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EMA/85747/2013 European Medicines Agency decision P/0055/2013 of 25 March 2013 on the agreement of a paediatric investigation plan and on the granting of a deferral and on the granting of a waiver for etoxybamide (EMEA-000764-PIP02-11) in accordance with Regulation (EC) No 1901/2006 of the European Parliament and of the Council Disclaimer This Decision does not constitute entitlement to the rewards and incentives referred to in Title V of Regulation (EC) No 1901/2006. Only the English text is authentic. 7 Westferry Circus Canary Wharf London E14 4HB United Kingdom Telephone +44 (0)20 7418 8400 Facsimile +44 (0)20 7523 7040 E-mail info@ema.europa.eu Website www.ema.europa.eu An agency of the European Union

European Medicines Agency decision P/0055/2013 of 25 March 2013 on the agreement of a paediatric investigation plan and on the granting of a deferral and on the granting of a waiver for etoxybamide (EMEA-000764-PIP02-11) in accordance with Regulation (EC) No 1901/2006 of the European Parliament and of the Council The European Medicines Agency, Having regard to the Treaty on the Functioning of the European Union, Having regard to Regulation (EC) No 1901/2006 of the European Parliament and of the Council of 12 December 2006 on medicinal products for paediatric use and amending Regulation (EEC) No. 1768/92, Directive 2001/20/EC, Directive 2001/83/EC and Regulation (EC) No 726/2004 1, Having regard to Regulation (EC) No 726/2004 of the European Parliament and of the Council of 31 March 2004 laying down Community procedures for the authorisation and supervision of medicinal products for human and veterinary use and establishing a European Medicines Agency 2, Having regard to the application submitted by Dr. Franz Köhler Chemie GmbH on 2 September 2011 under Article 16(1) of Regulation (EC) No 1901/2006 also requesting a deferral under Article 20 of said Regulation and a waiver under Article 13 of said Regulation, Having regard to the opinion of the Paediatric Committee of the European Medicines Agency, issued on 8 February 2013, in accordance with Article 18 of Regulation (EC) No 1901/2006, and Article 21 of said Regulation and and Article 13 of said Regulation, Having regard to Article 25 of Regulation (EC) No 1901/2006, Whereas: (1) The Paediatric Committee of the European Medicines Agency has given an opinion on the agreement of a paediatric investigation plan and on the granting of a deferral and on the granting of a waiver. (2) It is therefore appropriate to adopt a decision agreeing a paediatric investigation plan. (3) It is therefore appropriate to adopt a decision granting a deferral. (4) It is therefore appropriate to adopt a decision granting a waiver. 1 OJ L 378, 27.12.2006, p.1. 2 OJ L 136, 30.4.2004, p. 1. European Medicines Agency decision EMA/85747/2013 Page 2/8

Has adopted this decision: Article 1 A paediatric investigation plan for etoxybamide, sedation, intravenous use, the details of which are set out in the opinion of the Paediatric Committee of the European Medicines Agency annexed hereto, together with its appendices, is hereby agreed. Article 2 A deferral for etoxybamide, sedation, intravenous use, the details of which are set out in the opinion of the Paediatric Committee of the European Medicines Agency annexed hereto, together with its appendices, is hereby granted. Article 3 A waiver for etoxybamide, sedation, intravenous use, the details of which are set out in the opinion of the Paediatric Committee of the European Medicines Agency annexed hereto, together with its appendices, is hereby granted. Article 4 This decision is addressed to Dr. Franz Köhler Chemie GmbH, Werner-von-Siemens-Strasse 22 28, D-64625 Bensheim, Germany. Done at London, 25 March 2013 For the European Medicines Agency Guido Rasi Executive Director (Signature on file) European Medicines Agency decision EMA/85747/2013 Page 3/8

