News and Educations

Notice on availability of tetanus vaccine in the Republic of Croatia


Following to the misleading information on shortage of tetanus vaccine on the Croatian market, the Agency for Medicinal Products and Medical Devices would like to inform the public on the availability of this vaccine.

The vaccine Tetavax, suspension for injection in pre-filled syringe, tetanus vaccine, adsorbed is authorised in the Republic of Croatia.

According to the information that HALMED received from the local marketing authorisation holder’s representative for Tetavax, this vaccine is placed on the Croatian market and sufficient amount of the product is available for an undisturbed supply of the Croatian market. From the end of September 2015, 9500 doses of this vaccine has been placed on the Croatian market and in the beginning of November, a delivery of 32000 new doses is expected, therefore, there is no shortage of tetanus vaccine in Croatia.

In the case that there is a discontinuation in the supply chain or shortage of Tetavax, the marketing authorisation holder is obliged to notify HALMED, who will promptly make this information publically available and undertake adequate measures for ensuring adequate supply of the market with this vaccine.


Temporary suspension of use of the implants produced by the Brasilian manufacturer Silimed


The Agency for Medicinal Products and Medical Devices (HALMED) has recommended a temporary suspension of implantation of the Brasilian manufacturer SILIMED. According to the recommendation, further sale of these products has been discontinued in the Republic of Croatia. The suspension has been due to precautions after an unannounced inspection at the manufacturing site in Brasil discovered a impurity with particles on the surface of certain products of this manufacturer. According to the currently available safety data there are no indications that this issue could have a harmful effect on the health of patients with these implants.

Therefore, individuals with these implants are for now advised not to take any further steps than ordinary ones and regular controls according to doctor’s recommendations. In the case of concern patients should speak to their doctor who implanted the product.


HALMED in the global top 10 according to the number of suspected adverse reaction reports per one million inhabitants


According to the latest data published by the Uppsala Monitoring Centre (UMC), the collaborative center of the World Health Organisation (WHO) responsible for administering the global adverse reaction database VigiBase, the Republic of Croatia has become one of the ten countries in the world with the greatest number of suspected adverse reaction reports per one million inhabitants. This success is a result of common efforts of HALMED and all the health care professionals, patients and marketing authorisation holders who regularly report suspected adverse reactions.

Further information is accessible under the link below.


Inspections in Institute of Immunology started


HALMED will conduct audits from 8th to 12 June 2015 in Institute of Immunology d.d., due to establish whether the manufacturer complies with Good Manufacturing Practice. This audit upon Institute of Immunology’s application for granting a manufacturing license for bacterial vaccines and manufacture of medicinal products derived from human blood or plasma and sera of animal origin.

Decisions on granting or rejecting the two manufacturing licenses to Institute of Immunology d.d., will be taken following the entire procedure of granting/rejecting manufacturing licenses, where audits make only a part of the procedure. HALMED will complete these procedures as a priority, but when the decision will be taken depends on the applicant and how fast he will respond to eventual deficiencies. Namely, under Medicinal Products Act, the deadline for granting or rejecting manufacturing licenses is 90 following submission of a valid application, where the deadline may be prolonged for a clock-stop period needed by the applicant to prepare written justifications during the procedure.

All relevant information is accessible under the link below.


Notice on the audit in Institute of Immunology


The repeated procedure of granting/revoking manufacturing license in Institute of Immunology d.d. is currently undergoing. The procedure phase where initial review of the documentation submitted by Institute of Immunology d.d. has been completed and the new audit with the aim to verify the GMP compliance, will in agreement with Institute of Immunology be carried out in June.

We remind that HALMED’s intention was to repeat the audit of the Institute of Immunology already from 7 to 9 April, but Institute of Immunology asked for postponement in order to be better prepared. Therefore, the deadline for the audit of HALMED’s experts has been postponed, at manufacturer’s request. So, HALMED intended and was ready to conduct an urgent audit, however the audit was postponed exclusively on the existing of Institute of Immunology.


Institute of Immunology did not fulfil the conditions for manufacturing of sterile medicines and bacterial vaccines


The Agency for Medicinal Products and Medical Devices (HALMED) completely supports efforts of Direction and employees of Institute of Immunology aimed at fulfilling all necessary conditions for regaining manufacturing licenses and fully supports the initiative aimed at helping Institute of Immunology. At the same time, HALMED is as an independent scientific body obliged by its action to protect primarily the most important national interest and this is the safety and health of our patients. Therefore, we decidedly reject implications that we have protected any particular private interest by rejecting manufacturing licenses to Institute of Immunology. HALMED was guided in its procedures solely by the interest of Croatian patients, which means their safety protection.

