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International audience ; In relation to the "hot" topic of regenerative medicine, European Union law established a specific legal framework for advanced therapy medicinal products, manufactured from human or animal genes, cells or tissues. However, these medicinal products do not have always to be submitted to clinical trials as legal requirements vary according to the intended use: market of the whole of Member States, compassionate use, and hospital exemption. Moreover, specificities of these medicinal products make clinical trials difficult to be conducted. This paper highlights the consecutive competition between regulations and products that takes roots in the tension between the challenges of patients' safety and quick access to innovative treatments. It also shows the regulatory flexibility currently favored to ensure the necessary balance between safety and availability, is not without limits. ; Dans le contexte très discuté de la médecine régénératrice, le droit de l'Union a adopté un cadre juridique spécifique pour les médicaments de thérapie innovante, fabriqués à partir de gènes, cellules ou tissus d'origine humaine ou animale. Pourtant, ces médicaments ne sont pas toujours soumis à des essais cliniques car les exigences règlementaires diffèrent selon l'utilisation envisagée : marché de l'ensemble des Etats membres, usage compassionnel, exemption hospitalière. De même, les essais cliniques obligatoires sont difficiles à mettre en œuvre en raison des spécificités de ces médicaments. Cet article souligne la concurrence de réglementations et de produits qui en résulte et qui s'ancre dans la tension existante entre les enjeux de sécurité des patients et d'accès rapide à des traitements innovants. Il démontre également que la flexibilité réglementaire, à ce jour privilégiée pour garantir un équilibre indispensable entre sécurité et disponibilité, n'est pas sans présenter certaines limites.

International audience ; In relation to the "hot" topic of regenerative medicine, European Union law established a specific legal framework for advanced therapy medicinal products, manufactured from human or animal genes, cells or tissues. However, these medicinal products do not have always to be submitted to clinical trials as legal requirements vary according to the intended use: market of the whole of Member States, compassionate use, and hospital exemption. Moreover, specificities of these medicinal products make clinical trials difficult to be conducted. This paper highlights the consecutive competition between regulations and products that takes roots in the tension between the challenges of patients' safety and quick access to innovative treatments. It also shows the regulatory flexibility currently favored to ensure the necessary balance between safety and availability, is not without limits. ; Dans le contexte très discuté de la médecine régénératrice, le droit de l'Union a adopté un cadre juridique spécifique pour les médicaments de thérapie innovante, fabriqués à partir de gènes, cellules ou tissus d'origine humaine ou animale. Pourtant, ces médicaments ne sont pas toujours soumis à des essais cliniques car les exigences règlementaires diffèrent selon l'utilisation envisagée : marché de l'ensemble des Etats membres, usage compassionnel, exemption hospitalière. De même, les essais cliniques obligatoires sont difficiles à mettre en œuvre en raison des spécificités de ces médicaments. Cet article souligne la concurrence de réglementations et de produits qui en résulte et qui s'ancre dans la tension existante entre les enjeux de sécurité des patients et d'accès rapide à des traitements innovants. Il démontre également que la flexibilité réglementaire, à ce jour privilégiée pour garantir un équilibre indispensable entre sécurité et disponibilité, n'est pas sans présenter certaines limites.

International audience ; In relation to the "hot" topic of regenerative medicine, European Union law established a specific legal framework for advanced therapy medicinal products, manufactured from human or animal genes, cells or tissues. However, these medicinal products do not have always to be submitted to clinical trials as legal requirements vary according to the intended use: market of the whole of Member States, compassionate use, and hospital exemption. Moreover, specificities of these medicinal products make clinical trials difficult to be conducted. This paper highlights the consecutive competition between regulations and products that takes roots in the tension between the challenges of patients' safety and quick access to innovative treatments. It also shows the regulatory flexibility currently favored to ensure the necessary balance between safety and availability, is not without limits. ; Dans le contexte très discuté de la médecine régénératrice, le droit de l'Union a adopté un cadre juridique spécifique pour les médicaments de thérapie innovante, fabriqués à partir de gènes, cellules ou tissus d'origine humaine ou animale. Pourtant, ces médicaments ne sont pas toujours soumis à des essais cliniques car les exigences règlementaires diffèrent selon l'utilisation envisagée : marché de l'ensemble des Etats membres, usage compassionnel, exemption hospitalière. De même, les essais cliniques obligatoires sont difficiles à mettre en œuvre en raison des spécificités de ces médicaments. Cet article souligne la concurrence de réglementations et de produits qui en résulte et qui s'ancre dans la tension existante entre les enjeux de sécurité des patients et d'accès rapide à des traitements innovants. Il démontre également que la flexibilité réglementaire, à ce jour privilégiée pour garantir un équilibre indispensable entre sécurité et disponibilité, n'est pas sans présenter certaines limites.

