FrancophonIA/ELRC3.0 huggingface dataset:
English: Although fewer children receiving TIP discontinued the treatment, the overall number of children in EAGER study was small, and thus no definite conclusion about this subpopulation can be drawn.
Slovenian: Čeprav je zdravljenje prekinilo manj otrok, ki so prejemali TIP, je bilo skupno število otrok v študiji EAGER majhno, zato o tej podpopulaciji ni mogoče izpeljati dokončnih zaključkov.
English: Tobramycin is an aminoglycoside antibiotic.
Slovenian: Tombramicin je aminoglikozidni antibiotik.
English: Safety was the primary endpoint of this study, nevertheless it was powered for efficacy (secondary endpoint) and therefore demonstrated non-inferiority in terms of efficacy only.
Slovenian: Primarni opazovani dogodek v tej študiji je bila varnost, vendar je imela študija tudi statistično moč za ugotavljanje učinkovitosti (sekundarni opazovani dogodek), zato so dokazali neinferiornost samo v smislu učinkovitosti.
English: According to the European Cystic Fibrosis Society Patient Registry, 48.0% of cystic fibrosis patients in the 20 European countries presenting data are over 18 years of age3.
Slovenian: Po podatkih iz registra bolnikov Evropskega društva za cistično fibrozo je 48,0 % bolnikov s cistično fibrozo iz 20 evropskih držav, za katere obstajajo podatki, starejših od 18 let3.
English: These observations were replicated in post-hoc analyses of different age groups.
Slovenian: Do enakih opažanj so prišli tudi v naknadnih analizah različnih starostnih skupin.
English: When taken together, these elements allow to estimate that at least 10% of the target population may not be able to use TOBI Podhaler due to intolerance.
Slovenian: Ti elementi skupaj omogočajo oceno, da vsaj 10 % ciljne populacije zaradi intolerance morda ne more uporabljati zdravila TOBI Podhaler.
English: The CHMP issued a positive opinion by consensus recommending the granting of the marketing authorisation and of the summary of product characteristics, labelling and package leaflet as per the final versions achieved during the Coordination group procedure as mentioned in Annex III of the CHMP opinion.
Slovenian: Odbor CHMP je soglasno izdal pozitivno mnenje in priporočil izdajo dovoljenja za promet z zdravilom in odobritev povzetka glavnih značilnosti zdravila, označevanja in navodila za uporabo v obliki zadnjih različic, dogovorjenih v postopku skupine za usklajevanje, kot je navedeno v Prilogi III mnenja odbora CHMP.
English: With regards to the claim of clinical superiority on the ground of greater safety in a substantial portion of the target population, the applicant was requested by CHMP during the procedure:
Slovenian: V zvezi s trditvijo o klinični superiornosti na podlagi večje varnosti pri znatnem deležu ciljne populacije je odbor CHMP med postopkom od predlagatelja zahteval naslednje:
English: The overall discontinuation rates for TIP were 3.6% in the children (≥6 to <13 years), 18.2% in the adolescents (≥13 to <20 years), and 32.7% in the adults (≥ 20 years), while the discontinuation rates with TIS were 16.7% in the children and adolescents, and 18.9% in the adults.
Slovenian: Skupna stopnja prekinitve zdravljenja pri TIP je bila 3,6 % pri otrocih (≥ 6 do < 13 let), 18,2 % pri mladostnikih (≥ 13 do < 20 let) in 32,7 % pri odraslih (≥ 20 let), medtem ko je bila stopnja prekinitve zdravljenja pri TIS 16,7 % pri otrocih in mladostnikih ter 18,9 % pri odraslih.
English: Post hoc subgroup analyses of EAGER data compared the safety profiles of TIP and TIS in children, adolescents, and adults.
Slovenian: Z naknadnimi analizami podskupin podatkov iz študije EAGER so primerjali varnostna profila TIP in TIS pri otrocih, mladostnikih in odraslih.
English: A Marketing Authorisation for Tobramycin VVB can therefore only be granted with the currently proposed indication if at least one of the derogation grounds set out in Article 8(3) of Regulation (EC) No 141/2000 is fulfilled.
Slovenian: Dovoljenje za promet z zdravilom Tobramycin VVB se torej lahko izda le s trenutno predlagano indikacijo, če je izpolnjena vsaj ena podlaga za odstopanje iz člena 8(3) Uredbe (ES) št. 141/2000.
