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Good Manufacturing Practices:
WHO Inspections
Tony Gould
(Slides provided by Dr Andre van Zyl)
2 | PQ Workshop, Abu Dhabi | October 2010
To get started:
 Risk assessment (SOP)
 Scheduling
 Preparation
 Announce inspection
 Provide tentative inspection plan
 Inspect, prepare inspection report
 Review corrective action
Inspections
3 | PQ Workshop, Abu Dhabi | October 2010
Inspections
 Done by teams of inspectors
 WHO inspector plus appointed from DRA (PICS member)
 Invite local inspector (DRA)
 Some cases observers and technical advisors
 Technical assistance (independent, no conflict of interest)
Inspections
4 | PQ Workshop, Abu Dhabi | October 2010
Current trends in Inspections
Guide to
Manufacturer
Risk Classification
RELATIVE RISK CATEGORY
PRODUCT TYPE / ACTIVITY
LOW
MEDIUM
HIGH
CRITICAL
Finished Products:
X
Sterile finished products
X
Non-sterile finished products
APIs:
X
Sterile APIs
X
Nonsterile APIs where there is a
special risk (e.g. isomerism,
polymorphism, special risk of harmful
impurities, etc)
X
Other nonsterile APIs
X
QC Laboratories
X
CROs
5 | PQ Workshop, Abu Dhabi | October 2010
APIs
Why inspect?
 Quality
– Heparin
• Baxter – 2008, more than 80 deaths in USA
• Investigated – FDA (GMP – sourcing of starting material, lack of control)
– Nelfinavir, Lopinavir /Ritonavir
• Roche – 2008, global recall of batches
• genotoxic substance (GMP, cleaning of tanks)
• Morphic forms
 European law – FPP manufacturer's responsibility
– Self, contracted party, DRA
 Rationalization, economy
– Initially mostly in Europe – now Asia (India and China) – control?
6 | PQ Workshop, Abu Dhabi | October 2010
API
Parameters considered:
• Polymorphism
• Solubility in water
• Route of Synthesis
• Solvents used
• Impurities
• Sterile API
• Fermentation
• Toxicity
• Activity/potency
• Particle size
• Other properties to be considered
• Site compliance information (WHO/EDQM/Other)
7 | PQ Workshop, Abu Dhabi | October 2010
 VIII. PRODUCTION AND
IN-PROCESS
CONTROLS
 IX. PACKAGING AND
IDENTIFICATION
LABELING OF APIs AND
INTERMEDIATES
 X. STORAGE AND
DISTRIBUTION
 XI. LABORATORY
CONTROLS
 XII. VALIDATION
WHO GMP for APIs – ICH Q7
 II. QUALITY
MANAGEMENT
 III. PERSONNEL
 IV. BUILDINGS AND
FACILITIES
 V. PROCESS
EQUIPMENT
 VI.
DOCUMENTATION
AND RECORDS
 VII. MATERIALS
MANAGEMENT
8 | PQ Workshop, Abu Dhabi | October 2010
 XIII. CHANGE CONTROL
 XIV. REJECTION AND RE-USE OF
MATERIALS
 XV. COMPLAINTS AND RECALLS
 XVI. CONTRACT MANUFACTURERS
 XVII. AGENTS, BROKERS, TRADERS,
DISTRIBUTORS,
REPACKERS, AND RELABELLERS
API
9 | PQ Workshop, Abu Dhabi | October 2010
WHO GMP and Inspection of API manufacturers
Increasing GMP requirements
10 | PQ Workshop, Abu Dhabi | October 2010
APIs
Why inspect?
