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Preparing for an FDA
    Pre-Approval Inspection (PAI)


                         Jorge Torres
                       CMQ/OE, CQE, CQA
                          July, 2007




1
Agenda

     Introduction
     Understanding the PAI Experience:
     What to Expect
     Inspection Management Plan
     Preparing for the Inspection




2
Introduction




3
Why a Pre-Approval Inspection?

    The purpose of a pre-approval inspection (PAI) is to
    ensure that your facility is in compliance with FDA rules
    and regulations.
    Investigators want to know that product development
    was done appropriately and the current good
    manufacturing practices (cGMP) are up to FDA
    standards.

    An inspection can be very intimidating to all involved,
    but is vital if you want to obtain FDA approval.
4
What if I have a negative report?

    Major delays before you can market your product can
    arise from a negative report such as:
       •   Contract problems – You might have problems with
           Government, contracting partners, or other companies
       •   Legal problems
       •   Loss of reputation – Information from 483’s is routinely
           published
       •   Stockholder-Market issues – Negatively affects stock
           prices
       •   Consumer safety issues – Loss of trust by consumers


5
What’s the impact?

    At best, an FDA inspection can be disruptive to your
    operations.

    At worst, it can mean lost revenue and damage to your
    reputation. You can even be shut down!




6
Managing the Inspection

    One of the primary goals is to MANAGE the inspection
    from start to finish by:
       •   Understanding the FDA’s expectations
       •   Preparing your site
       •   Generating documented evidence of compliance with FDA
           regulations
       •   Interacting appropriately with FDA inspectors
       •   Managing the inspection on the day of the audit




7
Understanding the PAI
    Experience: What to Expect




8
What to Expect

    When pharmaceutical (drug) or device manufacturers
    apply for pre-market approval of a new product, the
    FDA must conduct a pre-approval inspection (PAI).

    FDA sends a team of individuals to conduct the pre-
    approval investigation. The team may include:
       –   Lead investigator
       –   Microbiologist
       –   Chemist
       –   Computer Specialist
       –   Reviewer from Headquarters (e.g. Drugs or Devices)


9
What to Expect

     Investigators will review your application before ever
     visiting your site. When they arrive, they will compare
     the information in the application to what they find.

     What investigators look for:
        •   How you handle Quality Assurance
        •   Proper training of employees
        •   Formulation development (for drugs)
        •   Deviation and failure investigations


10
FDA Inspection Trends

     Quality Assurance (QA) system is the number one
     issue for inspectors (in recent years).

     The PAI has been one area in which they have
     developed a risk-based approach. Rather than trying
     to cover everything, inspectors will look at how your
     facility manages and monitors anything that has risk.

     Important: Special attention is being given to the new
     Quality Systems programs that have been introduced
     under FDA’s “GMPs for the 21st Century” Initiative
11
Closing Meeting

     Form 483 – “Notice of Inspectional Observations” may be issued
     at the conclusion of the inspection if violations are found.
         –   If you do not receive a 483, do not assume that the FDA
             has approved of everything you are doing. It is probably
             just means that you were in compliance in the areas they
             had time to inspect on this visit.


     An Establishment Inspection Report (EIR) is prepared after the
     inspection regardless of whether violations were found.




12
Inspection Management Plan




13
Think about this!

     When the FDA comes to conduct a PAI, they expect to
     find some problems.
     If their investigation of your facility revealed no
     problems, they would likely turn your company upside
     down, trying to find out what you are hiding.




14
What are your issues?

     All companies have some issues – that is a given.
     What FDA investigators really want to see is how you
     address those problems:
        –   Do you honestly investigate your problems?
        –   Do you try to control the problems?
        –   Do you look for the root cause of a problem?

     Companies that try to control problems are viewed by
     the FDA as companies with a high standard of quality.


15
Inspection Management Plan

     In a PAI, you will have some advance notice of when the
     inspection will take place. Therefore, a Inspection
     Management Plan should be in place.
     The Inspection Management Plan should provide for:
          Response to arrival of investigators
          Guidance of inspectors’ activities
          Procedure for working with investigators
          Documentation of inspection
     The management plan or SOP should spell out all of the
     procedures that you will follow during an investigation.
16
Preparing for the Inspection




17
Conduct Internal Audits

     Internal Audits are a key element of the quality system.

        –   Required per §21CFR Part 820.22

        –   Objective is to evaluate activities and documentation to
            ensure compliance to regulations and internal procedures.

        –   Ideal for preparing organization for external audits.

