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The Secretary of State, being a Minister designated[1] for the purposes of section 2(2) of the European Communities Act 1972[2] in relation to medicinal products, in exercise of the powers conferred by the said section 2(2), and of all other powers enabling him in that behalf, hereby makes the following Regulations: Citation and commencement 1. These Regulations may be cited as the Medicines for Human Use (Clinical Trials) Regulations 2004 and shall come into force on 1st May 2004. Interpretation 2. - (1) In these Regulations -
(b) a dentist, (c) a nurse, or (d) a pharmacist;
(b) where the product (with or without other medicinal products of the same description) is already contained in the container in which it is to be sold or supplied, or used in a clinical trial, labelling the container before the product is sold or supplied, or used in a clinical trial, in that container,
and "assembly" has a corresponding meaning;
(b) in relation to a clinical trial conducted at more than one trial site, the authorised health care professional, whether or not he is an investigator at any particular site, who takes primary responsibility for the conduct of the trial;
(b) to identify any adverse reactions to one or more such products, or (c) to study absorption, distribution, metabolism and excretion of one or more such products,
with the object of ascertaining the safety or efficacy of those products;
(b) giving a prescription for an investigational medicinal product for the purposes of that trial, (c) carrying out any other medical or nursing procedure in relation to that trial, and (d) carrying out any test or analysis -
(ii) to identify any adverse reactions to those products, or (iii) to study absorption, distribution, metabolism and excretion of those products,
but does not include any activity undertaken prior to the commencement of the trial which consists of making such preparations for the trial as are necessary or expedient;
(b) the Ethics Committee constituted by regulations made by the Scottish Ministers under section 51(6) of the Adults with Incapacity (Scotland) Act 2000[13], or (c) the Gene Therapy Advisory Committee;
(b) provide advice on developments in gene therapy research and their implications;
(b) a dentist, (c) a nurse, (d) a pharmacist, (e) a person registered in a register of ophthalmic opticians maintained under section 7 of the Opticians Act 1989[16], (f) a person registered in a register established and maintained under article 5 of Health Professions Order 2001[17], (g) a registered osteopath as defined by section 41 of the Osteopaths Act 1993[18], or (h) a registered chiropractor as defined by section 43 of the Chiropractors Act 1994[19];
(b) a Special Health Authority, Primary Care Trust or Local Health Board established under the National Health Service Act 1977, (c) a Special Health Board established under the National Health Service (Scotland) Act 1978, (d) a special health and social services agency established under the Health and Personal Social Services (Special Agencies) (Northern Ireland) Order 1990[20], (e) the Dental Practice Board constituted under section 37(1) of the National Health Service Act 1977, (f) the Scottish Dental Practice Board or the Common Services Agency for the Scottish Health Service established under the National Health Service (Scotland) Act 1978, (g) the Northern Ireland Central Services Agency for the Health and Social Services established under the Health and Personal Social Services (Northern Ireland) Order 1972, (h) a National Health Service trust established under the National Health Service and Community Care Act 1990[21] or the National Health Service (Scotland) Act 1978, (i) an NHS foundation trust within the meaning of section 1(1) of the Health and Social Care (Community Health and Standards) Act 2003[22], or (j) a Health and Social Services trust established under the Health and Personal Social Services (Northern Ireland) Order 1991[23];
(ii) section 85B of the National Health Service (Scotland) Act 1978 (schemes for meeting losses and liabilities etc. of certain health service bodies in Scotland)[25], or (iii) Article 24 of the Health and Personal Social Services (Northern Ireland) Order 1991 (schemes for meeting losses and liabilities etc. of certain health service bodies in Northern Ireland)[26], or
(b) in accordance with guidance issued by -
(ii) the Scottish Ministers, (iii) the National Assembly for Wales, or (iv) the Department for Health, Social Services and Public Safety,
as to the arrangements to be adopted by health service bodies for meeting the costs arising from clinical negligence (known as NHS Indemnity);
(b) used for an indication not included in the summary of product characteristics under the authorization for that product, or (c) used to gain further information about the form of that product as authorised under the authorization;
(b) a marketing authorization issued by the competent authority of an EEA State, other than the United Kingdom, in accordance with Directive 2001/83/EC, (c) a marketing authorization granted by the European Commission under Council Regulation (EEC) 2309/93[28], or (d) a product licence granted by the licensing authority for the purposes of section 7 of the Medicines Act 1968[29];
(b) any product which is not a medicinal product within the meaning given by Article 1 of Directive 2001/83/EC, but which is a medicinal product within the meaning given by section 130 of the Act;
(b) the assignment of any patient involved in the study to a particular therapeutic strategy is not decided in advance by a protocol but falls within current practice, (c) the decision to prescribe a particular medicinal product is clearly separated from the decision to include the patient in the study, (d) no diagnostic or monitoring procedures are applied to the patients included in the study, other than those which are ordinarily applied in the course of the particular therapeutic strategy in question, and (e) epidemiological methods are to be used for the analysis of the data arising from the study;
(b) in relation to Northern Ireland, a person registered in the register of pharmaceutical chemists for Northern Ireland made out and maintained under Articles 6 and 9 of the Pharmacy (Northern Ireland) Order 1976;
(b) a person who, without satisfying the requirements referred to in paragraph (a) -
(ii) has, in accordance with paragraph 6(1) of Schedule 6, been named as a qualified person in a valid application for a manufacturing authorisation made prior to 1st May 2006, and (iii) is -
(bb) the holder of a diploma, certificate or other evidence of formal qualifications awarded on completion of a university or other higher education course of study in pharmacy, chemistry, medicine, biology or a related life science, which the licensing authority have stated in a notice in writing to that person to be qualifications sufficient for the purpose of performing the functions of a qualified person;
(b) in a case where an ethics committee has given an unfavourable opinion in relation to that trial but a favourable opinion has been given by an appeal panel in accordance with paragraph 4(4) of Schedule 4, that committee, or (c) in any other case, the ethics committee which has given a favourable opinion in relation to that trial in accordance with regulation 15;
(b) is life-threatening, (c) requires hospitalisation or prolongation of existing hospitalisation, (d) results in persistent or significant disability or incapacity, or (e) consists of a congenital anomaly or birth defect;
(b) without receiving any treatment or product, as a control;
(b) in the case of any other investigational medicinal product, in the investigator's brochure relating to the trial in question.
(2) Any reference in these Regulations to the holder of a manufacturing authorisation shall be construed as a reference to the holder of such an authorisation which is for the time being in force.
(b) allocate responsibility for carrying out the functions of the sponsor of that trial in accordance with paragraphs (4) to (10).
(3) If two or more persons take joint responsibility in accordance with paragraph (2)(a) -
(b) paragraphs (4) to (10) shall not apply.
(4) One of the persons referred to in paragraph (2) shall be responsible for carrying out the functions of a sponsor under Part 3 (authorisation for clinical trials and ethics committee opinion) and shall make the request for authorisation to conduct the trial in accordance with regulation 17.
(b) who is to be responsible for carrying out the functions of the sponsor under Part 4 (good clinical practice and the conduct of clinical trials); and (c) who is to be responsible for carrying out the functions of the sponsor under Part 5 (pharmacovigilance).
(6) After the clinical trial has been authorised by the licensing authority in accordance with regulation 18, 19 or 20, a different person may be specified as responsible for carrying out the functions of the sponsor under Part 3, 4 or 5 by making a substantial amendment to the terms of a clinical trial authorisation in accordance with regulations 24 to 26.
(b) Parts 2 to 4 of Schedule 3, (c) Schedule 5, in so far as it relates to decisions of the licensing authority under Part 3, and (d) Schedule 12,
shall, in relation to the trial, be construed as a reference to that person.
(b) Schedule 5, in so far as it relates to notices under regulation 31(1),
shall, in relation to the trial, be construed as a reference to that person.
(b) Parts 2 and 6 to 9, and (c) Schedules 1 and 7, and Part 1 of Schedule 3,
shall, in relation to the trial, include a reference to a person specified in accordance with paragraph (5) or (6).
(b) have a legal representative who is so established.
Responsibility for functions under the Directive United Kingdom Ethics Committees Authority 5. - (1) The body responsible for establishing, recognising and monitoring ethics committees in the United Kingdom in accordance with these Regulations is the United Kingdom Ethics Committees Authority, which is a body consisting of -
(b) the National Assembly for Wales; (c) the Scottish Ministers; and (d) the Department for Health, Social Services and Public Safety for Northern Ireland.
(2) The functions of the Authority -
(b) may be performed by any one of the Secretary of State for Health, the National Assembly for Wales, the Scottish Ministers and the Department for Health, Social Services and Public Safety for Northern Ireland acting alone solely in relation to a part of the United Kingdom with respect to which the Secretary of State, the Assembly, the Ministers or the Department, as the case may be, have responsibilities.
(3) In accordance with the preceding provisions of this regulation, in these Regulations "the United Kingdom Ethics Committees Authority" ("the Authority") means any one or more of the Secretary of State for Health, the National Assembly for Wales, the Scottish Ministers and the Department for Health, Social Services and Public Safety for Northern Ireland, and, in the case of anything falling to be done by the Authority, means any one or more of them acting as mentioned in paragraph (2).
(b) the provision of staff, premises or administrative services by the relevant authority to the Authority.
(6) Any arrangements under paragraph (5) for the exercise of any functions of the Authority shall not affect the responsibility of the Authority.
(b) in relation to such descriptions or classes of clinical trials,
as the Authority consider appropriate.
(b) abolish any such committee.
Recognition of ethics committees
(b) they are satisfied that the proposed arrangements for the membership and operation of that ethics committee would -
(ii) comply with the provisions of Schedule 2.
(2) An application for recognition of an ethics committee shall be -
(b) accompanied by such information, documents and particulars as are necessary to enable the Authority to determine the application.
(3) If any committee -
(ii) the Scottish Ministers, (iii) the National Assembly for Wales, (iv) the Department of Health, Social Services and Public Safety, or (v) a Strategic Health Authority, Health Board or Health and Social Services Board,
for the purpose of advising on the ethics of research investigations on human beings, and
the Authority may recognise that committee in accordance with paragraph (1) without an application for recognition being submitted.
(b) the description or class of clinical trial in relation to which it may act as an ethics committee; and (c) any other conditions or limitations that apply to that committee.
(5) The Authority may -
(b) vary the description or class of clinical trial in relation to which it may act as an ethics committee, or (c) vary or revoke any conditions or limitations imposed under paragraph (5),
where it considers it necessary or appropriate to do so.
(b) the committee is failing to perform its functions under these Regulations adequately or at all; or (c) it is otherwise necessary or expedient to do so.
Constitution and operation of ethics committees Interpretation of Part 3 11. In this Part -
(b) the protocol for that trial, or (c) the other particulars or documents accompanying that request for authorisation or application for ethics committee approval;
(b) the scientific value of the trial, (c) the conduct or management of the trial, or (d) the quality or safety of any investigational medicinal product used in the trial;
Requirement for authorisation and ethics committee opinion
(b) conduct a clinical trial,
unless the conditions specified in paragraph (3) are satisfied.
(b) issue an advertisement for the purpose of recruiting individuals to be subjects in a trial,
unless the condition specified in paragraph (3)(a) has been satisfied.
(b) the clinical trial has been authorised by the licensing authority.
(4) For the purposes of these Regulations, a clinical trial has been authorised by the licensing authority if -
(ii) the authority has accepted the request for authorisation in accordance with the procedure specified in Schedule 5; or
(b) in the case of a clinical trial to which regulation 19 or 20 applies -
(ii) the authority has accepted the request for authorisation in accordance with the procedure specified in Schedule 5.
