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This Regulation lays down specific rules concerning the authorisation, supervision and pharmacovigilance of advanced therapy medicinal products.

In addition to the definitions laid down in Article 1 of CCRMPHUD and in Article 3, points (a) to (l) and (o) to (q) of Directive 2004/23, the following definitions shall apply for the purposes of this Regulation:

‘Advanced therapy medicinal product’ means any of the following medicinal products for human use:

a gene therapy medicinal product as defined in Part IV of Annex I to CCRMPHUD,

a somatic cell therapy medicinal product as defined in Part IV of Annex I to CCRMPHUD,

a tissue engineered product as defined in point (b).

‘Tissue engineered product’ means a product that: A tissue engineered product may contain cells or tissues of human or animal origin, or both. The cells or tissues may be viable or non-viable. It may also contain additional substances, such as cellular products, bio-molecules, bio-materials, chemical substances, scaffolds or matrices. Products containing or consisting exclusively of non-viable human or animal cells and/or tissues, which do not contain any viable cells or tissues and which do not act principally by pharmacological, immunological or metabolic action, shall be excluded from this definition.

contains or consists of engineered cells or tissues, and

is presented as having properties for, or is used in or administered to human beings with a view to regenerating, repairing or replacing a human tissue.

Cells or tissues shall be considered ‘engineered’ if they fulfil at least one of the following conditions:

the cells or tissues have been subject to substantial manipulation, so that biological characteristics, physiological functions or structural properties relevant for the intended regeneration, repair or replacement are achieved. The manipulations listed in Annex I, in particular, shall not be considered as substantial manipulations,

the cells or tissues are not intended to be used for the same essential function or functions in the recipient as in the donor.

‘Combined advanced therapy medicinal product’ means an advanced therapy medicinal product that fulfils the following conditions:

it must incorporate, as an integral part of the product, one or more medical devices within the meaning of Article 1(2)(a) of Directive 93/42/EEC or one or more active implantable medical devices within the meaning of Article 1(2)(c) of Directive 90/385/EEC, and

its cellular or tissue part must contain viable cells or tissues, or

its cellular or tissue part containing non-viable cells or tissues must be liable to act upon the human body with action that can be considered as primary to that of the devices referred to.

Where a product contains viable cells or tissues, the pharmacological, immunological or metabolic action of those cells or tissues shall be considered as the principal mode of action of the product.

An advanced therapy medicinal product containing both autologous (emanating from the patient himself) and allogeneic (coming from another human being) cells or tissues shall be considered to be for allogeneic use.

A product which may fall within the definition of a tissue engineered product and within the definition of a somatic cell therapy medicinal product shall be considered as a tissue engineered product.

A product which may fall within the definition of:

a somatic cell therapy medicinal product or a tissue engineered product, and

a gene therapy medicinal product,

shall be considered as a gene therapy medicinal product.

Where an advanced therapy medicinal product contains human cells or tissues, the donation, procurement and testing of those cells or tissues shall be made in accordance with Directive 2004/23.

The rules set out in Article 6(7) and Article 9(4) and (6) of Directive 2001/20 in respect of gene therapy and somatic cell therapy medicinal products shall apply to tissue engineered products.

The Commission shall, after consulting the Agency, draw up detailed guidelines on good clinical practice specific to advanced therapy medicinal products.

The Commission shall, after consulting the Agency, draw up guidelines in line with the principles of good manufacturing practice and specific to advanced therapy medicinal products.

A medical device which forms part of a combined advanced therapy medicinal product shall meet the essential requirements laid down in Annex I to Directive 93/42/EEC.

An active implantable medical device which forms part of a combined advanced therapy medicinal product shall meet the essential requirements laid down in Annex 1 to Directive 90/385/EEC.

In addition to the requirements laid down in Article 6(1) of Regulation 2004/726, applications for the authorisation of an advanced therapy medicinal product containing medical devices, bio-materials, scaffolds or matrices shall include a description of the physical characteristics and performance of the product and a description of the product design methods, in accordance with Annex I to CCRMPHUD.

