In the EU, clinical evaluation (assessment of clinical data) is required to demonstrate that a medical or diagnostic device is safe and performs as intended. Manufacturers / developers of medical and diagnostic devices must demonstrate that they conform to the requirements outlined in the relevant European Directive before the product can be freely marketed in Europe
The clinical evaluation requirement depends on the device class and/or evidence available. For low-to-medium risk devices (Class I, Class IIa and IIb) a literature review and/or clinical evaluation can be sufficient whereas high risk devices (Class III) may require clinical investigation
The CE mark is a key indicator of a product’s compliance with EU legislation. The requirements and assessment process varies by class of device and diagnostic. For more information see guidance by the MHRA
Best practice is to prepare a technical file/design dossier to record evidence of your conformity with EU requirements (for both self-assessment or to be used as part of an assessment by a Notified Body)
Class I medical devices, where these have been assessed for conformation to EU standards you, or your authorised representative, must register with the competent authority in the EU state where you have an office or place of business. In the UK, the MHRA is the competent authority. For Class IIa and above, a notified body will assess your conformation with EU standards (no additional registration with a competent authority is required)
For diagnostics, there are a number of ways you can demonstrate conformity with the IVD Directive, which involve a choice of testing and quality assurance modules; the choices depend on the classification of the device
Further clinical and cost-effectiveness evidence may need to be gathered later in the development pathway to support the value proposition of the product
Consider alerting NIHR Horizon Scanning Research Intelligence Centre about your product’s development
Consider the route to reimbursement and finalise the price of the device for cost-effectiveness and pricing discussions
Phase III trials are only for medicines that have passed Phases I and II. Phase III trials involve giving a medicine to large groups of people (up to thousands) to collect information on its effectiveness, compare the drug to comparator treatments and monitor side effects. They often last a year or more, and these trials may test new treatments, new dosage levels or new methods of action
Once Phase III studies have been completed, all available evidence is compiled for the regulatory dossier
Cost effectiveness analyses are often carried out alongside clinical trials with comparators that reflect current practice; the UK has a number of expert organisations that can support this process
It is best practice for digital health technologies to develop clinical evidence around their safety and efficacy; you may want to consider the type of evidence you are collecting based on whether the technology is for prevention or intervention, and whether it will be bought be clinicians or patients
EU legislation requires all claims around health and wellbeing to be supported by evidence
Clinical evaluation (assessment of clinical data) is required to demonstrate that digital health technologies are safe and perform as intended.
Some digital health technologies may be classed as medical devices. The clinical evaluation requirement depends on the device class and/or evidence available. For low-to-medium risk devices (Class I, Class IIa and IIb) a literature review and/or clinical evaluation can be sufficient whereas high risk devices (Class III) may require clinical investigation
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