What is ICH and How Does it Impact Regulatory and Drug Development

What is ICH and Why?

ICH stands for International Council for Harmonization.

To be more precise, it is The International Council for Harmonization of Technical Requirements for Pharmaceuticals for Human Use.

ICH is established in 1990.

It started as a group of Pharma/Biotech Industry and Regulatory Agencies such as FDA from USA, Europe and Japan to discuss and harmonize scientific and technical aspects of drug registrations.

Now, there are many other countries that joined ICH (Korea, China, Canada etc.).

They meet three times a year and work on guidance to harmonize drug development on Safety, Efficacy and Quality aspects.

ICH Guidelines are a goldmine of information for understanding drug development.

When ICH Guidance or combined with regional guidance document, you have all powerful tools for development of drugs and information that regulators want to see to approve your drug.

There are Four types of guidance documents in ICH.

Q – Stands for Quality – These guidance documents provides information on building Quality in your drug. They discuss CMC or Chemistry Manufacturing and Controls aspects of drug development.

S- Stands for Safety – These guidance documents provides information on establishing Safety profile of your drug before trial can be started in humans. They discuss Non-Clinical aspects of drug development.

E- stands for Efficacy – These guidance documents provides information on establishing Efficacy profile of your drug. They discuss Clinical aspects of drug development.

M – stands for Multi-disciplinary – These guidance documents provides information that involve more than one of the above disciplines at a time. They discuss some combined aspects of drug development.

Together, these ICH guidelines help you develop drugs.

For example:

  1. Safety guidelines suggest you about the non-clinical testing that you need to work on before submitting First In Human studies.
  2. Quality guidelines suggest you about setting up specifications to control drug substance and drug product or determining the stability requirements.
  3. Efficacy guidelines suggest about designing the clinical trials.
  4. Multidisciplinary guidelines suggest about how all this information can be submitted to regulatory authorities in a common format.

How to use the ICH guidelines

Use ICH guidelines to understand the overall drug development.

Use them to gain deeper understanding into the general requirements for Non-Clinical, CMC and Safety aspects of drug development.

To go much deeper, you may need guidance documents from individual regulatory authorities.

For example, ICH guidelines will help you determine how doses used in Non-clinical studies can pave a way to safe starting dose in humans. However, to understand how to calculate those doses, you may need an FDA guidance.

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Art of Searching for FDA Forms for Regulatory Professionals

Regulatory Professionals need to work with FDA Forms on a daily basis whether they are dealing with an Investigational New Drug Application (IND) or New Drug Application (NDA) or Biologics License Application (BLA) or Abbreviated New Drug Applications (ANDA) or any device clearance applications. 

Our general instinct is to search for an FDA form on google. But sometimes google tend to show an outdated form. For example, my search for Form 1572 yielded the below form which is no longer current (See red highlight in the below image). 

The best way to get access to FDA forms is to directly download them from FDA website. Following steps will guide you through the process.

Step 1: Browse or go to https://www.fda.gov/about-fda/reports-manuals-forms/forms

You can either bookmark this website or alternately search on google for “FDA Forms” and it will take you to above website.

Step 2: In the search bar, type in the form you are looking for.

For example, If I am looking for form 1572, then I type 1572. This search yields two documents. One is the actual form and the other is the instruction or guidance on how to fill the form 1572.

Step 3: Download the actual form. 

In this case it is “FDA-1572_R7_Sec_03-30-2022.pdf1.12 MB”. Move your browser to the Form number field associated with actual PDF and click on it (see image below). Form is automatically downloaded on to the computer.

You can now save it to wherever you want on your computer. I strongly recommend downloading the instruction document and use it to fill the corresponding form until you get into the routine of completing the forms.

Note: You also notice a column showing the edition date. This is also the date you see on top right corner of the form once you open the form(see first image). Sometimes edition date could be in the past. For example if you search for 1571 form, the edition date is 03/2019. It does not mean that the Form is invalid or expired. As long as you are downloading it from FDA website, the form is valid. In case if you are habituated to use google to download forms, I strongly suggest you to cross check the edition date of that particular Form from FDA website.