 Variations
 Change manufacturers and suppliers
 Different specifications, route of synthesis, impurity profile
 Stability, re-test dates vs expiry dates
 Incomplete dossier, DMF, APIMF
11 | PQ Workshop, Abu Dhabi | October 2010
Examples of observations of non-compliance in 2007
Batch records and SOPs
 Before steps were processed… a complete centrifugation operation before actual
operation;
 BMR was not completed, although the step was already in progress... No start
time of the cooling process … no records of the temperature … for every 30
minute as required in the BMR… equipment logbook no entry…
 The SOP “cleaning of centrifuge bag” was incomplete…No evidence of:
– dedicated bags
– labeling of storage drums
 Also for fluid bed bags
 Risk of cross contamination
API
12 | PQ Workshop, Abu Dhabi | October 2010
Examples of major non-compliances (2009)
 Quality management
– Lack of knowledge and experience
– Deviations not reported
– Change control incomplete
 Documentation
– Recording of operations, also not reflecting all steps and full of errors
– Incomplete process validation
 Materials management
– Sampling (number of samples, release date before manufacturing date)
– Storage and use - FIFO
 Buildings and facilities
– Water systems; HVAC – poor design and controls
– equipment cleaning – show product residue after cleaning, equipment
cleaned in outside environment
API
13 | PQ Workshop, Abu Dhabi | October 2010
Inspection of API manufacturers
0
5
10
15
20
25
30
35
2002 2004 2005 2006 2007 2008 2009
Number of sites
Ave number
observations
14 | PQ Workshop, Abu Dhabi | October 2010
Inspection of API manufacturers
0
5
10
15
20
25
30
35
40
Ave (total) obs per
site
Ave (Major)
TB
HIV/AIDS
MAL
2007 -2009. Inspections (disease areas)
and number of observations
0
1
2
3
4
5
6
7
8
9
10
Major deficiencies
Materials
Management
SOPs
Cleaning
Batch records
Labeling
Cross
contamination
Areas of non-compliance
15 | PQ Workshop, Abu Dhabi | October 2010
Inspection of API manufacturers
Summary of trends
 Number of inspections between '05 and '09 – 9 to 12. Low number
in 2007
 Highest number of inspections in India, followed by China
 Observations range between 20 and 28 (low number in 2007)
 Lower number of observations in ARV manufacturers, but lower
number of major non compliances at malaria manufacturers
 Observations relating to material management, SOPs and
documents, cleaning
16 | PQ Workshop, Abu Dhabi | October 2010
To get started (FPP manufacturer):
 Product dossier submitted
 Listed as a manufacturer in a product dossier
 Assessment in progress
 Risk assessment
 Submit a SMF
 Announce inspection
 Provide tentative inspection plan
 Inspect, prepare inspection report – corrective
action
Inspection of FPP manufacturers
17 | PQ Workshop, Abu Dhabi | October 2010
Manufacturers: Normally over 4 days
 Covers all aspects of GMP
– Quality management, Quality assurance, Premises, Equipment, Documentation,
Validation, Materials, Personnel
– Utilities (e.g. HVAC, water) . . .
 Also data verification (dossier) including stability data, validation
(process), development batches and bio batches
 Quality control laboratory – specifications, reference standards,
methods of analysis, validation and qualification
Inspection of FPP manufacturers
18 | PQ Workshop, Abu Dhabi | October 2010
FPP
Findings
 Validation and qualification work was often incomplete
 Validation Master Plans (VMP) lacked details
 Validation policies as defined in the VMPs were not implemented
 Process validation was lacking
 Validated procedures (e.g. environmental monitoring) were lacking
 Incomplete (not detailed) qualification of HVAC, water and
computer systems
19 | PQ Workshop, Abu Dhabi | October 2010
FPP
Findings
 Insufficient filtration of air to production areas
– No prevention of possible cross-contamination and contamination.
 "As built" AHUs lacked components reflected in the schematic drawings,
including filters
 No qualification of sampling areas and reverse unidirectional air flow units
 Temperature and RH mapping studies incomplete, or results not applied
 HVAC systems not controlled or monitored, start up, shut down
 Filters:
– not planned, classified, tested (including installed filter leakage test), monitored
 Pressure differential gauges not controlled, including calibration and zero checks
20 | PQ Workshop, Abu Dhabi | October 2010
 PQR
– Not done annually
– Not all data reported including starting materials, commitments, variations
– Trends not reviewed / discussed – results merely reported
 Deviations
– Not reported, some are opened, new deviations opened on a deviation
– Not authorized by production manager or QA prior to implementation
– No assessment on impact, not additional testing
 Change control procedures not followed
– No assessment on impact, no routing to responsible persons
– No qualification or validation
– Wrong materials used (e.g. MOC extension of PW loop)
GMP ...