The Committee for Medicinal Products for Human Use shall consult the Committee for Advanced Therapies on any scientific assessment of advanced therapy medicinal products necessary to draw up the scientific opinions referred to in Article 5(2) and (3) of Regulation 2004/726. The Committee for Advanced Therapies shall also be consulted in the event of re-examination of the opinion pursuant to Article 9(2) of Regulation 2004/726.

When preparing a draft opinion for final approval by the Committee for Medicinal Products for Human Use, the Committee for Advanced Therapies shall endeavour to reach a scientific consensus. If such consensus cannot be reached, the Committee for Advanced Therapies shall adopt the position of the majority of its members. The draft opinion shall mention the divergent positions and the grounds on which they are based.

The draft opinion given by the Committee for Advanced Therapies under paragraph 1 shall be sent to the Chairman of the Committee for Medicinal Products for Human Use in a timely manner so as to ensure that the deadline laid down in Article 6(3) or Article 9(2) of Regulation 2004/726 can be met.

Where the scientific opinion on an advanced therapy medicinal product drawn up by the Committee for Medicinal Products for Human Use under Article 5(2) and (3) of Regulation 2004/726 is not in accordance with the draft opinion of the Committee for Advanced Therapies, the Committee for Medicinal Products for Human Use shall annex to its opinion a detailed explanation of the scientific grounds for the differences.

The Agency shall draw up specific procedures for the application of paragraphs 1 to 4.

Where a combined advanced therapy medicinal product is concerned, the whole product shall be subject to final evaluation by the Agency.

The application for a marketing authorisation for a combined advanced therapy medicinal product shall include evidence of conformity with the essential requirements referred to in Article 6.

The application for a marketing authorisation for a combined advanced therapy medicinal product shall include, where available, the results of the assessment by a notified body in accordance with Directive 93/42/EEC or Directive 90/385/EEC of the medical device part or active implantable medical device part.
The Agency shall recognise the results of that assessment in its evaluation of the medicinal product concerned.
The Agency may request the relevant notified body to transmit any information related to the results of its assessment. The notified body shall transmit the information within a period of one month.
If the application does not include the results of the assessment, the Agency shall seek an opinion on the conformity of the device part with Annex I to Directive 93/42/EEC or Annex 1 to Directive 90/385/EEC from a notified body identified in conjunction with the applicant, unless the Committee for Advanced Therapies advised by its experts for medical devices decides that involvement of a notified body is not required.

By way of derogation from Article 11 of CCRMPHUD, the summary of the product characteristics for advanced therapy medicinal products shall contain the information listed in Annex II to this Regulation, in the order indicated therein.

By way of derogation from Articles 54 and 55(1) of CCRMPHUD, the particulars listed in Annex III to this Regulation shall appear on the outer packaging of advanced therapy medicinal products or, where there is no outer packaging, on the immediate packaging.

In addition to the particulars mentioned in Article 55(2) and (3) of CCRMPHUD, the following particulars shall appear on the immediate packaging of advanced therapy medicinal products:

the unique donation and product codes, as referred to in Article 8(2) of Directive 2004/23;

in the case of advanced therapy medicinal products for autologous use, the unique patient identifier and the statement ‘For autologous use only’.

By way of derogation from Article 59(1) of CCRMPHUD, the package leaflet for an advanced therapy medicinal product shall be drawn up in accordance with the summary of product characteristics and shall include the information listed in Annex IV to this Regulation, in the order indicated therein.

The package leaflet shall reflect the results of consultations with target patient groups to ensure that it is legible, clear and easy to use.

In addition to the requirements for pharmacovigilance laid down in Articles 21 to 29 of Regulation 2004/726, the applicant shall detail, in the marketing authorisation application, the measures envisaged to ensure the follow-up of efficacy of advanced therapy medicinal products and of adverse reactions thereto.

