Tag: EUDAMED

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Exploring the EU COMBINE Programme

Understanding and Bridging the Gap in Clinical Research


The European Union’s (EU) healthcare landscape is continuously evolving, driven by the need to integrate
innovative treatments and technologies. One of the most ambitious initiatives in this realm is the EU
COMBINE Programme, launched in June 2023. This programme aims to address the complexities
and challenges at the intersection of three critical regulations: the Clinical Trials Regulation (CTR),
the Medical Devices Regulation (MDR), and the In Vitro Diagnostic Medical Devices Regulation
(IVDR).


Understanding the Need for COMBINE
In the EU, clinical trials of medicinal products, clinical investigations of medical devices, and
performance studies of in vitro diagnostics (IVDs) are governed by distinct regulatory frameworks.
These regulations, while comprehensive, often create operational challenges when combined
studies are required. Combined studies involve:

  • A clinical trial of a medicinal product alongside a performance study of an IVD
  • A clinical trial of a medicinal product alongside a clinical investigation of a medical device

    The COMBINE Programme was initiated to streamline these processes, ensuring that innovative
    treatments combining medicinal products with medical devices or IVDs can be developed more
    efficiently.

    One of the challenges presented by the stakeholders, was the duplication of work by submitting
    combined study application across multiple countries within the EU. Studies spanning multiple
    countries require multiple applications to each competent authority. In some cases, the information
    required, and outcome can vary depending on the country. Not only is this a duplication of work, it
    can put clinical study progression at risk.




The Goals of the COMBINE Programme
The primary objectives of the COMBINE Programme are to:

  1. Analyse Challenges: Identify and understand the root causes of difficulties faced by sponsors
    in conducting combined studies.
  2. Propose Solutions: Develop practical solutions to address these challenges, facilitating
    smoother regulatory processes.

Key Phases of the Programme
The COMBINE Programme is structured into two main phases:

  1. Analysis Phase: This initial phase involved collecting and analysing feedback from various
    stakeholders, including competent authorities, medical research ethics committees, and the
    European Medicines Agency (EMA). The findings were published in an analysis report in May
    2024, highlighting the primary issues and proposing potential solutions.
  2. Implementation Phase: Following the analysis, the Member States endorsed a strategy for
    the second phase in December 2024. This phase focuses on implementing the proposed
    solutions through a series of projects. These projects aim to align the regulatory frameworks
    and simplify the processes for combined studies.

Stakeholder Involvement
The success of the COMBINE Programme hinges on the collaboration of a diverse group of
stakeholders, including:

  • Competent Authorities: National bodies responsible for overseeing clinical trials and
    medical devices.
  • Medical Research Ethics Committees: Groups ensuring that clinical studies meet ethical
    standards.
  • European Medicines Agency (EMA): The agency providing scientific evaluation, supervision,
    and safety monitoring of medicines in the EU.
  • Industry Representatives: Stakeholders from the pharmaceutical and medical device sectors, including associations like the European Federation of Pharmaceutical Industries and Associations (EFPIA) and MedTech Europe.

Progress and Future Directions
As of early 2025, the projects within the COMBINE Programme are progressing according to the
established timelines. Regular reviews and updates ensure that the programme remains on track
and responsive to emerging challenges.


The ultimate goal is to create a more cohesive and efficient regulatory environment that supports
the development of innovative treatments, benefiting patients across the EU

The role of EUDAMED
EUDAMED (European Database on Medical Devices) is an IT system developed by the European
Commission to implement the Medical Devices Regulation (MDR) and the In Vitro Diagnostic Medical
Devices Regulation (IVDR). With the transition to the new regulations, EUDAMED will be enhanced
to create a more transparent and efficient regulatory tool for all industry stakeholders. However, the
implementation of EUDAMED has seen a number of delays, largely due to the complexity of the
system and resources required to implement. The result has been a lack of coordination between
competent authorities, this can be attributed to some of the challenges identified as part of the
COMBINE programme.

Conclusion
The EU COMBINE Programme represents a significant step forward in harmonizing the regulatory
landscape for combined studies. By addressing the complexities at the intersection of CTR, MDR, and
IVDR, the programme aims to foster innovation and improve patient access to cutting-edge
treatments.

The eventual roll out of EUDAMED will enable greater transparency and communication between
member states, and regulatory authorities.

As the projects within the programme continue to unfold, the healthcare community remains
optimistic about the potential for streamlined processes and enhanced collaboration.

Stay tuned for more updates on the progress and impact of the COMBINE Programme as it continues
to shape the future of clinical research in the EU.

How IVDEOLOGY is supporting the industry
The IVD regulation is a key cog in the mechanism for combined studies. We work with a number of
manufactures developing Companion Diagnostic medical devices, or clinical trial assays which fall
under this regulation. We help build regulatory strategies, and technical documentation to support
regulatory submissions.

