Pharmacovigilance: Questions and Answers

What is Pharmacovigilance?
Pharmacovigilance is the science of collecting, monitoring, researching, assessing and evaluating information from healthcare providers and patients on the adverse effects of medications, biological products, herbalism and traditional medicines.

What is the minimum criterion required for a valid case?
  • An identifiable reporter
  • An identifiable patient
  • A suspect product
  • An adverse drug event

What is an Adverse Drug Event (ADE)?
Any untoward medical occurrence in a patient or clinical investigation subject administered a pharmaceutical product and which does not necessarily have to have a causal relationship with this treatment.

What is an Adverse Drug Reaction (ADR)?
An adverse drug reaction is a “response to a drug which is noxious and unintended and which occurs at doses normally used in man for prophylaxis, diagnosis, or therapy of disease or for the modification of physiologic function.” Note that there is a causal link between a drug and an adverse drug reaction. In sum, an adverse drug reaction is harm directly caused by the drug at normal doses, during normal use.

What is the difference between an ADE and ADR?
There may not be a causal relationship between a drug and an ADE, whereas, there is a causal link between a drug and an adverse drug reaction.

When do you consider an event to be serious?
If an event is associated with any one of the following, it is considered to be serious
  • Death
  • Life threatening
  • Hospitalization or prolongation of hospitalization.
  • Congenital anomaly
  • Disability
  • Medically significant

Name the regulatory bodies in USA, UK, Japan and India?
USA: United States Food and drug administration (USFDA).
UK: European Medicines Agency (EMEA).
Japan: Ministry of Health, Labour and Welfare (MHLW).
India: Central Drugs Standard Control Organization (CDSCO)

What is Volume 9A?
  • Volume 9A brings together general guidance on the requirements, procedures, roles and activities in the field of pharmacovigilance, for both Marketing Authorization Holders (MAH) and Competent Authorities of medicinal products for human use; it incorporates international agreements reached within the framework of the International Conference on Harmonization (ICH).
  • Volume 9A is presented in four parts:
  1. Part I deals with Guidelines for Marketing Authorization Holders;
  2. Part II deals with Guidelines for Competent Authorities and the Agency;
  3. Part III provides the Guidelines for the electronic exchange of pharmacovigilance in the EU
  4. Part IV provides Guidelines on pharmacovigilance communication.

When do you consider a case to be medically confirmed?
A case is considered to be medically confirmed if it contains at least one event confirmed or reported by an HCP (Health Care Professional)
Note: HCP can be a physician, nurse, pharmacist, coroner or psychologist (only in Germany).

What do you mean by causality?
Causality is the relationship between a set of factors. In Pharmacovigilance, causality is the relationship between the suspect product and the adverse drug event.

What are the objectives in Pharmacovigilance?
Understanding the concepts of ADR, Medical Errors, Public Health Significance, Regulatory Interventions, ADR Monitoring schemes.

What are the types of Pharmacovigilance (PV)?
Two types.
  1. Active PV and 
  2. Passive PV
  1. Active PV: Active (or proactive) safety surveillance means that active measures are taken to detect adverse events. This is managed by active follow-up after treatment and the events may be detected by asking patients directly or screening patient records. The most comprehensive method is cohort event monitoring (CEM)
  2. Passive PV: Passive surveillance means that no active measures are taken to look for adverse effects other than the encouragement of health professionals and others to report safety concerns. Reporting is dependent on the initiative and motivation of the potential reporters. This is the most common form of pharmacovigilance. It is commonly referred to as “spontaneous” or “voluntary” reporting.

What are the due dates for safety reporting?
Safety reporting due dates are 7days for IND Reporting and 15 days for NDA Reporting

What are Data assessments in Pharmacovigilance?
Data assessments are 
  • Individual case report assessment
  • Aggregated assessment and interpretation
  • Signal detection
  • Interactions and risk factors
  • Serial study
  • Frequency
  • Estimation

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