Supply of investigational medicinal products for the purpose of clinical trials
(b) a health care professional who is a member of an investigator's team, (c) a person who provides or is to provide health care under the direction or control of a person referred to in sub-paragraphs (a) and (b), or (d) a subject,
for the purpose of administering that product in a clinical trial, unless the conditions specified in paragraph (2) are satisfied.
(b) in the case of an investigational medicinal product manufactured or assembled in an EEA State, other than in accordance with the terms of a marketing authorization relating to that product, or imported into an EEA State -
(bb) an authorisation referred to in Article 13 of the Directive granted by a competent authority of an EEA State other than the United Kingdom, and
(ii) the production batch of investigational medicinal products of which the product is a part has been checked and certified by a qualified person pursuant to Article 13(3) and (4) of the Directive.
(3) If an investigational medicinal product has been manufactured or imported prior to 1st May 2004 -
(b) the conditions specified in paragraph (2)(b)(ii) shall not apply.
(4) The restriction in paragraph (1) shall not apply to the sale or supply of a medicinal product in accordance with the terms of a marketing authorisation relating to that product, other than a marketing authorisation issued by the competent authority of an EEA State other than the United Kingdom.
(ii) in relation to an area of the United Kingdom in which the chief investigator is professionally based; and
(b) in relation to a description or class of clinical trial into which the proposed trial falls.
(4) If a clinical trial -
(b) involves adults unable by virtue of physical or mental incapacity to give informed consent; and (c) the chief investigator is professionally based at a hospital, health centre, surgery or other establishment or facility in Scotland,
the application for an ethics committee opinion in relation to that trial shall be made to the Ethics Committee constituted by regulations made by the Scottish Ministers under section 51(6) of the Adults with Incapacity (Scotland) Act 2000[31].
(b) signed by the chief investigator making the application; and (c) accompanied by the particulars and documents specified in Part 1 of Schedule 3.
(7) The application and any accompanying material shall be supplied in the English language.
(b) whether the evaluation of the anticipated benefits and risks as required under paragraph 2 of Part 2 of Schedule 1 is satisfactory and whether the conclusions are justified; (c) the protocol; (d) the suitability of the investigator and supporting staff; (e) the investigator's brochure; (f) the quality of the facilities for the trial; (g) the adequacy and completeness of the written information to be given, and the procedure to be followed, for the purpose of obtaining informed consent to the subjects' participation in the trial; (h) if the subjects are to include persons incapable of giving informed consent, whether the research is justified having regard to the conditions and principles specified in Part 5 of Schedule 1; (i) provision for indemnity or compensation in the event of injury or death attributable to the clinical trial; (j) any insurance or indemnity to cover the liability of the investigator or sponsor; (k) the amounts, and, where appropriate, the arrangements, for rewarding or compensating investigators and subjects; (l) the terms of any agreement between the sponsor and the owner or occupier of the trial site which are relevant to the arrangements referred to in sub-paragraph (k); and (m) the arrangements for the recruitment of subjects.
(6) If -
(b) the committee does not have a member with professional expertise in paediatric care,
it shall, before giving its opinion, obtain advice on the clinical, ethical and psychosocial problems in the field of paediatric care which may arise in relation to that trial.
(b) the committee does not have a member with professional expertise in the treatment of -
(ii) the patient population suffering that disease,
it shall, before giving its opinion, obtain advice on the clinical, ethical and psychosocial problems in the field of that disease and patient population which may arise in relation to that trial.
(8) The ethics committee shall consider, and give an opinion on, any other issue relating to the clinical trial, if -
(b) it is, in the committee's opinion, relevant to the other matters considered by the committee in accordance with this regulation.
(9) Where an ethics committee gives an opinion in accordance with this regulation, it shall publish a summary of that opinion.
(ii) where there is no such consultation, 90 days; or
(b) in any other case, 60 days;
(b) in the case of medicinal products containing genetically modified organisms, the administration of such products to humans.
Review and appeal relating to ethics committee opinion
(b) an ethics committee pursuant to paragraph 2 of Schedule 4.
(3) Where the opinion was given by an ethics committee other than the Gene Therapy Advisory Committee, the chief investigator may within 90 days of being notified that the committee's opinion is not favourable, give a notice to the United Kingdom Ethics Committees Authority -
(b) setting out his representations with respect to that opinion.
(4) Where the opinion was given by the Gene Therapy Advisory Committee, the chief investigator may, within 14 days of being notified of that opinion -
(b) give a notice in writing to the United Kingdom Ethics Committee Authority -
(ii) setting out his representations with respect to that opinion.
(5) Where the Gene Therapy Advisory Committee is required by a notice under paragraph (4) to review its opinion, it must do so within 60 days of receipt of the notice.
(b) setting out his representations with respect to that opinion
(8) Schedule 4 shall have effect to regulate the procedure where the Authority receives a notice in accordance with paragraph (3), (4) or (7).
(b) be accompanied by -
(ii) any fee which may be payable in connection with that application under the Medicines (Products for Human Use - Fees) Regulations 1995[32].
(3) The request and any accompanying material shall be supplied in the English language.
(b) stating that the licensing authority accepts the request for authorisation; or (c) stating that the licensing authority accepts the request for authorisation, subject to the conditions specified in the notice.
(3) Subject to paragraph (4), if -
(b) no notice is given in accordance with paragraph (2),
the clinical trial is to be treated as authorised.
(b) stating that the licensing authority accepts the amended request; or (c) stating that the licensing authority accepts the amended request, subject to the conditions specified in the notice.
(7) Subject to paragraph (8), if a valid amended request has been received and -
(b) no notice is given in accordance with paragraph (6),
the clinical trial is to be treated as authorised.
(b) the sponsor has submitted an amended request in accordance with paragraph (5), but the licensing authority gives written notice to the sponsor of grounds for non-acceptance in accordance with paragraph (6)(a),
the request is to be treated as rejected and the authority shall not consider any further amendments to the request.
(b) medicinal products containing genetically modified organisms.
(2) Subject to the following provisions of this regulation, the licensing authority may, within the period of 30 days from the date of receipt of a valid request for authorisation of a clinical trial to which this regulation applies -
(b) give a notice in writing to the sponsor setting out the grounds for not accepting the request.
(3) The licensing authority shall not authorise a clinical trial involving products for gene therapy if the use of those products in that trial would result in modifications to any subject's germ line genetic identity.
(b) give a notice in writing to the sponsor setting out the grounds for not accepting the request.
(8) A written authorisation issued under this regulation may contain such conditions as the licensing authority consider appropriate.
(b) such other body or committee as the licensing authority may consider appropriate in relation to the application under consideration.
Authorisation procedure for clinical trials involving medicinal products with special characteristics
(ii) which have an active ingredient -
(bb) containing biological components of human or animal origin, or (cc) the manufacturing of which requires such components,
other than products falling within regulation 19; or
(b) where the licensing authority, within 7 days from the date of receipt of a valid request for authorisation of the trial, issues a notice to the sponsor specifying that by virtue of the special characteristics of the medicinal product to which the trial relates, written authorisation for that trial is required.
(2) The licensing authority may, within the period of 30 days from the date of receipt of a valid request for authorisation of a clinical trial to which this regulation applies -
(b) give a notice in writing to the sponsor setting out the grounds for not authorising the trial.
(3) Where a sponsor is given a notice in accordance with paragraph (2)(b), he may, within the period of 14 days, or such extended period as the licensing authority may in any particular case allow, from the date on which the notice was received, send an amended request to the licensing authority for further consideration.
(b) give a notice in writing to the sponsor setting out the grounds for not accepting the request.
(5) A written authorisation issued under this regulation may contain such conditions as the licensing authority consider appropriate.
(b) an undertaking, given by the owner or occupier of any premises in that country at which the clinical trial is or is to be conducted, to permit those premises to be inspected by or on behalf of the licensing authority for the purpose of establishing whether the conditions and principles of good clinical practice are satisfied or adhered to in relation to that trial.
(2) If a sponsor fails to produce an undertaking required by the licensing authority in accordance with paragraph (1), that failure constitutes a ground for not accepting the request for authorisation, for the purposes of regulations 18 to 20.
(b) by the sponsor, in accordance with regulation 24 or 25.
Amendments by the licensing authority
(b) that the conditions and principles of good clinical practice are satisfied or adhered to in relation to the clinical trial.
(2) Where the licensing authority propose to make an amendment in accordance with paragraph (1), the authority shall, at least 14 days before the date on which it is proposed the amendment should take effect, serve a notice on the sponsor stating their proposal and the reasons for it.
(b) may delay the date the proposed amendment is to take effect, in order to allow time for them to consider those representations.
Amendments by the sponsor
(b) send those records, or copies of such records, to the licensing authority, where the authority send him a notice in writing requiring him to provide those records, or copies of such records.
(3) If the sponsor proposes to make a substantial amendment to a clinical trial authorisation which consists of, or includes, an amendment to -
(b) the particulars or documents that accompanied that request,
he shall send a valid notice of amendment to the licensing authority, whether or not he is also required to send a notice in accordance with paragraph (4).
(b) the particulars or documents that accompanied that application,
he shall send a valid notice of amendment to the relevant ethics committee, whether or not he is also required to send a notice in accordance with paragraph (3).
(b) stating that the licensing authority accepts the application for amendment, subject to any conditions which may be specified in the notice.
(6) A relevant ethics committee shall, within the period of 35 days from the date of receipt of a valid notice of amendment, give an opinion to the sponsor.
(b) no notice has been given by the licensing authority in accordance with paragraph (5).
(8) If the sponsor has been given a notice in accordance with paragraph (5)(b), he may make the amendment subject to the conditions, if any, specified in the notice.
(b) accompanied by -
(ii) any fee which may be payable in connection with that notice under the Medicines (Products for Human Use - Fees) Regulations 1995[35].
Modifying or adapting rejected proposals for amendment
(b) the sponsor has been notified by the licensing authority of any grounds for non-acceptance of a proposed amendment to the protocol,
and it is possible to modify or adapt the proposed amendment in order to meet the concerns of ethics committee or the licensing authority as set out in the opinion or, as the case may be, the grounds for non-acceptance, the sponsor may amend the protocol accordingly.
(b) if he receives no such notice, he may make the modified or adapted amendment.
Reference to the appropriate committee or the Medicines Commission
(ii) in accordance with regulation 18(2) or (6), 19(8) or 20(5), the trial is authorised subject to specified conditions;
(b) the licensing authority has amended a clinical trial authorisation under regulation 23; or
(ii) the authority accepts such an amendment subject to conditions,
the sponsor may, within 28 days, or such extended period as the licensing authority may in any particular case allow, of the notice being given, give notice in writing to the licensing authority of his wish to make written or oral representations to the appropriate committee or, if for the time being there is no such committee, the Medicines Commission[36].
(2) Schedule 5 shall have effect to regulate the procedure for reference to the appropriate committee, or as the case may be, the Medicines Commission following receipt of a notice in accordance with paragraph (1).
(b) before the event specified in the protocol as the event which indicates the end of the trial has occurred,
the sponsor shall notify the licensing authority and the relevant ethics committee in writing of the termination of the trial within 15 days of the date of termination. Good clinical practice and protection of clinical trial subjects 28. - (1) No person shall -
(b) perform the functions of the sponsor of a clinical trial (whether that person is the sponsor or is acting under arrangements made with that sponsor),
otherwise than in accordance with the conditions and principles of good clinical practice.
(b) any devices used for the administration of such products,
are made available to the subjects of the trial free of charge.
