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Global GDPs - A risk based approach to management of distribution Focus – Supply Chain Temp Controls Dave Ulrich, Abbvie HPCLC, Chicago Sept 20th 2016 Agenda 1. What do the regulations say Pharma / Biopharma companies need a QMS (Quality Management System) that includes QRM (Quality Risk Mgt) system 2. Where GDPs & GMPs meet One Big GxP (are you in control of your processes) 3. ICH Q9 – Quality Risk Management (QRM) Scientific approach to Risk 4. Temperature management Do I have to ship at label claim? 2 What are the GDPs? GDP Dashboard GDP's Regulations Countries Argentina Brazil Mexico Australia General GDPs GIP Quality Systems Importation Storage Buildings / Warehousing Transport, Delivery, Storage Labeling Inventory Procedures Exception Product Return, Port General Loading & Temperature Product Temperature- Humidity Shipping General Qualified Good Stock Management & Recall, GPS and Traceability / Building General Packaging, Serialization GS1 Handling / Offloading Layout / Receiving Monitored Stability Controlled Control and Containers Lableling Personnel, Documentatio Control Product Withdraw, Bulk Security, Stock Cleanliness Security Prcoessing & ePedigree Identification Customs Contruction Bays Storage Areas Profiles Transport Monitoring & Packing Relabeling Training n Practices Systems Compaint Control and Counterfeits Tracking Procedures Disposal There are core elements to all world-wide GDPs just like there are core elements to other GxPs (e.g. cGMPs): 1. Quality Management 2. Process 3. Validation / Qualification (process, cleaning, E/U/F) 4. Verification e.g. Audits (Internal and External) TCM DCS LAA Region Regulating the Cold Chain of Medicines (Ley Resolution - RDC No. 234 Guidelines for Imported Biotechnological & Code of Good Wholesaling Practice for Cold Chain Pharmaeutical Products India (OPPI) Guideline on Good Distribution Practices for Japan Biological Pharma Revision H15.5.15 Malaysia Guidelines on Good Distribution Practice Singapore Guidance Notes on Good Distribution South Africa Good Whilesaling Practice for Wholesales, Phillipines Adoption and Implementation of the World Central European Region Austria Austrian GDP Regulations Czech Guidelines for Correct Distribution of Human Republic Czech GDP Guidelines EMA European Medicines Agency: " QP Guidelines on Good Distribution Practice of Directive 2001/83/EC of the European EU The IPEC Good Distribution Practices Guide Europe - Good Distribution Practices Audit Rx-360 Summary of IPEC GDP Ireland Guide to Control and Monitoring of Storage Switzerland Distribution of Temperature Controlled North American Region Canada Guidelines for Temperature Control of Drug FDA to Revise Component GMPs to Bolster United States Bar Code Technologies for Drugs and Standards for Securing Drug Supply Chain... Middle-Eastern European Region Egypt Minster Decree for Wholesalers - Circular Pharmacist Regulations - Circular 6 Israel Status of Current GDP Regulations in Israel Romania NMA No. 30/24.09.2009 X x X x X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X x x x X X X X X x X x X X X X X X x X x X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X x x x x x x x X X X X X X X X X X Product Protection X X X X X X x X X X X X X X x X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X x x x x x x X X X X X X X X X X X X X X X X X X X X X X X X x X Good Distribution Practices (GDPs) X X X X X X X X Good Import Practices (GIPs) X X X X X X X X X X X X X X X X X Temperature Control Management (TCM) Distribution Control Systems (DCS) X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X What is it? Where did it come from? Is it allowed to come into commerce? Can you prove it is what you say it is? Saudi Arabia, GCC Guidelines for Stability, PP-SPC-9031, Saudi Food & TOPA GTS - 6000 Drug Authority UAE Circular No. 246-2011 International Health Organizations Updated Policy on Returns of Non-Defective Guidance on Preventing Breaches in the MHRA Cold Chain Distribution GDP Risk GDP Risk Assessment Strategy Regulatory Provisions for Quality Controlled Model requirements for the storage and WHO New Guidance for storage and transport of X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X 3 They are a “Logical” extension of the GMPs GDP's Regulations Countries Argentina Brazil Mexico Australia General GDPs GIP Quality Systems Importation TCM DCS LAA Region Regulating the Cold Chain of Medicines (Ley Resolution - RDC No. 234 Guidelines for Imported Biotechnological & Storage Buildings / Warehousing Transport, Delivery, Storage Labeling Inventory Procedures Exception Product Return, Port General Loading & Temperature Product Temperature- Humidity Shipping General Qualified Good Stock Management & Recall, GPS and Traceability / Building General Packaging, Serialization GS1 Handling / Offloading Layout / Receiving Monitored Stability Controlled