Paediatric Medicines in Europe: The Paediatric Regulation—Is It Time for Reform?

Objectives: In this paper, we investigated the effects of the European Paediatric Regulation (EC) N° 1901/2006 with respect to satisfying the paediatric therapeutic needs, assessed in terms of the increased number of paediatric medicinal products, new therapeutic indications in specific high-need co...

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Main Authors: Maddalena Toma, Mariagrazia Felisi, Donato Bonifazi, Fedele Bonifazi, Viviana Giannuzzi, Giorgio Reggiardo, Saskia de Wildt, Adriana Ceci, TEDDY European Network of Excellence for Paediatric Research
Format: Article
Language:English
Published: Frontiers Media S.A. 2021-02-01
Series:Frontiers in Medicine
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fmed.2021.593281/full
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author Maddalena Toma
Mariagrazia Felisi
Donato Bonifazi
Fedele Bonifazi
Viviana Giannuzzi
Giorgio Reggiardo
Saskia de Wildt
Adriana Ceci
TEDDY European Network of Excellence for Paediatric Research
author_facet Maddalena Toma
Mariagrazia Felisi
Donato Bonifazi
Fedele Bonifazi
Viviana Giannuzzi
Giorgio Reggiardo
Saskia de Wildt
Adriana Ceci
TEDDY European Network of Excellence for Paediatric Research
author_sort Maddalena Toma
collection DOAJ
description Objectives: In this paper, we investigated the effects of the European Paediatric Regulation (EC) N° 1901/2006 with respect to satisfying the paediatric therapeutic needs, assessed in terms of the increased number of paediatric medicinal products, new therapeutic indications in specific high-need conditions (neonates, oncology, rare disease, etc.) and increased number of paediatric clinical studies supporting the marketing authorisation.Methods: We analysed the paediatric medicinal products approved by the European Medicines Agency in the period January 2007-December 2019, by collecting the following data: year of approval, active substance, legal basis for the marketing authorisation, type of medicinal product (i.e., chemical, biological, or ATMP), orphan drug status, paediatric indication, Anatomical Therapeutic Chemical code (first-level), number and type of paediatric studies. Data were compared with similar data collected in the period 1996–2006.Results: In the period January 1996–December 2019, in a total of 1,190 medicinal products and 843 active substances, 34 and 38%, respectively, were paediatric. In the two periods, before and after the Paediatric Regulation implementation, the paediatric/total medicinal products ratio was constant while the paediatric/total active substances ratio decreased. Moreover, excluding generics and biosimilars, a total of 106 and 175 paediatric medicines were granted a new paediatric indication, dosage or age group in the two periods; out of 175, 128 paediatric medicines had an approved Paediatric Investigational Plan. The remaining 47 were approved without an approved Paediatric Investigational Plan, following the provisions of Directive 2001/83/EC and repurposing an off-patent drug. The analysis of the clinical studies revealed that drugs with a Paediatric Investigational Plan were supported by 3.5 studies/drug while drugs without a Paediatric Investigational Plan were supported by only 1.6 studies/drug.Discussion: This report confirms that the expectations of the European Paediatric Regulation (EC) N° 1901/2006 have been mainly satisfied. However, the reasons for the limited development of paediatric medicines in Europe, should be further discussed, taking advantage of recent initiatives in the regulatory field, such as the Action Plan on Paediatrics, and the open consultation on EU Pharmaceutical Strategy.