        –   Internal audit reports are not normally viewed by FDA
            inspectors.
18
Personnel Training

     Educate personnel about the inspection process so
     they can be prepared
     Train individuals to interface with FDA investigators
         Do’s & Don’ts
     Verify that training has been provided for personnel on
     their current job functions and that supporting records
     are on file
     The goal is to minimize the opportunity for incorrect
     answers provided to the inspectors or providing too
     much information
19
Review External Documents

     Be familiar with:
       FDA Regulations as applicable
          21CFR Parts 210/211 (Drugs), Part 820 (Devices)
       FDA Guidance Documents
       FDA Guidance Manuals for Inspectors
     Review:
       Warning Letters (www.fda.gov)
       Prior FDA 483’s
       Prior Establishment Inspection Reports (EIR)
20
Review Internal Documents

     Relevant documents and records should be reviewed
       prior to the inspection.
          Ensure that all relevant records exist and are readily available.
          Ensure that all records are accurate.
             Note: Do not change records after the fact; rather add the
             correction and an explanation, sign and date it!
     The FDA inspector will be comparing the details of the
        application to the records you have in house.
     Identify records that you will pre-stage for ease.
       Examples:
          Large volume validations
21        Design History Records
Review Internal Documents

     Some of the documentation to consider for pre-review:
        Clinical trials/studies        Training records – past
        Operating procedures           records and GMP training
        Batch reports                  Development reports
        Laboratory records             Validation/qualification
        (associated with batch test)   documents
                                          Process validation
        Non-conforming materials
                                          Cleaning validation
        reports
                                          Computer validation
        Out-of-specification              Environmental
        reports                           evaluation

22
Prepare an Inspection Team

     An inspection team to manage the inspection should be
     prepared and roles identified prior to the inspection.

     Rooms should be identified to ease the inspection:
       – An Audit room will be where the inspector will
         interview personnel.
       – A Staging “War” room will be where documents will
         be set up and processing of inspector requests will
         take place.

23
Inspection Team – Audit Room

     In the audit room personnel SHOULD include:
        –   Escort: Key personnel to accompany investigators. They
            should know how to develop a rapport with the investigator.
            They will answer most questions about quality systems.
        –   Scribe: Keeps detailed notes about the audit including topics
            discussed, questions asked, inspector mood, etc.
        –   Runner: Sends requests to staging room (walks or electronic)
            for processing.
        –   Subject Matter Expert (SME): Answers technical questions
            that Escort cannot answer.


24
Inspection Team – Staging Room

     In the staging room personnel MAY include:
        –   Room Head: Leads room, meet & greet SME’s
        –   Coordinator: Obtains requests from Audit room runner.
            Contacts appropriate SME. Tracks all requests to ensure
            they are filled.
        –   Reviewer: Reviews any documentation that will be sent to
            the inspector.
        –   Prep person: Prepares SME’s prior to going to Audit Room
        –   Runner/Helper: Handles administrative duties (copying,
            stapling, sorting, etc.). Backup to coordinator when things
25          get hectic.
Conduct Mock Audits

     Mock audits are conducted to evaluate the status of
     compliance of the firm and how employees respond to
     questioning. If possible use an external consultant.
     Items to consider during a mock audit include:
         Focus on the laboratory – an FDA “hot spot”
         Review of key internal documents
         Cleanliness of the workplace
         Employee responses to questioning
         How efficiently can you fill inspector requests
26
Remediate

     Use the lessons learned from all the activities to be
     ready for the FDA Inspection.

       – Fix the problems
       – Close the gaps


       Practice, practice, practice…



27
Conclusion




28
Conclusion

     You need not dread an FDA inspection if you are adequately
     prepared.
     FDA inspections have revealed some trends in recent years.
     The agency is taking a tougher posture on new applications and
     using a risk based approach.
     Inspectors usually look at two systems in depth. QA is their
     number one concern in recent years.
     They may also look at another system, such as facilities and
     equipment; materials; production; packaging and labeling; or
     laboratory controls.

29
Conclusion

      FDA does not expect your facility to be perfect. They expect all
      companies to have some issues. What they really want to see
      is how you address those problems.
      The FDA tends to view companies that try to control these
      problems to have a high standard of quality.
      Use the FDA inspection as a learning tool, not as a negative or
      adversarial experience.