English: For these patients, the nebuliser solution is a safer alternative (in terms of tolerability) and 10% is considered by CHMP to be a substantial portion of the target population.
Slovenian: Za te bolnike je inhalacijska raztopina za nebulator varnejša alternativa (v smislu prenašanja), in odbor CHMP meni, da 10 % pomeni znaten delež ciljne populacije.
English: Day 60 of the CMDh procedure was on 01 October 2015 and since the Member States failed to reach an agreement, the procedure was referred to the CHMP in accordance with Article 29(4) of Directive 2001/83/EC.
Slovenian: 60. dan postopka skupine CMDh je bil 1. oktobra 2015 in ker države članice niso dosegle dogovora, je bil postopek v skladu s členom 29(4) Direktive 2001/83/ES predložen odboru CHMP.
English: Local respiratory intolerability to the dry powder inhalation can manifest itself through symptoms such as cough, and result in discontinuation of treatment.
Slovenian: Lokalna intoleranca dihal za inhalacijo suhega praška se lahko kaže s simptomi, kot je kašelj, in privede do prekinitve zdravljenja.
English: • The Committee considered the notification of the referral initiated by the Reference Member State Lithuania under Article 29(4) of Directive 2001/83/EC where the Concerned Member State Poland raised objections to the granting of the marketing authorisation;
Slovenian: • Odbor je proučil obvestilo o napotitvi, ki ga je sprožila referenčna država članica Litva v skladu s členom 29(4) Direktive 2001/83/ES, pri čemer je zadevna država članica Poljska nasprotovala izdaji dovoljenja za promet z zdravilom;
English: In addition, 3.9% (12/308) of TIP-treated patients discontinued due to cough vs 1% (2/209) of TIS-treated patients.
Slovenian: Poleg tega je 3,9 % (12/308) bolnikov, zdravljenih s TIP, prekinilo zdravljenje zaradi kašlja, v primerjavi z 1 % (2/209) bolnikov, zdravljenih s TIS.
English: This study evaluated the safety, efficacy and convenience of TIP vs TIS in CF patients aged 6 years and above with chronic P. aeruginosa infection.
Slovenian: V tej študiji so ocenjevali varnost, učinkovitost in praktičnost TIP v primerjavi s TIS pri bolnikih s CF, starih 6 let ali več, ki imajo kronično okužbo z bakterijo P. aeruginosa.
English: Cough (not including productive cough) was the most frequently reported AE throughout the entire study period (TIP: 48.4%; TIS: 31.1%) despite being present in the same proportion of patients (42%) in both groups as a baseline symptom.
Slovenian: Kašelj (brez produktivnega kašlja) je bil najpogosteje poročani neželeni učinek v celem študijskem obdobju (TIP: 48,4 %; TIS: 31,1 %), kljub temu, da je bil kot izhodiščni simptom prisoten pri enakem deležu bolnikov (42 %) v obeh skupinah.
English: During the discussion, CHMP also noted the differences in terms of inhalation time between Tobramycin VVB and Tobi Podhaler.
Slovenian: Med razpravo je odbor CHMP opozoril tudi na razlike v inhalacijskem času med zdraviloma Tobramycin VVB in TOBI Podhaler.
English: The frequency of severe cough events was also higher in TIP group (2.6% versus 1.9%).
Slovenian: Tudi pogostnost hudega kašlja je bila večja v skupini s TIP (2,6 % v primerjavi z 1,9 %).
English: To substantiate the relevance of difference in the incidence of adverse events (e.g. cough, discontinuation, etc.) between Tobramycin VVB and the orphan-designated medicinal product TOBI Podhaler based on own and/or published data.
Slovenian: utemeljitev pomena razlike v pojavnosti neželenih učinkov (npr. kašlja, prekinitve zdravljenja itd.) med zdravilom Tobramycin VVB in zdravilom siroto TOBI Podhaler na podlagi lastnih in/ali objavljenih podatkov.
English: It is therefore established that there is a portion of the target population who cannot use powder inhalator due to the development of intolerance.
Slovenian: Tako je bilo torej ugotovljeno, da obstaja določen delež ciljne populacije, ki zaradi pojava intolerance ne more uporabljati inhalatorja s praškom.
English: This is in line with fact that cough is described as a ‘very common' adverse reaction in association with TOBI Podhaler, which means that it occurs with a frequency of at least 10%.
