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Pachocki J, Verter F. Polish regulatory system regarding ATMP hospital exemptions. Front Immunol 2024; 15:1379134. [PMID: 38803487 PMCID: PMC11128580 DOI: 10.3389/fimmu.2024.1379134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 04/16/2024] [Indexed: 05/29/2024] Open
Abstract
Introduction This article explains the current regulatory system in Poland regarding Advanced Therapy Medicinal Products given under Hospital Exemptions (ATMP-HE). Methods The relevant sections of Polish legislation are translated into English and their interaction is described. Results We analyze the impact of these regulations from the perspective of three stakeholder groups: manufacturers, physicians, and patients. Amendments enacted between 2018 and 2023 have substantially changed Polish implementation of the ATMP-HE pathway. In Poland, most ATMP-HE treatments have been therapies employing Mesenchymal Stromal Cells (MSC). Discussion Comparison to other European countries shows that Poland is within the mainstream of EU practices regarding ATMP-HE implementation. One notable issue is that Poland has relatively low per capita spending on healthcare, and ATMP-HE in Poland must be funded from outside the government healthcare system. Conclusions. The original intention of the legislation that created ATMP-HE was to allow access to experimental therapies for patients with unmet needs. It remains to be seen if that mission can be fulfilled amidst conflicting pressures from various stakeholder groups.
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Affiliation(s)
| | - Frances Verter
- Parent’s Guide to Cord Blood Foundation, Brookeville, MD, United States
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Matthews KRW, Lowe SJ, Master Z. US state laws on medical freedom and investigational stem cell procedures: a call to focus on state-based legislation. Cytotherapy 2024; 26:404-409. [PMID: 38310500 PMCID: PMC11010147 DOI: 10.1016/j.jcyt.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 01/04/2024] [Accepted: 01/21/2024] [Indexed: 02/05/2024]
Abstract
The premature marketing of investigational stem cell interventions (SCIs) is a growing market in the US. Several US states have passed legislation to permit and promote unproven and experimental SCIs for individuals with terminal or chronic diseases. These SCI medical freedom laws, which are largely based on right-to-try legislation, increase access to experimental SCIs with little to no oversight. They undermine federal regulatory authority and can compromise patient safety and informed decision-making. SCI medical freedom laws have gone largely unnoticed by scientific societies interested in the responsible translation of stem cell medicine. In this article, we analyze state SCI medical freedom laws and describe their detrimental impact on patients and society. We contend that scientific and medical societies are uniquely poised to advocate against state-based policy promoting unproven SCIs but recognize resource and other constraints to advocate for or against legislation in 50 states. We recommend societies establish coalitions and share resources to address state-based SCI medical freedom laws and other legislation surrounding unproven SCIs.
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Affiliation(s)
- Kirstin R W Matthews
- Baker Institute Center for Health and Biosciences, Rice University, Houston, Texas, USA.
| | - Samantha J Lowe
- Baker Institute Center for Health and Biosciences, Rice University, Houston, Texas, USA
| | - Zubin Master
- Baker Institute Center for Health and Biosciences, Rice University, Houston, Texas, USA; Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA.
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Sanchez-Guijo F, Vives J, Ruggeri A, Chabannon C, Corbacioglu S, Dolstra H, Farge D, Gagelmann N, Horgan C, Kuball J, Neven B, Rintala T, Rocha V, Sanchez-Ortega I, Snowden JA, Zwaginga JJ, Gnecchi M, Sureda A. Current challenges in cell and gene therapy: a joint view from the European Committee of the International Society for Cell & Gene Therapy (ISCT) and the European Society for Blood and Marrow Transplantation (EBMT). Cytotherapy 2024:S1465-3249(24)00054-9. [PMID: 38416085 DOI: 10.1016/j.jcyt.2024.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Revised: 02/12/2024] [Accepted: 02/12/2024] [Indexed: 02/29/2024]
Abstract
Cell and gene therapy poses evolving challenges. The current article summarizes the discussions held by European Regional Committee of the International Society for Cell & Gene Therapy and the European Society for Blood and Marrow Transplantation (EBMT) on the current challenges in this field, focusing on the European setting. This article emphasizes the imperative assessment of real-world cell and gene therapy activity, advocating for expanded registries beyond hematopoietic transplantation and chimeric antigen receptor-T-cell therapy. Accreditation's role in ensuring standardized procedures, as exemplified by JACIE (The Joint Accreditation Committee of ISCT-Europe and EBMT), is crucial for safety. Access to commercial products and reimbursement variations among countries underscore the need for uniform access to advanced therapy medical products (ATMPs). Academic product development and point-of-care manufacturing face barriers to patient access. Hospital Exemption's potential, demonstrated by some initial experiences, may increase patient accessibility in individual situations. Regulatory challenges, including the ongoing European ATMPs legislation review, necessitate standardized criteria for Hospital Exemption and mandatory reporting within registries. Efforts to combat unproven therapies and fraud involve collaboration between scientific societies, regulatory bodies and patient groups. Finally, is important to highlight the vital role of education and workforce development in meeting the escalating demand for specialized professionals in the ATMP field. Collaboration among scientific societies, academic institutions, industry, regulatory bodies and patient groups is crucial for overcoming all these challenges to increase gene and cell therapy activity in Europe.