21 | PQ Workshop, Abu Dhabi | October 2010
 In process controls
– Some less critical ones reported
– Wrong results represented
– Even though "fail" – reported as "pass"
 Qualification
– Often incomplete
– Wrong sequence
– Unreliable data
– "approved" and signed off despite non compliance
with specifications, errors not picked up
– Computers, software, excel calculations
 Process validation
– Lacking
– Unreliable results
GMP ...
22 | PQ Workshop, Abu Dhabi | October 2010
OOS
 SOP for the reporting and investigation of Out of
Specification (OOS) results not implemented
 No record of OOS results
 In case of an OOS, re-testing was done, however, the
results were recorded on a loose piece of paper, other
sheets were not appropriately completed e.g. method
number, no of samples, LIMS number
FPP
23 | PQ Workshop, Abu Dhabi | October 2010
Reworking materials / products:
 GMP allows in exceptional cases - reworks were done on a
routine basis.
 Inappropriate authorization for the reworks including no prior
authorization by QA, authorization by production supervisors up to
7 weeks after the rework was initiated.
 A rework was even initiated prior to the conclusion of the OOS
investigation.
 Reworked batches were not subjected to additional testing
including stability studies
 Only one of all the reworked batches was subjected to stability
testing according to the stability plan.
FPP
24 | PQ Workshop, Abu Dhabi | October 2010
Inspection of FPP manufacturers
Inspections by country
0
5
10
15
20
25
China Egypt India Morocco South Africa
Country
Number
of
sites
2008
2009
Co-inspectors by country
0
2
4
6
8
10
12
14
Austr CH Es Fr Hu UK WHO SA DEN
Country
Number
of
sites
2008
2009
Total
25 | PQ Workshop, Abu Dhabi | October 2010
Inspection of FPP manufacturers
Observations 2008 and 2009
0
20
40
60
80
100
120
1 3 5 7 9 11 13 15 17 19 21 23 25
Number of sites
Number
of
observations
2008 Total
2009 Total
2008 Major
2009 Major
Non compliant sites
0
2
4
6
8
10
R H T M INJ OSD
Disease group
Number
2008
2009
Total
26 | PQ Workshop, Abu Dhabi | October 2010
Inspections of Contract Research Organizations
(CROs)
New York Times 2007
 Clinical sites: Normally over 2 days
 Started 2004 -Covers all aspects of
GCP and GLP
– Ethical considerations, Protocol,
Volunteers etc
 Data verification – identified
misrepresentation of data
 Clinical part
– Clinic, Pharmacy and related
areas, data verification
 Bio-analytical part
– Laboratory and data verification
 Statistical analysis
27 | PQ Workshop, Abu Dhabi | October 2010
28 | PQ Workshop, Abu Dhabi | October 2010
Also:
Guidance for Industry
Bio-analytical Method Validation
U.S. Department of Health and Human Services
Food and Drug Administration
Center for Drug Evaluation and Research (CDER)
Center for Veterinary Medicine (CVM)
May 2001
Inspections of Contract Research
Organizations (CROs)
29 | PQ Workshop, Abu Dhabi | October 2010
Inspections of
Contract Research Organizations (CROs)
Clinical Part of the study
 Protocol, Ethics committee
 Volunteers
 Informed consent
 Source data and CRFs
Bio-analytical part of the study
 Sample management
 Method validation and sample analysis
30 | PQ Workshop, Abu Dhabi | October 2010
Inspections of
Contract Research Organizations (CROs)
Main problems in some CROs:
 Many haven't done studies for "regulated market" submissions
 Lack of GCP and GLP regulations, requirements, enforcement and
compliance
 IEC not independent – set up by sponsors
 Manipulation of data
 No source data / records available (CRO and Sponsor)
31 | PQ Workshop, Abu Dhabi | October 2010
Inspections of
Contract Research Organizations (CROs)
Examples of observations
 Half of the CRFs "missing"
 Source data destroyed accidently by fire or "monsoon"
 Sponsor claims the data were kept by the CRO, and the CRO
claims the data were kept by the sponsor
 All data and retention samples destroyed as the product "expired"
– even though the submission is still under evaluation
32 | PQ Workshop, Abu Dhabi | October 2010
Inspections of Contract Research
Organizations (CROs)
Examples
 Half of the CRFs "missing" (at
sponsor / CRO?), source data
destroyed accidently by fire or
"monsoon", destroyed as the product
"expired"
 Out of 95 ECGs copied by the
inspectors, 43 appear to have been
recorded from the same and single
subject during a single session
 Manual integration and results not
real
33 | PQ Workshop, Abu Dhabi | October 2010
Inspections of
Contract Research Organizations (CROs)
Example: Numerous improper manual integrations were noted
by the inspectors for QC samples.
