Pharmacovigilance basic interview questions

Pharmacovigilance is the science of collecting, monitoring, researching, assessing and evaluating information from healthcare providers and patients on the adverse effects of medications, biological products, herbalism and traditional medicines.

• An identifiable reporter
• An identifiable patient
• A suspect product
• An adverse drug event

Any untoward medical occurrence in a patient or clinical investigation subject administered a pharmaceutical product, which does not necessarily have to have a causal relationship with this treatment.

An adverse drug reaction is a “response to a drug which is noxious and unintended and which occurs at doses normally used in man for prophylaxis, diagnosis, or therapy of disease or for the modification of physiologic function.” Note that there is a causal link between a drug and an adverse drug reaction. In sum, an adverse drug reaction is harm directly caused by the drug at normal doses, during normal use.

There may not be a causal relationship between a drug and an ADE, whereas there is a causal link between a drug and an adverse drug reaction.

If an event is associated with any one of the following, it is considered to be serious:

• Death
• Life threatening
• Hospitalisation or prolongation of hospitalisation
• Congenital anomaly
• Disability
• Medically significant

• USA: United States Food and Drug Administration (USFDA)
• UK: European Medicines Agency (EMEA)
• Japan: Ministry of Health, Labour and Welfare (MHLW)
• India: Central Drugs Standard Control Organization (CDSCO)

Volume 9A brings together general guidance on the requirements, procedures, roles and activities in the field of pharmacovigilance, for both Marketing Authorisation Holders (MAH) and Competent Authorities of medicinal products for human use; it incorporates international agreements reached within the framework of the International Conference on Harmonisation (ICH).

Volume 9A is presented in four parts:

• Part I — Guidelines for Marketing Authorisation Holders
• Part II — Guidelines for Competent Authorities and the Agency
• Part III — Guidelines for the electronic exchange of pharmacovigilance in the EU
• Part IV — Guidelines on pharmacovigilance communication

A case is considered to be medically confirmed if it contains at least one event confirmed or reported by an HCP (Health Care Professional).

Note: an HCP can be a physician, nurse, pharmacist, coroner or psychologist (only in Germany).

Causality is the relationship between a set of factors. In pharmacovigilance, causality is the relationship between the suspect product and the adverse drug event.

• Patient demographics: age, gender and race
• Suspect product details: drug, dose, dosage form, therapy dates, therapy duration and indication
• Adverse event details: event, event onset date, seriousness criterion, event end date and latency

A narrative should consist of precise and concise information about the source of the report, patient demographics, patient’s medical history, concomitant medications, suspect product details and adverse event details, in an orderly manner.

Medical Dictionary for Regulatory Activities.

1. SOCSystem Organ Class
2. HLGTHigh Level Group Term
3. HLTHigh Level Term
4. PTPreferred Term
5. LLTLower Level Term

• E2A: gives standard definitions and terminology for key aspects of clinical safety reporting. It also gives guidance on mechanisms for handling expedited (rapid) reporting of adverse drug reactions in the investigational phase of drug development.
• E2B: guidelines for the maintenance of clinical safety data management, and information about the data elements for transmission of Individual Case Safety Reports.
• E2C: guidelines for the maintenance of clinical safety data management, and information about the Periodic Safety Update Reports for marketed drugs.