TheEuropean Medicines Agency (EMA) is anagency of the European Union (EU) in charge of the evaluation and supervision ofpharmaceutical products. Prior to 2004, it was known as theEuropean Agency for the Evaluation of Medicinal Products (EAEMP) orEuropean Medicines Evaluation Agency (EMEA).[4][5]
The EMA was set up in 1995, with funding from theEuropean Union and thepharmaceutical industry, as well as indirect subsidy from member states, its stated intention to harmonise (but not replace) the work of existing nationalmedicine 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 theprotectionist tendencies ofsovereign 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 inLondon prior to theUnited Kingdom's vote for withdrawal from the European Union, relocating toAmsterdam in March 2019.[6][7]
The European Medicines Agency (EMA) operates as a decentralised scientificagency (as opposed to aregulatory authority) of theEuropean Union (EU) 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.[8] 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, andherbal medicinal products. The agency is composed of theSecretariat (ca. 600 staff), a management board, seven scientific committees (human, veterinary and herbal medicinal products,orphan drugs, paediatrics, advanced therapies andpharmacovigilance risk assessment) 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 ofexecutive director. The Board includes one representative of each of the 27 Member States, two representatives of theEuropean Commission, two representatives of theEuropean Parliament, two representatives of patients' organisations, one representative of doctors' organisations and one representative of veterinarians' organisations. The Agencydecentralises 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 (NCAs) of EU Member states.
A single evaluation is carried out through theCommittee for Medicinal Products for Human Use (CHMP).[15] 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 theEuropean Commission to be transformed into a marketing authorisation valid for the whole of the EU. A special type of approval is thepaediatric-use marketing authorisation (PUMA), which can be granted for medical products intended exclusively for paediatric use.[16]
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.[17]
The review process of the European Medicines Agency regarding medical issues has been criticized for its lack of transparency.[18] In a rebuttal of an EMS review that included her work, Louise Brinth, a Danish physician, noted that "experts" reviewing data remain unnamed and seem to be bound to secrecy. Minutes are not released and diverging opinions are not reported suggesting that all the "experts" are of the same opinion. In her view the process is unscientific and undemocratic.[19]
TheCommittee on Orphan Medicinal Products (COMP) administers the granting oforphan 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 theEuropean Commission.[21]
The Paediatric Committee (PDCO) deals with the implementation of the paediatric legislation in Europe Regulation (EC) No 1901/2006 since 2007. Under this legislation, all applications formarketing 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.[23]
TheCommittee for Advanced Therapies (CAT) was established in accordance with Regulation (EC) No 1394/2007 on advanced-therapy medicinal products (ATMPs) such asgene therapy,somatic cell therapy andtissue engineered products. It assesses the quality, safety and efficacy of ATMPs, and follows scientific developments in the field.[24]
A seventh committee, the Pharmacovigilance Risk Assessment Committee (PRAC) has come into function in 2012 with the implementation of the new EU pharmacovigilance legislation (Directive 2010/84/EU).[25]
The Agency carries out a number of activities, including:
Pharmacovigilance: The Agency constantly monitors the safety of medicines through a pharmacovigilance network andEudraVigilance, 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 andEudraPharm.
The centralised procedure allows companies to submit a single application to the agency to obtain from the European Commission a centralised (or "community") marketing authorisation (MA) valid in allEuropean Union member states and inIceland,Liechtenstein andNorway.[26] 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 fororphan medicines (for rare diseases). 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.