Institute of Immunology did not fulfil stipulated conditions and requirements of Good manufacturing Practice and it was not in the capacity of eliminating discovered deficiencies that might represent a public health risk, or health of every individual patient using medicinal products manufactured at these premises. Therefore, with the aim to protect Croatian patients, HALMED had to reject granting a renewal of these manufacturing licenses to Institute of Immunology.

We would like to stress that there is no question about “too strict” requirements, but rather about the same standard conditions and requirements that all other pharmaceutical manufacturers in Croatia fulfil, and that are indispensable for producing sterile medicinal products and vaccines. With the necessary improvement and investment, Institute of Immunology would be in capacity to fulfil them, as all other local manufacturers do.

In the case of the annulment of HALMED’s decisions on rejection of manufacturing licenses to Institute of Immunology, it is about different interpretations of the Medicinal Products Act and Act on the Common Administrative Procedure, that in the end has no influence on the scientific decision that Institute of Immunology at that time did not fulfil the manufacturing conditions. To support this is the fact that Institute of Immunology has never initiated any administrative court appeal against these HALMED’s decisions, which testifies that did not contradict the established situation according to which they do not fulfil the manufacturing conditions. Exactly opposite, even the Institute of Immunology’s Directorate at that time on several occasions publically confirmed the existence of discovered important and critical deficiencies that they were not in the capacity to remedy in order to fulfil the necessary prerequisites for renewal of manufacturing licenses.

When granting decisions on rejecting manufacturing licenses to Institute of Immunology, HALMED completely acted in accordance with the Medicinal Products Act and Act on Common Administrative Procedure. Based on all relevant facts, it was established that Institute of immunology d.d. at that time did not fulfil the conditions for producing sterile medicinal products and bacterial vaccines, which was unbiasedly established by a scientific committee, composed from HALMED’s experts and the Ministry of Health’s pharmaceutical inspector.

The main objection to HALMED’s decisions is that they are allegedly founded on the opinion of the Ministry of Health’s pharmaceutical inspector, but rather opposite – they are based on the opinion of the legally responsible HALMED’s inspector and they are additionally referring to the opinion of the inspector who previously was the only inspector in Croatia. Namely, the procedure of granting/rejecting manufacturing licenses to Institute of Immunology was initiated before Croatia’s accession to the EU, when the GMP inspection was responsibility of the Ministry of Health. However, during the procedure, with the day of accession to the EU, the new medicinal Products Act came into effect, where the GMP inspection started to be part of HALMED’s responsibilities and the decision on rejection of manufacturing licenses to Institute of Immunology was based on the opinion of the responsible HALMED’s inspector.

It is a paradox that the fact that HALMED did not take account of its own inspector only, but rather included a scientific opinion of the Ministry’s inspector which is even more relevant when taking account of her long GMP inspection experiences, is considered to be a mistake. Also like the fact that the Report was not signed only by the HALMED’s inspector, but also by members of the Committee that the Agency under the relevant Ordinance was entitled to appoint.

The attempt to oppose the competency of the scientific Committee is completely wrong, because under Art. 26 the Ordinance clearly indicates that the Agency may appoint a committee composed of different experts, which the Agency in that case did, in order to support the scientific decision.

In addition, by incorrectly interpreting certain words in the opinion of the HALMED’s inspector and their pulling out of context in the Ministerial decision a wrong conclusion is indicated that the Agency’s inspector was possibly considering to grant a conditional license. However, just opposite, the Agency’s inspector in its opinion clearly states that 6 important deficiencies and even 2 critical ones, which means those that might put patients at risk, were discovered during the audit in Institute of Immunology.

Therefore, the opinion of the Agency’s inspector was completely in accordance with the Ministry’s pharmaceutical inspector, so the opinion of the Ministry’s inspector could have not changed the final decision. In other words, both these opinions are equally indicating the existence of critical deficiencies in manufacturing at Institute of Immunology, according to which licenses could have not been renewed or granted again.

We remind that Institute of immunology was already in 2012 granted conditional licenses with a one year deadline to remedy the discovered deficiencies. Bearing in mind that Institute of Immunology was not in the capacity to remedy the discovered deficiencies and ensure the relevant conditions for producing sterile vaccines and medicinal products, it was not possible to renew manufacturing licenses.

HALMED stays firmly behind this decision on rejecting manufacturing licenses that was taken completely in compliance with laws and bylaws and in compliance with our role as a an independent national regulatory body obliged to protect the interest of Croatian patients.