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. 2014 Jun 4;9(6):e98348.
doi: 10.1371/journal.pone.0098348. eCollection 2014.

Oral medicines for children in the European paediatric investigation plans

Diana A van Riet-Nales  1 , Erwin G A W Römkens  2 , Agnes Saint-Raymond  3 , Piotr Kozarewicz  4 , Alfred F A M Schobben  1 , Toine C G Egberts  5 , Carin M A Rademaker  6
Affiliations

Oral medicines for children in the European paediatric investigation plans

Diana A van Riet-Nales et al. PLoS One. .

Abstract

Introduction: Pharmaceutical industry is no longer allowed to develop new medicines for use in adults only, as the 2007 Paediatric Regulation requires children to be considered also. The plans for such paediatric development called Paediatric Investigation Plans (PIPs) are subject to agreement by the European Medicines Agency (EMA) and its Paediatric Committee (PDCO). The aim of this study was to evaluate the key characteristics of oral paediatric medicines in the PIPs and the changes implemented as a result of the EMA/PDCO review.

Methods: All PIPs agreed by 31 December 2011 were identified through a proprietary EMA-database. PIPs were included if they contained an agreed proposal to develop an oral medicine for children 0 to 11 years. Information on the therapeutic area (EMA classification system); target age range (as defined by industry) and pharmaceutical characteristics (active substance, dosage form(s) as listed in the PIP, strength of each dosage form, excipients in each strength of each dosage form) was extracted from the EMA website or the EMA/PDCO assessment reports.

Results: A hundred and fifty PIPs were included corresponding to 16 therapeutic areas and 220 oral dosage forms in 431 strengths/compositions. Eighty-two PIPs (37%) included tablets, 44 (20%) liquids and 35 (16%) dosage forms with a specific composition/strength that were stored as a solid but swallowed as a liquid e.g. dispersible tablets. The EMA/PDCO review resulted in an increase of 13 (207 to 220) oral paediatric dosage forms and 44 (387 to 431) dosage forms with a specific composition/strength. For many PIPs, the target age range was widened and the excipient composition and usability aspects modified.

Conclusion: The EMA/PDCO review realized an increase in the number of requirements for the development of oral dosage forms and a larger increase in the number of dosage forms with a specific composition/strength, both targeting younger children. Changes to their pharmaceutical design were less profound.

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Conflict of interest statement

Competing Interests: Diana van Riet is vice chair of the European Medicines Agency's (EMAs) Quality Working Party for human medicines and an EMA expert. Alfred Schobben is a member of the Medicines Evaluation Board in the Netherlands and EMA expert. Toine Egberts is also an EMA expert. Agnes Saint-Raymond and Piotr Kozarewicz are full time employees of the EMA. There are no patents, products in development or marketed products to declare. The data on which this study is based can be obtained from the authors or from the EMA upon request. This declaration does not alter the author's adherence to all the PLOS ONE policies on sharing data and materials.

Figures

Figure 1
Figure 1. PIPs including at least one oral medicine for children 0–11 years.
Figure 2
Figure 2. Oral preparations in the PIPs per target age group.
See this image and copyright information in PMC

References

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