30
References

      www.fdanews.com
      –   “Preparing for an FDA PreApproval Inspection”, Copyright© 2006
          FDANews
      www.labcompliance.com
      –   “FDA Inspections Survival Package”, Revision 3.0, January 2007,
          LabCompliance
      www.fda.gov
      –   FDA Compliance Program Guidance Manual (CPGM) 7346.832,
          Chapter 46 – New Drug Evaluation
      –   FDA Enforcement Manual, August 1999, Tab 300
      –   “Guidance for Industry, Quality Systems Approach to Pharmaceutical
          cGMP Regulations”, September 2006, Food and Drug Administration


31
Contact Information

     Stay tuned for Part 2 of FDA Inspections:
             “Managing the Inspection”
                 October 17, 2007

          For additional information please contact

            Jorge Torres, CMQ/OE, CQE, CQA
                Jorge_CQM@yahoo.com
                     (951) 275-4604
32

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FDA PreApproval Inspection - Part 1

  • 1. Preparing for an FDA Pre-Approval Inspection (PAI) Jorge Torres CMQ/OE, CQE, CQA July, 2007 1
  • 2. Agenda Introduction Understanding the PAI Experience: What to Expect Inspection Management Plan Preparing for the Inspection 2
  • 4. Why a Pre-Approval Inspection? The purpose of a pre-approval inspection (PAI) is to ensure that your facility is in compliance with FDA rules and regulations. Investigators want to know that product development was done appropriately and the current good manufacturing practices (cGMP) are up to FDA standards. An inspection can be very intimidating to all involved, but is vital if you want to obtain FDA approval. 4
  • 5. What if I have a negative report? Major delays before you can market your product can arise from a negative report such as: • Contract problems – You might have problems with Government, contracting partners, or other companies • Legal problems • Loss of reputation – Information from 483’s is routinely published • Stockholder-Market issues – Negatively affects stock prices • Consumer safety issues – Loss of trust by consumers 5
  • 6. What’s the impact? At best, an FDA inspection can be disruptive to your operations. At worst, it can mean lost revenue and damage to your reputation. You can even be shut down! 6
  • 7. Managing the Inspection One of the primary goals is to MANAGE the inspection from start to finish by: • Understanding the FDA’s expectations • Preparing your site • Generating documented evidence of compliance with FDA regulations • Interacting appropriately with FDA inspectors • Managing the inspection on the day of the audit 7
  • 8. Understanding the PAI Experience: What to Expect 8
  • 9. What to Expect When pharmaceutical (drug) or device manufacturers apply for pre-market approval of a new product, the FDA must conduct a pre-approval inspection (PAI). FDA sends a team of individuals to conduct the pre- approval investigation. The team may include: – Lead investigator – Microbiologist – Chemist – Computer Specialist – Reviewer from Headquarters (e.g. Drugs or Devices) 9
  • 10. What to Expect Investigators will review your application before ever visiting your site. When they arrive, they will compare the information in the application to what they find. What investigators look for: • How you handle Quality Assurance • Proper training of employees • Formulation development (for drugs) • Deviation and failure investigations 10
  • 11. FDA Inspection Trends Quality Assurance (QA) system is the number one issue for inspectors (in recent years). The PAI has been one area in which they have developed a risk-based approach. Rather than trying to cover everything, inspectors will look at how your facility manages and monitors anything that has risk. Important: Special attention is being given to the new Quality Systems programs that have been introduced under FDA’s “GMPs for the 21st Century” Initiative 11
  • 12. Closing Meeting Form 483 – “Notice of Inspectional Observations” may be issued at the conclusion of the inspection if violations are found. – If you do not receive a 483, do not assume that the FDA has approved of everything you are doing. It is probably just means that you were in compliance in the areas they had time to inspect on this visit. An Establishment Inspection Report (EIR) is prepared after the inspection regardless of whether violations were found. 12
  • 14. Think about this! When the FDA comes to conduct a PAI, they expect to find some problems. If their investigation of your facility revealed no problems, they would likely turn your company upside down, trying to find out what you are hiding. 14
  • 15. What are your issues? All companies have some issues – that is a given. What FDA investigators really want to see is how you address those problems: – Do you honestly investigate your problems? – Do you try to control the problems? – Do you look for the root cause of a problem? Companies that try to control problems are viewed by the FDA as companies with a high standard of quality. 15
  • 16. Inspection Management Plan In a PAI, you will have some advance notice of when the inspection will take place. Therefore, a Inspection Management Plan should be in place. The Inspection Management Plan should provide for: Response to arrival of investigators Guidance of inspectors’ activities Procedure for working with investigators Documentation of inspection The management plan or SOP should spell out all of the procedures that you will follow during an investigation. 16
  • 17. Preparing for the Inspection 17
