Implementing FDA REMS Elements to Assure Safe Use (ETASU) Requirements using a Business Process Management Suite(BPMS)

It is essential that all new products developed and marketed by bio-pharma and device companies are safe to use and fulfill their efficacy requirements. However, it has been our practical experience over many decades that in most cases there are certain unwanted side effects. Hence, to ensure that the benefits outweigh the risks, regulators have been approving certain drugs under strict risk management assurances from the license holders.

In the US, the Federal Drug Administration (FDA) has been trying to address this through various regulations for over five years through Risk Management Action Plans (RiskMAP) and Risk Evaluation and Mitigation Strategies (REMS). The most recent guidance on this subject was issued in September 2009 through “Guidance for Industry Format and Content of Proposed Risk Evaluation and Mitigation Strategies (REMS), REMS Assessments, and Proposed REMS Modifications”. In this guidance one of the important REMS elements that may be required is “Elements to Assure Safe Use”.

As part of this requirement the NDA/BLA applicants have to take measures to provide safe access for patients to drugs with known serious risks that would otherwise be unavailable. If a product is assessed to fulfill ETASU requirements then the sponsors are required to train and certify health care providers, pharmacies, patients and drugs. The drugs may be released to patients in a controlled manner only upon receiving evidence of their lab results. The sponsors may also have to register the patients and might subject them to certain monitoring as well. In a few cases the sponsor may be asked to extend the certification process to wholesalers, distributers etc. as well.

In order to fulfill the above mentioned requirements sponsors typically set out to build new IT systems. This is a challenging task as there is a possibility that these requirements could change over time and also there aren’t any commercial off the shelf products available in the market to address the specific REMS ETASU requirements.

To overcome this challenge, sponsors can look up to a Business Process Management System (BPMS) that is precisely built to handle such scenarios. Many other industries have successfully used BPMS to meet their ever changing requirements and priorities by integrating their business processes based on rules. Many commercially available BPMS systems typically include a process engine, Business Analytics, Content Management and Collaboration tools. These BPMS system building blocks can be effectively leveraged to fulfill the ETASU requirements by effectively providing features like Rules management, Content Management, Training Management, Patient/Provider/Pharmacy Registries, Collaboration Portal/Website, IVR/IWR, 21 CFR Part 11 compliance, Audits and integration with other enterprise applications.

Update: 01-17-2012

My Article on the same topic is published on “Drug Safety Directions” Website. You can access the article here: “Implementing FDA REMS Elements to Assure Safe Use (ETASU) Requirements using a Business Process Management Suite“.


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About Venu Mallarapu

I am currently working as Director & Global Client Partner at Cognizant Technology Services in their Life Sciences division. I have over 19 years of experience in developing IT Solutions and Services, specifically for Life Sciences industry for over 13 years. I have worked with small to large pharma customers to address their business needs across R&D, Sales and Marketing and Manufacturing & Supply Chain areas. My passion is Pharma R&D. I blog and write about varied topics in Pharma Industry as well as latest Technology trends that impact Clinical Research and have also presented at various conferences and workshops on wide variety of related topics.

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