Where there is particular cause for concern, the Commission shall, on the advice of the Agency, require as part of the marketing authorisation that a risk management system designed to identify, characterise, prevent or minimise risks related to advanced therapy medicinal products, including an evaluation of the effectiveness of that system, be set up, or that specific post-marketing studies be carried out by the holder of the marketing authorisation and submitted for review to the Agency.
In addition, the Agency may request submission of additional reports evaluating the effectiveness of any risk management system and the results of any such studies performed.
Evaluation of the effectiveness of any risk management system and the results of any studies performed shall be included in the periodic safety update reports referred to in Article 24(3) of Regulation 2004/726.

The Agency shall forthwith inform the Commission if it finds that the marketing authorisation holder has failed to comply with the requirements referred to in paragraph 2.

The Agency shall draw up detailed guidelines relating to the application of paragraphs 1, 2 and 3.

If serious adverse events or reactions occur in relation to a combined advanced therapy medicinal product, the Agency shall inform the relevant national competent authorities responsible for implementing Directives 90/385/EEC, 93/42/EEC and 2004/23/EC.

The holder of a marketing authorisation for an advanced therapy medicinal product shall establish and maintain a system ensuring that the individual product and its starting and raw materials, including all substances coming into contact with the cells or tissues it may contain, can be traced through the sourcing, manufacturing, packaging, storage, transport and delivery to the hospital, institution or private practice where the product is used.

The hospital, institution or private practice where the advanced therapy medicinal product is used shall establish and maintain a system for patient and product traceability. That system shall contain sufficient detail to allow linking of each product to the patient who received it and vice versa.

Where an advanced therapy medicinal product contains human cells or tissues, the marketing authorisation holder, as well as the hospital, institution or private practice where the product is used, shall ensure that the traceability systems established in accordance with paragraphs 1 and 2 of this Article are complementary to, and compatible with, the requirements laid down in Articles 8 and 14 of Directive 2004/23 as regards human cells and tissues other than blood cells, and Articles 14 and 24 of Directive 2002/98 as regards human blood cells.

The marketing authorisation holder shall keep the data referred to in paragraph 1 for a minimum of 30 years after the expiry date of the product, or longer if required by the Commission as a term of the marketing authorisation.

In case of bankruptcy or liquidation of the marketing authorisation holder, and in the event that the marketing authorisation is not transferred to another legal entity, the data referred to in paragraph 1 shall be transferred to the Agency.

In the event that the marketing authorisation is suspended, revoked or withdrawn, the holder of the marketing authorisation shall remain subject to the obligations laid down in paragraphs 1, 3 and 4.

The Commission shall draw up detailed guidelines relating to the application of paragraphs 1 to 6, in particular the type and amount of data referred to in paragraph 1.

The applicant or holder of a marketing authorisation may request advice from the Agency on the design and conduct of pharmacovigilance and of the risk management system referred to in Article 14.

By way of derogation from Article 8(1) of Council Regulation 1995/297 of 10 February 1995 on fees payable to the European Agency for the Evaluation of Medicinal Products ( 14 ) , a 90 % reduction for small and medium-sized enterprises and 65 % for other applicants shall apply to the fee for scientific advice payable to the Agency for any advice given in respect of advanced therapy medicinal products pursuant to paragraph 1 of this Article and Article 57(1) (n) of Regulation 2004/726.

Any applicant developing a product based on genes, cells or tissues may request a scientific recommendation of the Agency with a view to determining whether the referred product falls, on scientific grounds, within the definition of an advanced therapy medicinal product. The Agency shall deliver this recommendation after consultation with the Commission and within 60 days after receipt of the request.

The Agency shall publish summaries of the recommendations delivered in accordance with paragraph 1, after deletion of all information of commercial confidential nature.

Small and medium-sized enterprises developing an advanced therapy medicinal product may submit to the Agency all relevant quality and, where available, non-clinical data required in accordance with modules 3 and 4 of Annex I to CCRMPHUD, for scientific evaluation and certification.

By way of derogation from Regulation 1995/297, the fee for marketing authorisation shall be reduced by 50 % if the applicant is a hospital or a small or medium-sized enterprise and can prove that there is a particular public health interest in the Community in the advanced therapy medicinal product concerned.

Paragraph 1 shall also apply to fees charged by the Agency for post-authorisation activities in the first year following the granting of the marketing authorisation for the advanced therapy medicinal product.

