5 research outputs found
Identifikacija krivotvorenih lijekova za erektilnu disfunkciju iz ilegalnog lanca opskrbe
The appearance of counterfeit medicines in supply chains is a global public health problem that may seriously affect patients. Counterfeit drugs do not meet quality standards and do not declare their real composition and/or source for the purposes of fraud. They may be generic or innovative, they may contain genuine constituents in a fake packaging, or wrong ingredients, or inactive ingredients, or an incorrect quantity of the active substance. In Croatia, no cases of counterfeit medicines have been detected so far, but the Agency for Medicinal Products and Medical Devices has received 34 samples of medicines and other products for testing from Zagreb City Police. The samples included medicines for erectile dysfunction:
sildenafi l, tadalafi l, and vardenafi l. Twenty-three samples of tablets without marketing authorisation in Croatia were tested with high-performance liquid chromatography (HPLC) for the declared sildenafi l and tadalafi l content. Samples labelled 1 (batch T/33), 3 (batch T/33), 5 (batch 4), 6 (batch M0016J), 10 (batch T-070235), 12 (batch T-070544), 15 (batch 314833201), 16 (batch 832718474), and 17 (batch 504830028) containing sildenafi l and samples labelled 20 (batch 070356), 21 (batch 05668), and 22 (batch T 378 5)
containing tadalafi l did not contain the active substance within the acceptable 95 % to 105 % margin of deviation from the declared content. While most samples cannot be described as fake with a reasonable amount of certainty, there is still a suspicion of counterfeit. A correct conclusion can be drawn only with the assistance of the manufacturers and by conducting additional laboratory tests.Pojava krivotvorenih lijekova u lancima opskrbe globalni je javnozdravstveni problem koji može imati ozbiljnih posljedica za pacijenta. Krivotvoreni lijekovi ne zadovoljavaju propisane standarde kakvoÄe te su u svrhu prijevare drugaÄije deklarirani u odnosu na njihov stvarni sastav i/ili podrijetlo. Mogu biti generiÄki, ili inovativni, mogu sadržavati ispravne sastojke, ali pogreÅ”no pakiranje, pogreÅ”ne sastojke, ne sadržavati djelatnu tvar ili ne sadržavati dovoljnu koliÄinu djelatne tvari. U Hrvatskoj do sada nisu zabilježeni sluÄajevi krivotvorenih lijekova, ali je Agencija za lijekove i medicinske proizvode od policijske uprave ZagrebaÄke zaprimila 34 uzorka lijeka i ostalih proizvoda u svrhu ispitivanja. Od lijekova, radilo se o lijekovima za erektilnu disfunkciju sildenafi lu, tadalafi lu i vardenafi lu. 23 uzorka tableta koji nemaju odobrenje za stavljanje lijeka u promet u Hrvatskoj ispitana su metodom tekuÄinske kromatografi je visokog uÄinka (HPLC) na deklarirani sadržaj sildenafi la i tadalafi la. Ustanovljeno je da uzorci pod oznakama 1 (serija T/33), 3 (serijaT/33), 5 (serija 4), 6 (serija M0016J), 10 (serija T-070235), 12 (serija T-070544), 15 (serija 314833201), 16 (serija 832718474), 17 (serija 504830028) koji su sadržavali sildenafi l te uzorci 20 (serija 070356), 21 (serija 05668), 22 (serija T 378 5) i 23 (702099) koji su sadržavali tadalafi l, ne sadržavaju djelatnu tvar unutar prihvatljivih granica odstupanja od 95 % do 105 % od deklarirane vrijednosti. Iako se ne može sa sigurnosti za veÄinu uzoraka reÄi da se radi o krivotvorini, ipak se može govoriti o sumnji na krivotvorinu, a cjeloviti zakljuÄak može se izvesti jedino uz suradnju i miÅ”ljenje proizvoÄaÄa te provedbom dodatnih laboratorijskih ispitivanja
Nova uredba Europske Komisije o izmjenama ā uÄinak na hrvastko zakonodavstvo
Variations introduced to medicinal product documentation must not affect the quality, efficacy, and safety of the product. Croatian Medicinal Products Act and accompanying ordinances are largely aligned with the EU regulations. The EU has now tried to simplify the issue of variations with a new Regulation, creating differences in the definition of and approach to resolving certain types of variations between Croatia and the EU. These differences could hinder the approval procedure for variations in Croatia, particularly for medicines already approved in the EU. Amending the Croatian Ordinance on medicines already authorised in the EU would be one way of maintaining the efficiency of the Croatian regulatory system.UvoÄenje izmjena u dokumentaciju o lijeku na temelju koje je lijek dobio odobrenje za stavljanje u promet mora biti provedeno na naÄin da te izmjene ne utjeÄu na kakvoÄu, djelotvornost i sigurnost primjene lijeka. Navedeno je u Republici Hrvatskoj regulirano Zakonom o lijekovima i prateÄim Pravilnicima koji su uvelike harmonizirani s propisima Europske unije. Hrvatski propisi u zadnjih 12 godina doživjeli su niz promjena u cilju donoÅ”enja potpunijih i jasnijih odredbi. Paralelno i u Europskoj uniji nastojalo se je
pojednostaviti rjeŔavanje izmjena te je donesena nova Uredba o izmjenama.