(b) the National Health Service (Scotland) Act 1978[38]; or (c) the Health and Personal Social Services (Northern Ireland) Order 1972[39],
in respect of any medicinal products or devices provided in pursuance of those Acts or that Order.
(b) the request for authorisation to conduct that trial specifies that in relation to one or more trial sites the duties of the sponsor under paragraphs (2) and (3) are to be performed by a person other than the sponsor,
those duties shall, in relation to that site or those sites, be performed by the person so specified.
(b) the terms of -
(ii) the application for an ethics committee opinion in relation to that trial, and (iii) any particulars or documents, other than the protocol, accompanying that request or that application,
as may be amended from time to time in accordance with regulations 22 to 25; and
Urgent safety measures
(ii) any condition imposed by the licensing authority under regulation 18(2) or (6), 19(8), 20(5), 24(4) or Schedule 5,
is no longer satisfied (either generally or at a particular trial site); or
the licensing authority may, by a notice served in accordance with paragraph (2), require that the trial, or the conduct of the trial at a particular trial site, be suspended or terminated.
(ii) the investigator at each trial site;
(b) in a case where the suspension or termination applies to the conduct of a trial at a particular trial site, on -
(ii) the investigator at that trial site.
(3) The notice shall specify -
(b) whether the notice requires suspension or termination of the trial; (c) if the notice requires suspension of the trial -
(ii) any conditions which are to be satisfied before the trial or, as the case may be, the conduct of the trial at a particular site, may be recommenced; and
(d) whether suspension or termination is to take effect immediately on receipt of the notice or on such date as may be specified in the notice.
(4) If the licensing authority issues a notice under paragraph (1), they shall forthwith inform -
(b) competent authorities of each EEA State, other than the United Kingdom; (c) the relevant ethics committee; (d) the European Medicines Agency; and (e) the European Commission.
(5) Subject to paragraph (6), at least one week before issuing a notice under paragraph (1) the licensing authority shall, by a notice in writing to the sponsor or the investigator -
(b) advise him that they may, within one week of the date of the notice, furnish the authority with written representations as to whether the trial, or the conduct of the trial at a particular site, should be so suspended or terminated.
(6) Paragraph (5) shall not apply where it appears to the licensing authority that there is an imminent risk to the health or safety of any of the subjects of the clinical trial. Notification of adverse events 32. - (1) An investigator shall report any serious adverse event which occurs in a subject at a trial site at which he is responsible for the conduct of a clinical trial immediately to the sponsor. (2) An immediate report under paragraph (1) may be made orally or in writing. (3) Following the immediate report of a serious adverse event, the investigator shall make a detailed written report on the event. (4) Paragraphs (1) to (3) do not apply to serious adverse events specified in the protocol or the investigator's brochure as not requiring immediate reporting. (5) Adverse events, other than those to which paragraphs (1) to (3) apply, that are identified in the protocol as critical to evaluations of the safety of the trial shall be reported to the sponsor in accordance with the reporting requirements, including the time periods for such reporting, specified in that protocol. (6) The reports made under paragraphs (1), (3) and (5) shall identify each subject referred to in the report by a number assigned to that subject in accordance with the protocol for the trial. (7) The number assigned to a subject in accordance with the protocol must be different from the number of any other subject in that trial, including any subject at a trial site outside the United Kingdom. (8) Where the event reported under paragraph (1) or (5) consists of, or results in, the death of a subject, the investigator shall supply -
(b) in any case where the death has been reported to the relevant ethics committee, that committee,
with any additional information requested by the sponsor or, as the case may be, the committee.
(b) reported as soon as possible to -
(ii) the competent authorities of any EEA State, other than the United Kingdom, in which the trial is being conducted, and (iii) the relevant ethics committee,
and in any event not later that 7 days after the sponsor was first aware of the reaction.
(2) A sponsor shall ensure that within 8 days of a report in accordance with paragraph (1)(b), any additional relevant information is sent to the persons or bodies listed in that paragraph.
(b) the competent authorities of any EEA State, other than the United Kingdom, in which the trial is being conducted; and (c) the relevant ethics committee,
and in any event not later that 15 days after the sponsor is first aware of the reaction.
(b) ensure that the details of those reactions are entered in the European database established in accordance with Article 11 of the Directive, whether by the sponsor or the authority.
Clinical trials conducted in third countries
(ii) any other trials relating to that product which are conducted outside the United Kingdom and for which he is the sponsor,
including those reactions relating to any investigational medicinal product used as a placebo or as a reference in those trials; and
(2) In paragraph (1), "reporting year", in relation to an investigational medicinal product, means the year ending on the anniversary of -
(b) in any other case, the earliest date on which any clinical trial -
(ii) for which the person responsible for making the report was the sponsor,
was authorised in an EEA State.
(3) For the purposes of paragraph (2)(b), the date on which a clinical trial was authorised in an EEA State is -
(b) in the case of any other EEA State, the date on which the trial was authorised by the competent authority of that EEA State in accordance with the Directive.
Requirement for authorisation to manufacture or import investigational medicinal products 36. - (1) Subject to paragraph (2) and regulation 37, no person shall manufacture, assemble or import any investigational medicinal product except in accordance with an authorisation granted by the licensing authority for the purposes of this regulation ("a manufacturing authorisation"). (2) The restriction in paragraph (1) shall not apply to the manufacture or assembly of a medicinal product to the extent that such manufacture or assembly is in accordance with the terms and conditions of a marketing authorization relating to that product. Exemption for hospitals and health centres 37. - (1) The restriction imposed by regulation 36(1) shall not apply to the assembly of an investigational medicinal product where the conditions specified in paragraph (2) are satisfied. (2) The conditions referred to in paragraph (1) are that -
(ii) by a doctor, a pharmacist or a person acting under the supervision of a pharmacist; and
(b) the investigational medicinal products are assembled exclusively for use in -
(ii) any other hospital or health centre which is a trial site for the clinical trial in which the product is to be used.
Application for manufacturing authorisation
(b) in writing; and (c) signed by or on behalf of the applicant.
(2) Every application for the grant of a manufacturing authorisation shall specify which, if any, of the standard provisions referred to in regulation 40(4) it is desired shall be excluded or modified in relation to the grant of the authorisation.
(b) any fee which may be payable in connection with that application under the Medicines (Products for Human Use - Fees) Regulations 1995[41].
(4) The application and any accompanying material shall be supplied to the licensing authority in the English language.
(b) the qualified person referred to in regulation 43.
(3) Where the licensing authority give a notice pursuant to paragraph (2), the period specified in paragraph (1) shall be suspended from the date the notice is given and shall recommence only on receipt of the information requested.
(b) the operations carried on or to be carried on in the course of manufacturing them,
to be inspected by or on behalf of the licensing authority.
(ii) has at his disposal suitable and sufficient premises, technical equipment and control facilities complying with the requirements of Commission Directive 2003/94/EC, as regards the manufacture or import, and control, of the products to which the authorisation relates and the storage of such products, (iii) has at his disposal the services of at least one qualified person, and (iv) if a notice has been given under regulation 39(2), has provided the information requested by the licensing authority; and
(b) they have established that the particulars supplied pursuant to regulation 38(3) are accurate.
(2) Subject to paragraph (1), the licensing authority may grant a manufacturing authorisation in respect of any or all of -
(b) the manufacturing, assembling or importation operations; or (c) the premises,
specified in the application made pursuant to regulation 38.
(b) such other provisions as the licensing authority consider appropriate.
(4) The provisions specified -
(b) in the case of a manufacturing authorisation relating to the importation of investigational medicinal products, in Part 3 of Schedule 7,
may be incorporated by the licensing authority in any manufacturing authorisation, with or without modifications and either generally or in relation to investigational medicinal products of any particular class.
(b) to grant a manufacturing authorisation otherwise than in accordance with the application.
(6) Where the licensing authority -
(b) grant a manufacturing authorisation otherwise than in accordance with the application,
and the applicant requests the authority to state their reasons, the licensing authority shall give the applicant a notice in writing stating the reasons for their decision.
(b) the manufacturing, assembling or importation operations; and (c) the premises,
specified in the application made pursuant to regulation 38 and in respect of which the authorisation is granted.
(b) the provisions referred to in regulation 40(3).
Qualified persons
(ii) the Pharmaceutical Society, (iii) the Royal Society of Chemistry, or (iv) such other body as may appear to the licensing authority to be an appropriate body for the purpose of this paragraph; and
(b) he is regarded by the body of which he is a member as so satisfying those provisions.
(6) Where, after giving the holder of the authorisation and the person acting as a qualified person the opportunity of making representations to them (orally or in writing), the licensing authority are of the opinion that -
(ii) the requirements as to qualifications and experience specified in paragraph (b) of the definition of "qualified person" in regulation 2(1); or
(b) he is failing to carry out the duties referred to in paragraph (2) adequately or at all,
and have notified the holder of the authorisation accordingly in writing, the holder of the authorisation shall not permit that person to act as a qualified person.
(ii) the manufacturing, assembling or importation operations, (iii) the premises, (iv) the technical equipment and control facilities,
in respect of which the authorisation has been granted, may vary or refuse to vary the authorisation within a period not exceeding 30 days from the date the application is received;
(3) If the application falls within paragraph (2)(a), but it appears to the licensing authority to be necessary to conduct an inspection of any premises to which the variation relates, the authority may vary or refuse to vary the authorisation within a period not exceeding 90 days from the date the application is received.
(b) after consideration of such an application, refuse to vary a manufacturing authorisation,
the licensing authority shall notify the holder of that authorisation in writing, stating the reasons for their decision.
(b) in writing and signed by or on behalf of the applicant; (c) specifying the variation requested by the applicant; (d) accompanied by -
(ii) any fee which may be payable in connection with that application under the Medicines (Products for Human Use - Fees) Regulations 1995[43]; and
(e) where the application, and any accompanying material, is in the English language.
Suspension and revocation of manufacturing authorisation
(b) the particulars accompanying the application in accordance with regulation 38(3), were false or incomplete in a material particular; (c) a material change of circumstances has occurred in relation to any of those matters or particulars; (d) the holder of the authorisation has failed to any material extent to comply with his obligations under regulation 42 or 43(1); (e) the holder has manufactured, assembled or, as the case may be, imported investigational medicinal products otherwise than in accordance with the terms of the authorisation; (f) the holder has manufactured or assembled investigational medicinal products otherwise than in accordance with -
(ii) in the case of products manufactured for the purpose of export, the specification for the product provided by the person to whose order the products are manufactured, or (iii) in any other case, the specification for the product contained in the investigational medicinal product dossier for that product;
(g) the qualified person has failed to carry out the duties referred to in regulation 43(2), adequately or at all; and
(ii) the importation operations to which the authorisation relates,
including any handling, storage or distribution activities relating to those operations.
(2) The suspension or revocation of an authorisation under this regulation may be -
(b) limited to investigational medicinal products -
(ii) manufactured, assembled or stored on any particular premises or in a particular part of any premises.
(3) The provisions of Schedule 8 shall have effect where the licensing authority propose to suspend or revoke a manufacturing authorisation in accordance with this regulation. Labelling 46. - (1) An investigational medicinal product shall be labelled in accordance with Article 15 of Commission Directive 2003/94/EC[44]. (2) Paragraph (1) shall not apply where the investigational medicinal product is -
(b) dispensed to a subject in accordance with a prescription given by an authorised health care professional; and (c) labelled in accordance with the requirements of Schedule 5 to the Medicines for Human Use (Marketing Authorisations Etc.) Regulations 1994[45] that apply in relation to dispensed relevant medicinal products.