Slovenian: To je skladno z dejstvom, da je kašelj v povezavi z zdravilom TOBI Podhaler opisan kot 'zelo pogost' neželeni učinek, kar pomeni, da se pojavlja z vsaj 10-odstotno pogostnostjo.
English: Post hoc analysis of AEs profile in different age groups confirmed the results that were originally observed in EAGER study, i.e., any AE and cough, dysphonia and dysgeusia were more frequent among TIP-treated patients across all age groups.
Slovenian: Naknadna analiza profila neželenih učinkov pri različnih starostnih skupinah je potrdila rezultate, ki so jih prvotno opazili v študiji EAGER, tj. kateri koli neželeni učinek in kašelj, disfonija in disgevzija so bili v vseh starostnih skupinah pogostejši pri bolnikih, zdravljenih s TIP.
English: • The Committee reviewed the responses submitted by the applicant to address the issues raised with regard to the claim for clinical superiority of Tobramycin VVB vs. TOBI Podhaler;
Slovenian: • Odbor je pregledal odgovore, ki jih je predložil predlagatelj v zvezi z vprašanji glede trditve o klinični superiornosti zdravila Tobramycin VVB v primerjavi z zdravilom TOBI Podhaler;
English: However, CHMP concluded that these differences are not relevant in the context of the claim of clinical superiority based on greater safety as the patients constituting a substantial portion of the target population are intolerant to Tobi Podhaler and cannot use therefore Tobi Podhaler.
Slovenian: Vendar je zaključil, da te razlike v kontekstu trditve o klinični superiornosti na podlagi večje varnosti niso pomembne, saj bolniki, ki sestavljajo znaten delež ciljne populacije, ne prenašajo zdravila Tobi Podhaler in ga torej ne morejo uporabljati.
English: Results of audiology performed in a subpopulation of patients (TIP: 78 [25.3%]; TIS: 45 [21.5%]) revealed that a higher proportion of TIP-treated patients (25.6%; 20/78) than TIS-treated patients (15.6%; 7/45) experienced a decrease from baseline in any audiology test frequency at any visit.
Slovenian: Rezultati avdioloških preiskav, opravljenih pri podpopulaciji bolnikov (TIP: 78 [25,3 %]; TIS: 45 [21,5 %]) so pokazali, da je bil delež bolnikov, zdravljenih s TIP (25,6 %; 20/78), pri katerih je ob vsakem obisku
English: During the assessment of the marketing authorisation application for Tobramycin VVB and in the context of the abovementioned Article, a similarity assessment was performed concluding that Tobramycin VVB was similar to Tobi Podhaler.
Slovenian: Med ocenjevanjem vloge za pridobitev dovoljenja za promet z zdravilom Tobramycin VVB in v kontekstu zgoraj navedenega člena je bila opravljena ocena podobnosti, s katero so zaključili, da je zdravilo Tobramycin VVB podobno zdravilu Tobi Podhaler.
English: The proposed medicinal product contains the same qualitative and quantitative composition and the same pharmaceutical form as TOBI 300mg/5 ml nebuliser solution, therefore clinical studies for demonstrating therapeutic equivalence can be waived in accordance with the scientific guidelines (EMEA/CHMP/QWP/49313/2005 Corr. and CPMP/EWP/4151/00 Rev.1).
Slovenian: Predlagano zdravilo ima enako kakovostno in količinsko sestavo in enako farmacevtsko obliko kot zdravilo TOBI 300 mg/5 ml inhalacijska raztopina za nebulator, zato se klinične študije za dokaz terapevtske enakovrednosti v skladu z znanstvenimi smernicami (EMEA/CHMP/QWP/49313/2005 popr.
English: Considering the data from EAGER study and its post-hoc analyses, the difference in overall discontinuations is nearly 9% and difference in discontinuations due AEs is ~5% in favour of Tobramycin nebuliser solution.
Slovenian: Z upoštevanjem podatkov iz študije EAGER in njenih naknadnih analiz je razlika v skupni stopnji prekinitve zdravljenja skoraj 9 %, razlika v stopnji prekinitve zdravljenja zaradi neželenih učinkov pa ~5 % v korist inhalacijske raztopine tobramicina za nebulator.
English: Cough events were suspected by the investigator as being related to study drug in 25.3% and 4.3% of patients in the TIP and TIS group, respectively.
