European Medicines Agency - Human Medicines - Medicines for children - Paediatric investigation plans (PIPs), waivers and modifications

Medicines for children
Guidance for applicants
Paediatric investigation plans (PIPs), waivers and modifications
The Paediatric Regulation requires, where necessary, the early submission of a development plan for medicines - the paediatric investigation plan (PIP). The normal development of a medicine requires that various studies be performed to ensure its quality, safety and efficacy. The development plan can be modified at a later stage, with increasing knowledge and if the applicant encounters such difficulties with its implementation as to render the plan unworkable or no longer appropriate.

A paediatric investigation plan is a development plan aimed at ensuring that the necessary data are obtained through studies in children, when it is safe to do so, to support the authorisation of the medicine for children. The plan should be submitted by pharmaceutical companies to the Paediatric Committee, which is responsible for agreement or refusal of the plan.

The paediatric investigation plan includes a description of the studies and of the measures to adapt the way the medicine is presented (formulation) to make its use more acceptable in children. For example, children cannot swallow big tablets, so a liquid formulation may be more appropriate.

The plan should cover the needs of all age groups of children, from birth to adolescence.

The plan also defines the timing of studies in children compared to adults. In some cases, studies will be deferred until after the studies in adults have been conducted, to ensure that research with children is done only when it is safe and ethical to do so. Even when studies are deferred, the PIP should include details on the studies and the timelines.

As some diseases do not affect children (for example Parkinson's disease), the development of medicines for these diseases should not be performed in children, and so a paediatric investigation plan will not be required by the Paediatric Committee; the requirement for a PIP will therefore be waived in these cases. A list of these "class" waivers can be found here.

On 24 September 2008, the European Commission published the guideline entitled 'Guideline on the format and content of applications for agreement or modification of a paediatric investigation plan and requests for waivers or deferrals and concerning the operation of the compliance check and on criteria for assessing significant studies' (Commission Communication 2008/C 243/01).

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European Medicines Agency - Human Medicines - Medicines for children - Paediatric investigation plans (PIPs), waivers and modifications