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204
11.7.1 current regulatOry lanDscaPe FOr 3DP Pharmaceuticals
Handbook of 3D Printing in Pharmaceutics
The FDA approval of a 3DP pharmaceutical product (Spritam®) in 2015 is a turning
point in the history of 3DP technology in the pharmaceutical eld. Even though all
regulatory agencies place a top priority on the quality of pharmaceutical substances to
ensure the patients’ safety, no proper guidelines have been issued till now for the production of 3DP products (Cui et al., 2021). In addition, it is not clear that regulatory
permission is required only for the nished product or at all phases of product design,
including during manufacture. Even the safety precautions and standard operating
procedures are to be considered in the 3DP process because toxic substances may be
released at different steps of the 3DP process, like fusion, extrusion, or heating, that
affect the skin or respiratory organs (Gioumouxouzis et al., 2019).
11.7.2 gOOD manuFacturing Practices (gmP) in 3D Printing
3DP has shown considerable potential in the pharmaceutical market and has the capability to revolutionize personalized medicine production and drug discovery in the
pharmaceutical industry. Various regulatory practices, such as good manufacturing
techniques (GMPs), good documentation practices (GDPs), and good laboratory
practices (GLPs), are applied to maintain the manufacturing standards of pharmaceutical products. Therefore, it is also necessary to develop suitable regulations for the
production and marketing of 3DP pharmaceutical formulations, like GMP accreditation, which is required for premises that produce and distribute 3DP pharmaceutical
formulations (Acosta- Velez, 2016).
11.7.3 Quality assurance anD DOcumentatiOn reQuirements
QbD is an alternative strategy to pharmaceutical product quality assurance that has
recently gained popularity. Proper documentation and traceability are also necessary
for QC in 3DP to ensure that all manufacturing and QC processes are accurately
recorded, managed, and veriable. Recording the materials utilized, the settings of
the 3DP process, and the ndings of the inspection are all part of this. By providing
this documentation, it is possible to trace the nal product’s origin and ensure its
traceability. Document management and storage may require the use of electronic
document management.
11.8 CASE STUDIES AND REAL- WORLD APPLICATIONS
Several aspects of a 3DP product, including its mechanical qualities, dimensional
accuracy, surface quality, and compliance with specications are considered and
assessed to establish the quality of the product by NDTs. It was reported that the
NIRS was employed for in- line process control of different layers of UV- curable
printing inks (Mirschel et al., 2014), evaluation of 3DP pharmaceuticals (lms and
tablets), and near- infrared chemical imaging to study inkjet- printed pharmaceuticals
(Vakili et al., 2015). Raman confocal spectroscopy nds its use in examining the

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205
FIGURE 11.2 Determining the dosage content in polyprintlets using a portable NIR device.
(Treneld et al., 2020.)
distribution of the medication and polymer within the 3DP tablet. In situ sensors and
cameras are used to acquire process data for quality analysis and real- time monitoring
of the 3DP techniques. A thermal camera is utilized to collect facts regarding the
potential degradation processes (Aho et al., 2019), which aids in chemical mapping
of the drug and excipients and also to observe the variations in the solid forms of the
nished product.
According to Figure 11.2, a study was carried out to determine the dose content
of the polyprintlets containing two different medications (lisinopril and amlodipine)
placed into cylindrical polyprintlets and 3D- printed lms, with drug concentration
ranges from 1– 20% w/ w and 1– 3% w/ w, respectively, by a portable NIR spectrometer non- destructively, and calibration models were also established (Treneld et al.,
2020) and compared with HPLC output.
A quality management system, “certify- as- you- build”, can watch a printlet
throughout the printing process and identify print aws in real time by comparing the
created geometry with the computational model and 3D- DIC can be used to capture
the structure and record the real- time aws in 3DP product (Holzmond and Li, 2017).
Figure 11.3 represents the real- time fault detection of specic and general defects by
3D- DIC.
11.8.1 exemPlary Qc strategies in 3DP Drug FOrmulatiOns
Non- destructive testing is frequently used to provide efcient QC and preventive or
predictive maintenance without altering the properties or original state of the material.
One of the main purposes of the adaptation of QbD and PAT is to facilitate real- time
release testing (RTRT), ensuring the quality of the medicinal product without damaging end- products. Taguchi’s strategy is to complement approaches to conventional
experimental design methods because it combines engineering and management
approaches with statistical ones to produce improved- quality products and reduce
costs quickly.

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Handbook of 3D Printing in Pharmaceutics
FIGURE 11.3 Real- time fault detection of both specic and general defects by using 3DDIC. (Holzmond, et al., 2017.)
11.8.2 lessOns learneD FrOm successFul imPlementatiOn
OF Qc methODs
Several factors, such as production process, the material being used, and the existence of contaminants, inuence the selection and application of a non- destructive
testing technique as each approach has its own guiding principles. Even the regulatory measures need to place a lot of emphasis on the quality assurance and management steps that lead to product formation by using new approaches to ensure quality
throughout the production process.