Application of enforcement provisions of the Act 47. - (1) Sections 107 to 116, 118, 119, 121 to 125, 127, 129, 131 and 132(1) of, and Schedule 3 to, the Act shall apply for the purposes of these Regulations, but with the modifications specified in Schedule 9. (2) In those provisions as applying by virtue of paragraph (1), a reference to any part of those provisions or a part of any of them is a reference to the provision or part as so applying. Infringement notices 48. - (1) If an enforcement authority have objective grounds for considering that any person has contravened any provision to which this regulation applies, they may serve upon that person a notice in writing (in these Regulations referred to as an "infringement notice") -
(b) specifying the relevant provision of these Regulations; (c) specifying the measures which the person must take in order to ensure that the contravention does not continue or, as the case may be, does not recur; (d) requiring the person to take those measures, within such period as may be specified in the notice; (e) warning the person that unless the requirements of sub-paragraph (d) are met, further action may be taken in respect of the contravention.
(2) An infringement notice may include directions as to the measures to be taken by the person on whom the notice is served to ensure that the contravention does not continue or, as the case may be, does not recur, including the different ways of securing compliance.
(b) the relevant ethics committee; and (c) the European Commission.
(4) This regulation applies to regulations 22(b), 27, 28(1) to (3), 29, 30(2) and 32 to 35.
(b) regulation 13(1); (c) regulation 27; (d) regulation 28(1) to (3); (e) regulation 29; (f) regulation 30(2); (g) regulation 32(1), (3), and (5) to (9) (h) regulation 33(1) to (5) (i) regulation 34 (j) regulation 35(1); (k) regulation 36(1); (l) regulation 42; and (m) regulation 43(1) and (6),
shall be guilty of an offence.
(b) to a person for the purpose of administering the product to such a subject,
the labelling of which does not comply with regulation 46, shall be guilty of an offence.
(b) to a person for the purpose of administering the product to such a subject,
the labelling of which does not comply with regulation 46, knowing, or having reasonable cause to believe, that the labelling does not so comply, shall be guilty of an offence.
(b) making a request for authorisation to conduct a clinical trial; or (c) making an application for the grant or variation of a manufacturing authorisation,
provides to the licensing authority or an ethics committee any relevant information which is false or misleading in a material particular shall be guilty of an offence.
(b) is a sponsor of such a clinical trial; (c) while acting under arrangements made with a sponsor of such a clinical trial, performs the functions of that sponsor; or (d) holds a manufacturing authorisation,
and who, for the purposes of these Regulations, provides to the licensing authority or an ethics committee any relevant information which is false or misleading in a material particular shall be guilty of an offence.
(b) the safety or scientific validity of a clinical trial; or (c) whether, with regard to a clinical trial, the conditions and principles of good clinical practice are being satisfied or adhered to.
Defence of due diligence
(b) on conviction on indictment to a fine or to imprisonment for a term not exceeding two years or to both.
Construction of references to specified publications 53. - (1) Where any authorisation granted under these Regulations refers to a specified publication, but not to any particular edition of that publication, then, for the purpose of determining whether anything done, at a time when the authorisation is in force, is done in accordance with the authorisation, the reference shall, unless the authorisation otherwise expressly provides, be construed as a reference to the current edition of that publication as in force at that time. (2) In this regulation any reference to the current edition of a specified publication as in force at a particular time is a reference to the edition of that publication in force, under whatever title, at that time together with any amendments, additions and deletions made to it up to that time. (3) In this regulation, "specified publication" has the meaning given by section 103(1) of the Act[46]. Consequential and other amendments to enactments 54. The provisions of the enactments specified in Schedule 10 are amended as there specified. Revocations 55. The enactments specified in column (1) of Schedule 11 are revoked to the extent specified in column (3) of that Schedule. Transitional provisions 56. The transitional provisions set out in Schedule 12 shall have effect. Signed by authority of the Secretary of State for Health Warner Parliamentary Under Secretary of State, Department of Health 31st March 2004 1. - (1) The conditions and principles specified in Part 2 apply to all clinical trials. (2) If any subject of a clinical trial is -
(b) an adult who has given informed consent to taking part in the clinical trial prior to the onset of incapacity,
the conditions and principles specified in Part 3 apply in relation to that subject.
(b) did not, prior to the onset of incapacity, give or refuse to give informed consent to taking part in the clinical trial,
the conditions and principles specified in Part 5 apply in relation to that subject.
(b) has, prior to the onset of incapacity, refused to give informed consent to taking part in the clinical trial,
that person cannot be included as a subject in the clinical trial.
(bb) is available and willing to so act for those purposes, or
(ii) if there is no such person, a person, other than a person connected with the conduct of the clinical trial, who is -
(bb) a person nominated by the relevant health care provider; and
(b) in relation to adults in Scotland -
(ii) if there is no such guardian or welfare attorney, the adult's nearest relative, or (iii) if it is not reasonably practicable to contact a guardian or welfare attorney or the adult's nearest relative before the decision to enter the adult as a subject of the clinical trial is made, a person, other than a person connected with the conduct of the clinical trial, who is -
(bb) a person nominated by the relevant health care provider;
(b) in relation to Scotland, has the same meaning as in the Children (Scotland) Act 1985[49], and (c) in relation to Northern Ireland, has the same meaning as in the Children (Northern Ireland) Order 1995[50];
(b) a person employed or engaged by, or acting under arrangements made with, the sponsor and who undertakes activities in connection with the management of the trial, (c) an investigator for the trial, (d) a health care professional who is a member of an investigator's team for the purposes of the trial, or (e) a person who provides health care under the direction or control of a person referred to in paragraphs (c) and (d) above, whether in the course of the trial or otherwise;
(ii) in any other case, the health service body which entered the arrangements under which those services are provided, or
(b) in relation to any other person receiving health care, the person primarily responsible for providing that health care; and
3.
- (1) For the purposes of this Schedule, a person gives informed consent to take part, or that a subject is to take part, in a clinical trial only if his decision -
(b) either -
(ii) if the person is unable to sign or to mark a document so as to indicate his consent, is given orally in the presence of at least one witness and recorded in writing.
(2) For the purposes of this Schedule, references to informed consent -
(b) include references to informed consent given or refused by an adult unable by virtue of physical or mental incapacity to give informed consent, prior to the onset of that incapacity.
Principles based on International Conference on Harmonisation GCP Guideline[54] 1. Clinical trials shall be conducted in accordance with the ethical principles that have their origin in the Declaration of Helsinki, and that are consistent with good clinical practice and the requirements of these Regulations. 2. Before the trial is initiated, foreseeable risks and inconveniences have been weighed against the anticipated benefit for the individual trial subject and other present and future patients. A trial should be initiated and continued only if the anticipated benefits justify the risks. 3. The rights, safety, and well-being of the trial subjects are the most important considerations and shall prevail over interests of science and society . 4. The available non-clinical and clinical information on an investigational medicinal product shall be adequate to support the clinical trial. 5. Clinical trials shall be scientifically sound, and described in a clear, detailed protocol. 6. A trial shall be conducted in compliance with the protocol that has a favourable opinion from an ethics committee. 7. The medical care given to, and medical decisions made on behalf of, subjects shall always be the responsibility of an appropriately qualified doctor or, when appropriate, of a qualified dentist. 8. Each individual involved in conducting a trial shall be qualified by education, training, and experience to perform his or her respective task(s). 9. Subject to the other provisions of this Schedule relating to consent, freely given informed consent shall be obtained from every subject prior to clinical trial participation. 10. All clinical trial information shall be recorded, handled, and stored in a way that allows its accurate reporting, interpretation and verification. 11. The confidentiality of records that could identify subjects shall be protected, respecting the privacy and confidentiality rules in accordance with the requirements of the Data Protection Act 1998 and the law relating to confidentiality. 12. Investigational medicinal products used in the trial shall be -
(b) used in accordance with the approved protocol.
13.
Systems with procedures that assure the quality of every aspect of the trial shall be implemented. 1. The subject has had an interview with the investigator, or another member of the investigating team, in which he has been given the opportunity to understand the objectives, risks and inconveniences of the trial and the conditions under which it is to be conducted. 2. The subject has been informed of his right to withdraw from the trial at any time. 3. The subject has given his informed consent to taking part in the trial. 4. The subject may, without being subject to any resulting detriment, withdraw from the clinical trial at any time by revoking his informed consent. 5. The subject has been provided with a contact point where he may obtain further information about the trial. Conditions 1. Subject to paragraph 6, a person with parental responsibility for the minor or, if by reason of the emergency nature of the treatment provided as part of the trial no such person can be contacted prior to the proposed inclusion of the subject in the trial, a legal representative for the minor has had an interview with the investigator, or another member of the investigating team, in which he has been given the opportunity to understand the objectives, risks and inconveniences of the trial and the conditions under which it is to be conducted. 2. That person or legal representative has been provided with a contact point where he may obtain further information about the trial. 3. That person or legal representative has been informed of the right to withdraw the minor from the trial at any time. 4. That person or legal representative has given his informed consent to the minor taking part in the trial. 5. That person with parental responsibility or the legal representative may, without the minor being subject to any resulting detriment, withdraw the minor from the trial at any time by revoking his informed consent. 6. The minor has received information according to his capacity of understanding, from staff with experience with minors, regarding the trial, its risks and its benefits. 7. The explicit wish of a minor who is capable of forming an opinion and assessing the information referred to in the previous paragraph to refuse participation in, or to be withdrawn from, the clinical trial at any time is considered by the investigator. 8. No incentives or financial inducements are given -
(b) to a person with parental responsibility for that minor or, as the case may be, the minor's legal representative,
except provision for compensation in the event of injury or loss.
(b) by other research methods.
12.
The corresponding scientific guidelines of the European Medicines Agency are followed. Conditions 1. The subject's legal representative has had an interview with the investigator, or another member of the investigating team, in which he has been given the opportunity to understand the objectives, risks and inconveniences of the trial and the conditions under which it is to be conducted. 2. The legal representative has been provided with a contact point where he may obtain further information about the trial. 3. The legal representative has been informed of the right to withdraw the subject from the trial at any time. 4. The legal representative has given his informed consent to the subject taking part in the trial. 5. The legal representative may, without the subject being subject to any resulting detriment, withdraw the subject from the trial at any time by revoking his informed consent. 6. The subject has received information according to his capacity of understanding regarding the trial, its risks and its benefits. 7. The explicit wish of a subject who is capable of forming an opinion and assessing the information referred to in the previous paragraph to refuse participation in, or to be withdrawn from, the clinical trial at any time is considered by the investigator. 8. No incentives or financial inducements are given to the subject or their legal representative, except provision for compensation in the event of injury or loss. 9. There are grounds for expecting that administering the medicinal product to be tested in the trial will produce a benefit to the subject outweighing the risks or produce no risk at all. 10. The clinical trial is essential to validate data obtained -
(b) by other research methods.
11.
The clinical trial relates directly to a life-threatening or debilitating clinical condition from which the subject suffers. Interpretation 1. In this Schedule -
(b) in relation to an ethics committee recognised by the Authority after an application in accordance with regulation 7(1), the person who applied for recognition, or (c) in relation to an ethics committee recognised without an application for recognition being submitted in accordance with regulation 7(3), the Authority;
(b) has professional qualifications or experience relating to the conduct of, or use of statistics in clinical trials, unless those professional qualifications or experience relate only to the ethics of clinical research or medical treatment, or (c) is not a health care professional, but has been a registered medical practitioner or a person registered in the dentists register under the Dentists Act 1984;
Application of provisions of the Schedule
(b) lay members.
(2) An ethics committee shall have no more than 18 members.