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Affiliation(s)
- Fermin Sanchez-Guijo
- University of Salamanca, IBSAL-University Hospital of Salamanca, Salamanca, Spain.
| | - Joaquim Vives
- Banc de Sang i Teixits (BST). Musculoskeletal Tissue Engineering Group, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Annalisa Ruggeri
- Hematology and BMT Unit, San Raffaele Scientific Institute, Milano, Italy, and Cellular Therapy and Immunobiology working party of the EBMT
| | - Christian Chabannon
- Centre de Thérapie Cellulaire, Institut Paoli-Calmettes Comprehensive Cancer Center & Module Biothérapies du Centre d'Investigation Clinique de Marseille, CBT-1409 INSERM, Aix-Marseille Université, AP-HM, Institut Paoli-Calmettes, Marseille, France
| | | | - Harry Dolstra
- Laboratory of Hematology - Department of Laboratory Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Dominique Farge
- AP-HP, Hôpital St-Louis, Unité de Médecine Interne (UF04): CRMR MATHEC, Maladies Auto-immunes et Thérapie Cellulaire, Centre de Référence des Maladies auto-immunes systémiques Rares d'Ile-de-France, and Université Paris Cité, IRSL, Recherche Clinique en hématologie, immunologie et transplantation, URP3518, Paris, France
| | - Nico Gagelmann
- University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Claire Horgan
- Department of Bone Marrow Transplant and Cellular Therapy, Royal Manchester Children's Hospital, Manchester University NHS Foundation Trust, Manchester, UK
| | - Jurgen Kuball
- Department of Hematology and Center for Translational Immunology, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Benedicte Neven
- Immuno-hematology and Rheumatology Unit, Necker Children's Hospital, Assistance Publique-Hôpitaux de Paris, Université de Paris, INSERM 1163, Institut Imagine, Paris, Île-de-France, France
| | | | - Vanderson Rocha
- Hematology Bone Marrow Transplant Unit, Hospital Sirio-Libanes, Sao Paulo, Brazil
| | | | - John A Snowden
- Department of Haematology, Sheffield Teaching Hospitals NHS Foundation Trust and Division of Clinical Medicine, School of Medicine and Population Health, University of Sheffield, Sheffield, UK
| | | | - Massimiliano Gnecchi
- Department of Molecular Medicine, Unit of Cardiology, University of Pavia, Pavia, Italy; Department of Cardiothoracic and Vascular Sciences, Translational Cardiology Unit, Fondazione IRCCS, Policlinico San Matteo, Pavia, Italy
| | - Anna Sureda
- Clinical Hematology Department, Institut Català d'Oncologia - L'Hospitalet, IDIBELL, Universitat de Barcelona, Barcelona, Spain
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Ikka T, Hatta T, Saito Y, Fujita M. Does the Act on the Safety of Regenerative Medicine in Japan ensure "safety"?: Implications of low adverse event reporting. Stem Cell Reports 2023; 18:2297-2299. [PMID: 37977143 PMCID: PMC10724052 DOI: 10.1016/j.stemcr.2023.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/18/2023] [Accepted: 10/19/2023] [Indexed: 11/19/2023] Open
Abstract
Public document analysis reveals that the adverse events reported for therapeutic administration under the Act on the Safety of Regenerative Medicine (ASRM) in Japan are substantially fewer than those under the Pharmaceuticals and Medical Devices Act. This study highlights the flawed reporting mechanisms and unmet legislative intentions of the ASRM.
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Affiliation(s)
- Tsunakuni Ikka
- Division of Bioethics & Healthcare Law, Institute for Cancer Control, National Cancer Center Japan, Chuo-ku, Tokyo 104-0045, Japan; Division of Bioethics, Center for Research Administration and Support, National Cancer Center Japan, Chuo-ku, Tokyo 104-0045, Japan.
| | - Taichi Hatta
- Graduate School of Public Health, Shizuoka Graduate University of Public Health, Aoi-ku, Shizuoka 420-0881, Japan.
| | - Yoko Saito
- Division of Bioethics, Center for Research Administration and Support, National Cancer Center Japan, Chuo-ku, Tokyo 104-0045, Japan
| | - Misao Fujita
- Uehiro Research Division for iPS Cell Ethics, Center for iPS Cell Research and Application (CiRA), Kyoto University, Sakyo-ku, Kyoto 606-8507, Japan; Institute for the Advanced Study of Human Biology (WPI-ASHBi), KUIAS, Kyoto University, Sakyo-ku, Kyoto 606-8501, Japan
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