 Such integrations were found both for the method validation and for
the trial phase. These integrations were corrected during the
inspection by one staff member under control of one inspector.
 The status of the results of several QC samples was affected by
these improper manual integrations
 Taking these corrected results into consideration the results of
subjects No. 5 and 20 should be rejected:
– subject No. 5: results were only obtained for 4 of the 6 QC samples and the results of
2 of these 4 samples fall out of acceptance limits;
– subject No. 20: the results of both LQC samples fall out of acceptance limits..
34 | PQ Workshop, Abu Dhabi | October 2010
Example discrepancies
35 | PQ Workshop, Abu Dhabi | October 2010
36 | PQ Workshop, Abu Dhabi | October 2010
Recent observations included unreliable data such as:
 Discrepancies between electronic raw data files and data submitted
in study reports for assessment;
 Improper manual integration of chromatograms observed during
inspections even as "no manual integration" was reported;
 Differences in chromatogram peak areas between the electronic
raw data files and the printouts submitted to the WHO;
 Batches that fail when data is calculated from raw data files during
inspections (e.g. for QC samples) even as these batches were
presented as "passing" with values different from those actually
obtained during subject sample analysis;
 Inappropriate bio analytical method validation.
Inspections of
Contract Research Organizations (CROs)
37 | PQ Workshop, Abu Dhabi | October 2010
Number of inspections
0
10
20
30
40
50
60
2005 2006 2007 2008 2009
FPP
API
CRO
QCL
total
38 | PQ Workshop, Abu Dhabi | October 2010
That’s all…

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1-5_PQ-Inspections.ppt

  • 1. Good Manufacturing Practices: WHO Inspections Tony Gould (Slides provided by Dr Andre van Zyl)
  • 2. 2 | PQ Workshop, Abu Dhabi | October 2010 To get started:  Risk assessment (SOP)  Scheduling  Preparation  Announce inspection  Provide tentative inspection plan  Inspect, prepare inspection report  Review corrective action Inspections
  • 3. 3 | PQ Workshop, Abu Dhabi | October 2010 Inspections  Done by teams of inspectors  WHO inspector plus appointed from DRA (PICS member)  Invite local inspector (DRA)  Some cases observers and technical advisors  Technical assistance (independent, no conflict of interest) Inspections
  • 4. 4 | PQ Workshop, Abu Dhabi | October 2010 Current trends in Inspections Guide to Manufacturer Risk Classification RELATIVE RISK CATEGORY PRODUCT TYPE / ACTIVITY LOW MEDIUM HIGH CRITICAL Finished Products: X Sterile finished products X Non-sterile finished products APIs: X Sterile APIs X Nonsterile APIs where there is a special risk (e.g. isomerism, polymorphism, special risk of harmful impurities, etc) X Other nonsterile APIs X QC Laboratories X CROs
  • 5. 5 | PQ Workshop, Abu Dhabi | October 2010 APIs Why inspect?  Quality – Heparin • Baxter – 2008, more than 80 deaths in USA • Investigated – FDA (GMP – sourcing of starting material, lack of control) – Nelfinavir, Lopinavir /Ritonavir • Roche – 2008, global recall of batches • genotoxic substance (GMP, cleaning of tanks) • Morphic forms  European law – FPP manufacturer's responsibility – Self, contracted party, DRA  Rationalization, economy – Initially mostly in Europe – now Asia (India and China) – control?