(b) conducts clinical research.
(5) An appointing authority shall, in relation to an ethics committee, exercise their power under sub-paragraph (3) so as to ensure that -
(b) at least half of the lay members must be persons who are not, or who never have been -
(ii) persons involved in the conduct of clinical research, other than as a subject of such research, or (iii) a chairman, member or director of -
(bb) a body, other than a health service body, which provides health care.
4.
A member of an ethics committee shall hold and vacate office as a member in accordance with the terms of the instrument appointing him as a member.
(b) another member to be vice-chairman; and (c) another member to be alternate vice-chairman.
(2) The members appointed as chairman, vice-chairman and alternate vice-chairman shall each be appointed for such period, not exceeding the remainder of his term as a member, as the appointing authority may specify on appointing him.
(b) if the vice-chairman is also is unable to perform his duties, the alternate vice-chairman; or (c) if all three individuals are unavailable, a member appointed by the appointing authority for the purposes of acting as chairman until one of those individuals is available to perform his duties.
Committees, meetings and proceedings
(b) make arrangements for the exercise, on behalf of the committee, of any of its functions by such a sub-committee,
in accordance with the standing orders and operating procedures adopted under sub-paragraph (3).
(b) may, subject to approval by the Authority, vary or revoke such orders or procedures,
including provision for the suspension of the standing orders or operating procedures or any of them.
(ii) a chairman, member, director, officer or employee of a health service body; and
(b) one expert member.
Deputies and co-opted members
(b) secure that arrangements are made for such administration, maintenance, cleaning and other services as may, in their opinion, be necessary for such accommodation and facilities.
(3) To enable an ethics committee to perform its functions, a health service body may make staff, premises and facilities available to an ethics committee under arrangements made with the appointing authority.
(b) the decisions made by the committee in relation to those applications.
(2) The ethics committee shall send a copy of the report to the Authority and, if the Authority is not the appointing authority for that committee, to its appointing authority.
(b) an ethics committee is abolished or ceases operation.
(2) If the person who was the appointing authority before revocation, abolition or the ceasing of operation of the committee ("the old committee") is the Authority, that person may nominate another ethics committee as responsible for the work of the committee.
(b) that committee shall be the relevant ethics committee for any clinical trial in relation to which the old committee had given a favourable opinion in accordance with regulation 15.
1. An application document including the following information or, in each case, an explanation of why that information is not being provided -
(b) particulars identifying the trial including -
(ii) full and short titles of the trial;
(c) the following particulars relating to the trial design -
(ii) the primary, and any secondary, research hypothesis, (iii) statistical analysis and justification for the numbers of subjects to be recruited for the trial, and (iv) details of the process for peer review of the scientific value of the trial;
(d) brief details of any plans to conduct the trial outside the UK and any authorisation given in relation to the trial by a competent authority of an EEA State in accordance with Article 9 of the Directive;
(ii) the arrangements for remuneration of, or re-imbursement of expenses incurred by, subjects, (iii) any provision for compensation in the event of injury or death attributable to the trial, (iv) details of any insurance or indemnity to cover the liability of the sponsor and investigator, and (v) summary details of any financial arrangements between -
(bb) the sponsor or person funding the trial and the owner or occupier of the trial site;
(h) arrangements for the recruitment of subjects, including the materials to be used;
(ii) any aspect of normal clinical care to be withheld or other deviation from normal treatment, and (iii) the plan for treatment or care of subjects once their participation in the trial has ended;
(n) the procedures for -
(ii) providing subjects with updated information during and (where relevant) after the trial, and (iii) obtaining informed consent;
(o) details of the arrangements for access to confidential data about the subjects and the arrangements to protect subjects' privacy;
(ii) the event specified in the protocol as the event which indicates that the end of the trial has occurred;
(q) any agreement on -
(ii) the policy for publication of that data;
(r) an assessment of the ethical issues relating to the trial, including -
(ii) an assessment of the potential benefits, and (iii) an assessment of the possible risks for the subjects;
(s) details relating to the chief investigator and each investigator, including -
(ii) any potential conflicts of interest; and
(t) details of any proposed trial site and its suitability for conducting the trial.
2.
A document containing the particulars specified in paragraphs 1 to 4 and 6 to 9 of Part 2 of this Schedule.
(b) the investigator's brochure for the proposed trial or, where the investigational medicinal product has a marketing authorisation and the product is to be used in accordance with the terms of that authorisation, the summary of product characteristics relating to that product; (c) any document providing evidence of any insurance to cover the liability of the sponsor and investigator; (d) copies of the advertisement material for recruitment of research participants; (e) in the case of advertising contained on video or audio cassettes, a copy of the script for that advertising; (f) a copy of any letter inviting a subject to participate in the trial; (g) a copy of any questionnaire, diary or sample card to be completed by the subject in writing; (h) a copy of all written information to be given to a potential subject or their legal representative prior to seeking informed consent; (i) a copy of the form to be used to record the consent of a subject or their legal representative; (j) a copy of any letters or other written information to be sent to any person who normally provides a subject's clinical care; (k) a summary curriculum vitae for the chief investigator and each investigator.
1. The name and address of -
(b) if the sponsor is not established in the European Community, his legal representative, (c) if any person has been authorised by the sponsor to make the request on his behalf, that person, (d) if the persons taking responsibility for the initiation, management and financing (or arranging the financing) of the clinical trial have allocated responsibility in accordance with regulation 3(4), any person responsible for carrying out the functions of the sponsor under Part 4 or 5 of these Regulations, and (e) any other person to whom the sponsor has delegated any of his responsibilities in relation to the proposed trial.
2.
If any person is specified as a person responsible for the duties of the sponsor under regulation 28(2) and (3) in relation to the trial -
(b) the trial sites in relation to which they are so responsible.
3.
The address of each trial site and the names and address of the investigator responsible for the conduct of the trial at each site.
(b) the manufacturing or assembling operations performed at those premises.
9.
A description of the proposed clinical trial.
(b) summaries of the non-clinical pharmacology and toxicology data on that product, if available; and (c) summaries of the available data from previous clinical trials of, and human experience with, that product.
(4) In the case of an investigational medicinal product which has a marketing authorization, the dossier must contain -
(b) if there has been a change -
(ii) of manufacturer of that product or substance,
the summaries referred to in sub-paragraph (3)(a);
(5) In the case of an investigational medicinal product which does not have a marketing authorization, but where -
(b) the investigational medicinal product is supplied by the holder of that authorization,
the dossier must contain the summaries referred to in sub-paragraph (3)(a), in so far as they relate to the finished product to be used in the trial, and the summaries referred to in sub-paragraph (3)(b) and (c), in so far as they relate to the product to be used in the trial.
(b) the investigational medicinal product is supplied by the manufacturer of that other product,
the dossier must contain the summaries referred to in sub-paragraph (3)(a), in so far as they relate to that other product, and the summaries referred to in sub-paragraph (3)(b) and (c), in so far as they relate to the product to be used in the trial.
(b) the sponsor of that trial authorises the licensing authority to refer to the dossier submitted in relation to that trial.
12.
A description or sample of the labelling which is to appear on each investigational medicinal product when supplied to a subject in the trial. 1. The name and address of -
(b) if the sponsor is not established in the European Community, his legal representative, and (c) if any person has been authorised by the sponsor to send the notice on his behalf, that person.
2.
Particulars identifying the trial, including -
(b) the number allocated to the trial on the European database referred to in Article 11 of the Directive.
3.
A description of the proposed amendment.
(b) any other particulars or documents accompanying the request for authorisation or the application for an ethics committee opinion.
6.
Summaries of -
(b) any change to the assessment referred to in paragraph 11(2) of Part 2.
1. The name and address of -
(b) if the sponsor is not established in the European Community, his legal representative.
2.
Particulars identifying the trial, including -
(b) the number allocated to the trial on the European database referred to in Article 11 of the Directive.
3.
The investigational medicinal product tested in the trial. 1. - (1) Subject to the following sub-paragraphs, where the United Kingdom Ethics Committee Authority ("the Authority") receive a notice pursuant to regulation 16(3) or (7) that a chief investigator wishes to appeal against an ethics committee opinion which is not favourable, the Authority shall, subject to sub-paragraph (2) -
(b) appoint a panel in accordance with paragraph 3 ("an appeal panel") and refer the opinion to that panel.
(2) Subject to sub-paragraph (4), the Authority may refuse to give a direction or appoint a panel pursuant to sub-paragraph (1) where it considers that the grounds for appealing against the opinion are unfounded.
(ii) any additional information provided by the chief investigator,
to the ethics committee specified in the direction; and
3.
- (1) An appeal panel appointed pursuant to paragraph 1(1)(b) shall consist of a chairman and at least 6 other members.
(b) a person having professional qualifications or experience relating to the conduct of, or use of statistics in, clinical trials, unless those professional qualifications or experience relate only to the ethics of clinical research or medical treatment, or (c) a person who, although not a health care professional, has been a registered medical practitioner or a person registered in the dentists register under the Dentists Act 1984.
4.
- (1) An appeal panel shall consider an ethics committee opinion referred to it in accordance with the following sub-paragraphs.
(b) the application for that opinion; (c) the particulars and documents accompanying that application; (d) the matters specified in regulation 15(6); (e) any representations set out in the notice to the Authority; and (f) in a case where the opinion has been confirmed by the Gene Therapy Advisory Committee on a review pursuant to regulation 16(5), the reasons given by the Committee for that confirmation.
(3) The panel may, if the chief investigator so requests, hold a hearing to consider the opinion, at which the chief investigator may make oral representations. 1. - (1) Where the licensing authority are notified of the sponsor's wish to make representations in accordance with regulation 26(1) or 31(7) the authority shall afford an opportunity for the sponsor to make written or oral representations to the appropriate committee or, if for the time being there is no such committee, the Medicines Commission. (2) After considering the representations, the appropriate committee or the Medicines Commission shall report their findings and advice, and the reasons for their advice, to the licensing authority. (3) In the case of a decision not to accept a request for authorisation or an amendment to the clinical trial authorisation, the licensing authority shall, after considering the report of the appropriate committee or the Commission -
(b) accept the request for authorisation or amendment to the clinical trial authorisation, subject to such conditions as the licensing authority may consider appropriate.
(4) In the case of a decision to impose a condition following a request for authorisation or notice of amendment, the licensing authority shall, after considering the report of the appropriate committee or the Commission -
(b) remove or alter the condition in question.
(5) In the case of a notice to suspend or terminate a trial, the licensing authority shall, after considering the report of the appropriate committee or the Commission, confirm or revoke the notice.
(b) their decision in accordance with sub-paragraphs (3), (4) or (5).
2.
- (1) If a person to whom a notice is given under paragraph 1(6) is dissatisfied and he has not made representations to the Medicines Commission under paragraph 1(1), he may give notice in writing to the licensing authority within 28 days, or such extended period as the licensing authority may in any particular case allow, of the notice being given of his wish to make written or oral representations to the Medicines Commission.
(b) give notice to the person of -
(ii) the licensing authority's confirmation or alteration of their decision under paragraph 1(3) to (5).
3.
- (1) If a decision notified in accordance with paragraphs 1(6) or 2(4) is a decision to which this paragraph applies, the sponsor may within the time allowed after the notification was given, give notice of his wish to appear before and be heard by a person appointed for the purpose by the licensing authority, or of making representations in writing to the licensing authority with respect to the decision referred to in the notification.
(b) if the applicant or holder so requests, the hearing shall be in public; and (c) if the applicant or holder so requests, the licensing authority shall furnish to him a copy of the report of the person so appointed.