Control and Containers Lableling Personnel, Documentatio Control Product Withdraw, Bulk Security, Stock Cleanliness Security Prcoessing & ePedigree Identification Customs Contruction Bays Storage Areas Profiles Transport Monitoring & Packing Relabeling Training n Practices Systems Compaint Control and Counterfeits Tracking Procedures Disposal X x X x X X x X x X X x X x X X X x X x • Good Distribution Practices (GDPs) • Good Import Practices (GIPs) • Security Audits & Supply Chain • Export Controls GPP Controls • Marketing Authorization and License Global Control Code of Good Wholesaling Practice for Cold Chain Pharmaeutical Products India (OPPI) Guideline on Good Distribution Practices for Japan Biological Pharma Revision H15.5.15 Malaysia Guidelines on Good Distribution Practice Singapore Guidance Notes on Good Distribution South Africa Good Whilesaling Practice for Wholesales, Phillipines Adoption and Implementation of the World Central European Region Austria Austrian GDP Regulations Czech Guidelines for Correct Distribution of Human Republic Czech GDP Guidelines EMA European Medicines Agency: " QP Guidelines on Good Distribution Practice of Directive 2001/83/EC of the European EU The IPEC Good Distribution Practices Guide Europe - Good Distribution Practices Audit Rx-360 Summary of IPEC GDP Ireland Guide to Control and Monitoring of Storage Switzerland Distribution of Temperature Controlled North American Region Canada Guidelines for Temperature Control of Drug FDA to Revise Component GMPs to Bolster United States Bar Code Technologies for Drugs and Standards for Securing Drug Supply Chain... Middle-Eastern European Region Egypt Minster Decree for Wholesalers - Circular Pharmacist Regulations - Circular 6 Israel Status of Current GDP Regulations in Israel Romania NMA No. 30/24.09.2009 • X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X Product Temperature Control Management • Distribution Control Systems Protection (TCM) (DCS) X X X X X X X X x X X X X X X X X X X X X x x X X x x x x x X X X X X X X X X X X X X X X X X • Cold Chain End-2-End Supply Chain Management Saudi Arabia, GCC Guidelines for Stability, PP-SPC-9031, Saudi Food & TOPA GTS - 6000 Drug Authority UAE Circular No. 246-2011 International Health Organizations Updated Policy on Returns of Non-Defective Guidance on Preventing Breaches in the MHRA Cold Chain Distribution GDP Risk GDP Risk Assessment Strategy Regulatory Provisions for Quality Controlled Model requirements for the storage and WHO New Guidance for storage and transport of X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X x x X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X x x x x x x x X X X X X X X X X X X X X X X X X X X X X • GS1, Track and Trace, Serial Number Mgmt., Trade Relations X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X X 4 Core areas of focus for GDP 1. General GDPs 2. Temperature Control 3. Trade Controls (import/export) 4. Supply Chain Traceability 5. Supply Chain Risk Management Vs. Temp Mgt 5 Structure of EU GDP Guideline Chapters Introduction: 1. Quality Management 2. Personnel 3. Premises and Equipment 4. Documentation 5. Operations 6. Complaints, Returns, Falsified Medicinal Products and Recalls 7. Outsourced Activities 8. Self-Inspections 9. Transportation 10. Specific Provisions for Brokers 6 Supply Chain Maps – where do you ship your product from - to 2012 – European Commission: Health and Consumers Directorates Central EU GDPs (Good Distribution Practices) • Commission Guidelines on Good Distribution Practice of Medicinal Products for Human Use Approval – Dec. 2012, effective June 2013 Sec. 5.4 “… The supply chain of medicinal products should be known and documented.” Stresses GMP, supply chain security and temp mgt Supply Chain Maps Control of APIs (Active Good Distribution Pharmaceutical Practices Ingredients) Issued March 2013 Importation FalsifiedRe-issued Nov. 2013 Medicine Directive Safety Features Barcodes and TEP (Tamper Evident Packaging) Internet Sales 7 Supply Chain Mapping – Annex 16 EU GMP • The entire supply chain of the active substance and medicinal product up to the stage of certification is documented and available for the QP. • This should include the manufacturing sites of the starting materials and packaging materials for the medicinal product and any other materials deemed critical through a risk assessment of the manufacturing process. • The document should preferably be in the format of a comprehensive diagram, where each party, including subcontractors of critical steps such as the sterilisation of components and equipment for aseptic processing, are included. 8 Supply Chain Mapping – Distribution • Same philosophy for distribution: • Routes • Carriers / contractors • Conditions • End-to-end approach = knowledge! 