International audience ; In relation to the "hot" topic of regenerative medicine, European Union law established a specific legal framework for advanced therapy medicinal products, manufactured from human or animal genes, cells or tissues. However, these medicinal products do not have always to be submitted to clinical trials as legal requirements vary according to the intended use: market of the whole of Member States, compassionate use, and hospital exemption. Moreover, specificities of these medicinal products make clinical trials difficult to be conducted. This paper highlights the consecutive competition between regulations and products that takes roots in the tension between the challenges of patients' safety and quick access to innovative treatments. It also shows the regulatory flexibility currently favored to ensure the necessary balance between safety and availability, is not without limits. ; Dans le contexte très discuté de la médecine régénératrice, le droit de l'Union a adopté un cadre juridique spécifique pour les médicaments de thérapie innovante, fabriqués à partir de gènes, cellules ou tissus d'origine humaine ou animale. Pourtant, ces médicaments ne sont pas toujours soumis à des essais cliniques car les exigences règlementaires diffèrent selon l'utilisation envisagée : marché de l'ensemble des Etats membres, usage compassionnel, exemption hospitalière. De même, les essais cliniques obligatoires sont difficiles à mettre en œuvre en raison des spécificités de ces médicaments. Cet article souligne la concurrence de réglementations et de produits qui en résulte et qui s'ancre dans la tension existante entre les enjeux de sécurité des patients et d'accès rapide à des traitements innovants. Il démontre également que la flexibilité réglementaire, à ce jour privilégiée pour garantir un équilibre indispensable entre sécurité et disponibilité, n'est pas sans présenter certaines limites.

The European Medicines Agency (EMA) is a European Agency as it is a decentralized body governed by European public law; it has its own legal personality and is also distinct from the European Union institutions (Council, Parliament, Commission, etc.). The EMA presents itself, and is commonly recognised, as a public health agency. This is notably supported by its recent transition from the Regional Direction of Research to the Regional Direction of Public Health. Four recognized principles of public health can be identified as such: assessment, transparency, precaution and independence. These principles appear to be closely linked to those forming the basis of good European governance regarding agencies: efficacy, coherence, openness, participation and responsibility. Thus, it is interesting to study how these principles are applied by the EMA in order to assess the reality of its qualification as a Public Health European Agency. The principles of assessment and transparency seem to be largely applied whereas the principles of precaution and independence are more problematic.

The European Medicines Agency (EMA) is a European Agency as it is a decentralized body governed by European public law; it has its own legal personality and is also distinct from the European Union institutions (Council, Parliament, Commission, etc.). The EMA presents itself, and is commonly recognised, as a public health agency. This is notably supported by its recent transition from the Regional Direction of Research to the Regional Direction of Public Health. Four recognized principles of public health can be identified as such: assessment, transparency, precaution and independence. These principles appear to be closely linked to those forming the basis of good European governance regarding agencies: efficacy, coherence, openness, participation and responsibility. Thus, it is interesting to study how these principles are applied by the EMA in order to assess the reality of its qualification as a Public Health European Agency. The principles of assessment and transparency seem to be largely applied whereas the principles of precaution and independence are more problematic.

The European Medicines Agency (EMA) is a European Agency as it is a decentralized body governed by European public law; it has its own legal personality and is also distinct from the European Union institutions (Council, Parliament, Commission, etc.). The EMA presents itself, and is commonly recognised, as a public health agency. This is notably supported by its recent transition from the Regional Direction of Research to the Regional Direction of Public Health. Four recognized principles of public health can be identified as such: assessment, transparency, precaution and independence. These principles appear to be closely linked to those forming the basis of good European governance regarding agencies: efficacy, coherence, openness, participation and responsibility. Thus, it is interesting to study how these principles are applied by the EMA in order to assess the reality of its qualification as a Public Health European Agency. The principles of assessment and transparency seem to be largely applied whereas the principles of precaution and independence are more problematic.

The European Medicines Agency (EMA) is a European Agency as it is a decentralized body governed by European public law; it has its own legal personality and is also distinct from the European Union institutions (Council, Parliament, Commission, etc.). The EMA presents itself, and is commonly recognised, as a public health agency. This is notably supported by its recent transition from the Regional Direction of Research to the Regional Direction of Public Health. Four recognized principles of public health can be identified as such: assessment, transparency, precaution and independence. These principles appear to be closely linked to those forming the basis of good European governance regarding agencies: efficacy, coherence, openness, participation and responsibility. Thus, it is interesting to study how these principles are applied by the EMA in order to assess the reality of its qualification as a Public Health European Agency. The principles of assessment and transparency seem to be largely applied whereas the principles of precaution and independence are more problematic.