If you think this article is going to help someone, please share it with them.

Note: If you have any questions related to Drug/Biologics Regulatory Affairs, please mail to regulatorybuddy@gmail.com

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One thing that FDA looks into before it allows to test drugs in humans and how.

FDA or any regulatory authority takes Safety first approach when dealing with drugs. They do not want to risk any human lives. Hence, a drug is studied in several hundreds if not thousands of patients before it is approved. That one thing that FDA looks into before it lets companies test drugs in humans is “Safety” of the drug.

How is it that FDA do not want to give approval before testing it in patients and how is it that they do not want to risk human lives? Aren’t they risking by testing drugs on humans in the first place without knowing how it behaves in humans? Sounds like a chicken and egg problem?

Not really!

Luckily, there is a work around to understand whether a drug is going to be safe or not before we can test it in human subjects. To understand those safety aspects of drug, companies test drugs in petridish and in animals (mice, rats, hamsters, dogs, monkeys etc). This part of testing is called Non-clinical testing.

As part of non-clinical testing, we get a preliminary understanding about drug in the following aspects:

  1. Whether a drug has intended effect or not – This translates to Pharmacology in technical terms.
  2. Whether a drug will affect any of the important physiological systems in the body (like Respiratory system, cardiovascular system and Nervous system) – This translates to Safety Pharmacology in technical terms.
  3. How is drug traveling inside the body and how is it going out – This translates to Pharmacokinetics that includes absorption, distribution, metabolism and excretion.
  4. Whether a drug shows any toxicity – This translates to Toxicology.
Animal testing helps us understand safety of a drug

At the end of these preliminary non-clinical studies, scientists understand how much amount of drug is required to show intended effect and still be safe enough. Obviously, given the size and nature of human bodies, the amount of drug that is safe and effective enough in animals will not be same to show similar effect in humans. So, scientists use several factors to calculate the amount of drug that would be safe to start testing in humans (called as Human Equivalent Dose in technical terms).

Even after getting an understanding of human equivalent amount of drug that is safe, FDA suggests to start testing on humans with one tenth the amount of drug and slowly increase that amount as you gain better understanding of drugs in the human subjects.

Note: If you are interested in learning from FDA guidances about these aspects, look into these two documents.

  1. Nonclinical Safety Studies.
  2. Human Equivalent dose calculation.

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The Three Pillars of Dug Development

In my last article, we discussed about the “Public Health” as a single most major responsibility of FDA or any health authority. In the same article, we also saw several mission statements of different regulatory authorities including FDA, Health Canada and MHRA.

For example, FDA’s mission statement reads something like this: “The Food and Administration is responsible for protecting the public health by ensuring the safety, efficacy, and security of human and veterinary drugs, biological products, and medical devices; and by ensuring the safety of our nation’s food supply, cosmetics, and products that emit radiation”

One theme that is common in those mission statements are terms: Quality, Safety and Efficacy. What are they and why are they important?

1. Safety: Regulatory authorities first and foremost look to see if a drug is safe enough in humans or not. The last thing regulatory authorities want is that the drug that causes damage to the health. Regulatory authorities never take risk with human lives. It all comes down to safety first. If drug is not safe enough, it will not be approved. Period.

2. Efficacy: Think efficacy like effect. Regulatory authorities look into whether a drug is showing its intended effect or not. To put it in other words, is it doing what it is supposed to do? Is it treating a disease and making a patient feel better? If a drug is not doing its job properly, it cannot be even called a drug. It cannot be approved.

3. Quality: How well a product is made. Regulatory authorities determine how well a product is made. Every single pill or every ounce in the bottle is supposed to do the same job. If not, how can you trust it? If you cannot trust the quality of product, you cannot approve it.

The safety, efficacy and quality, in technical terms translate to Non-clinical, Clinical and CMC (Chemistry, Manufacturing and Controls). Safety and Efficacy are common themes in both non-clinical and clinical. However, non-clinical is primarily used to evaluate safety even before drug can be tested in humans and hence non-clinical translates to safety.