11.8.3 Future trenDs anD aDVancements in Qc FOr Pharmaceutical
3D Printing
3DP is a breakthrough innovation; it provides novel approaches for both patients
and the pharmaceutical industry that have a signicant impact on the pharmaceutical
sector. The QC methods that are employed for traditional pharmaceutical products
are not suitable for 3DP products so NDTs are adopted for the characterization of
3DP pharmaceuticals. Spectroscopic techniques like NIRS, Fourier transform NIRS,
HSI coupled with NIRS and RS, or Raman confocal microscopy can be installed
ofine, at- line, or in- line, and they can yield both quantitative and qualitative data.
Another method, using an advanced algorithm, has been developed by ZoomlabTM
(Tracy et al., 2023), which helps to select the optimal excipients for a given API.
This method minimizes costs by reducing the requirement for several laboratory
tests, reducing wastage of expensive excipients, and checking the compatibility of
various excipient– API combinations virtually. The numerous technological and legal
challenges and the availability of online non- destructive quality- control procedures
that 3D printing technology is currently confronting will be resolved in the near
future.

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11.9 CONCLUSION
207
3DP has received signicant attention from the pharmaceutical industry over the past
ten years owing to its rapid production, affordable price, and versatility in pharmaceutical formulations, thus enabling patients to obtain more effective and safer medication.
In the pharmaceutical sector, quality control is a fundamental and crucial activity that
ensures high- quality pharmaceutical products. The primary objective is to ensure that
the product is safe, efcient, consistent, and reproducible throughout the entire manufacturing procedure. So it is critical to improve 3D printing quality since low standards
could discourage consumers from buying 3D- printed products. Conventional QC
techniques that have become prevalent in large- scale manufacturing represent the endproduct testing paradigm; such approaches are generally destructive and inappropriate
for the 3DP. This demands the development of a non- destructive PAT that requires
little to no sample preparation and retains the integrity of the nished product. PAT is
currently gaining recognition in research as a QC technique that allows the monitoring
of the production process by offering real- time evaluation and management of critical
process parameters and previously established CQA. Non- destructive techniques like
3D- DIC, photogrammetry techniques, NIR, RS, and hyper imaging are employed to
reduce manufacturing oversights, material waste, variations, and imperfections in the
3DP process, as well as to enhance product quality during the manufacturing process.
QC techniques and regulatory strategies like GMP at every stage of manufacture are
crucial in enhancing the quality of 3DP formulations.
ACKNOWLEDGEMENTS
The authors are thankful to the management of Malla Reddy Pharmacy College for
their unwavering support.
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3D- Printed
12
Pharmaceuticals
Current Regulatory Scenario
Raja Rajeswari Kamisetti, Ajmeer Ramkishan,
Prakash Katakam, and Subhas Sahoo
12.1 INTRODUCTION
3D printing (3DP), an expository advancing technology in versatile fabrication
systems including pharmaceuticals, bio- medicine, aviation and automobiles and so
on with its ubiquitous utilization with an expectation to grow signicantly to $42.9
billion by 2025 (CAGR Markets press release, Tracy et al., 2023). However, despite
its potential and focus on digital savings, there is no systematic plan for 3DP. While
compliance with rules is generally lacking in nations like India, certain countries have
specic regulations focused on certain areas such as medical equipment.
These innovations are contemporary with multiple edges to the pharmaceutical
industry, during early stages of drug development by their less time and expenditure. The timelines in the developmental stages was marked during the COVID- 19
pandemic requiring rapid drug development and repurposing trials. In the course of
pre- clinical and clinical formulation development, this technology is a prototype tool
to rapidly evaluate intermittent batches of dissimilar drug product replications with a
jolt on critical quality imputes.
3DP is a viable alternative to traditional manufacturing processes in the pharmaceutical business for producing personalized medications, offering cost savings
compared to conventional procedures. However, these formulas have signicance in
improving medicinal effects. Formulations can be customized to individual patient
requirements using 3DP under controlled conditions, a procedure already employed
in the healthcare sector. Many manufacturers use this technology for the mass production of personalized hearing aids.
Industries worldwide must proactively adjust and shape the direction of technology, while governments should prioritize 3DP. In recent times, major nations such
as China, the United States (US), and the European Union (EU). China has been
actively developing its 3DP business and implementing policies to regulate these
technologies. In 2017, an action plan called the “Additive Manufacturing Industry
Development Action Plan (2017– 2020)” was created (www.gov.cn/ xin wen/ 2017- 12/
14/ cont ent_ 5246 754.htm).