Nova Uredba EK o izmjenama donesena je nakon stupanja na snagu važeÄih hrvatskih propisa s podruÄja lijekova i njihovom usporedbom uoÄavaju se razlike u defi niranju i pristupu rjeÅ”avanja odreÄenih vrsta izmjena u Hrvatskoj i zemljama EU.
Moglo bi se dogoditi da Äe navedene razlike, otežati provoÄenje procedura o odobravanju izmjena na naÄin kako defi niraju hrvatski propisi. Jedan od naÄina kako bi se mogla zadržati jednaka efikasnost hrvatskog regulatornog sustava jest pristupiti izmjeni Pravilnika o posebnim uvjetima za stavljanje gotovog lijeka u
promet u Republici Hrvatskoj koji ima odobrenje u Europskoj uniji
Dobra proizvoÄaÄka praksa: uloga domaÄih proizvoÄaÄa i nadležnih tijela
In every country, a manufacturer of medicinal products for either human or veterinary use is required to operate in compliance with local legislation effect that they are committed to abide by the same standards. The candidate countries transpose the acquis into their national legislation, including the good manufacturing practice (GMP). Consequently, the local manufacturer is required to strictly comply with GMP and the manufacturing licence, including for medicinal products exclusively intended for export. A vital role is also played by national regulatory authorities, in Croatia by the Agency for Medicinal Products and Medical Devices which issues the manufacturing licence, GMP certifi cate, and the Certifi cate of a Pharmaceutical Product (CPP) and conducts laboratory control of
products. GMP inspection is carried out by the Pharmaceutical Inspectorate with the Ministry of Health and Social Welfare. Both authorities are responsible only for human medicines. There are legislative issues not yet harmonised with the acquis, but as a country aspiring for the EU membership, Croatia is expected
to demonstrate that its industry and competent authorities are able to conform to current requirements and thus fully adhere to the integrated European regulatory network. Hence the importance of strengthening the institutional capacity of the competent authorities, as insuffi cient resources may have a direct bearing
on patients by limiting their access to affordable treatment.U svakoj zemlji proizvoÄaÄ lijekova za humanu ili za veterinarsku uporabu obavezan je poslovati sukladno lokalnom zakonodavstvu, koje je u EU usklaÄeno za sve Älanice koje moraju poÅ”tivati jednake standarde. Zemlje kandidati za Älanstvo ugraÄuju europsko zakonodavstvo u nacionalno i na taj naÄin implementiraju dobru proizvoÄaÄku praksu (GMP). Sukladno tomu, proizvoÄaÄ lijeka obvezan je osigurati da se svi proizvodni postupci za lijekove izvode u skladu s dobrom proizvoÄaÄkom praksom i proizvodnom dozvolom
ukljuÄujuÄi i lijekove koji su namijenjeni samo za izvoz. Ovdje je nezaobilazna i uloga nacionalnih regulatornih tijela posebno Agencije za lijekove i medicinske proizvode koja izdaje proizvodnu dozvolu,
GMP certifi kate i certifi kate o farmaceutskom proizvodu - lijeku (CPP) te provodi laboratorijsku kontrolu proizvoda. GMP inspekciju provodi farmaceutski inspektorat koji je u sastavu Ministarstva zdravstva i socijalne skrbi. Oba su tijela nadležna samo za lijekove za humanu uporabu. Postoje joÅ” neka neusklaÄena pitanja Å”to se tiÄe prihvaÄanja Pravne steÄevine na ovome polju, ali kako je Hrvatska zemlja kandidat za punopravno Älanstvo u EU, oÄekuje se da Äe moÄi demonstrirati da njezina industrija i nadležna tijela poÅ”tuju važeÄe zahtjeve EU i tako potpuno pristupaju europskoj regulatornoj mreži. Stoga je važno jaÄati institucionalni kapacitet nadležnih tijela, jer nedostatni potencijali mogu izravno utjecati na pacijente ograniÄavajuÄi im pristup dostupnim terapijama
ARE THERE COUNTERFEIT MEDICINES IN CROATIA?