Slovenian: Po mnenju raziskovalca je bil kašelj povezan s študijskim zdravilom pri 25,3 % bolnikov iz skupine TIP in pri 4,3 % bolnikov iz skupine TIS.
English: On day 210, major issues on safety and efficacy were raised which remained unsolved; hence the procedure was referred to the CMDh, under Article 29, paragraph 1 of Directive 2001/83/EC by Lithuania on 24 July 2015.
Slovenian: 210. dan so se pojavili pomembnejši pomisleki o varnosti in učinkovitosti, ki se niso razrešili, zato je Litva 24. julija 2015 postopek predložila skupini CMDh v skladu s 1. odstavkom člena 29
English: In the EAGER trial, the overall discontinuation rate was higher with TIP (26.9%) than TIS (18.2%).
Slovenian: V preskušanju EAGER je bila skupna stopnja prekinitve zdravljenja večja pri TIP (26,9 %) kot pri TIS (18,2 %).
English: The higher cough rate observed with TOBI Podhaler may be due to a higher powder deposition in the throat in comparison to nebuliser products.
Slovenian: Večja stopnja kašlja pri zdravilu TOBI Podhaler je morda posledica večjega odlaganja praška v grlu v primerjavi z zdravili v obliki nebulatorja.
English: The difference is even more pronounced in the adult cystic fibrosis patient population (14% difference in overall discontinuations and 8% - in discontinuations due to AEs).
Slovenian: Razlika je še izrazitejša v populaciji odraslih bolnikov s cistično fibrozo (razlika 14 % v skupni stopnji prekinitve zdravljenja in 8 % v stopnji prekinitve zdravljenja zaradi neželenih učinkov).
English: A higher percentage of TIP- than TIS-treated patients reported AEs (90.3% versus 84.2%, p<0.05).
Slovenian: O neželenih učinkih je poročal večji odstotek bolnikov, zdravljenih s TIP, kot bolnikov, zdravljenih s TIS (90,3 % v primerjavi s 84,2 %, p<0,05).
English: This is particularly illustrated by the differences in the discontinuation rates due to AEs (13% for the inhalation powder vs. 8% for the nebuliser solution), development of cough as an adverse drug related event (25% for the inhalation powder vs. 4% for the nebuliser solution) and dysphonia rates (13% for the inhalation powder vs. 4% for the nebuliser solution).
Slovenian: To še zlasti dokazujejo razlike v stopnji prekinitve zdravljenja zaradi neželenih učinkov (13 % pri prašku za inhalacijo v primerjavi z 8 % pri inhalacijski raztopini za nebulator), v pojavnosti kašlja kot neželenega učinka zdravila (25 % pri prašku za inhalacijo v primerjavi s 4 % pri inhalacijski raztopini za nebulator) in pojavnosti disfonije (13 % pri prašku za inhalacijo v primerjavi s 4 % pri inhalacijski raztopini za nebulator).
English: • The Committee was of the view that the data support the claim for clinical superiority of Tobramycin VVB versus TOBI Podhaler based on greater safety in a substantial portion of the target population, as per Article 8(3)(c) of Regulation (EC) No 141/2000 read in combination with Article 3(3)(d)(2) of Regulation (EC) No 847/2000;
Slovenian: • Odbor je bil mnenja, da podatki podpirajo trditev o klinični superiornosti zdravila Tobramycin VVB v primerjavi z zdravilom TOBI Podhaler na podlagi večje varnosti pri znatnem deležu ciljne populacije v skladu s členom 8(3)(c) Uredbe (ES) št. 141/2000 v povezavi s členom 3(3)(d)(2) Uredbe (ES) št. 847/2000;
English: In the light of the above, to further justify why the applicant considers Tobramycin VVB clinically superior in a substantial portion of the target population to the orphan-designated medicinal product TOBI Podhaler.
Slovenian: V luči zgoraj navedenega naj predlagatelj nadalje utemelji, zakaj meni, da je zdravilo Tobramycin VVB klinično superiorno pri znatnem deležu ciljne populacije v primerjavi z zdravilom siroto TOBI Podhaler.
English: Other treatment-related AEs more commonly reported in the TIP group were dysphonia (13.6% vs 3.8%) and dysgeusia (3.9% vs 0.5%).
