European Medicines Agency - Human Medicines - Medicines for children - Paediatric investigation plans (PIPs), waivers and modifications

Medicines for children
Guidance for applicants
The PDCO has adopted a draft "Standard Paediatric Investigation Plan" (PIP) to be used for allergen products for specific immunotherapy. This document might be revised following the outcome of a meeting with experts to take place in early 2010. Updated on martes, 24 de noviembre de 2009

The regulatory requirements for a PIP are the usual ones, as described by art.7 and art.8 of the Paediatric Regulation.

The PDCO has adopted a “Standard Paediatric Investigation Plan” (PIP) to be used for H1N1 pandemic influenza vaccines during the current pandemics. The regulatory requirements for a PIP are the usual ones, as described by art. 7 and art. 8 of the Paediatric Regulation.
Applications for pandemic flu vaccines using the standard PIP may follow an accelerated procedure for agreement of the PIP.

Importantly, even if a PIP is not required for a pandemic flu vaccine, this “Standard PIP” sets out the minimum set of data that should be obtained in the different paediatric age groups, as children are the main target of the disease.

Electronic-only submissions: Starting with the 12 June deadline, the EMEA will accept electronic-only applications for Paediatric Investigation Plans, Waivers, Modification of Agreed Paediatric Investigation Plans, and Compliance check. This also applies to responses to the Request for Modifications. Applicants should submit their applications as a CD or DVD with a cover letter. As previously, the deadlines refer to the last acceptable day of receipt of electronic documents (via either Eudralink or CD/DVD).

Paediatric investigation plans (PIPs), waivers and modifications
The Paediatric Regulation requires, where necessary, the early submission of a development plan for medicines — the paediatric investigation plan. The normal development of a medicine requires that various studies be performed to ensure its quality, safety and efficacy. The development plan can be modified with increasing knowledge about the medicine.

A paediatric investigation plan is a development plan aimed at ensuring that the necessary data are obtained through studies in children, when it is safe to do so, to support the authorisation of the medicine for children. The plan should be submitted by pharmaceutical companies to the Paediatric Committee, which is responsible for agreement or refusal of the plan.

The paediatric investigation plan includes a description of the studies and of the measures to adapt the way the medicine is presented (formulation) to make its use more acceptable in children. For example, children cannot swallow big tablets, so a syrup may be more appropriate.

The plan should cover the needs of all age groups of children, from birth to adolescence.

The plan also defines the timing of studies in children compared to adults. In some cases, studies will be deferred until after the studies in adults have been conducted, to ensure that research with children is done only when it is safe and ethical to do so.

As some diseases do not affect children (for example Parkinson's disease), the development of medicines for these diseases should not be performed in children, and so a paediatric investigation plan will not be required by the Paediatric Committee; the requirement for a PIP will therefore be waived in these cases.

On 24 September 2008, the European Commission published the final version of the guideline entitled 'Guideline on the format and content of applications for agreement or modification of a paediatric investigation plan and requests for waivers or deferrals and concerning the operation of the compliance check and on criteria for assessing significant studies'.

Commission Communication (2008/C 243/01). The guidelines can be found here.

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European Medicines Agency - Human Medicines - Medicines for children - Paediatric investigation plans (PIPs), waivers and modifications