(3) The licensing authority shall take into account the report of the person appointed and decide whether to confirm or alter their decision.
(ii) their decision to impose a condition, or (iii) the notice to suspend or terminate the trial,
against the advice of the Medicines Commission under paragraph 1(2);
1. The name and address of the applicant, and, where the applicant is not the proposed holder of the authorisation, the name and address of the proposed holder. 2. A statement of the types of investigational medicinal products in respect of which the authorisation is required. 3. A statement of the manufacturing, assembling or importation operations to which the authorisation is to relate, including a statement whether they include one or more of the following -
(b) the assembly of investigational medicinal products; or (c) the importation of investigational medicinal products.
4.
- (1) The address of each of the premises where the manufacturing, assembling or importation operations to which the application relates, including any testing associated with manufacture, assembly or import, are or are to be carried out.
(b) the extent of the authority to be delegated to him to reject unsatisfactory batches of investigational medicinal products, and (c) the name and function of the person to whom he is responsible.
7.
A description of the arrangements for the identification and storage of materials and ingredients before and during manufacture and for the storage of investigational medicinal products after manufacture, assembly or importation.
(b) for maintaining records of analytical and other testing procedures applied in the course of manufacture, assembly or importation for ensuring compliance of materials used in the manufacture of any investigational medicinal products with the specification of such materials or medicinal products; and (c) for keeping reference samples of materials used in the manufacture of any investigational medicinal products and of the investigational medicinal products.
In this Schedule, "product specification" means -
(b) in the case of an investigational medicinal product manufactured for the purpose of export, the specification for that product provided by the person to whose order the products are manufactured, or (c) in any other case, the specification for an investigational medicinal product contained in the investigational medicinal product dossier for that product.
1. The holder of the authorisation shall -
(b) not carry out any such manufacture or assembly except at the premises specified in his manufacturing authorisation.
2.
The holder of the authorisation shall -
(b) not use for such purposes premises other than those specified in the authorisation or which may be approved from time to time by the licensing authority; and (c) ensure that any arrangements he makes with a person for the storage and distribution of the investigational medicinal products are adequate to maintain the quality of those products.
3.
The holder of the authorisation shall place the quality control system referred to in Article 11(1) of Commission Directive 2003/94/EC under the authority of the person notified to the licensing authority in accordance with paragraph 6(3) of Schedule 6 as being responsible for quality control.
(b) of the operations being carried out in relation to such manufacture or assembly.
6.
The holder of the authorisation shall -
(b) inform the licensing authority of any change that he proposes to make in any personnel named in his authorisation as respectively -
(ii) responsible for quality control of the investigational medicinal products being manufactured or assembled including the person named as the qualified person for the purposes of regulation 43 and paragraph 14.
7.
The holder of the authorisation shall -
(b) permit the person authorised to take copies or make extracts from such documentation.
8.
The holder of the authorisation shall keep readily available for examination by a person authorised by the licensing authority the samples of each batch of bulk formulated products referred to in Article 11(4) of Commission Directive 2003/94/EC.
(b) the provisions of these Regulations, the Act or any regulations under the Act that are applicable to the investigational medicinal product,
he shall, if so directed, withhold such batch from distribution for use in clinical trials, so far as may be reasonably practicable, for such a period not exceeding six weeks as may be specified by the licensing authority.
(b) that investigational medicinal product is not manufactured by the holder of the authorisation; and (c) particulars as to the name and address of the manufacturer of, or of the person who imports, that investigational medicinal product had been given by the holder of the authorisation to the licensing authority,
the holder of the authorisation shall forthwith notify the licensing authority in writing of any changes in such particulars.
(b) amending the clinical trial authorisation in accordance with regulation 23 or 24; or (c) suspending or terminating any clinical trial in accordance with regulation 31,
shall permit, and provide all necessary facilities to enable, any person duly authorised in writing by the licensing authority, on production if required of his credentials, to carry out such inspection or to take such samples or copies, in relation to things belonging to, or any business carried on by, the holder of the authorisation, as such person would have the right to carry out or take under the Act for the purpose of verifying any statement contained in an application for an authorisation or licence. 1. The holder of the authorisation shall -
(b) not use for such purposes premises other than those specified in the authorisation or which may be approved from time to time by the licensing authority; and (c) ensure that any arrangements he makes with a person for the storage and distribution of the investigational medicinal products are adequate to maintain the quality of those products.
2.
The holder of the authorisation may use a contract laboratory pursuant to Article 11(2) of Commission Directive 2003/94/EC if operated by a person approved by the licensing authority.
(b) inform the licensing authority if he changes the person named as the qualified person for the purposes of regulation 43 and paragraph 9.
5.
The holder of the authorisation shall -
(b) permit the person authorised to take copies or make extracts from such documentation.
6.
Where the holder of the authorisation has been informed by the licensing authority that any batch of any investigational medicinal product to which his authorisation relates has been found not to conform as regards strength, quality or purity with -
(b) the provisions of these Regulations, the Act or any regulations under the Act that are applicable to the investigational medicinal product,
he shall, if so directed, withhold such batch from distribution for use in clinical trials, so far as may be reasonably practicable, for such a period not exceeding six weeks as may be specified by the licensing authority.
(b) amending the conduct of a clinical trial in accordance with regulation 23 or 24; or (c) suspending or terminating any clinical trial in accordance with regulation 31,
shall permit, and provide all necessary facilities to enable, any person duly authorised in writing by the licensing authority, on production if required of his credentials, to carry out such inspection or to take such samples or copies, in relation to things belonging to, or any business carried on by, the holder of the authorisation, as such person would have the right to carry out or take under the Act for the purpose of verifying any statement contained in an application for an authorisation or licence. 1. In this Schedule -
2.
Subject to paragraph 6, if the licensing authority propose -
(b) to grant an authorisation other than in accordance with the application; or (c) to revoke, vary or suspend an authorisation,
the licensing authority shall notify the applicant or holder accordingly.
(b) if the applicant or holder so requests, the hearing shall be in public; and (c) if the applicant or holder so requests, the licensing authority shall furnish to him a copy of the report of the person so appointed.
(2) The licensing authority shall take into account the report of the person appointed and decide whether to grant the authorisation, revoke, vary or suspend the authorisation or confirm or alter their decision, as the case may be. 1. The modifications of the Act mentioned in regulation 47 are as follows. 2. - (1) Amendments in section 107 (validity of decisions and related proceedings) as follows. (2) In subsection (1), for "Part II of this or of a Minister under section 75 of this Act, and the validity of any licence or certificate" substitute "the Clinical Trials Regulations, and the validity of any authorisation". (3) In subsections (2)(a) and (3)(b), for "this Act" substitute "the Clinical Trials Regulations". (4) In subsection (2)(b), for "this Act or of any regulations made under this Act" substitute "the Clinical Trials Regulations". (5) In subsection (4) (effect of quashing a decisions) substitute -
(b) to give notice accepting a request for an authorisation, is quashed under this section.
(4A) Any authorisation granted or issued, or notice given, in pursuance of the decision shall be void.
3.
For section 108 (enforcement in England and Wales) substitute -
(2) It shall be the duty of the National Assembly for Wales to enforce in Wales, or to secure the enforcement in Wales of, the provisions of the Clinical Trials Regulations".
4.
In section 109 (enforcement in Scotland), for subsections (1) to (3), substitute -
5.
For section 110 (enforcement in Northern Ireland) substitute -
6.
- (1) Amendments in section 111 (rights of entry) as follows.
(b) for "application for the licence or certificate" substitute "application or request for the authorisation".
7.
- (1) Amendments in section 112 (power to inspect, take samples and seize goods and documents) as follows.
(3) In subsection (2) (items of which samples may be taken), before the word "or" at the end of paragraph (a) insert -
(4) In subsection (3) (right to require production etc. of books and documents), after paragraph (a) insert -
(ii) any person who, under arrangements made with the sponsor of a clinical trial, carries out functions of the sponsor of the trial, (iii) an investigator for a trial, (iv) any person, other than an investigator, who conducts a trial, (v) any person occupying premises at which a clinical trial is being conducted, or (vi) any person who, in the courses in the course of their employment with a person of a description specified in any of sub-paragraphs (i) to (v) of this paragraph, undertakes activities in connection with a clinical trial,
to produce any books or documents relating to the clinical trial which are in his possession or under his control;".
(5) In subsection (3)(b) (powers to take copies of documents produced), for "the preceding paragraph" substitute "paragraph (a) or (aa) of this subsection;".
(7) In subsection (4) (right to seize items and documents), for "offence under this Act is" substitute -
(b) under section 114, 118 or 123 of this Act,
is."
(8) In that subsection, for "under this Act" (in the second place) substitute "under those Regulations or under any of the provisions of this Act applied by regulation 47 of those Regulations".
(b) for "the application for the licence or certificate" substitute "the application or request for the authorisation".
(11) In subsection (9) (Schedule 3 to have effect in relation to samples obtained for purposes of the Act), for "this Act" (in the second place) substitute "the Clinical Trials Regulations".
8.
- (1) Amendments in section 115 (analysis of samples) as follows.
10.
In section 118(1)(b) (restrictions on disclosing of information obtained in pursuance of the Act), for "this Act" substitute "the Clinical Trials Regulations or any provision of this Act applied by regulation 47 of those Regulations".
(b) for "this Act" (in the second place) substitute "that legislation".
(3) In subsection (3) (meaning of "officer"), for "this Act" substitute "relevant legislation".
(b) any provision of this Act applied by regulation 47 of those Regulations."
12.
- (1) Amendments in section 121 (contravention due to fault of other person) as follows.
15.
- (1) Amendments in section 125 (prosecutions) as follows.
(b) at the end add -
17.
- (1) Amendments in section 129 (orders and regulations) as follows.
(8) Omit subsections (6A) and (7) (which apply only in relation to veterinary products or instruments made otherwise than under Part 8 of the Act).
(b) anything that is an investigational medical product for the purposes of the Clinical Trials Regulations;".
(5) Omit the definition of "offence under this Act".
20.
- (1) Amendments in Schedule 3 (sampling) as follows. The Act 1. - (1) Section 3 of the Act (general functions of the Medicines Commission)[55] is amended as follows - (2) In subsection (1), for the words from "advice" to "products, where" substitute -
(b) relating to the exercise of any power conferred by this Act, (c) relating to the execution of the Clinical Trials Regulations, (d) relating to the exercise of any power conferred by those regulations, or (e) otherwise relating to medicinal products,
where."
(3) In subsection (2), after "by or under this Act" insert "or the Clinical Trials Regulations".
(ii) without being required to do so, elect to consult the Commission with respect to any matter arising under any of those provisions."
2.
In section 4 of the Act (establishment of committees)[56], in subsection (2), for the words from "connected with" onwards substitute -
(b) the exercise of any power conferred by this Act or those regulations,
either generally or in relation to any particular class of substances or articles to which any provision of this Act or those regulations applies.".
3.
In section 7 of the Act (restrictions as to dealings with medicinal products)[57], after subsection (3), insert the following subsection -
4.
- (1) Section 8 of the Act (provisions as to manufacture and wholesale dealing) shall be amended as follows.
(b) to the extent that the manufacture or assembly of the product is in accordance with the terms and conditions of that licence or authorization.
(2B) In subsection (2A) of this section -
(c) a marketing authorization granted by the European Commission under Council Regulation (EEC) 2309/93[58].".
(4) In subsections (3) and (3A)[59], for "subsection (3C)", in both places those words appear, substitute "subsections (3C) and (3D)".
5.
- (1) Section 23 of the Act (special provisions as to the effect of manufacturer's licence)[60] shall be amended as follows.