Slovenian: Druga neželena učinka, povezana z zdravljenjem, o katerih so pogosto poročali v skupini TIP, sta bila disfonija (13,6 % v primerjavi s 3,8 %) in disgevzija (3,9 % v primerjavi z 0,5 %).
English: Having established that there is a portion of the target population who cannot use powder inhalator due to the development of intolerance and that for these patients the tobramycin nebuliser solution is a safer alternative, in order for a conclusion on clinical superiority to be drawn CHMP needed to assess whether these patients correspond to a substantial portion of the target population.
Slovenian: Ko je odbor CHMP ugotovil, da obstaja delež ciljne populacije, ki ne more uporabljati praška za inhalacijo zaradi pojava intolerance in pri katerem je inhalacijska raztopina tobramicina za nebulator varna alternativa, in da bi lahko izpeljal zaključek o klinični superiornosti, je moral oceniti, ali ti bolniki ustrezajo znatnemu deležu ciljne populacije.
English: The smallest difference was observed in the adult population (45% powder inhalation vs 34% nebuliser solution).
Slovenian: Najmanjšo razliko so opazili pri odrasli populaciji (45 % pri prašku za inhalacijo v primerjavi s 34 % pri inhalacijski raztopini za nebulator).
English: The Applicant's claim for clinical superiority based on greater safety (tolerability) of tobramycin nebulizer solution (TIS) over tobramycin inhalation powder (TIP) in a substantial portion of the target population relies on clinical data generated by the open-label EAGER study1 and its post hoc analyses2.
Slovenian: Predlagateljeva trditev o klinični superiornosti v smislu večje varnosti (prenašanja) inhalacijske raztopine tobramicina za nebulator (TIS) v primerjavi s praškom tobramicina za inhaliranje (TIP) pri znatnem deležu ciljne populacije se opira na klinične podatke iz odprte študije EAGER1 in njenih naknadnih analiz2.
English: • The Committee therefore considered that, in the context of Article 8(3) of Regulation (EC) No 141/2000, clinical superiority of Tobramycin VVB over TOBI Podhaler in a substantial portion of the target population can be established.
Slovenian: • Odbor je zato menil, da je v kontekstu člena 8(3) Uredbe (ES) št. 141/2000 moč ugotoviti klinično superiornost zdravila Tobramycin VVB v primerjavi z zdravilom TOBI Podhaler pri znatnem deležu ciljne populacije.
English: The most common reasons for discontinuation were adverse events (AEs) - 40 (13.0%) of TIP as compared to 17 (8.1%) TIS-treated patients.
Slovenian: Najpogostejši razlog za prekinitev zdravljenja so bili neželeni učinki (NU) - 40 (13,0 %) pri bolnikih, zdravljenih s TIP, in 17 (8,1 %) pri bolnikih, zdravljenih s TIS.
English: Therefore the CHMP concluded that the clinical relevance of the abovementioned differences between Tobramycin VVB and TOBI Podhaler demonstrates the clinical superiority of Tobramycin VVB over TOBI Podhaler based on greater safety in a substantial portion of the target population.
Slovenian: Zato je zaključil, da klinični pomen zgoraj navedenih razlik med zdraviloma Tobramycin VVB in TOBI Podhaler dokazuje klinično superiornost zdravila Tobramycin VVB v primerjavi z zdravilom TOBI Podhaler na podlagi večje varnosti pri znatnem deležu ciljne populacije.
English: Poland considered that the clinical superiority of Tobramycin VVB vs. the orphan-designated medicinal product TOBI Podhaler 28 mg inhalation powder (hereinafter “TOBI Podhaler”) was not demonstrated, therefore derogation as per Article 8(3) of Regulation (EC) No 141/2000 was not fulfilled and a marketing authorisation as proposed by the RMS could not be granted.
Slovenian: Poljska je bila mnenja, da klinična superiornost zdravila Tombramycin VVB v primerjavi z zdravilom siroto TOBI Podhaler 28 mg prašek za inhalacijo (v nadaljevanju „TOBI Podhaler“) ni bila dokazana, zato odstopanje v skladu s členom 8(3) Uredbe (ES) št. 141/2000 ni bilo izpolnjeno in dovoljenja za promet z zdravilom, kot je predlagala referenčna država članica, ni mogoče izdati.