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spelling doaj.art-21996e36f4954970a9d231bc8c69ed5e2022-12-21T23:05:19ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2021-02-01810.3389/fmed.2021.593281593281Paediatric Medicines in Europe: The Paediatric Regulation—Is It Time for Reform?Maddalena Toma0Mariagrazia Felisi1Donato Bonifazi2Fedele Bonifazi3Viviana Giannuzzi4Giorgio Reggiardo5Saskia de Wildt6Adriana Ceci7TEDDY European Network of Excellence for Paediatric ResearchFondazione per la Ricerca Farmacologica “Gianni Benzi” Onlus, Bari, ItalyConsorzio per Valutazioni Biologiche e Farmacologiche, Bari, ItalyConsorzio per Valutazioni Biologiche e Farmacologiche, Bari, ItalyFondazione per la Ricerca Farmacologica “Gianni Benzi” Onlus, Bari, ItalyFondazione per la Ricerca Farmacologica “Gianni Benzi” Onlus, Bari, ItalyConsorzio per Valutazioni Biologiche e Farmacologiche, Bari, ItalyRadboud Institute for Molecular Life Sciences, Radboud University Medical Center, Nijmegen, NetherlandsFondazione per la Ricerca Farmacologica “Gianni Benzi” Onlus, Bari, ItalyObjectives: In this paper, we investigated the effects of the European Paediatric Regulation (EC) N° 1901/2006 with respect to satisfying the paediatric therapeutic needs, assessed in terms of the increased number of paediatric medicinal products, new therapeutic indications in specific high-need conditions (neonates, oncology, rare disease, etc.) and increased number of paediatric clinical studies supporting the marketing authorisation.Methods: We analysed the paediatric medicinal products approved by the European Medicines Agency in the period January 2007-December 2019, by collecting the following data: year of approval, active substance, legal basis for the marketing authorisation, type of medicinal product (i.e., chemical, biological, or ATMP), orphan drug status, paediatric indication, Anatomical Therapeutic Chemical code (first-level), number and type of paediatric studies. Data were compared with similar data collected in the period 1996–2006.Results: In the period January 1996–December 2019, in a total of 1,190 medicinal products and 843 active substances, 34 and 38%, respectively, were paediatric. In the two periods, before and after the Paediatric Regulation implementation, the paediatric/total medicinal products ratio was constant while the paediatric/total active substances ratio decreased. Moreover, excluding generics and biosimilars, a total of 106 and 175 paediatric medicines were granted a new paediatric indication, dosage or age group in the two periods; out of 175, 128 paediatric medicines had an approved Paediatric Investigational Plan. The remaining 47 were approved without an approved Paediatric Investigational Plan, following the provisions of Directive 2001/83/EC and repurposing an off-patent drug. The analysis of the clinical studies revealed that drugs with a Paediatric Investigational Plan were supported by 3.5 studies/drug while drugs without a Paediatric Investigational Plan were supported by only 1.6 studies/drug.Discussion: This report confirms that the expectations of the European Paediatric Regulation (EC) N° 1901/2006 have been mainly satisfied. However, the reasons for the limited development of paediatric medicines in Europe, should be further discussed, taking advantage of recent initiatives in the regulatory field, such as the Action Plan on Paediatrics, and the open consultation on EU Pharmaceutical Strategy.https://www.frontiersin.org/articles/10.3389/fmed.2021.593281/fullEU paediatric regulationpaediatric medicinespaediatric agetherapeutic areaspaediatric clinical studiespaediatric repurposing
spellingShingle Maddalena Toma
Mariagrazia Felisi
Donato Bonifazi
Fedele Bonifazi
Viviana Giannuzzi
Giorgio Reggiardo
Saskia de Wildt
Adriana Ceci
TEDDY European Network of Excellence for Paediatric Research
Paediatric Medicines in Europe: The Paediatric Regulation—Is It Time for Reform?
Frontiers in Medicine
EU paediatric regulation
paediatric medicines
paediatric age
therapeutic areas
paediatric clinical studies
paediatric repurposing
title Paediatric Medicines in Europe: The Paediatric Regulation—Is It Time for Reform?
title_full Paediatric Medicines in Europe: The Paediatric Regulation—Is It Time for Reform?
title_fullStr Paediatric Medicines in Europe: The Paediatric Regulation—Is It Time for Reform?
title_full_unstemmed Paediatric Medicines in Europe: The Paediatric Regulation—Is It Time for Reform?
title_short Paediatric Medicines in Europe: The Paediatric Regulation—Is It Time for Reform?
title_sort paediatric medicines in europe the paediatric regulation is it time for reform
topic EU paediatric regulation
paediatric medicines
paediatric age
therapeutic areas
paediatric clinical studies
paediatric repurposing
url https://www.frontiersin.org/articles/10.3389/fmed.2021.593281/full
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