  • 6. 6 | PQ Workshop, Abu Dhabi | October 2010 API Parameters considered: • Polymorphism • Solubility in water • Route of Synthesis • Solvents used • Impurities • Sterile API • Fermentation • Toxicity • Activity/potency • Particle size • Other properties to be considered • Site compliance information (WHO/EDQM/Other)
  • 7. 7 | PQ Workshop, Abu Dhabi | October 2010  VIII. PRODUCTION AND IN-PROCESS CONTROLS  IX. PACKAGING AND IDENTIFICATION LABELING OF APIs AND INTERMEDIATES  X. STORAGE AND DISTRIBUTION  XI. LABORATORY CONTROLS  XII. VALIDATION WHO GMP for APIs – ICH Q7  II. QUALITY MANAGEMENT  III. PERSONNEL  IV. BUILDINGS AND FACILITIES  V. PROCESS EQUIPMENT  VI. DOCUMENTATION AND RECORDS  VII. MATERIALS MANAGEMENT
  • 8. 8 | PQ Workshop, Abu Dhabi | October 2010  XIII. CHANGE CONTROL  XIV. REJECTION AND RE-USE OF MATERIALS  XV. COMPLAINTS AND RECALLS  XVI. CONTRACT MANUFACTURERS  XVII. AGENTS, BROKERS, TRADERS, DISTRIBUTORS, REPACKERS, AND RELABELLERS API
  • 9. 9 | PQ Workshop, Abu Dhabi | October 2010 WHO GMP and Inspection of API manufacturers Increasing GMP requirements
  • 10. 10 | PQ Workshop, Abu Dhabi | October 2010 APIs Why inspect?  Variations  Change manufacturers and suppliers  Different specifications, route of synthesis, impurity profile  Stability, re-test dates vs expiry dates  Incomplete dossier, DMF, APIMF
  • 11. 11 | PQ Workshop, Abu Dhabi | October 2010 Examples of observations of non-compliance in 2007 Batch records and SOPs  Before steps were processed… a complete centrifugation operation before actual operation;  BMR was not completed, although the step was already in progress... No start time of the cooling process … no records of the temperature … for every 30 minute as required in the BMR… equipment logbook no entry…  The SOP “cleaning of centrifuge bag” was incomplete…No evidence of: – dedicated bags – labeling of storage drums  Also for fluid bed bags  Risk of cross contamination API
  • 12. 12 | PQ Workshop, Abu Dhabi | October 2010 Examples of major non-compliances (2009)  Quality management – Lack of knowledge and experience – Deviations not reported – Change control incomplete  Documentation – Recording of operations, also not reflecting all steps and full of errors – Incomplete process validation  Materials management – Sampling (number of samples, release date before manufacturing date) – Storage and use - FIFO  Buildings and facilities – Water systems; HVAC – poor design and controls – equipment cleaning – show product residue after cleaning, equipment cleaned in outside environment API
  • 13. 13 | PQ Workshop, Abu Dhabi | October 2010 Inspection of API manufacturers 0 5 10 15 20 25 30 35 2002 2004 2005 2006 2007 2008 2009 Number of sites Ave number observations
  • 14. 14 | PQ Workshop, Abu Dhabi | October 2010 Inspection of API manufacturers 0 5 10 15 20 25 30 35 40 Ave (total) obs per site Ave (Major) TB HIV/AIDS MAL 2007 -2009. Inspections (disease areas) and number of observations 0 1 2 3 4 5 6 7 8 9 10 Major deficiencies Materials Management SOPs Cleaning Batch records Labeling Cross contamination Areas of non-compliance
  • 15. 15 | PQ Workshop, Abu Dhabi | October 2010 Inspection of API manufacturers Summary of trends  Number of inspections between '05 and '09 – 9 to 12. Low number in 2007  Highest number of inspections in India, followed by China  Observations range between 20 and 28 (low number in 2007)  Lower number of observations in ARV manufacturers, but lower number of major non compliances at malaria manufacturers  Observations relating to material management, SOPs and documents, cleaning
  • 16. 16 | PQ Workshop, Abu Dhabi | October 2010 To get started (FPP manufacturer):  Product dossier submitted  Listed as a manufacturer in a product dossier  Assessment in progress  Risk assessment  Submit a SMF  Announce inspection  Provide tentative inspection plan  Inspect, prepare inspection report – corrective action Inspection of FPP manufacturers