(b) for paragraph (b), substitute the following paragraph -
(ii) if the products are to be used for the purposes of a clinical trial, the sponsor of that trial,".
(3) After subsection (5), insert the following subsection -
6.
Section 31 of the Act shall be omitted
(b) for paragraph (a), substitute the following paragraph -
(c) in paragraph (b), omit "trial or".
(6) In subsection (7) -
(b) omit "of a clinical trial or"; and (c) in paragraph (a), omit "trial or".
(7) In subsection (8), omit paragraph (a).
(b) in subsection (2), omit "clinical trial or"; (c) in subsection (3), omit "clinical trial certificates or".
9.
- (1) Section 37 of the Act (transitional provisions as to clinical trials and medicinal tests on animals) shall be amended as follows.
(b) for "section 31 or section 32 of this Act do not apply to anything done in relation to medicinal products of that description or (as the case may be)" substitute "section 32 of the Act do not apply to anything done".
(5) In subsection (4) -
(b) in paragraph (a), for the words from the beginning to "so specified" substitute "substances or articles specified in the application".
10.
In section 38 of the Act (duration and renewal of certificate) -
(b) in subsections (5) and (6), for "a clinical trial certificate or animal test certificate" substitute "an animal test certificate".
11.
In section 39 of the Act (suspension, revocation or variation of certificate) -
(b) in subsection (2)(c) and (e), omit "clinical trial or".
12.
In section 44 of the Act (provision of information to licensing authority), in subsections (1) and (2), for "a clinical trial certificate or animal test certificate" substitute "an animal test certificate".
(b) in subsection (3), for "a clinical trial certificate or animal test certificate" substitute "an animal test certificate".
14.
In section 46 of the Act (special defences under section 45), for "a clinical trial certificate or animal test certificate" (in each place) substitute "an animal test certificate".
(c) to the provisions of the Clinical Trials Regulations and to any authorisation granted or other thing done by virtue of those regulations.".
17.
In section 104 of the Act (application of Act to certain articles and substances), in subsection (1), after "such provisions of this Act" insert ", or the Clinical Trials Regulations,".
(ii) before the definition of "the Commission" insert the following definition -
The Medicines Act 1971
The Adults with Incapacity (Scotland) Act 2000
(b) after subsection (3), insert the following subsection -
(b) without the consent of any guardian or welfare attorney, or the adult's nearest relative, if -
(ii) consent has been obtained from a person, other than a person connected with the conduct of the clinical trial, who is -
(B) a person nominated by the relevant health care provider."; and
(c) at the end insert the following subsection -
1. In the Medicines (Standard Provisions for Licences and Certificates) Regulations 1971[63] -
(b) in regulation 3 (standard provisions for licences and certificates), omit paragraph (2); and (c) in Schedule 1, omit Part II (standard provisions for clinical trial certificates and clinical trial certificates of right).
2.
In the Medicines (Surgical Materials) Order 1971[64], in article 3, for the words from ", the provisions contained in Parts I and II of the Act" to the end substitute -
(b) the provisions of the Clinical Trials Regulations shall have effect in relation to the said articles or substances.".
3.
- (1) In the Medicines (Exemption from Licences) (Special Cases and Miscellaneous Provisions) Order 1972[65], article 4 shall be amended as follows.
(b) in subparagraph (a), omit "a clinical trial, or, as the case may be,".
(3) In paragraph (2) -
(ii) in paragraph (b), omit "clinical trial or";
(b) in subparagraph (iii) -
(ii) omit the words from "the doctor or dentist" to "as the case may be,";
(c) in subparagraph (iv) -
(ii) omit the words "the trial, or, as the case may be".
(4) Omit paragraph (3).
(b) the provisions of the Clinical Trials Regulations shall have effect in relation to those substances.".
5.
In the Medicines (Specified Articles and Substances) Order 1976[67], in article 2, in paragraph (1), for the words from "the provisions of the Act" to the end substitute -
(b) the provisions of the Clinical Trials Regulations shall have effect in relation to those articles or substances.".
6.
- (1) The Medicines (Labelling) Regulations 1976[68] shall be amended as follows.
(b) in paragraph (2), omit ", clinical trial certificate".
(7) Omit Schedule 2 (particulars required in the labelling of containers and packages of medicinal products for clinical trials).
(b) in paragraph (g), omit "clinical trial certificate or".
8.
In Schedule 1 to the Medicines (Fixing of Fees Relating to Medicinal Products for Human Use) Order 1989[71], after paragraph 9A[72] insert the following paragraph -
9.
In the Medicines Act 1968 (Application to Radiopharmaceutical-Associated Products) Regulations 1992[73], in the Schedule -
(b) in the entry relating to section 45 of the Act, omit "section 31,", in both places those words appear; (c) in the entry relating to section 46 of the Act, for ""or of a clinical trial certificate or animal test certificate"" substitute ""or of an animal test certificate""; and (d) in the entry relating to section 47 of the Act -
(ii) for "", or any clinical trial certificate or animal test certificate,"" substitute "", or any animal test certificate,"".
10.
In the Medicines (Homoeopathic Medicinal Products for Human Use) Regulations 1994[74], in Schedule 4 (application of the provisions of the Act) -
(b) in the entry relating to section 44 of the Act, for "a clinical trial certificate or animal test certificate", in both places those words appear, substitute "an animal test certificate"; (c) in the entry relating to section 45 of the Act -
(ii) for ""or of a clinical trial certificate or animal test certificate"" substitute ""or of an animal test certificate""; and
(d) in the entry relating to section 46 of the Act, for ""or of a clinical trial certificate or animal test certificate"" substitute ""or of an animal test certificate"".
11.
In the Dangerous Substances and Preparations (Safety) (Consolidation) Regulations 1994[75], in regulation 1 (citation, commencement and interpretation), in paragraph (2), in the definition of "medicinal product" -
(b) omit sub-paragraph (iii).
12.
In the Medicines for Human Use (Marketing Authorisations Etc.) Regulations 1994[76] -
(b) in Schedule 1, in paragraph 2, for sub-paragraph (e)[77] substitute the following sub-paragraph -
(ii) has been manufactured, assembled or imported as an investigational medicinal product by the holder of an authorization referred to in Article 13 of the Clinical Trials Directive"; and.
13.
In the Prescription Only Medicines (Human Use) Order 1997[78] -
14.
In the Ionising Radiation (Medical Exposure) Regulations 2000[79], in regulation 2 (interpretation), in paragraph (1), after the definition of "ionising radiation", insert the following definition -
(b) the Ethics Committee constituted by regulations made by the Scottish Ministers under section 51(6) of the Adults with Incapacity (Scotland) Act 2000, or (c) any other committee established to advise on the ethics of research investigations in human beings, and recognised for that purpose by or on behalf of the Secretary of State, the National Assembly for Wales or Scottish Ministers;".
15.
In the Private and Voluntary Health Care (England) Regulations 2001[80], in regulation 24 (research), for paragraph (2) substitute the following paragraph -
(b) any other committee established to advise on the ethics of research investigations in human beings, and recognised for that purpose by or on behalf of the Secretary of State;".
16.
In the Misuse of Drugs Regulations 2001[81], in regulation 18 (marking of bottles and other containers), for paragraph (3) substitute the following paragraph -
17.
In the Health Service (Control of Patient Information) Regulations 2002[82], in regulation 1 (citation, commencement, interpretation and extent), in paragraph (2), for the definition of "research ethics committee" substitute the following definition -
(b) any other committee established to advise on the ethics of research investigations in human beings, and recognised for that purpose by or on behalf of the Secretary of State or the National Assembly for Wales;".
18.
In the National Health Service (Functions of Strategic Health Authorities and Primary Care Trusts and Administration Arrangements) (England) Regulations 2002[83], in regulation 2 (interpretation), in paragraph (1), for the definition of "research ethics committee" substitute the following definition -
(b) any other committee established to advise on the ethics of research investigations on human beings and recognised for that purpose by or on behalf of the Secretary of State;".
Ethical approval given before 1st May 2004 1. - (1) This sub-paragraph applies where -
(b) no ethics committee has given a favourable opinion in relation to that trial in accordance with regulation 15; and (c) a committee established or recognised for the purpose of advising on the ethics of research investigations on human beings has before 1st May 2004 given a favourable ethical opinion in relation to that trial.
(2) Subject to the following sub-paragraphs, where sub-paragraph (1) applies -
(b) regulations 12, 24(3) and 29 shall apply in relation to the trial with the modification that references to the application for an ethics committee opinion shall be read as references to the application for approval made to the committee referred to in sub-paragraph (1)(c); and (c) regulations 24, 25, 27, 30 to 35 and 48 shall apply in relation to the trial with the modification that references to the relevant ethics committee shall be read as references to the committee referred to in sub-paragraph (1)(c).
(3) This sub-paragraph applies where the committee referred to in sub-paragraph (1)(c) has not been recognised by the Authority in accordance with regulation 7 -
(b) for the description or class of clinical trial into which the trial falls,
before 1st September 2004.
(ii) for the description or class of clinical trial into which the trial falls,
for an amendment to the protocol for the trial within the meaning of Part 3 of these Regulations; or
(5) Where an ethics committee receives an application for an amendment in accordance with sub-paragraph (4)(a), it shall consider the amendment as if it was a valid notice of amendment under regulation 24.
(b) regulations 24, 25, 27, 30 to 35 and 48 shall apply in relation to the trial with the modification that references to the relevant ethics committee shall be read as references to the committee which gave that favourable opinion.
(7) Where an ethics committee gives a favourable opinion in relation to an application pursuant to sub-paragraph (4)(a), sub-paragraph (2) shall cease to apply in relation to that trial
(b) regulations 24, 25, 27, 30 to 35 and 48 shall apply in relation to the trial with the modification that references to the relevant ethics committee shall be read as references to the committee so nominated.
Applications for ethical approval prior to 1st May 2004
(b) the committee has not given its opinion before 1st May 2004; and (c) the committee has been recognised by the Authority in accordance with regulation 7 for the area in which the trial sites are situated, or for the description or class of clinical trial into which the trial falls,
the committee shall consider the application as if it had been made in accordance with regulation 14.
(b) immediately before 1st May 2004, a clinical trial certificate was in force and the trial was being conducted in accordance with that certificate.
(2) Where sub-paragraph (1) applies -
(b) regulations 17 to 21 shall not apply in relation to the trial; and (c) regulations 11, 24(2), 29, 31 and 45(1), and Schedule 7, shall apply in relation to the trial with the modification that references to the request for authorisation shall be read as references to the application for the clinical trial certificate.
4.
- (1) This sub-paragraph applies where -
(b) immediately before 1st May 2004, the exemption conferred by article 3 of the Medicines (Exemption from Licences) (Clinical Trials) Order 1995[84] applied in respect of the sale or supply of medicinal products for the purposes of that trial.
(2) Where sub-paragraph (1) applies -
(b) regulations 17 to 21 shall not apply in relation to the trial; and (c) regulations 11, 24(2), 29, 31 and 45(1), and Schedule 7, shall apply in relation to the trial with the modification that references to the request for authorisation shall be read as references to the notice to the licensing authority specified in article 4(1)(a) of the Medicines (Exemption from Licences) (Clinical Trials) Order 1995 .
5.
- (1) This sub-paragraph applies where -
(b) the investigational medicinal product used in the trial is a product with a marketing authorization; (c) the trial has before 1st May 2004 been notified to the licensing authority by the person supplying the product for the purposes of that trial; and (d) the licensing authority has before 1st May 2004 notified that person that -
(ii) the authority agreed to the trial proceeding.