  • 18. Conduct Internal Audits Internal Audits are a key element of the quality system. – Required per §21CFR Part 820.22 – Objective is to evaluate activities and documentation to ensure compliance to regulations and internal procedures. – Ideal for preparing organization for external audits. – Internal audit reports are not normally viewed by FDA inspectors. 18
  • 19. Personnel Training Educate personnel about the inspection process so they can be prepared Train individuals to interface with FDA investigators Do’s & Don’ts Verify that training has been provided for personnel on their current job functions and that supporting records are on file The goal is to minimize the opportunity for incorrect answers provided to the inspectors or providing too much information 19
  • 20. Review External Documents Be familiar with: FDA Regulations as applicable 21CFR Parts 210/211 (Drugs), Part 820 (Devices) FDA Guidance Documents FDA Guidance Manuals for Inspectors Review: Warning Letters (www.fda.gov) Prior FDA 483’s Prior Establishment Inspection Reports (EIR) 20
  • 21. Review Internal Documents Relevant documents and records should be reviewed prior to the inspection. Ensure that all relevant records exist and are readily available. Ensure that all records are accurate. Note: Do not change records after the fact; rather add the correction and an explanation, sign and date it! The FDA inspector will be comparing the details of the application to the records you have in house. Identify records that you will pre-stage for ease. Examples: Large volume validations 21 Design History Records
  • 22. Review Internal Documents Some of the documentation to consider for pre-review: Clinical trials/studies Training records – past Operating procedures records and GMP training Batch reports Development reports Laboratory records Validation/qualification (associated with batch test) documents Process validation Non-conforming materials Cleaning validation reports Computer validation Out-of-specification Environmental reports evaluation 22
  • 23. Prepare an Inspection Team An inspection team to manage the inspection should be prepared and roles identified prior to the inspection. Rooms should be identified to ease the inspection: – An Audit room will be where the inspector will interview personnel. – A Staging “War” room will be where documents will be set up and processing of inspector requests will take place. 23
  • 24. Inspection Team – Audit Room In the audit room personnel SHOULD include: – Escort: Key personnel to accompany investigators. They should know how to develop a rapport with the investigator. They will answer most questions about quality systems. – Scribe: Keeps detailed notes about the audit including topics discussed, questions asked, inspector mood, etc. – Runner: Sends requests to staging room (walks or electronic) for processing. – Subject Matter Expert (SME): Answers technical questions that Escort cannot answer. 24
  • 25. Inspection Team – Staging Room In the staging room personnel MAY include: – Room Head: Leads room, meet & greet SME’s – Coordinator: Obtains requests from Audit room runner. Contacts appropriate SME. Tracks all requests to ensure they are filled. – Reviewer: Reviews any documentation that will be sent to the inspector. – Prep person: Prepares SME’s prior to going to Audit Room – Runner/Helper: Handles administrative duties (copying, stapling, sorting, etc.). Backup to coordinator when things 25 get hectic.
  • 26. Conduct Mock Audits Mock audits are conducted to evaluate the status of compliance of the firm and how employees respond to questioning. If possible use an external consultant. Items to consider during a mock audit include: Focus on the laboratory – an FDA “hot spot” Review of key internal documents Cleanliness of the workplace Employee responses to questioning How efficiently can you fill inspector requests 26
  • 27. Remediate Use the lessons learned from all the activities to be ready for the FDA Inspection. – Fix the problems – Close the gaps Practice, practice, practice… 27
  • 29. Conclusion You need not dread an FDA inspection if you are adequately prepared. FDA inspections have revealed some trends in recent years. The agency is taking a tougher posture on new applications and using a risk based approach. Inspectors usually look at two systems in depth. QA is their number one concern in recent years. They may also look at another system, such as facilities and equipment; materials; production; packaging and labeling; or laboratory controls. 29
  • 30. Conclusion FDA does not expect your facility to be perfect. They expect all companies to have some issues. What they really want to see is how you address those problems. The FDA tends to view companies that try to control these problems to have a high standard of quality. Use the FDA inspection as a learning tool, not as a negative or adversarial experience. 30
  • 31. References www.fdanews.com – “Preparing for an FDA PreApproval Inspection”, Copyright© 2006 FDANews www.labcompliance.com – “FDA Inspections Survival Package”, Revision 3.0, January 2007, LabCompliance www.fda.gov – FDA Compliance Program Guidance Manual (CPGM) 7346.832, Chapter 46 – New Drug Evaluation – FDA Enforcement Manual, August 1999, Tab 300 – “Guidance for Industry, Quality Systems Approach to Pharmaceutical cGMP Regulations”, September 2006, Food and Drug Administration 31
  • 32. Contact Information Stay tuned for Part 2 of FDA Inspections: “Managing the Inspection” October 17, 2007 For additional information please contact Jorge Torres, CMQ/OE, CQE, CQA Jorge_CQM@yahoo.com (951) 275-4604 32