  • 17. 17 | PQ Workshop, Abu Dhabi | October 2010 Manufacturers: Normally over 4 days  Covers all aspects of GMP – Quality management, Quality assurance, Premises, Equipment, Documentation, Validation, Materials, Personnel – Utilities (e.g. HVAC, water) . . .  Also data verification (dossier) including stability data, validation (process), development batches and bio batches  Quality control laboratory – specifications, reference standards, methods of analysis, validation and qualification Inspection of FPP manufacturers
  • 18. 18 | PQ Workshop, Abu Dhabi | October 2010 FPP Findings  Validation and qualification work was often incomplete  Validation Master Plans (VMP) lacked details  Validation policies as defined in the VMPs were not implemented  Process validation was lacking  Validated procedures (e.g. environmental monitoring) were lacking  Incomplete (not detailed) qualification of HVAC, water and computer systems
  • 19. 19 | PQ Workshop, Abu Dhabi | October 2010 FPP Findings  Insufficient filtration of air to production areas – No prevention of possible cross-contamination and contamination.  "As built" AHUs lacked components reflected in the schematic drawings, including filters  No qualification of sampling areas and reverse unidirectional air flow units  Temperature and RH mapping studies incomplete, or results not applied  HVAC systems not controlled or monitored, start up, shut down  Filters: – not planned, classified, tested (including installed filter leakage test), monitored  Pressure differential gauges not controlled, including calibration and zero checks
  • 20. 20 | PQ Workshop, Abu Dhabi | October 2010  PQR – Not done annually – Not all data reported including starting materials, commitments, variations – Trends not reviewed / discussed – results merely reported  Deviations – Not reported, some are opened, new deviations opened on a deviation – Not authorized by production manager or QA prior to implementation – No assessment on impact, not additional testing  Change control procedures not followed – No assessment on impact, no routing to responsible persons – No qualification or validation – Wrong materials used (e.g. MOC extension of PW loop) GMP ...
  • 21. 21 | PQ Workshop, Abu Dhabi | October 2010  In process controls – Some less critical ones reported – Wrong results represented – Even though "fail" – reported as "pass"  Qualification – Often incomplete – Wrong sequence – Unreliable data – "approved" and signed off despite non compliance with specifications, errors not picked up – Computers, software, excel calculations  Process validation – Lacking – Unreliable results GMP ...
  • 22. 22 | PQ Workshop, Abu Dhabi | October 2010 OOS  SOP for the reporting and investigation of Out of Specification (OOS) results not implemented  No record of OOS results  In case of an OOS, re-testing was done, however, the results were recorded on a loose piece of paper, other sheets were not appropriately completed e.g. method number, no of samples, LIMS number FPP
  • 23. 23 | PQ Workshop, Abu Dhabi | October 2010 Reworking materials / products:  GMP allows in exceptional cases - reworks were done on a routine basis.  Inappropriate authorization for the reworks including no prior authorization by QA, authorization by production supervisors up to 7 weeks after the rework was initiated.  A rework was even initiated prior to the conclusion of the OOS investigation.  Reworked batches were not subjected to additional testing including stability studies  Only one of all the reworked batches was subjected to stability testing according to the stability plan. FPP
  • 24. 24 | PQ Workshop, Abu Dhabi | October 2010 Inspection of FPP manufacturers Inspections by country 0 5 10 15 20 25 China Egypt India Morocco South Africa Country Number of sites 2008 2009 Co-inspectors by country 0 2 4 6 8 10 12 14 Austr CH Es Fr Hu UK WHO SA DEN Country Number of sites 2008 2009 Total
  • 25. 25 | PQ Workshop, Abu Dhabi | October 2010 Inspection of FPP manufacturers Observations 2008 and 2009 0 20 40 60 80 100 120 1 3 5 7 9 11 13 15 17 19 21 23 25 Number of sites Number of observations 2008 Total 2009 Total 2008 Major 2009 Major Non compliant sites 0 2 4 6 8 10 R H T M INJ OSD Disease group Number 2008 2009 Total
