potential bioequivalence problem, and they meet an acceptable in vitro standard, or
If they do present such a known or potential problem, they are shown to meet an appropriate bioequivalence standard
They are adequately labeled and are manufactured in compliance with Current Good Manufacturing Practice regulations
Drugs marketed before 1938 and drugs marketed between 1938 and 1962 that are safe but not approved are excluded from FDA evaluations. When administered under conditions specified in the product label, therapeutic equivalents are expected to have the same clinical effect and safety profile.
Reference
1. Approved Drug Products With Therapeutic Equivalence Evaluations. 23rd ed. 2003. FDA/CDER Web site. Available at: http://www.fda.gov/cder/ob/docs/preface/ecpreface.htm#Therapeutic Equivalence-Related Terms. Accessed September 29, 2003.
Bioequivalence.
The FDA considers drug products bioequivalent if they are pharmaceutical equivalents whose rate and extent of absorption are not statistically different when the products administered to patients or subjects at the same molar dose under similar experimental conditions.1
Bioequivalence may be demonstrated through in vivo or in vitro test methods. An in vitro bioequivalence standard may be used, especially when an in vitro test has been correlated with human in vivo bioavailability data.
In addition, bioequivalency may also be demonstrated through comparative clinical trials or pharmacodynamic studies.
Reference
1. Approved Drug Products With Therapeutic Equivalence Evaluations. 23rd ed. 2003. FDA/CDER Web site. Available at: http://www.fda.gov/cder/ob/docs/preface/ecpreface.htm#Therapeutic Equivalence-Related Terms. Accessed September 29, 2003.
FDA Methods to Determine Bioequivalence.
Under the Drug Price Competition and Patent Term Restoration Act of 1984, manufacturers seeking approval to market a generic drug product must submit data demonstrating that the drug product is bioequivalent to the reference (innovator) drug product.1
Methods used to define bioequivalence include PK studies, pharmacodynamic (PD) studies, comparative clinical trials, and in vitro studies.
The choice of study used is based on the site of action of the drug and the ability of the study design to adequately compare the generic and reference drug products.
Reference
1. Food and Drug Administration. Code of Federal Regulations. Title 21, Part 320: Bioavailability and Bioequivalence Requirements. Section 320.24. 2003. Available at: http://www.accessdata.fda.gov. Accessed September 29, 2003.
Pharmacokinetic Studies. Key Measurements.
To investigate the bioequivalence of 2 drug products or compounds, the FDA considers PK studies that determine the area under the concentration-time curve (AUC), maximum concentration (Cmax), and time to Cmax (Tmax) for the study compound (generic) and a reference compound (innovator).1 Each of these values for the study compound are compared with those of the reference compound.
For the study and reference compounds to be considered bioequivalent, their rates and extents of absorption must not show a significant difference when administered at the same molar dose of the therapeutic ingredient under similar experimental conditions.
The red area in the diagram represents the AUC, or the extent of absorption, of the reference compound. The yellow area represents the AUC of the study compound. Cmax is an indicator of the absorption rate and Tmax is influenced by the route of compound administration.
A difference of greater than 20% in Cmax or the AUC represents a significant difference between the study and reference compounds.
Reference
1. Approved Drug Products With Therapeutic Equivalence Evaluations. 23rd ed. 2003. FDA/CDER Web site. Available at: http://www.fda.gov/cder/ob/docs/preface/ecpreface.htm#Therapeutic Equivalence-Related Terms. Accessed September 29, 2003.