EMA/PDCO/755510/2012 Opinion of the Paediatric Committee on the agreement of a Paediatric Investigation Plan and a deferral and a waiver EMEA-000764-PIP02-11 Scope of the application Active substance(s): Etoxybamide Condition(s): Sedation Pharmaceutical form(s): Solution for injection/infusion Route(s) of administration: Intravenous use Name/corporate name of the PIP applicant: Dr. Franz Köhler Chemie GmbH Basis for opinion Pursuant to Article 16(1) of Regulation (EC) No 1901/2006 as amended, Dr. Franz Köhler Chemie GmbH submitted for agreement to the European Medicines Agency on 2 September 2011 an application for a paediatric investigation plan for the above mentioned medicinal product and a deferral under Article 20 of said Regulation and a waiver under Article 13 of said Regulation. The procedure started on 12 October 2011. Supplementary information was provided by the applicant on 13 November 2012. The applicant proposed modifications to the paediatric investigation plan. 7 Westferry Circus Canary Wharf London E14 4HB United Kingdom Telephone +44 (0)20 7418 8400 Facsimile +44 (0)20 7523 7040 E-mail info@ema.europa.eu Website www.ema.europa.eu An agency of the European Union

Opinion 1. The Paediatric Committee, having assessed the proposed paediatric investigation plan in accordance with Article 17 of Regulation (EC) No 1901/2006 as amended, recommends as set out in the appended summary report: to agree the paediatric investigation plan in accordance with Article 18 of said Regulation; to grant a deferral in accordance with Article 21 of said Regulation; to grant a waiver for one or more subsets of the paediatric population in accordance with Article 13 of said Regulation and concluded in accordance with Article 11(1)(a) of said Regulation, on the grounds that the specific medicinal product is likely to be ineffective or unsafe in part or all of the paediatric population. The Norwegian Paediatric Committee member agrees with the above-mentioned recommendation of the Paediatric Committee. 2. The measures and timelines of the agreed paediatric investigation plan and the subset(s) of the paediatric population and condition(s) covered by the waiver are set out in the Annex I. This opinion is forwarded to the applicant and the Executive Director of the European Medicines Agency, together with its annex and appendix. London, 8 February 2013 On behalf of the Paediatric Committee Dr Daniel Brasseur, Chairman (Signature on file) Opinion of the Paediatric Committee on the agreement of a Paediatric Investigation Plan and a deferral and a waiver EMA/PDCO/755510/2012 Page 5/8

Annex I The subset(s) of the paediatric population and condition(s) covered by the waiver and the measures and timelines of the agreed Paediatric Investigation Plan Opinion of the Paediatric Committee on the agreement of a Paediatric Investigation Plan and a deferral and a waiver EMA/PDCO/755510/2012 Page 6/8

1. Waiver 1.1. Condition: sedation The waiver applies to: Neonates and infants from birth to less than 2 years of age; for solution for injection / infusion for intravenous use; on the grounds that the specific medicinal product is likely to be unsafe. 2. Paediatric Investigation Plan 2.1. Condition: sedation 2.1.1. Indication(s) targeted by the PIP Sedation for diagnostic and therapeutic procedures. 2.1.2. Subset(s) of the paediatric population concerned by the paediatric development From 2 to less than 18 years of age. 2.1.3. Pharmaceutical form(s) Solution for injection / infusion for intravenous use. 2.1.4. Measures Area Number of measures Description Quality 1 Measure 1: Development of an age-appropriate formulation Nonclinical 0 Not applicable. Clinical 2 Measure 2: Open, uncontrolled, single-dose, pharmacokinetic-pharmacodynamic study with etoxybamide in paediatric patients from 2 to less than 18 years of age undergoing elective surgery and requiring sedation (premedication) before anaesthesia Measure 3: Single-blind, randomised, active-controlled study to evaluate postoperative sedative efficacy and tolerability of etoxybamide vs midazolam during continuous infusion after complex surgery in patients from 2 to less than 18 years of age Opinion of the Paediatric Committee on the agreement of a Paediatric Investigation Plan and a deferral and a waiver EMA/PDCO/755510/2012 Page 7/8

3. Follow-up, completion and deferral of PIP Concerns on potential long term safety or efficacy issues in relation to paediatric use: Date of completion of the paediatric investigation plan: Deferral for one or more measures contained in the paediatric investigation plan: No By December 2017 Yes Opinion of the Paediatric Committee on the agreement of a Paediatric Investigation Plan and a deferral and a waiver EMA/PDCO/755510/2012 Page 8/8