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22nd Annual Conference on Quality in the Space and Defense Industries

February 23–24, 2015 • Cape Canaveral, FL

22nd Annual Conference on Quality in the Space and Defense Industries

February 23–24, 2015 • Cape Canaveral, FL

Manufacturing in the

Healthcare Industry:

Quality Challenges

and Tools

Gerard J. Pearce Executive Vice President

SQA Services, Inc.

22nd Annual Conference on Quality in the Space and Defense Industries

February 23–24, 2015 • Cape Canaveral, FL

22nd Annual Conference on Quality in the Space and Defense Industries

February 23–24, 2015 • Cape Canaveral, FL

Forces impacting

Quality in healthcare

manufacturing

New Technology

Internal Change

External Threat

Tools and Techniques

for Quality

Adaptation

Prioritization

Optimization

TODAY

Objective Focus

22nd Annual Conference on Quality in the Space and Defense Industries

February 23–24, 2015 • Cape Canaveral, FL

HEALTHCARE QUALITY PLAYING FIELD

• Highly regulated, and focused on patient safety

• Conservative, risk-averse

• Relatively long development cycle

• Innovation emphasis on R&D

N Engl J Med 2013; 368:2043-2045

22nd Annual Conference on Quality in the Space and Defense Industries

February 23–24, 2015 • Cape Canaveral, FL

ANTICIPATING

QUALITY

NEEDS

• FDA working to respond

to, anticipate, and help drive

scientific developments

• FDA defining and clarifying

regulatory pathways and

policies

• Establishing a basis for

Quality professionals to

anticipate and prepare for

the changes to come with

new technologies

22nd Annual Conference on Quality in the Space and Defense Industries

February 23–24, 2015 • Cape Canaveral, FL

HEALTHCARE QUALITY INFLUENCERS

Parenteral Drug Association

22nd Annual Conference on Quality in the Space and Defense Industries

February 23–24, 2015 • Cape Canaveral, FL

QUALITY FOCUS

• Best patient and business outcome

• Regulatory, in conjunction with FDA goal that

“products consistently meet applicable

requirements and specifications”

• Environmental (Internal)

• Environmental (External) Regulatory

External Internal

Quality

22nd Annual Conference on Quality in the Space and Defense Industries

February 23–24, 2015 • Cape Canaveral, FL

Finished Product Raw Materials

API

Excipient

Packaging

Distribution Delivery Use

GMP GIP GDP

GPP Pharmacovigilance

QUALITY IN THE PRODUCT CHAIN

22nd Annual Conference on Quality in the Space and Defense Industries

February 23–24, 2015 • Cape Canaveral, FL

REGULATORY INITIATIVES

• FDA Safety and Innovation Act 2012 (risk

management, global focus, enhanced tools)

• FDA Drug Quality and Security Act 2013

(Track and Trace)

• EMA Falsified Medicines Directive 2013

(authenticity, controls, documentation)

• FDA Unique Device Identification Guidance

2014 (safety, surveillance)

22nd Annual Conference on Quality in the Space and Defense Industries

February 23–24, 2015 • Cape Canaveral, FL

COMMERCIAL CHANGES

• Actavis – Allergan

• Pfizer – Wyeth

• Glaxo Wellcome – SmithKline Beecham

• Teva – Barr

• Merck – Schering-Plough

• Abbott – Solvay

• etc.

22nd Annual Conference on Quality in the Space and Defense Industries

February 23–24, 2015 • Cape Canaveral, FL

SAFE SUPPLY

FOCUS

• Extended supply

chains

• Growth in

outsourcing

• Decentralized

controls

22nd Annual Conference on Quality in the Space and Defense Industries

February 23–24, 2015 • Cape Canaveral, FL

COST OF POOR QUALITY

22nd Annual Conference on Quality in the Space and Defense Industries

February 23–24, 2015 • Cape Canaveral, FL

QUALITY FAKES

22nd Annual Conference on Quality in the Space and Defense Industries

February 23–24, 2015 • Cape Canaveral, FL

MHRA Warns Diabetics About

Counterfeit Insulin Pen Needles Counterfeit batch of insulin pen needles found

circulating in UK supply system The Medicines and Healthcare products Regulatory

Agency (MHRA) is today warning diabetics about a

counterfeit batch of insulin pen needles that are

circulating in the UK.

14

May 7, 2007

80 children die in Haiti due to contaminated

glycerin in acetaminophen syrup

COST OF POOR QUALITY

22nd Annual Conference on Quality in the Space and Defense Industries

February 23–24, 2015 • Cape Canaveral, FL

QUALITY CONCERNS

• Fast changes, slow industry

• Interpretation of standards

– Client-specific needs

– Controlling quality at contract

manufacturers

• Supply Chain globalization

• Other:

– Security

– Managing ‘end-of-cycle’

22nd Annual Conference on Quality in the Space and Defense Industries

February 23–24, 2015 • Cape Canaveral, FL

SUPPLIER EVALUATION

• Supply chain is a moving target

• Distance, language, culture and local

knowledge

• CAR Sickness

• ‘Standard’ Tools and Systems

• Quality-Supply Management disconnect

22nd Annual Conference on Quality in the Space and Defense Industries

February 23–24, 2015 • Cape Canaveral, FL

Forces impacting

Quality in healthcare

manufacturing

New Technology

Internal Change

External Threat

Tools and Techniques

for Quality

Adaptation

Prioritization

Optimization

TODAY

Objective Focus

22nd Annual Conference on Quality in the Space and Defense Industries

February 23–24, 2015 • Cape Canaveral, FL

ADAPTING TO CONDITIONS

• Risk-based approach

• Harnessing best practice and technology

• Social Media and Industry Collaboration

• Structure for Success

22nd Annual Conference on Quality in the Space and Defense Industries

February 23–24, 2015 • Cape Canaveral, FL

RISK-BASED APPROACH

• Focus based on status and risk

• Strategic Partners

• Strategic Stinkers

• Regional Coverage

low medium high

high

medium

low

Criticality

Fai

lure

s

22nd Annual Conference on Quality in the Space and Defense Industries

February 23–24, 2015 • Cape Canaveral, FL

RISK-BASED APPROACH

Spend/Leverage

Criticality Low High

Quality Performance

Environment

Good Poor

Little Much

Stable Unstable

less

fre

quent

more

fre

quent

22nd Annual Conference on Quality in the Space and Defense Industries

February 23–24, 2015 • Cape Canaveral, FL

RISK-BASED APPROACH

High-level look to low-level look:

1. ‘D&B-style’ check

2. Self- or desk-audit

3. ISO-style audit

4. Specialized audit

5. Assessment

22nd Annual Conference on Quality in the Space and Defense Industries

February 23–24, 2015 • Cape Canaveral, FL

Qualification

& Validation

Lead

ers

hip

Policy and

Strategy for

GMPs

Resources

GMP

Compliance

Personnel

Orientation

Current Auditing

Coverage moving towards broader scope

RISK-BASED APPROACH

Investigation System & Improvement

Ris

k M

anag

em

ent

Pro

cess

es

Contr

ols

and A

ctual

Cap

abili

ty

Busi

ness

Resu

lts

(KPIs

)

Enablers Results

General

System

Inputs

and

Outputs

Elements needed

for full PDCA

Closure

Total Quality Management

Supplier Evaluation Evolution:

22nd Annual Conference on Quality in the Space and Defense Industries

February 23–24, 2015 • Cape Canaveral, FL

RISK-BASED APPROACH

Supplier

Impact

Evaluation

Investment

Supplier Impact-Investment Map

22nd Annual Conference on Quality in the Space and Defense Industries

February 23–24, 2015 • Cape Canaveral, FL

BEST PRACTICE AND TECHNOLOGY

• Supplier review and rationalization

• Deeper supplier scrutiny

• Quality Agreements

• Common-sense controls

• Tracking and Screening Methods

22nd Annual Conference on Quality in the Space and Defense Industries

February 23–24, 2015 • Cape Canaveral, FL

XY RSA

BC Plan.pdf

BEST PRACTICE AND TECHNOLOGY

• ‘Virtual’ replaces ‘Desktop’

• True ‘Remote’ Audits

• Both quantitative and

qualitative

• Results trigger next steps

22nd Annual Conference on Quality in the Space and Defense Industries

February 23–24, 2015 • Cape Canaveral, FL

BEST PRACTICE AND TECHNOLOGY

Helping answer two key questions:

• Is the program on track?

• What is the program telling us?

22nd Annual Conference on Quality in the Space and Defense Industries

February 23–24, 2015 • Cape Canaveral, FL

BEST PRACTICE AND TECHNOLOGY

Data Analytics aim to create

‘Supply Chain Intelligence’

22nd Annual Conference on Quality in the Space and Defense Industries

February 23–24, 2015 • Cape Canaveral, FL

BEST PRACTICE AND TECHNOLOGY

Quality / Performance Are they succeeding?

External

factors - Are they

impacted by the

environment?

Compliance - Are they set up to

succeed?

Criticality

- how important are they?

Overall Risk

Supplier Scorecard

Supplier Dashboard

Supplier Quality Profile

…others?

Integrating supply chain data:

22nd Annual Conference on Quality in the Space and Defense Industries

February 23–24, 2015 • Cape Canaveral, FL

SOCIAL MEDIA & INDUSTRY COLLABORATION

22nd Annual Conference on Quality in the Space and Defense Industries

February 23–24, 2015 • Cape Canaveral, FL

STRUCTURE FOR SUCCESS

Balance between:

Inspections

Non-conforming product

Supplier Corrective Action

Material returns

Quality Agreements

Supplier Scorecards

Supplier Consolidation

Supplier Qualification

Supplier Audits & Assessments

Supplier Remediation

Quality

Control and Quality

Development

22nd Annual Conference on Quality in the Space and Defense Industries

February 23–24, 2015 • Cape Canaveral, FL

Finished Product Raw Materials

API

Excipient

Packaging

Distribution Delivery Use

GMP GIP GDP

GPP Pharmacovigilance

QUALITY IN THE PRODUCT CHAIN

22nd Annual Conference on Quality in the Space and Defense Industries

February 23–24, 2015 • Cape Canaveral, FL

TODAY

Forces impacting

Quality in healthcare

manufacturing

New Technology

Internal Change

External Threat

Tools and Techniques

for Quality

Adaptation

Prioritization

Optimization

Objective Focus

22nd Annual Conference on Quality in the Space and Defense Industries

February 23–24, 2015 • Cape Canaveral, FL

RECOMMENDED READING

• Dangerous Doses – Katherine Eban

• The Signal and the Noise – Nate Silver

• Single Point of Failure – Gary Lynch

• Reinventing Discovery – Michael Nielsen

• Phake – Roger Bate

22nd Annual Conference on Quality in the Space and Defense Industries

February 23–24, 2015 • Cape Canaveral, FL

22nd Annual Conference on Quality in the Space and Defense Industries

February 23–24, 2015 • Cape Canaveral, FL

Questions and further information:

Gerard Pearce

310-802-4448

gpearce@sqaservices.com

THANK YOU!

22nd Annual Conference on Quality in the Space and Defense Industries

February 23–24, 2015 • Cape Canaveral, FL

GBP • Complex environment

• Detailed requirements

• Simple trigger

• Action