  • 26. 26 | PQ Workshop, Abu Dhabi | October 2010 Inspections of Contract Research Organizations (CROs) New York Times 2007  Clinical sites: Normally over 2 days  Started 2004 -Covers all aspects of GCP and GLP – Ethical considerations, Protocol, Volunteers etc  Data verification – identified misrepresentation of data  Clinical part – Clinic, Pharmacy and related areas, data verification  Bio-analytical part – Laboratory and data verification  Statistical analysis
  • 27. 27 | PQ Workshop, Abu Dhabi | October 2010
  • 28. 28 | PQ Workshop, Abu Dhabi | October 2010 Also: Guidance for Industry Bio-analytical Method Validation U.S. Department of Health and Human Services Food and Drug Administration Center for Drug Evaluation and Research (CDER) Center for Veterinary Medicine (CVM) May 2001 Inspections of Contract Research Organizations (CROs)
  • 29. 29 | PQ Workshop, Abu Dhabi | October 2010 Inspections of Contract Research Organizations (CROs) Clinical Part of the study  Protocol, Ethics committee  Volunteers  Informed consent  Source data and CRFs Bio-analytical part of the study  Sample management  Method validation and sample analysis
  • 30. 30 | PQ Workshop, Abu Dhabi | October 2010 Inspections of Contract Research Organizations (CROs) Main problems in some CROs:  Many haven't done studies for "regulated market" submissions  Lack of GCP and GLP regulations, requirements, enforcement and compliance  IEC not independent – set up by sponsors  Manipulation of data  No source data / records available (CRO and Sponsor)
  • 31. 31 | PQ Workshop, Abu Dhabi | October 2010 Inspections of Contract Research Organizations (CROs) Examples of observations  Half of the CRFs "missing"  Source data destroyed accidently by fire or "monsoon"  Sponsor claims the data were kept by the CRO, and the CRO claims the data were kept by the sponsor  All data and retention samples destroyed as the product "expired" – even though the submission is still under evaluation
  • 32. 32 | PQ Workshop, Abu Dhabi | October 2010 Inspections of Contract Research Organizations (CROs) Examples  Half of the CRFs "missing" (at sponsor / CRO?), source data destroyed accidently by fire or "monsoon", destroyed as the product "expired"  Out of 95 ECGs copied by the inspectors, 43 appear to have been recorded from the same and single subject during a single session  Manual integration and results not real
  • 33. 33 | PQ Workshop, Abu Dhabi | October 2010 Inspections of Contract Research Organizations (CROs) Example: Numerous improper manual integrations were noted by the inspectors for QC samples.  Such integrations were found both for the method validation and for the trial phase. These integrations were corrected during the inspection by one staff member under control of one inspector.  The status of the results of several QC samples was affected by these improper manual integrations  Taking these corrected results into consideration the results of subjects No. 5 and 20 should be rejected: – subject No. 5: results were only obtained for 4 of the 6 QC samples and the results of 2 of these 4 samples fall out of acceptance limits; – subject No. 20: the results of both LQC samples fall out of acceptance limits..
  • 34. 34 | PQ Workshop, Abu Dhabi | October 2010 Example discrepancies
  • 35. 35 | PQ Workshop, Abu Dhabi | October 2010
  • 36. 36 | PQ Workshop, Abu Dhabi | October 2010 Recent observations included unreliable data such as:  Discrepancies between electronic raw data files and data submitted in study reports for assessment;  Improper manual integration of chromatograms observed during inspections even as "no manual integration" was reported;  Differences in chromatogram peak areas between the electronic raw data files and the printouts submitted to the WHO;  Batches that fail when data is calculated from raw data files during inspections (e.g. for QC samples) even as these batches were presented as "passing" with values different from those actually obtained during subject sample analysis;  Inappropriate bio analytical method validation. Inspections of Contract Research Organizations (CROs)
  • 37. 37 | PQ Workshop, Abu Dhabi | October 2010 Number of inspections 0 10 20 30 40 50 60 2005 2006 2007 2008 2009 FPP API CRO QCL total
  • 38. 38 | PQ Workshop, Abu Dhabi | October 2010 That’s all…