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In 2018, “Centre of Medical Devices Evolution” of China issued suggestions for
the management and directive of 3DP medical equipment that are specically custombuilt additive- manufactured medical devices (www.cmde.org.cn/ CL0 063/ 6954.
html). In 2020, technical guidelines were adhered to permit the production of 3DP
replacement vertebrae www.cmde.org.cn/ CL0 112/ 21043.html) and an acetabular cup
(www. cmde.org.cn/ CL0 112/ 21042.html).
In 2017, the Federal government made a signicant shift when the Foods and
Drugs Administration of USA (FDA) issued recommendations aimed at additive
produced medical devices (Martin et al., 2017). The agency authorized the production of 3D- printed parts for commercial engines (www.ge.com/ news/ repo rts/ the- faaclea red- the- rst- 3d- prin ted- part- to- y- 2).
The Federal government has attempted to regulate the misuse of 3DP of
rearms by introducing multiple laws in Congress (H.R.7115 2015). Despite being
obscured by darkness, regulatory rules have been developed based on important
recommendations.
12.1.1 key regulatOry cOnsiDeratiOns FOr 3DP Pharmaceuticals
Design and development: the design and development of 3D- printed pharmaceuticals
must be carefully controlled to ensure the safety and efcacy with regard to the
products. This includes material choices and design of the dosage form, and the
printing process.
Manufacturing: the manufacturing of 3DP pharmaceuticals must be done in conformity with good manufacturing processes (GMP). This ensures that the products are
produced consistently and reliably, and that they meet the required quality standards.
Quality control: 3DP pharmaceuticals must be subject to rigorous quality- control
testing to ensure their safety and efcacy. This testing should include the tests to
determine the identication, pureness, strength, effectiveness, and stability of the
pharmaceuticals.
Labeling: the labeling of 3DP pharmaceuticals must be accurate and complete, and
it must comply with all applicable regulations. The labeling should include information about the ingredients, the dosage, the route of administration, and the storage
conditions.
The regulatory landscape for 3DP pharmaceuticals is still sprouting, but it is
apparent that these products will be subject to austere regulations to warrant the
safety and efcacy of these products, which have the potential to revolutionize the
way to deliver medicines.
12.2 US FOOD & DRUG ADMINISTRATION (USFDA)
The regulating body is responsible for ensuring the safety and efcacy for the medical supplies such as medicines, biological products, and medical- devices, including
3D- printed medical products. The USFDA does not have strict monitoring in place

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for 3D printers, but it does closely oversee the automated processes and production
of these 3D printers if the resulting product are medical devices that meet quality
standards.
3DP devices must adhere to regulatory regulations, like all other devices. Premarket
requirements relate to medical devices before they are launched, whereas post- market
essentials use on medical products after they are sold.
There are three groups of medical equipment: Class I, Class II, and Class III. As
you move from Class I to Class III, regulatory control grows.
The futuristic 3D printing technology and FDA’s policy relates to the following:
(a) the fabrication, labeling, marketing, manufacturing, and analysis of regulated
products, (b) the dispensation, at ease, for assessment or endorsement of regulatory
submissions and (c) scrutiny and implementation of guidelines.
But the authority also states that a substitutional determine if it meets the criteria
of the relevant laws. Hence, this outlined guidance is predominantly organized into
two specic sections:
12.2.1 Design anD manuFacturing cOnsiDeratiOns
This involves addressing technical factors to comply with Quality Systems (QS)
standards for a device based on its governing category or applicable legislation. The
guidelines cover manufacturing issues and thoroughly address all regulatory criteria
needed to develop a quality system for device manufacturing (U.S. Food and Drug
administration, 2017).
12.2.2 DeVice testing cOntemPlatiOns
The section 510(k) of the guidance describes how to submit premarket notication submissions, related to applications of premarket approval (PMA), humanitarian device exemption (HDE), investigational device exemption (IDE) and de novo
requests for 3D- printed devices.
The device categorization system denes the statutory prerequisites for general
device types. Mostly devices belonging to Class I are exempted from section 510 (k),
however the rules are mandatory for the devices belonging to Class II and Class III
devices (www.gov.cn/ xin wen/ 2017- 12/ 14/ cont ent_ 5246 754.htm).
Based on their inventiveness, 3DP has versatile medical applications, medical
devices are regulated by the Center for Devices & Radiological Health (CDRH). The
Center for Biologics Evaluation and Research (CBER) regulates biologics and the
drugs are regulated by the Center for Drug Evaluation and Research (CDER).
Whilst the general 3DP devices are controlled by CDRH, the CBER oversees the
regulatory oversight of all applications of additive manufacturing that use biological,
cellular, or tissue- based materials. The CDER oversees medication applications
involving 3DP, while the Ofce of the Combination Products (OCP) supervises goods
with components typically overseen by multiple FDA Centres.
The FDA has not yet established a denitive policy regarding 3D- printed
pharmaceuticals, but it has afrmed that they would be regulated as drugs or medical devices, depending on the specic product. The Foods, Drugs, and Cosmetics
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