English: The applicant of Tobramycin VVB has applied for a derogation from the market exclusivity of TOBI Podhaler 28 mg inhalation powder claiming that Tobramycin VVB 300 mg/5 ml nebuliser solution is clinically superior to the authorised orphan medicinal product (TOBI Podhaler 28 mg inhalation powder) in terms of providing greater safety in a substantial portion of the target population.
Slovenian: Predlagatelj za zdravilo Tobramycin VVB je zaprosil za odstopanje od tržne ekskluzivnosti zdravila TOBI Podhaler 28 mg prašek za inhaliranje s trditvijo, da je zdravilo Tobramycin VVB 300 mg/5 ml inhalacijska raztopina za nebulator klinično superiornejša od odobrenega zdravila sirote (TOBI Podhaler 28 mg prašek za inhalacijo) v smislu večje varnosti pri znatnem deležu ciljne populacije.
English: In the EAGER study, cough described as an adverse drug related event was observed in 25% of patients on the inhalation powder vs. 4% of patients on the nebuliser solution.
Slovenian: V študiji EAGER so kašelj, opisan kot neželeni učinek zdravila, opazili pri 25 % bolnikov, ki so prejemali prašek za inhalacijo, in pri 4 % bolnikov, ki so prejemali inhalacijsko raztopino za nebulator.
English: Fewer adolescents and adults on TIS discontinued study medication as a result of AEs, compared with those on TIP (9.1% on TIS discontinued vs 17.3% on TIP).
Slovenian: Zaradi neželenih učinkov je jemanje študijskega zdravila prekinilo manj mladostnikov in odraslih, ki so prejemali TIS, v primerjavi s tistimi, ki so prejemali TIP (jemanje je prekinilo 9,1 % bolnikov s TIS in 17,3 % s TIP).
English: The importance of cough as AE for a powder formulation was already acknowledged during the assessment of TOBI Podhaler, and it is recommended that alternative treatment with the nebuliser solution is considered for patients using TOBI Podhaler who experience continued therapy-induced cough.
Slovenian: Pomen kašlja kot neželenega učinka pri formulaciji s praškom je bil priznan že med ocenjevanjem zdravila TOBI Podhaler, zato se priporoča, da se pri bolnikih, ki uporabljajo zdravilo TOBI Podhaler, pri katerih se stalno pojavlja kašelj kot posledica zdravljenja, razmisli o alternativnem zdravljenju z inhalacijsko raztopino za nebulator.
English: The medicinal product TOBI Podhaler 28 mg inhalation powder is covered by an orphan designation in the condition treatment of P. aeruginosa lung infection in cystic fibrosis (orphan designation EU/3/03/140).
Slovenian: Zdravilo TOBI Podhaler 28 mg prašek za inhalacijo je določeno kot zdravilo sirota pri stanju zdravljenje okužbe pljuč z bakterijo P. aeruginosa pri cistični fibrozi (določitev zdravila sirote EU/3/03/140).
English: The proposed therapeutic indication for Tobramycin VVB 300 mg/5 ml nebuliser solution is the same as for TOBI Podhaler (EU/1/10/652, Tobramycin, inhalation powder) and identical to that of TOBI 300 mg/5ml nebuliser solution: “suppressive therapy of chronic pulmonary infection due to Pseudomonas aeruginosa in adults and children aged 6 years and older with cystic fibrosis.”
Slovenian: Predlagana terapevtska indikacija za zdravilo Tobramycin VVB 300 mg/5 ml inhalacijska raztopina za nebulator je enaka kot za zdravilo TOBI Podhaler (EU/1/10/652, tobramicin, prašek za inhaliranje) in identična kot pri zdravilu TOBI 300 mg/5 ml inhalacijska raztopina za nebulator: „supresivno zdravljenje kronične okužbe pljuč z bakterijo Pseudomonas aeruginosa pri odraslih in otrocih, starih 6 let ali več, ki imajo cistično fibrozo.“
English: Notification of a referral for arbitration, under Article 29(4) of Directive 2001/83/EC, to the CHMP was made by the Reference Member State Lithuania on 14 October 2015 based on concerns raised by the Concerned Member State Poland.
Slovenian: 14. oktobra 2015 je referenčna država članica, Litva, odboru CHMP poslala obvestilo o napotitvi v arbitražo v skladu s členom 29(4) Direktive 2001/83/ES na podlagi pomislekov zadevne države članice Poljske.