European Medicines Agency
The European Medicines Agency is an agency of the European Union in charge of the evaluation and supervision of medicinal products. Prior to 2004, it was known as the European Agency for the Evaluation of Medicinal Products or European Medicines Evaluation Agency.
The EMA was set up in 1995, with funding from the European Union and the pharmaceutical industry, as well as indirect subsidy from member states, its stated intention to harmonise the work of existing national medicine regulatory bodies. The hope was that this plan would not only reduce the €350 million annual cost drug companies incurred by having to win separate approvals from each member state but also that it would eliminate the protectionist tendencies of sovereign states unwilling to approve new drugs that might compete with those already produced by domestic drug companies.
The EMA was founded after more than seven years of negotiations among EU governments and replaced the Committee for Proprietary Medicinal Products and the Committee for Veterinary Medicinal Products, though both of these were reborn as the core scientific advisory committees. The agency was located in London prior to the United Kingdom's vote for withdrawal from the European Union, relocating to Amsterdam in March 2019.
Operations
The EMA operates as a decentralised scientific agency of the European Union and its main responsibility is the protection and promotion of public and animal health, through the evaluation and supervision of medicines for human and veterinary use. More specifically, it coordinates the evaluation and monitoring of centrally authorised products and national referrals, develops technical guidance and provides scientific advice to sponsors. Its scope of operations is medicinal products for human and veterinary use including biologics and advanced therapies, and herbal medicinal products. The agency is composed of the Secretariat, a management board, seven scientific committees and a number of scientific working parties. The Secretariat is organised into five units: Directorate, Human Medicines Development and Evaluation, Patient Health Protection, Veterinary Medicines and Product Data Management, Information and Communications Technology and Administration. The Management Board provides administrative oversight to the Agency: including approval of budgets and plans, and selection of Executive Director. The Board includes one representative of each of the 28 Member States, two representatives of the European Commission, two representatives of the European Parliament, two representatives of patients' organisations, one representative of doctors' organisations and one representative of veterinarians' organisations. The Agency decentralises its scientific assessment of medicines by working through a network of about 4500 experts throughout the EU. The EMA draws on resources of over 40 National Competent Authorities of EU Member states.Centralised marketing authorisations
The centralised procedure allows companies to submit a single application to the agency to obtain from the European Commission a centralised marketing authorisation valid in all EU and European Economic Area -European Free Trade Association states. The centralised procedure is compulsory for all medicines derived from biotechnology and other high-tech processes, as well as for human medicines for the treatment of HIV/AIDS, cancer, diabetes, neurodegenerative diseases, auto-immune and other immune dysfunctions, and viral diseases, and for veterinary medicines for use for growth or yield enhancers. It is also compulsory for advanced-therapy medicines such as gene-therapy, somatic cell-therapy or tissue-engineered medicines and for Orphan medicines. The centralised procedure is also open to products that bring a significant therapeutic, scientific or technical innovation, or is in any other respect in the interest of patient or animal health. As a result, the majority of genuinely novel medicines are authorised through the EMA.For products eligible for or requiring centralised approval, a company submits an application for a marketing authorisation to the EMA.
Committees
Committee for Medicinal Products for Human Use
A single evaluation is carried out through the Committee for Medicinal Products for Human Use. If the Committee concludes that the quality, safety and efficacy of the medicinal product is sufficiently proven, it adopts a positive opinion. This is sent to the European Commission to be transformed into a marketing authorisation valid for the whole of the EU. A special type of approval is the paediatric-use marketing authorisation, which can be granted for medical products intended exclusively for paediatric use.The CHMP is obliged by the regulation to reach decisions within 210 days, though the clock is stopped if it is necessary to ask the applicant for clarification or further supporting data.
Committee for Medicinal Products for Veterinary Use
The Committee for Medicinal Products for Veterinary Use operates in analogy to the CHMP as described above.Committee on Orphan Medicinal Products
The Committee on Orphan Medicinal Products administers the granting of orphan drug status since 2000. Companies intending to develop medicinal products for the diagnosis, prevention or treatment of life-threatening or very serious conditions that affect not more than five in 10,000 persons in the European Union can apply for 'orphan medicinal product designation'. The COMP evaluates the application and makes a recommendation for the designation which is then granted by the European Commission.Committee on Herbal Medicinal Products
The Committee on Herbal Medicinal Products assists the harmonisation of procedures and provisions concerning herbal medicinal products laid down in EU Member States, and further integrating herbal medicinal products in the European regulatory framework since 2004.Paediatric Committee
The Paediatric Committee deals with the implementation of the paediatric legislation in Europe Regulation No 1901/2006 since 2007. Under this legislation, all applications for marketing authorisation of new medicinal products, or variations to existing authorisations, have to either include data from paediatric studies previously agreed with the PDCO, or obtain a PDCO waiver or a deferral of these studies.Committee for Advanced Therapies
The Committee for Advanced Therapies was established in accordance with Regulation No 1394/2007 on advanced-therapy medicinal products such as gene therapy, somatic cell therapy and tissue engineered products. It assesses the quality, safety and efficacy of ATMPs, and follows scientific developments in the field.Pharmacovigilance Risk Assessment Committee
A seventh committee, the Pharmacovigilance Risk Assessment Committee has come into function in 2012 with the implementation of the new EU pharmacovigilance legislation.Other activities
The Agency carries out a number of activities, including:- Pharmacovigilance: The Agency constantly monitors the safety of medicines through a pharmacovigilance network and EudraVigilance, so that it can take appropriate actions if adverse drug reaction reports suggest that the benefit-risk balance of a medicine has changed since it was authorised.
- Referrals: The Agency coordinates arbitration procedures relating to medicinal products that are approved or under consideration by Member States in non-centralized authorisation procedures.
- Scientific Advice: Companies wishing to receive scientific advice from the CHMP or CVMP on the appropriate tests and studies to carry out in the development of a medicinal products can request it prior to or during the development program.
- Telematics projects: The Agency is responsible for implementing a central set of pan-European systems and databases such as EudraVigilance, EudraCT and EudraPharm.
Relocation
It had also been speculated that the Strasbourg-based seat for the European Parliament could be moved to Brussels, in exchange for the city to host the EMA. Others speculated on the merits of Amsterdam, well before the final decision was made.
The decision on the relocation was made on 20 November 2017, during the EU General Affairs Council meeting, after three voting rounds and finally drawing of lots. After the first round of voting, Milan, Amsterdam and Copenhagen were the only contenders left. After the second voting round, two cities were left: Milan and Amsterdam. These two cities tied in the subsequent vote, after which a drawing of lots identified Amsterdam as the host city of EMA.
It is unclear what future arrangements the United Kingdom proposes to make for its own medicinal evaluation after leaving the EU. Paul Workman, the president of the London-based Institute of Cancer Research, has suggested that pharmaceutical companies would naturally seek regulatory approval for new drugs in the biggest markets first, leaving the UK facing delays in approval if they set up independent arrangements.