(2) Where sub-paragraph (1) applies -
(b) regulations 17 to 21 shall not apply in relation to the trial; and (c) regulations 11, 24(2), 29, 31 and 45(1), and Schedule 7, shall apply in relation to the trial with the modification that references to the request for authorisation shall be read as references to the notification referred to in sub-paragraph (1)(c).
6.
- (1) This sub-paragraph applies where -
(b) immediately before 1st May 2004, the exemption conferred by article 2(2) of the Medicines (Exemption from Licences) (Special Cases and Miscellaneous Provisions) Order 1972[86] applied in respect of the sale or supply of medicinal products for the purposes of that trial.
(2) Where sub-paragraph (1) applies -
(b) regulations 17 to 21 shall not apply in relation to the trial; and (c) regulations 11, 24(2), 29, 31 and 45(1), and Schedule 7, shall apply in relation to the trial with the modification that references to the request for authorisation shall be read as references to the notification to the licensing authority specified in article 2(3)(c) or (4)(a) of the Medicines (Exemption from Licences) (Special Cases and Miscellaneous Provisions) Order 1972.
Applications for clinical trial exemptions or notifications prior to 1st May 2004
(b) the licensing authority has received a notice pursuant to article 4(1)(a) of the Medicines (Exemption from Licences) (Clinical Trials) Order 1995 and on 1st May 2004 -
(ii) the authority has not given or sent a notice pursuant to article 4(1)(b); or
(c) the licensing authority has received a notice pursuant to article 4(2)(iv) of the Medicines (Exemption from Licences) (Special Cases and Miscellaneous Provisions) Order 1972 and on 1st May 2004 -
(ii) the authority has not given a direction pursuant to that article.
(2) Where sub-paragraph (1) applies the licensing authority shall treat the application or notice as a valid request for authorisation to conduct the clinical trial to which the application or notice relates under regulation 17. (This note is not part of the Regulations) These Regulations implement Directive 2001/20/EC on the approximation of laws, regulations and administrative provisions of the Member States relating to the implementation of good clinical practice in the conduct of clinical trials on medicinal products for human use ("the Directive"). The Regulations provide that the licensing authority established in accordance with the Medicines Act 1968 for the purpose of Part II of that Act (licences and certificates relating to medicinal products) shall exercise the functions of the competent authority under the Directive and certain functions falling to be performed by Member States under that Directive (regulation 4), unless those functions are conferred on any other person or body (for example, enforcement functions are conferred on the Secretary of State for Health, the National Assembly for Wales, the Scottish Ministers and the Department for Health, Social Services and Public Safety in Northern Ireland). Regulations 5 to 10, and Schedule 2, make provision for ethics committees in the United Kingdom, which are to be responsible, amongst other things, for giving opinions on the ethics of clinical trials involving medicinal products. Regulation 5 provides for the United Kingdom Ethics Committees Authority, which is to be responsible for establishing, recognising, and monitoring ethics committees. Regulations 11 to 27, and Schedules 3 to 5, make provision for clinical trial authorisations by the licensing authority and for ethics committee opinions. In particular: regulation 12 provides that a clinical trial may be conducted only if it has been authorised by the licensing authority and an ethics committee has given a favourable opinion; regulation restricts the supply of medicinal products for the purposes of clinical trials; regulations 14 to 16 and Schedules 3 and 4 make provision for applications for ethics committee opinions; and regulations 17 to 21 and Schedule 3 deal with requests to the licensing authority for authorisation. Regulations 22 to 25 make provision for amendments to clinical trial authorisations; and regulation 26 and Schedule 5 make provision for the reference to the appropriate committee or the Medicines Commission of decisions to refuse authorisations, amendments etc. Regulation 27 makes provision for the conclusion of a trial. Regulations 28 to 31, and Schedules 1 and 5, make provision for: the conduct of a clinical trial, including the requirement to adhere to the principles of Good Clinical Practice; urgent safety measures to protect trial subjects from immediate hazards; and the suspension and termination of a trial. Schedule 5 includes provisions for referral to the appropriate committee or the Medicines Commission where a trial is suspended or terminated by the licensing authority. Regulations 32 to 35 make provision for pharmacovigilance; i.e. the recording and reporting of adverse events and reactions to medicinal products being used in a clinical trial. Regulations 36 to 45, and Schedules 6 to 8, make provision for the manufacture and importation of medicinal products to be used in clinical trials. In particular they make provision for: authorisations for manufacture, assembly and importation (regulations 36 and 37); the applications for, consideration of and grant or refusal of such authorisations (regulations 38 to 40 and Schedules 6 to 8); the application and effect of authorisations (regulations 41 and 42); the qualified persons responsible for checking the quality of products being manufactured, assembled or imported (regulation 43); and the variation, suspension and revocation of authorisations (regulations 44 and 45 and Schedule 8). Regulation 46 concerns the labelling of such medicinal products. Regulations 47 to 52, and Schedule 9, make provision for enforcement and related matters, including powers of inspection, infringement notices, offences and penalties for breaches of the Regulations. Regulations 53 to 56, and Schedules 10 to 12, contain miscellaneous provisions for the construction of references in authorisations to pharmacopoeias and other publications, for the consequential amendment and revocation of legislation, and for transitional arrangements. A full regulatory impact assessment of the effect that this instrument will have on the costs of business is available from the Medicines and Healthcare products Regulatory Agency, Room 10-202, Market Towers, 1 Nine Elms Lane, London SW8 5NQ. A copy of that assessment, and a Transposition Note in relation to the implementation of Directive 2001/20/EC, have been placed in the libraries of both Houses of Parliament. Notes: [1] S.I. 1972/1811.back [4] OJ No. L262, 14.10.2003, p.22.back [6] OJ No. L121, 1.5.2001, p.34.back [7] OJ No. L311, 28.11.2001, p.67.back [8] See Article 31 of Directive 2002/98/EC (OJ No. L33, 8.2.2003, p.30) and Commission Directive 2003/63/EC (OJ No. L159, 27.6.2003, p.46).back [9] See Schedule 1 of the Interpretation Act 1978 (c. 30), as amended by paragraph 18 of Schedule 5 to the Medical Act 1983 (c. 54).back [10] OJ No. L1, 3.1.1994, p.3.back [11] OJ No. L1, 3.1.1994, p.572.back [12] OJ No. L214, 24.8.93, p.1.back [13] 2000 asp. 4; see S.S.I. 2002/190.back [14] S.I. 1972/1265 (N.I. 14).back [20] S.I. 1990/247 (N.I.3)back [23] S.I. 1991/194 (N.I.1).back [24] 1990 c. 19; section 21 was amended by paragraph 79 of Schedule 1 to the Health Authorities Act 1995 (c. 17) and paragraph 81 of Schedule 4 to the Health Act 1999 (c. 8).back [25] 1978 c. 29; section 85 was inserted by section 41 of the National Health Service and Community Care Act 1990 (c. 19) and was amended by paragraph 56 of Schedule 4 to the Health Act 1999 (c. 8).back [26] S.I. 1991/194 (N.I. 1).back [27] S.I. 1994/3144, as amended by S.I. 1998/3105, 2000/292, 2001/795, 2002/236, 2002/542 and 2003/????.back [28] OJ No. L214, 24.8.1993, p.1.back [29] Section 7 does not apply to "relevant medicinal products" within the meaning given by S.I. 1994/3144.back [30] See section 8 of the National Health Service Act 1977 (c. 49) as substituted by section 1(2) of the National Health Service Reform and Health Care Professions Act 2002 (c. 17).back [31] 2000 asp. 4; see S.S.I. 2002/190.back [33] The Committee on Safety of Medicines was established under section 4 of the Act, by S.I. 1970/1257, for the purposes set out in that instrument.back [34] OJ No. L214, 24.8.93, p.1.back [36] See section 2 of the Act.back [39] S.I. 1972/1265 (N.I. 14).back [40] See section 2 of the Act.back [42] A copy of the Code of Practice may be obtained by writing to the Institute of Biology, 20 Queensbury Place, London SW7 2DZ, the Royal Pharmaceutical Society of Great Britain, 1 Lambeth High Street, London SE1 7JN or the Royal Society of Chemistry, Burlington House, Piccadilly, London W1V 0BN.back [44] OJ No. L262, 14.10.2003, p.22.back [45] S.I. 1994/3144; Schedule 5 was amended by S.I. 1998/3105, 2000/292 and 2002/542; "dispensed relevant medicinal product" is defined in paragraph 1 of Schedule 5.back [46] Section 103 was amended by section 22(1) of the Health and Medicines Act 1988 (c. 49).back [48] 1989 c. 41; see, in particular, sections 3(1) and 5(6).back [49] 1995 c. 36; see, in particular, sections 1(3) and 7(5).back [50] S.I. 1995/755 (N.I.2); see, in particular, article 6.back [53] S.I. 1972/1265 (N.I. 14).back [54] See Section 2 of the Note for Guideline on Good Clinical Practice (CPMP/ICH/135/95) published by the European Agency for the Evaluation of Medicinal Products in July 2002.back [55] Section 3 has effect as if any reference to the Act included a reference to the Medicines for Human Use (Marketing Authorisations Etc) Regulations 1994 (S.I. 1994/3144) ("the 1994 Regulations"); see regulation 9(1) of the 1994 Regulations.back [56] Section 4 has effect as if any reference to the Act included a reference to the Medicines for Human Use (Marketing Authorisations Etc) Regulations 1994 (S.I. 1994/3144) ("the 1994 Regulations"); see regulation 9(1) of the 1994 Regulationsback [57] Section 7 does not apply to "relevant medicinal products" within the meaning of regulation 1(2) of the 1994 Regulations; see regulation 9(2) of the 1994 Regulations.back [58] OJ No. L214, 24.8.1993, p.1.back [59] Subsections (3A) to (3C) of section 8 were inserted by regulation 2(4) of S.I. 1993/834back [60] Section 23 of the Act has effect as if any reference in subsection (1) to a product licence included a reference to a marketing authorization; see regulation 9(1) of the 1994 Regulations.back [61] Section 1 of the Medicines Act 1971 has effect as if any reference in subsection (1) to any application in pursuance of the Act for a licence under Part II of the Act (or for the variation or renewal of such a licence) included a reference to any application under the Medicines for Human Use (Marketing Authorisations Etc) Regulations 1994 (S.I. 1994/3144) for a marketing authorization (or for the variation or renewal of such an authorization) and any reference in subsection (2)(b) to a licence under Part II of the Act included a reference to a marketing authorization; see regulation 9(12) of the those Regulations.back [63] S.I. 1971/972; regulation 3(3) and Part III of Schedule 1 are revoked insofar as they apply to animal test certificates by S.I. 2003/3309.back [64] S.I. 1971/1267, as amended by S.I. 1994/3119.back [66] S.I. 1975/533, as amended by S.I. 1994/3119.back [67] S.I. 1976/968, as amended by S.I. 1994/3119.back [68] S.I. 1976/1726; the Regulations were revoked in so far as they relate to the labelling of containers and packages of medicinal products for administration in certain medicinal tests on animals by S.I. 1996/2194.back [69] As amended by S.I. 1994/3144.back [70] S.I. 1978/40; regulation 3 was amended by S.I. 1994/3142 and 3144.back [72] Paragraph 9A was inserted by S.I. 1995/871.back [75] S.I. 1994/2844; regulation 1(2) was substituted by S.I. 1996/2635.back [77] Paragraph 2(e) of Schedule 1 was amended by SI 2002/236.back [78] S.I. 1997/1830; the relevant amending instrument is S.I. 2003/696.back
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