The impact of the new European IVD-classification rules on the notified body involvement; a study on the IVDs registered in the Netherlands
Title
The impact of the new European IVD-classification rules on the notified body involvement; a study on the IVDs registered in the NetherlandsTranslated Title
De impact van de nieuwe Europese IVD-classificatieregels op de betrokkenheid van notified bodies; Een studie over de in Nederland geregistreerde IVD'sPubliekssamenvatting
In vitro diagnostics (IVDs) are medical devices for carrying out a test using human specimens such as urine or blood. Examples of these products are pregnancy tests, tests for determining the level of glucose or cholesterol in the blood, and tests that determine the blood group. To ensure that these products are safe and effective in use, the manufacturers must go through a procedure before the IVDs may be sold. The current legislation contains two lists on which IVDs are subdivided into a medium-risk and a high-risk category. IVDs that are not on these lists are automatically classified as low risk. An example of an IVD with high risk is an HIV test, whereas a blood collection tube or a pregnancy test has a low risk. A more stringent market authorisation procedure applies for IVDs with a high risk level and additional approval by an external party, a so-called notified body, is required. For low-risk IVDs, manufacturers may carry out the licensing procedure themselves. This system with lists is no longer sufficient. It has therefore been changed in the new European legislation for IVDs, which comes into effect in 2022. The risk of IVDs is then determined according to rules and subdivided into a cascade of four categories. Examples of factors that determine the risk are severity of the disorder tested for and possible consequences of an incorrect test result. Research carried out by the National Institute for Public Health and the Environment (RIVM) has shown that this means that many more IVDs will end up in a higher risk category (84 instead of 7 percent). This means that the number of IVDs for which the manufacturer requires approval of a notified body in order to obtain market authorization will be much greater.In-vitro diagnostica (IVDs) zijn medische hulpmiddelen om lichaamsmateriaal zoals urine of bloed te testen. Voorbeelden van deze producten zijn zwangerschapstesten, testen om het gehalte van glucose of cholesterol in het bloed te meten en testen die de bloedgroep bepalen. Om te waarborgen dat deze producten veilig en effectief in het gebruik zijn, moeten fabrikanten een procedure doorlopen voordat de IVD's mogen worden verkocht. De huidige wetgeving bevat twee lijsten waarop IVD's zijn onderverdeeld in een 'midden' en een 'hoog' risico. IVD's die niet op deze lijst staan worden automatisch ingeschaald als 'laag' risico. Een voorbeeld van een IVD met een hoog risico is een hiv-test, terwijl een bloedbuisje of zwangerschapstest een laag risico heeft. Voor IVD's met een hoog risico geldt een zwaardere toelatingsprocedure en is een extra goedkeuring door een externe partij, een zogenaamde notified body, nodig. Voor laag risico IVD's mogen fabrikanten zelf de toelatingsprocedure uitvoeren. Dit systeem met lijsten voldoet niet meer. Daarom is het in de nieuwe Europese wetgeving voor IVD's, die in 2022 in werking treedt, veranderd. Het risico van IVD's wordt dan volgens nieuw opgestelde regels bepaald en trapsgewijs in vier klassen onderverdeeld. Factoren die van invloed zijn op het risico zijn bijvoorbeeld de ernst van de aandoening waarop wordt getest en mogelijke gevolgen van een onjuiste testuitslag. Uit onderzoek van het RIVM blijkt dat hierdoor veel meer IVD's in een hogere risicoklasse zullen vallen (84 in plaats van 7 procent). Dat betekent dat het aantal IVD's waarvoor de fabrikant goedkeuring van een notified body nodig heeft om het product op de markt te mogen brengen, veel groter zal zijn.
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