To FDA or Regulatory Authorities eyes, these three factors (Safety, Efficacy and Quality) need to be strong enough before they can give an approval for a drug to be sold. That is the reason why, through drug development lens, these three pillars (Non-clinical, Clinical and Quality) should form a solid foundation for a drug.

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What is the Major Responsibility of any Health Authority

The single major responsibility of any Health Authority/Drug Regulatory Authority is to protect the health of its public.

Remember the term: PUBLIC HEALTH

That is also a reason why majority of drug regulatory authorities are nested under “Department of Health” within their Country.

For example:

  1. Food and Drug Administration (FDA), Drug Regulatory Authority in USA is nested under “The Department of Health and Human Services”.
  2. Medicines and Healthcare products Regulatory Agency (MHRA), the Drug Regulatory Authority in UK falls under “Department of Health and Social Care”
  3. Health Canada (HC), the Drug Regulatory Authority in Canada falls under “The Federal Ministry of Health”
  4. Therapeutics Good Administration (TGA) of Australia falls under Australian Government “Department of Health”

So, how do these authorities protect the public health?

Let us look into the mission statements of some of these agencies to get a better idea:

First Paragraph of United States FDA Mission says:

“The Food and Administration is responsible for protecting the public health by ensuring the safety, efficacy, and security of human and veterinary drugs, biological products, and medical devices; and by ensuring the safety of our nation’s food supply, cosmetics, and products that emit radiation”

Here is the mission statement for United Kingdom’s MHRA:

“The mission of the inspectorate is to protect the pubic health by making sure that medicines are available and are of right quality, applying appropriate standards of regulation”

Here is the mission statement from Republic of India’s Central Drug Standard Control Organization (CDSCO):

“To safeguard and enhance the public health by assuring the safety, efficacy and quality of drugs, cosmetics and medical devices”

Australia’s TGA describes the following in their regulatory performance framework:

“The TGA administers the Therapeutic Goods Act 1989, applying a risk management approach designed to ensure therapeutic goods supplied in Australia meet acceptable standards of quality, safety and efficacy (performance), when necessary.

You can see the commonality between these statements. Irrespective of processes they use to regulate drugs or cosmetics, their bulls eye is to protect the “Public Health”.

In my next post, I will write about how these mission statements fit into drug development.

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Regulatory Authority or Health Authority?

After I started working in Regulatory Affairs, I started noticing that we use regulatory authority and health authority interchangeably when talking about organizations such as FDA, Health Canada or MHRA (the organizations to which we generally submit drug applications for various purposes).

What is the difference between both terms? Can we really use them interchangeably? Is there a time when we should specifically use “Health Authority”?

Regulatory Authority is a government agency that regulates businesses in the public interest. In other words, it is an administrative body of government with administrative responsibilities towards its public. Regulatory Authorities define regulations. Regulation is a rule or order telling how something is to be done. In general, whether we know it or not, regulations have an impact in our daily life. They are not specific to a single Industry. Industries such as health care (Pharma/Biotech), finance, utilities, banking are regulated industries. And each industry is regulated by one or more regulatory authorities. For example, within US, Federal Deposit Insurance Corporation (FDIC) and Federal Reserve Board regulates Banks; FDA regulates Food and Drugs.

Because the products of Pharma/Biotech field impact public health, we are governed by regulations related to health. Hence, we use regulatory authority or health authority within the industry interchangeably. All health authorities are regulatory authorities but not all regulatory authorities are health authorities. Within our Industry, it is ok to use Health Authority or FDA or Regulatory Authority interchangeably. But you may not be talking about the same agency or authority if you are in a group that has people from different industries.

In a room full of people with different industries, if it every happens, better use the term “Health Authority” or specific agency (such as FDA) to refer to FDA.

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What is Regulatory Affairs

Before I started my career full time in Regulatory Affairs, my view of it is that Regulatory Affairs gets involved in multiple areas of drug development and as someone who has experience in different areas, i felt it would be a perfect fit for me. But I started pondering about “What is Regulatory Affairs” not until someone asked me what do I do and what it means?. I realized I never articulated it for myself.