Book a call with us to discuss your regulatory challenges or questions and see how IVDeology can
help you

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EUDAMED: A recap for what it means for you

IVDeology are a UK based regulatory and quality compliance support company, with over 100 years combined of expertise within our team, providing you everything you need for your in-vitro diagnostic device life cycle to support you on your compliance journey. In this most recent blog written by Regulatory specialist TszWai Woo takes a look at what EUDAMED is, and what the changes mean to you.

The Medical Devices Regulation (Regulation (EU) 2017/745, ‘MDR’) and the In Vitro Diagnostic Medical Devices Regulation (Regulation (EU) 2017/746, ‘IVDR’) introduced the requirement of EUDAMED, the European database on medical devices. It has been over 3 and 2 years, respectively, since the date of application of the MDR and IVDR, and even after several transition extensions and amendments to both regulations, EUDAMED is still a way off from being fully functional.

With another proposed Regulation (2024/0021 (COD)) due to be published in the Official Journal of the European Union, it is worth having a recap on what EUDAMED is, the current status and what changes the new regulation will introduce.

What is EUDAMED?

EUDAMED is a European database on medical devices that the European Commission was to set up, maintain and manage, as required by the MDR and IVDR. The aim of EUDAMED is to improve transparency and provide information on medical devices on the EU market to the public and healthcare professionals. It also aims to improve medical device traceability, enhance coordination between the EU National Competent Authorities and provide them with easy access to relevant regulatory information.

EUDAMED contains information on medical devices which are organised into the following 6 categories, also known as modules:

  • Actor registration
  • UDI/Devices registration
  • Notified Bodies and Certificates (except for the mechanism for scrutiny and the clinical evaluation consultation procedure (CECP) functionalities)
  • Clinical Investigations and Performance Studies
  • Vigilance and post-market surveillance
  • Market Surveillance

A lot of the information within EUDAMED is to be accessible to the public via a public website.

Current State of Play

To date, only the following 3 modules have been available for voluntary use:

  • Actor registration (since December 2020)
  • UDI/Devices registration (since Oct 2021)
  • Notified Bodies and Certificates (since Oct 2021)

Therefore, manufacturers can submit their organisation and device details on a voluntary basis.

For Actor registration, as well as providing the organisation details, all manufacturers will need to provide a declaration on information security responsibilities and non-EU manufacturers will also need to provide a mandate summary document.

For UDI/Device registration, manufacturer will need to submit device information such as the Basic UDI-DI & UDI-DI, the European Medical Device Nomenclature (EMDN) and notified body (NB) certificate information (if applicable). For devices requiring NB conformity assessment, the NB must confirm the device information in EUDAMED before the device can be publicly available. Therefore, conformity assessment must be completed before prior to registering a device in EUDAMED.

NBs can register certificates and Summaries of Safety and Clinical Performance (SSCP) on voluntary basis. However, there is a caveat: all the parties referenced in the certificates must first be registered, also on a voluntary basis, in EUDAMED.

Additionally, the ‘Vigilance and post-market surveillance’ and ‘Market Surveillance’ modules are due to be made available Q2/2024 and the ‘Clinical Investigations and Performance Studies’ module is not due to be made available before Q3/2026.

EUDAMED was intended to be mandatory for all economic operators to use, after all 6 modules were declared fully functional following an independent audit and a Commission notice was published in the Official Journal of the European Union.

Proposed changes to EUDAMED requirements

Instead of waiting for the completion of the 6th module to make the use of EUDAMED mandatory, 2024/0021 (COD) proposes a gradual roll-out of the mandatory use of each EUDAMED module, once they have been audited and declared functional.

This means that the mandatory use of 3 modules (Actor registration, UDI/Device registration and Notified Bodies & certificates) could therefore start in Q4/2025.

Given the requirements of Article 123 (3) (d) MDR/113 (3) (f) IVDR and Article 123 (3) (e) MDR/113 (3) (a) IVDR, this would mean that mandatory use of all six modules cannot be expected before Q4/2027 and final transitional periods will not end before Q2/2029.

Final Thoughts

Whilst the medical device industry waits with bated breath for the proposed regulation to be published in the Official Journal of the European Union, it is advisable that manufacturers ensure they understand and have all the information they need for the EUDAMED Actor and UDI/Devices registration processes. Hopefully, the proposal will encourage more manufacturers to register on a voluntary basis, as delays in the module development have resulted in low adoption of EUDAMED.

As a UK provider of quality and regulatory services, IVDeology are proud to engage with the IVD industry and keen to support IVD manufacturers with IVD devices market access. For further information on how we can help, please contact [email protected] or you can book straight into our calendar here

Note: This blog contains a summary of the key changes within the proposal, it is important that Manufacturers read and understand the proposal in full, and get independent legal advice if required.