Paragraphs 1 and 2 shall apply during the transitional periods laid down in Article 29.

A Committee for Advanced Therapies shall be established within the Agency.

Save where otherwise provided in this Regulation, Regulation 2004/726 shall apply to the Committee for Advanced Therapies.

The Executive Director of the Agency shall ensure appropriate coordination between the Committee for Advanced Therapies and the other Committees of the Agency, in particular the Committee for Medicinal Products for Human Use and the Committee for Orphan Medicinal Products, their working parties and any other scientific advisory groups.

The Committee for Advanced Therapies shall be composed of the following members:

five members or co-opted members of the Committee for Medicinal Products for Human Use from five Member States, with alternates either proposed by their respective Member State or, in the case of co-opted members of the Committee for Medicinal Products for Human Use, identified by the latter on the advice of the corresponding co-opted member. These five members with their alternates shall be appointed by the Committee for Medicinal Products for Human Use;

one member and one alternate appointed by each Member State whose national competent authority is not represented among the members and alternates appointed by the Committee for Medicinal Products for Human Use;

two members and two alternates appointed by the Commission, on the basis of a public call for expressions of interest and after consulting the European Parliament, in order to represent clinicians;

two members and two alternates appointed by the Commission, on the basis of a public call for expressions of interest and after consulting the European Parliament, in order to represent patients’ associations.

The alternates shall represent and vote for the members in their absence.

All members of the Committee for Advanced Therapies shall be chosen for their scientific qualification or experience in respect of advanced therapy medicinal products. For the purposes of paragraph 1(b), the Member States shall cooperate, under the coordination of the Executive Director of the Agency, in order to ensure that the final composition of the Committee for Advanced Therapies provides appropriate and balanced coverage of the scientific areas relevant to advanced therapies, including medical devices, tissue engineering, gene therapy, cell therapy, biotechnology, surgery, pharmacovigilance, risk management and ethics.
At least two members and two alternates of the Committee for Advanced Therapies shall have scientific expertise in medical devices.

The members of the Committee for Advanced Therapies shall be appointed for a renewable period of three years. At meetings of the Committee for Advanced Therapies, they may be accompanied by experts.

The Committee for Advanced Therapies shall elect its Chairman from among its members for a term of three years, renewable once.

The names and scientific qualifications of all members shall be made public by the Agency, in particular on the Agency’s website.

In addition to the requirements laid down in Article 63 of Regulation 2004/726, members and alternates of the Committee for Advanced Therapies shall have no financial or other interests in the biotechnology sector and medical device sector that could affect their impartiality. All indirect interests that could relate to these sectors shall be entered in the register referred to in Article 63(2) of Regulation 2004/726.

The Committee for Advanced Therapies shall have the following tasks:

to formulate a draft opinion on the quality, safety and efficacy of an advanced therapy medicinal product for final approval by the Committee for Medicinal Products for Human Use and to advise the latter on any data generated in the development of such a product;

to provide advice, pursuant to Article 17, on whether a product falls within the definition of an advanced therapy medicinal product;

at the request of the Committee for Medicinal Products for Human Use, to advise on any medicinal product which may require, for the evaluation of its quality, safety or efficacy, expertise in one of the scientific areas referred to in Article 21(2);

to provide advice on any question related to advanced therapy medicinal products, at the request of the Executive Director of the Agency or the Commission;

to assist scientifically in the elaboration of any documents related to the fulfilment of the objectives of this Regulation;

at the Commission’s request, to provide scientific expertise and advice for any Community initiative related to the development of innovative medicines and therapies which requires expertise in one of the scientific areas referred to in Article 21(2);

to contribute to the scientific advice procedures referred to in Article 16 of this Regulation and in Article 57(1) (n) of Regulation 2004/726.

The Commission shall, after consulting the Agency and in accordance with the regulatory procedure with scrutiny referred to in Article 26(3), amend Annexes I to IV in order to adapt them to scientific and technical evolution.

By 30 December 2012, the Commission shall publish a general report on the application of this Regulation, which shall include comprehensive information on the different types of advanced therapy medicinal products authorised pursuant to this Regulation.