9 EU GMP – Annex 15: Qualification and Validation 10 Verification of Transportation in the EU GMP 6. VERIFICATION OF TRANSPORTATION 6.1. Finished medicinal products, investigational medicinal products, bulk product and samples should be transported from manufacturing sites in accordance with the conditions defined in the marketing authorisation, the approved label, product specification file or as justified by the manufacturer. 6.2. It is recognised that verification of transportation may be challenging due to the variable factors involved however, transportation routes should be clearly defined. Seasonal and other variations should also be considered during verification of transport 11 Verification of Transportation in the EU GMP 6. VERIFICATION OF TRANSPORTATION 6.3. A risk assessment should be performed to consider the impact of variables in the transportation process other than those conditions which are continuously controlled or monitored, e.g. delays during transportation, failure of monitoring devices, topping up liquid nitrogen, product susceptibility and any other relevant factors. 6.3. Due to the variable condition expected during transportation, continuous monitoring and recording of any critical environmental conditions to which the product may be subjected should be performed, unless otherwise justified. 12 Scenario (Real issue) • A short-term temperature excursion during the transport of a product from a third country to the EU. • The label claim for the product is ‘store below 25°C’, and the excursion was up to 29°C for 3 days. • Existing stability data demonstrated no issues when stored at 30°C for up to 3 months. • Is this an ‘unexpected’ or ‘expected’ deviation (in terms of definitions within Annex 16)? 13 Scenario (continued) • This situation would fall within the scope of ‘unexpected deviations’, provided that the shipment process was designed to comply with the registered conditions (i.e. that the excursion could be reasonably described as ‘unexpected’). • However if there were no controls over shipment conditions, then the use of stability data as a ‘routine’ means to justify such an excursion would not be acceptable. • Understand the risks and address with the appropriate risk control strategy. • https://mhrainspectorate.blog.gov.uk/2015/12/07/transportation-of-medicinalproducts-some-things-to-consider/ 14 ICH Q9 – Quality Risk Management Storage, logistics and distribution conditions • To assess the adequacy of arrangements to ensure maintenance of appropriate storage and transport conditions (e.g., temperature, humidity, container design); • To determine the effect on product quality of discrepancies in storage or transport conditions (e.g., cold chain management) in conjunction with other ICH guidelines; • To maintain infrastructure (e.g., capacity to ensure proper shipping conditions, interim storage, handling of hazardous materials and controlled substances, customs clearance); • To provide information for ensuring the availability of pharmaceuticals (e.g., ranking risks to the supply chain). 15 Definition: Risk Management Identify, characterize, and assess threats Assess the vulnerability of critical assets to specific threats Determine the risk (i.e. the expected consequences of specific types of attacks on specific assets) Identify ways to reduce those risks Prioritize risk reduction measures based on a strategy 16 Know what use you are developing the data for ! There are 2 main issues with pharma supply chain controls 1. Temperature controls (how robust) 2. Security (street value) 17 Know failure points How the product reacts at highs (50C) and lows (-20C) That will help determine level of control needed during shipping 18 Control the storage label 19 E.g. CRT Stability Budget (Knowledge) Can I ship this product outside of the filed temperature range 15-30C (30C is 86F) We ship it 2-40C with excursions to 50C based off the stab budget 20 So when the inevitable happens….. Options for CRT shipping 1. Active shippers 2. Passive shippers 3. Blankets 4. Controlled networks 5. Risk it 21 Bulk Drug Shipment Temp Monitoring (Stability Budget) Mean ambient temperature at O’Hare on 6/22/2014: 21.17°C Pack out at Mfg’ing site Held by Port (CBP, MoH, etc)) Transport to packaging site Mean ambient temperature at Airport on 6/19/2014: 16.11°C Belly of plane Arrival at packaging site 22 Passive Shippers – one origin, multiple destinations Internal & External Monitoring – Know your product and know your data Tarmac handling Loading final unloading Example of multiple shipments – same origin and destination Need to know your supply chain temps and How your product reacts 23 Summary / Conclusion • Global expectation surrounding GDPs are increasing • Have & maintain the knowledge • Supply chain map • Risks (intrinsic & extrinsic) • Storage Temperature Label claim (filed data) • Stability data / stability budget • Embrace risk management & mitigation • Audit have a documented risk assessment that shows: • Stability budget • Supply Chain • Controls needed 24