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152
Manufacture and Supply, Science and Reg ulation Towards High-Qua lity Medicinal Products
Packaging Process Control — Control of labels and packaging materials, bulk and finished
products — Batch packaging records — Validation, revalidation and change controls
Personnel — Wearing appropriate PPE
The packaging areas are also covered under the PIC/S Guide to GMP for Medicinal Products Chapter 5, the same chapter as for produc­tion areas. After inspecting the packaging rooms, the inspector will proceed to audit the QC Laboratories which include the Chemistry Laboratory and the Microbiology Laboratory.
5.3.5. Why are the QC Laboratories Inspected?
The objective of inspecting the QC Laboratories is to assess that:
— properly trained analysts are available and there is independent
authority for Head of QC and Head of Production;
— QC test methods approved by the national medicines regulatory
authority are robust, sensitive, accurate and reliable for testing as evident from records of analytical method validation and routine QC test results;
— approved written procedures are in place for maintenance,
calibration, status labeling and assuring integrity of QC test equipment, e.g., high-performance liquid chromatography system, gas chromatography system, dissolution testing apparatus; and
Compliance of Pharmaceutical Manufacturers to Good Manufacturing Practice Standards
— approved written procedures are in place for receipt, storage,
security, record-keeping of test samples, reagents, and reference standards.
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Quality control (QC) laboratory
The items and areas covered during the inspection of the QC Labo­ratories include the approved written procedures for handling:
— test samples (e.g., API, finished products, water, swabs) — prepared reagents — reference standards (primary and secondary) — retained (or retention) samples for stability or regulatory testing — approved test methods — validation and calibration of analytical equipment
analytical validation reports
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Manufacture and Supply, Science and Reg ulation Towards High-Qua lity Medicinal Products
records and/or calibration certificates electronic records and raw data
— failure investigation — stability studies conducted by the manufacturer.
The QC Laboratories are covered under the PIC/S Guide to GMP for Medicinal Products Chapter 6.
5.3.6. Why do GMP Inspectors Visit Other Miscellaneous Areas?
Other miscellaneous areas which the GMP inspector would visit include ancillary premises such as the engineering or maintenance workshop, the corridors and even the restrooms (or toilets). The restrooms do give a clue or two about the housekeeping attitude of the manufacturer and may provide some correlation with the over­all GMP compliance of the manufacturing facility. In fact, there are inspectors who like to start an on-site audit by visiting the restrooms first (instead of the warehouse) to have a look at their overall con­ditions. If the restrooms are poorly maintained, it is likely that the cleaning, maintenance and general housekeeping of the company cannot be expected to be meticulous or great.
5.3.7. Why do GMP Inspectors Audit Outsourced Activities,
e.g., Contract Testing Laboratories?
Contract testing laboratories provide QC testing services to phar­maceutical manufacturers based on a written contract specify­ing clearly the roles and responsibilities of the contract giver and contract acceptor, and for an agreed service fee. Contract testing
Compliance of Pharmaceutical Manufacturers to Good Manufacturing Practice Standards
laboratories are often located at a dierent address because they are not part of the manufacturing company. Inspectors have the authority to inspect such contract testing laboratories for compli­ance with QC requirements of the PIC/S Guide to GMP for Medic­inal Products. Alternatively, the inspector could rely on the audit report of the contract testing laboratory conducted by the national accreditation authority. In Singapore, contract testing laboratories are audited and accredited by SPRING Singapore under its Singa­pore Laboratory Accreditation Scheme (SINGLAS) based on the ISO 17025 standard. Thus, the GMP inspector can rely on the SINGLAS report for certified contract testing laboratories engaged by licensed manufacturers of medicinal products. Often, the inspector does not need to carry out an on-site audit of certified outsourced or contract testing laboratories, unless there are serious quality issues associ­ated with medicinal products made by the licensed manufacturer. The ISO 17025 certificate issued by SPRING Singapore under SIN­GLAS is acceptable to HSA’s inspectors. This arrangement is also practiced by some other PIC/S Participating Authorities.
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5.3.8. Why is there a Need to Conduct Documentation Audit/Review?
A GMP inspection is incomplete without the documentation audit or review of the “Great Mountains of Papers”, comprising the SOPs, records, reports, specifications, protocols, registers and other manu­facturing documents.
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Manufacture and Supply, Science and Reg ulation Towards High-Qua lity Medicinal Products
The objective of documentation audit is to assess whether legal requirements under national laws for the licensing of the establish­ment and registration of medicinal products have been complied with by the manufacturer. Documentation audit can also verify whether the regulatory commitments submitted by the manufac­turer to the national medicines regulatory authority to obtain mar­ket authorization have been fulfilled by the manufacturer. These regulatory commitments include the composition of the finished product and specifications of starting materials, the test methods used and their validation status, the process validation and stabil­ity reports, and their protocols and acceptance criteria. During the documentation audit, SOPs that include those on product quality reviews, handling of complaints and recalls, and self-inspection are also reviewed by the inspector. The inspector also verifies that the manufacturing and QC test records are authentic, and there is no falsification of data. In short, the documentation audit is performed to confirm that the manufacturer conforms to legal requirements, regulatory commitments as well as the PIC/S GMP standard.
