Affiliations: Amgen International Regulatory Affairs, Cambridge, UK.
E-mail: chwalker@amgen.com
Abstract: Having achieved orphan designation, sponsors complete clinical
investigations and submit the outcome of these investigations to the regulatory
authorities to gain marketing authorisations. The (mandated) centralised review
process for such applications is similar to that for non-orphan applications,
relying on demonstration of adequate product quality, clinical safety and
efficacy. However, due to the rarity of the condition under investigation it is
likely that the data package provided with respect to clinical safety and
efficacy will be more limited and may lead to the CHMP having to work with the
PDCO to assess whether benefit risk has been appropriately demonstrated to the
full extent possible and whether conditions should be placed on any marketing
authorisation issued due to the limited available evidence. This may lead to
conditional or exceptional marketing authorisation approvals where the company
is either able or unable (respectively) to eventually provide a complete
evidence package. Such approval status for an orphan drug would have to be
clearly highlighted in corresponding labelling and would require more regular
reporting of safety experience due to a less well documented risk profile for
the product. In addition companies may be required to commit to further
clinical investigations to the extent permitted by the prevalence of the
disease. These post marketing conditions (PMCs) or follow up measures would be
reported on a regular basis allowing a more frequent re-assessment of the
current benefit risk profile of the product in the disease. Amgen has
experience of approval of a non-orphan designated product gaining a conditional
approval and of regulatory assessment of a marketing authorisation application
for an orphan designated product.
Keywords: Orphan designation, centralized procedure, post marketing condition