Saturday, August 2, 2014

A Good Paper on Comparison of Approaches to Regulation of Different Countries

The paper titled "Ensuring Medical Device Effectiveness and Safety: A Cross-National Comparison of Approaches to Regulation" by Kramer et al. provided a systematic and in-depth comparisons of regulation of the US, EU, Japan, and China. The comparisons are based on six key features of device regulation:
  1. Regulatory Authority
  2. Pre-Market Evaluation
  3. Adverse Event Reporting
  4. Quality System Regulation
  5. Post-Approval Studies
  6. Post-Market Regulation Actions
Emerging strategies of post-approval surveillance were also discussed such as unique device identifier (UDI) system.

    New Final Guidance of 510(K) by the FDA

    On July 28, 2014, FDA issued the newest "Final Guidance of The 510(k) Program: Evaluating Substantial Equivalence in Premarket Notifications [510(k)]" after revised draft guidance issued in Dec 28, 2011. The final guidance gives more examples than the 2011 draft guidance to better illustrate the decision-making process during a 510(k) review. It also includes a sample 510(k) summary which is more much detailed than most 510(k) summary documents found on the FDA website. Special and Abbreviated 510(k) sections were removed. FDA intends to finalize these sections separately. Although FDA states that this guidance is "not intended to implement significant policy changes," the guidance clarifies and addresses many key issues in the 510(k) program.

    The US FDA requires that the manufacturers demonstrate safety and efficacy of the product, unless the devicecan be shown to be substantially equivalent (SE) to a predicate product that is legally marketed in the United States (via the 510(k)). For most new products, those without predicates, and certain high-risk products (typically Class III), a PMA is required. Certain Class I and exempted Class II medical devices are permitted to be marketed without the FDA’s prior authorization, although manufacturing(Quality System Regulations) and/or documentation controls may still apply. Some important points are summaried below:

    Predicate Device

    Predicate device is a the legally marketed device a legally marketed device, which is a device that (i) was legally marketed prior to May 28, 1976 (preamendments device) and for which a PMA is not required; or (ii) has been reclassified from Class III to Class II or I; or (iii) has been found SE through the 510(k) process. Although a manufacturer can identify multiple predicate devices, FDA recommends identifying a primary predicate in the submission.