The items covered during the documentation audit include the:
Document control system — SOP on preparation of SOPs — SOP on document control — Control of e-documents and records
SOP and records on pest control
SOP and records on temperature and relative humidity
monitoring
Batch manufacturing records
Stability testing program
Compliance of Pharmaceutical Manufacturers to Good Manufacturing Practice Standards
Process validation protocols, acceptance criteria and validation master plan
GMP training program
SOP on records of product quality review, handling of com-
plaints and recalls, and self-inspection programs
5.3.8.1. Assessing Product Quality Review
Product quality review comes under the PIC/S Guide to GMP for Medicinal Products Chapter 1. The inspector will assess the product quality review records to ensure that these reviews are conducted annually by the manufacturer for all its authorized products, covering:
— Quality of starting materials; — Quality of finished products and critical in-process controls; — Failed batches of products and investigations; — Manufacturing and QC deviations, and their corrective actions
and preventive actions (CAPA) reports;
— Changes to manufacturing processes and analytical methods; — Changes to market authorizations; — Stability testing and monitoring program; — Complaints and product recalls, their investigations and closed-
out reports; and
— Qualification status of key equipment and utilities, e.g., steam,
water, and heating, ventilating and air-conditioning (HVAC) system.
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The inspector will verify whether product quality review results have been trended, investigated with CAPAs taken based on root
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Manufacture and Supply, Science and Reg ulation Towards High-Qua lity Medicinal Products
cause analysis, and whether statistical tools such as control charts have been used for trending the quality parameters.
5.3.8.2. Assessing Program for Managing Complaints and
Product Recalls
The complaints and product recalls program of the manufacturer is audited by the inspector in accordance with the PIC/S Guide to GMP for Medicinal Products Chapter 8. For handling of com­plaints, the inspector checks for compliance to the following requirements:
A designated person is responsible for handling complaints and deciding on actions to be taken;
A written procedure (SOP) on handling complaints is in place;
All complaints are recorded, investigated and closed out with decisions taken documented;
All complaint records are reviewed regularly for any recurring trend; and
The Competent Authority (National Medicines Regulatory Authority) is notified if manufacturer is considering product recall following serious quality defects, faulty manufacture and evidence of counterfeit products.
For handling of product recalls, the inspector checks for compliance with the following requirements:
A designated person, independent of sales and marketing, is responsible for coordinating and executing recalls;
Compliance of Pharmaceutical Manufacturers to Good Manufacturing Practice Standards
An approved written procedure (SOP) is in place for product recall;
Distribution records are readily available to the designated person;
The Competent Authority (National Medicines Regulatory Authority), where the product is distributed, is notified if man­ufacturer is considering product recall;
Recalled products are stored securely while awaiting decision on their fate;
Progress of recall process is recorded and a final report issued, including a reconciliation between delivered and recovered products; and
Eectiveness of recall procedure is evaluated regularly.
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5.3.8.3. Assessing Self-Inspection Program
The self-inspection program of the manufacturer is audited by the inspector in accordance with the PIC/S Guide to GMP for Medicinal Products Chapter 9. The following requirements are checked by the inspector:
Self-inspections are carried out periodically in accordance with pre-arranged program;
The areas covered during self-inspection include production, QC, premises, equipment, personnel and documentation, i.e., all nine chapters and relevant annexes of PIC/S GMP standard;
Self-inspection is conducted in an independent and detailed way by designated competent persons from the company;
Independent audits by external experts are conducted, when they are deemed useful;
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Manufacture and Supply, Science and Reg ulation Towards High-Qua lity Medicinal Products
All self-inspections are recorded, including observations made and the proposed CAPAs; and
Statement(s) of eventual action(s) taken are recorded.
5.3.8.4. Fish Bone Diagram: Link between GMP Compliance and
Product Quality
GMP compliance is an integral and critical component of quality assurance. The Fish Bone Diagram is used to illustrate the relation­ship between GMP compliance and product quality. Product qual­ity, which is represented by the fish head, is aected by the four Ms, namely, Manpower, Machine, Method, Material, and one P, namely, Premises. The backbone of the fish represents the overall pharma­ceutical quality system of the manufacturer, which includes prod­uct quality review, quality risk management and the programs for
Compliance of Pharmaceutical Manufacturers to Good Manufacturing Practice Standards
handling complaints and recalls and self-inspection. It is very clear from the Fish Bone Diagram that GMP compliance by the phar­maceutical manufacturer is integral and directly linked to product quality.

5.4. The 20 Annexes of PIC/S GMP Standard

Annex 1 – Manufacture of Sterile Products
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Manufacture of sterile products
Annex 1 describes the GMP requirements for the manufacture of sterile products such as injections, eye drops and eye ointments, and the need for Clean Rooms to be designed with special airlocks and air-handling systems to keep out particles and micro-organisms. Annex 1 also stipulates the types of PPE such as hair covers, masks,