The Commission shall be assisted by the Standing Committee on Medicinal Products for Human Use set up by Article 121(1) of CCRMPHUD.

Where reference is made to this paragraph, Articles 5 and 7 of Decision 1999/468/EC shall apply, having regard to the provisions of Article 8 thereof.
The period laid down in Article 5(6) of Decision 1999/468/EC shall be set at three months.

Where reference is made to this paragraph, Article 5 a(1) to (4) and Article 7 of Decision 1999/468/EC shall apply, having regard to the provisions of Article 8 thereof.

Regulation 2004/726 is hereby amended as follows:

in the first subparagraph of Article 13(1), the first sentence shall be replaced by the following: ‘Without prejudice to Article 4(4) and (5) of CCRMPHUD, a marketing authorisation which has been granted in accordance with this Regulation shall be valid throughout the Community.’;

Article 56 shall be amended as follows:

in paragraph 1, the following point shall be inserted:

the Committee for Advanced Therapies;’

in the first sentence of the first subparagraph of paragraph 2, the words ‘paragraph 1(a) to (d)’ shall be replaced by ‘paragraph 1(a) to (da)’;

the Annex shall be amended as follows:

the following point shall be inserted: ( *1 ) OJ L 324, 10.12.2007, p. 121 ’;"

Advanced therapy medicinal products as defined in Article 2 of ATMPR of the European Parliament and of the Council of 13 November 2007 on advanced therapy medicinal products ( *1 ) .

In point 3, the second subparagraph shall be replaced by the following: ‘After 20 May 2008, the Commission, having consulted the Agency, may present any appropriate proposal to amend this point and the European Parliament and the Council shall take a decision thereon in accordance with the Treaty.’

CCRMPHUD is hereby amended as follows:

in Article 1, the following point shall be inserted: ( *2 ) OJ L 324, 10.12.2007, p. 121 ’;"

Advanced therapy medicinal product: A product as defined in Article 2 of ATMPR of the European Parliament and of the Council of 13 November 2007 on advanced therapy medicinal products ( *2 ) .

in Article 3, the following point shall be added: ( *3 ) OJ L 136, 30.4.2004, p. 1 . Regulation as amended by MPPUR ( OJ L 378, 27.12.2006, p. 1 ).’;"

Any advanced therapy medicinal product, as defined in ATMPR, which is prepared on a non-routine basis according to specific quality standards, and used within the same Member State in a hospital under the exclusive professional responsibility of a medical practitioner, in order to comply with an individual medical prescription for a custom-made product for an individual patient. Manufacturing of these products shall be authorised by the competent authority of the Member State. Member States shall ensure that national traceability and pharmacovigilance requirements as well as the specific quality standards referred to in this paragraph are equivalent to those provided for at Community level in respect of advanced therapy medicinal products for which authorisation is required pursuant to Regulation 2004/726 of the European Parliament and of the Council of 31 March 2004 laying down Community procedures for the authorisation and supervision of medicinal products for human and veterinary use and establishing a European Medicines Agency ( *3 ) .

in Article 4, the following paragraph shall be added:

in Article 6(1), the first subparagraph shall be replaced by the following: ‘No medicinal product may be placed on the market of a Member State unless a marketing authorisation has been issued by the competent authorities of that Member State in accordance with this Directive or an authorisation has been granted in accordance with Regulation 2004/726, read in conjunction with ATMPR. ’

Advanced therapy medicinal products, other than tissue engineered products, which were legally on the Community market in accordance with national or Community legislation on 30 December 2008, shall comply with this Regulation no later than 30 December 2011.

Tissue engineered products which were legally on the Community market in accordance with national or Community legislation on 30 December 2008 shall comply with this Regulation no later than 30 December 2012.

By way of derogation from Article 3(1) of Regulation 1995/297, no fee shall be payable to the Agency in respect of applications submitted for the authorisation of the advanced therapy medicinal products mentioned in paragraphs 1 and 2 of this Article.

This Regulation shall enter into force on the 20th day following its publication in the Official Journal of the European Union . Official Journal of the European Union