The EMA was set up in 1995, with funding from theEuropean Union and thepharmaceutical industry, as well as indirect subsidy from member states, its stated intention to harmonise (but not replace) the work of existing nationalmedicine 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 theprotectionist tendencies ofSovereign states unwilling to approve new drugs that might compete with those already produced by domestic drug companies.[citation needed]
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 inLondon prior to theUnited Kingdom's vote for withdrawal from the European Union, relocating toAmsterdam in March 2019.[6][7]
Prior to 2004, it was known as theEuropean Agency for the Evaluation of Medicinal Products orEuropean Medicines Evaluation Agency (EMEA).[4][5]
The EMA contributed to the Global Vaccine Action Plan developed by the Decade of Vaccines Collaboration, endorsed by the 194 Member States of theWorld Health Assembly in May 2012, and published on theWorld Health Organization's website in February 2013.[27]
Following the 2016 decision of theUnited Kingdom to leave the European Union ("Brexit"), the EMA chose to search for another base of operations. According to EU Law theEuropean Commission had to decide on the fate of the EMA's location. The EU ministers met to vote on their preferred successor.[28] The EU's Health CommissionerVytenis Andriukaitis said that the preferred choice would be a location where an "easy set up and guarantee of smooth operations" would be available. All the remaining EU member states except for the Baltic States and Luxembourg submitted proposals to host the agency.[29][30][31][32][33][34][35][36][37][38]
It had also been speculated that theStrasbourg-based seat for theEuropean Parliament could be moved to Brussels, in exchange for the city to host the EMA.[39] Others speculated on the merits of Amsterdam, well before the final decision was made.[40][41]
The decision on the relocation was made on 20 November 2017, during the EUGeneral Affairs Council meeting,[41] after three voting rounds and finally drawing of lots. After the first round of voting,Milan (25 votes),Amsterdam (20 votes) andCopenhagen (20 votes) were the only contenders left. After the second voting round, two cities were left: Milan (twelve votes) and Amsterdam (nine votes). These two cities tied in the subsequent vote (thirteen votes each), after which a drawing of lots identified Amsterdam as the host city of EMA.[42]
EMA staff left its London premises in March 2019 to relocate to a temporary building in Amsterdam, and by January 2020 the relocation to the permanent building in Amsterdam'sZuidas district was finalised.[1] The EMA sought, unsuccessfully, to argue that their lease on the London premises could be terminated on the legal ground of "frustration", because of the legal obligation of the EU to locate the agency within EU territory. TheHigh Court ruled that the doctrine of frustration did not apply in the circumstances and the EMA was left in possession of a lease with much of its initial 25-year term still to run.[43]
It participated in the Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV)public–private partnership hosted by theFoundation for the National Institutes of Health, collaborating with international government agencies and corporations to coordinate a research strategy for prioritizing and speeding up development of COVID-19 vaccines and pharmaceutical products.[45]
While in the process of evaluating thePfizer–BioNTech COVID-19 vaccine in December 2020, the EMA suffered acyberattack, resulting in the leak of classified regulatory documents to journalists, academics and the public via thedark web.[46][47][48] The documents revealed internal concerns about low production quality in themRNA vaccine candidate, and regulators' efforts to havePfizer andBioNTech rectify these deficiencies.[49][50][51] The EMA ultimately authorized the vaccine on 21 December 2020, satisfied that the product quality was "sufficiently consistent and acceptable."[52][53]
As of 2016, the EMA was roughly parallel to the drug part of the U.S.Food and Drug Administration (FDA),[54] but withoutcentralisation.[55] The timetable for product approval via the EMA's centralised procedure of 210 days compares well with the average of 500 days taken by the FDA in 2008 to evaluate a product.[56]
^abSet up by EC Regulation No. 2309/93 as the European Agency for the Evaluation of Medicinal Products, and renamed by EC Regulation No. 726/2004 to the European Medicines Agency, it had the acronym EMEA until December 2009. The European Medicines Agency does not call itself EMA either – it has no official acronym but may reconsider if EMA becomes commonly accepted (seecommunication on new visual identityArchived 1 June 2010 at theWayback Machine andlogoArchived 25 December 2009 at theWayback Machine).
^Louise Brinth:Responsum to Assessment Report on HPV-vaccines released by EMA November 26th 2015.,online (PDF; 1,3 MB)Archived 7 July 2016 at theWayback Machine
^"Herbal medicinal products". European Medicines Agency (EMA). 17 September 2018.Archived from the original on 30 June 2018. Retrieved26 December 2022.
^"Paediatric Regulation". European Medicines Agency (EMA). 17 September 2018.Archived from the original on 26 December 2022. Retrieved26 December 2022.
^Gu, A; Patel, D; Nayak, R (2016). "Chapter 10: Drug shortages". In Fulda, TR; Lyles, A; Wertheimer (eds.).Pharmaceutical Public Policy. CRC Press. pp. 151–160.ISBN9781498748513.
^Boslaugh, SE (2015). "European Medicines Agency".The SAGE Encyclopedia of Pharmacology and Society. SAGE Publications.ISBN9781506346182.