Krivotvoreni lijekovi postaju sve veÄi problem u svijetu jer ugrožavaju zdravlje pacijenta i javnozdravstveni su rizik. Ovi su lijekovi rezultat dobro organiziranog kriminala koji u svrhu stvaranja dobiti plasira na tržiÅ”te lažne lijekove. U otkrivanje i sprjeÄavanje trgovine takvim proizvodima ukljuÄena su regulatorna tijela za lijekove, policija, carina, pravosudna tijela i farmaceutska industrija. U Hrvatskoj do sada nije zabilježena pojava krivotvorenih lijekova u ovlaÅ”tenim lancima opskrbe. MeÄutim, na crnom tržiÅ”tu katkad se jave lijekovi koji potjeÄu iz drugih zemalja i koji nemaju odobrenje za stavljanje u promet u Hrvatskoj. NajÄeÅ”Äe su to lijekovi za lijeÄenje erektilne disfunkcije: sildenafil, tadalafil i vardenafil. U ovom radu ispitani su uzorci 26 lijekova zaplijenjenih u ilegalnom lancu opskrbe, a koji su namijenjeni za lijeÄenje erektilne disfunkcije. Za kvalitativno i kvantitativno odreÄivanje djelatnih tvari u ispitanim uzorcima lijekova upotrijebljena je metoda tekuÄinske kromatografije visokog uÄinka (HPLC). UtvrÄeno je da od 26 uzoraka 13 ima odstupanja od deklariranog sastava i sukladno tomu ne udovoljavaju zahtjevima kakvoÄe. Nadalje, dva uzorka nisu uopÄe sadržavala djelatnu tvar vardenafil, Å”to upuÄuje i na moguÄnost krivotvorine.Counterfeit medicines are a growing problem in the world, for their use may endanger patientās health and therefore they pose an enormous public health risk. The manufacture of counterfeit medicines usually involves organised crime groups which place the counterfeit medicines on the market for reasons of profit. Detection and prevention of trade in counterfeit medicines requires close cooperation between medicine regulatory authorities, police, customs, judiciary and pharmaceutical industry. To this day, there have been no recorded cases of counterfeit medicines in the legal supply chain in Croatia. However, medicines without marketing authorisation in Croatia, originating from different countries, could be found on the illegal market. Most frequently, this includes medicines for the treatment of erectile dysfunction such as: sildenafil, tadalafil, vardenafil. In this study, 26 medicines for the treatment of erectile dysfunction, seized in illegal supply chain, were tested. High performance liquid chromatography (HPLC) was used for identification and quantification of active substances in the tested samples. It was determined that 13 out of 26 samples did not comply with declared composition of medicine and quality specification. Furthermore, two samples did not contain declared active substance vardenafil and that may indicate that these medicines are counterfeit
Regulating Medicines in Croatia: Five-year Experience of Agency for Medicinal Products and Medical Devices
Aim To present the activities of the Agency for Medicinal
Products and Medical Devices in the first 5 years of its existence
and to define its future challenges.
Methods Main activities within the scope of the Agency
as a regulatory authority were retrospectively analyzed for
the period from 2004-2008. Data were collected from the
Agencyās database and analyzed by descriptive statistics.
Results The number of issued medicine authorizations
rose from 240 in 2004 to 580 in 2008. The greatest number
of new chemical and biological entities was approved
in 2005. The greatest number of regular quality controls
(n = 5833) and special quality controls was performed in
2008 (n = 589), while the greatest number of off-shelf quality
controls (n = 132) was performed in 2007. The greatest
number of medicine labeling irregularities was found
in 2007 (n = 19) and of quality irregularities in 2004 (n = 9).
The greatest number of adverse reactions was reported in
2008 (n = 1393). The number of registered medical devices
rose from 213 in 2004 to 565 in 2008.
Conclusion Over its 5 years of existence, the Agency has
successfully coped with the constant increase in workload.
In the future, as Croatia enters the European Union, the
Agency will have to face the challenge of joining the integrated
European regulatory framework