I have been working in this profession for about 3 years as of this writing. But when I stumble across this question, i usually do not define in a way I used to about my previous jobs (It was much easier to answer what I do while I was working as a non-clinical scientist in academia or a drug product development scientist in Industry).

Here is how that conversation goes:

My initial responses to someone who asks me what I do in career: “I work in Regulatory Affairs”. At least people outside of Pharmaceutical/Biotech space ask me “what is regulatory affairs”. I tell them, I liaise between regulatory agencies such as FDA and Sponsor company.

“What does that mean?” – They exactly want to know what is it?

I respond “I submit different applications to FDA to perform clinical trials or for approval of drugs to market them”.

“Ohh……..So you do document management then”.

“Yes, it is part of it but i work on regulatory strategy too”

“What is regulatory strategy?” They ask.

“Regulatory strategy involves collaboration with different subject matter experts (clinical, non-clinical and quality teams) to drive drug development and overcome any hurdles in developing and marketing of drugs.

Fact is that Regulatory Affairs is all of the above things, it has strategy component to it, writing component to it, document management component to it, project management component to it, leadership component to it and probably there are few other components that I am not aware of. All these are different roles and responsibilities within Regulatory Affairs but do not define what Regulatory Affairs is.

After couple of such conversations, I felt I really need to know “What Regulatory Affairs” is and should be able to define it precisely during my next such conversation. I started looking it up.

This is when I learnt that “Regulatory Affairs” is created fairly recently from the desire of government and pharmaceutical companies to protect public health by controlling the safety and efficacy of different products.

One book defined regulatory affairs as: “As a discipline, regulatory affairs covers a broad range of specific skills and occupations. Under the best of circumstances, it is composed of a group of people who act as a liaison between the potentially conflicting worlds of government, industry, and consumers to help make sure that marketed products are safe and effective when used as advertised”.

Another book suggests that “Regulatory affairs liaisons manage the process of working with project teams and interacting with the regulatory health agencies, such as the FDA or the International Conference of Harmonization (ICH)”.

Another book noted that “The Regulatory affairs department of a pharmaceutical company is responsible for obtaining approval for new pharmaceutical products and ensuring that approval is maintained for as long as the company wants to keep the product on the market”.

Please note that the above books gave a detailed definition and I put a concise version above.

Eventually, I came up with my own answer for it:

“Regulatory affairs is a core that holds different parts of pharmaceutical/biotech industry together from discovery phase through marketing and life cycle management and it acts as a bridge between Regulatory Authorities, Industry and public”.

I believe many professionals working in Regulatory Affairs and Pharma/Biotech industry in general agree with this one. The strategy, documentation, management, writing etc are actually the responsibilities of Regulatory Affairs professionals.

If someone asks me next time, I know what to answer.

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Introduction to Regulatory Buddy

Drug development is a technically deep field with so many moving parts. Regulatory Affairs is like a Core that holds all these parts together and liaise between the sponsor (or a company developing the drug) and Regulatory Agencies (Eg: FDA in US; MHRA in UK) to protect the health of public by providing safe and efficacious drugs.

Regulatory affairs professionals are involved in reading a lot: Regulations, laws, guidance documents etc. A lot of patience is required to read and understand all these documents. Even after putting those long hours of reading, you may forget it next time when you need it because Regulatory Affairs is too dry of a subject to stick. Of course, things do tend to stick as you read/do them again and again. But, to keep up with huge volumes of guidance documents is a gigantic task.

I am relatively young in this Regulatory field as of this writing and have about 12 years of experience between academia and Industry before joining regulatory. One way to grow in the regulatory is by doing a lot of reading and use it whenever necessary. Similarly, Few ways to learn anything quickly or get what you learned to stick is by teaching it to others or by writing them down in your own words and that is what I am trying to do at Regulatory Buddy. Why not articulate whatever I am reading so that it sticks to me and may help others. And hence this publication or blog.

My idea is to give following perspectives to different guidance document or articles so that it is easy for a reader to understand: Why, When, Who, Where and How. But then, different documents are different and I highly doubt if one size will fit all. So, I will tailor as needed as I travel along. I am still learning and will always do.

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