Best Ways to Address a Deviation Backlog

A deviation backlog in a regulated industry, such as pharmaceuticals, can pose significant risks to compliance, product quality, and overall operational efficiency. Addressing this backlog effectively requires a structured approach that prioritizes risk management, resource allocation, and continuous improvement.

You need to do two things first:

Prioritize Urgent Requests

Identify Critical Issues: Focus on resolving high-priority and time-sensitive deviations first to drive compliance.

Isolate and Organize

Separate Backlog from Ongoing Deviations: Create distinct queues for backlog deviations and new deviations to streamline management.
Create a Backlog Team: Assign a dedicated team to tackle the backlog, ensuring that regular support operations continue smoothly.

From there, you can then proceed into the next steps to tackle a deviation backlog:

1. Prioritize Based on Risk

Not all deviations have the same impact. Prioritizing the backlog based on the severity and risk part of each deviation is crucial. This involves:

Assessing Severity: Evaluate the potential impact of each deviation on product quality, patient safety, and regulatory compliance. Ideally you already classify deviations into categories such as minor, moderate, and major. based on those you will need to additional work to prioritize the backlog.
Risk-Based Approach: Focus on resolving high-risk deviations first to mitigate the most critical issues promptly.

2. Allocate Adequate Resources

Addressing a backlog efficiently often requires additional resources. Consider the following actions:

Increase Staffing: Temporarily augment your team with additional personnel or external consultants to handle the increased workload.
Specialized Teams: Form dedicated teams to focus solely on backlog reduction, ensuring that regular operations are not disrupted.

3. Improve and Make Robust Deviation Management Processes

A systematic approach to deviation management helps prevent backlogs from recurring. Key steps include:

Root Cause Analysis (RCA): Conduct thorough investigations to identify the underlying causes of deviations.
Corrective and Preventive Actions (CAPA): Develop and implement CAPA plans to address root causes and prevent future deviations. Ensure these plans are reviewed and approved by relevant stakeholders.

4. Regular Monitoring and Review

Continuous monitoring and regular reviews are essential to keep the backlog under control:

Track Progress: Use metrics and key performance indicators (KPIs) to monitor the progress of backlog reduction efforts. Tools like burndown charts can be helpful.
Periodic Reviews: Conduct regular review meetings to assess the status of the backlog and make necessary adjustments to the plan.

5. Enhance Deviation Management Systems

Improving your deviation management system can prevent future backlogs and streamline the resolution process:

Automation and Software Tools: Implement a eQMS or evaluate and improve the current one.
Training and Education: Ensure that all employees are well-trained in deviation management processes and understand the importance of timely reporting and resolution.

6. Foster a Culture of Continuous Improvement

Promote a culture that values continuous improvement and proactive problem-solving:

Encourage Reporting: Create an environment where employees feel comfortable reporting deviations without fear of retribution.
Learn from Deviations: Analyze deviation trends to identify areas for process improvement and implement changes to prevent recurrence.

7. Set Clear Goals and Deadlines

Establish clear goals and deadlines for backlog reduction:

Set Due Dates: Assign due dates for resolving backlog items to ensure timely action. Items that exceed their due dates should be reviewed and either expedited or reassessed for relevance.
Regular Updates: Keep all stakeholders informed about the progress and any changes to the plan through regular updates and communication.

Conclusion

Addressing a deviation backlog effectively requires a combination of prioritization, resource allocation, robust processes, continuous monitoring, and a culture of improvement. By implementing these strategies, organizations can reduce their backlog, improve compliance, and enhance overall product quality and safety.

Deviation Review for CxO – Best Practice

Regulatory agencies have continually continued to make it clear that when a Contract Manufacturing Organization (CMO) or Contract Research Organization (CRO) experiences a deviation, the sponsor/Marketing Authorization Holder (MAH) has several key responsibilities:

Review the deviation: The sponsor must thoroughly review the deviation to ensure it was appropriately defined and investigated. This review is crucial as the sponsor cannot delegate their responsibility to ensure the drug product is safe, effective, and conforms to specifications and regulatory commitments.
Assess product impact: The sponsor should ensure that the CMO has properly assessed the impact of the deviation on the product. This includes evaluating whether the deviation affected material quality, safety, or efficacy.
Verify appropriate material control: It’s the sponsor’s responsibility to ensure the CMO has appropriately controlled the affected material and extended this control to any other potentially affected materials.
Make disposition decisions: Ultimately, the sponsor is responsible for deciding whether the product should be released, reprocessed, or rejected. This decision is especially critical if the deviation affected material in clinical trials.
Oversee corrective and preventive actions: The sponsor should understand how the CMO’s corrective and preventive action (CAPA) system operates and ensure appropriate measures are taken to prevent recurrence of the deviation.
Maintain oversight: While the quality agreement defines the CMO’s responsibilities, the sponsor retains 100% oversight, including executed batch record review, change control, and deviation review and approval.
Risk-based approach: For major or critical deviations, sponsors should employ a risk-based approach to assess the severity and potential impact.

To simplify the deviation notification process with a Contract Organization (CxO), sponsors and can implement several strategies:

Clear Communication and Documentation

Establish a Well-Defined Quality Agreement: Create a comprehensive quality agreement that clearly outlines the deviation notification process, including timelines, classification criteria, and reporting requirements.
Implement Standardized Templates: Develop and provide standardized templates for deviation reporting to ensure consistency and completeness of information.
Set Clear Notification Timelines: Agree on specific timelines for different deviation categories. For example, critical and major deviations should be reported within one business day.

Risk-Based Approach

Adopt a Quality Risk Management (QRM) Mindset: Approach the partnership with a focus on risk management, ensuring that both parties understand the potential impact of deviations on product quality and patient safety.
Calibrate Risk Classification: Align the deviation classification system between the sponsor and CxO to avoid discrepancies in severity assessment.

Streamlined Processes

Utilize Electronic Quality Management Systems: Implement digital tools to facilitate real-time reporting and tracking of deviations, improving efficiency and transparency. Yes, the sponsor should be taking a risk based approach to tracking deviations in their eQMS that captures the important sponsor/MAH decision making.
Define Clear Roles and Responsibilities: Clearly delineate who is responsible for each step of the deviation management process, from identification to reporting and investigation.

Training and Support

Provide Comprehensive Training: Ensure that CxO staff are well-trained on the sponsor’s quality expectations, deviation reporting procedures, and the use of any specific tools or systems.
Offer Ongoing Support: Establish a dedicated point of contact or support team to assist the CxO with questions or issues related to deviation reporting.

Regular Review and Improvement

Conduct Periodic Reviews: Schedule regular meetings to review the deviation notification process, discuss any challenges, and identify areas for improvement.
Encourage Open Dialogue: Foster an environment where the CMO feels comfortable reporting issues promptly without fear of punitive action.

I strongly believe that a CxO needs to implement these strategies (do not put it only on the MAH’s shoulders) as part of their client onboarding and management process to create a more efficient and effective deviation notification process. This approach not only simplifies the process but also ensures that critical quality information is communicated promptly and accurately, ultimately contributing to better product quality and regulatory compliance. Add some value and don’t make the sponsor beg for information.

What do I need a Toxicologist for in the GMPs

Working on a job description for a toxicologist. Here’s what I have so far: what am I missing on the GMP side (not the GCP, GVP, or GLP sides).

A toxicologist plays several important roles in GMP activities, including in cleaning validation and extractable/leachable (E&L) studies for pharmaceutical manufacturing:

For cleaning validation:

Establishing safety thresholds: Toxicologists help determine the Permitted Daily Exposure (PDE) or Acceptable Daily Exposure (ADE) limits for residual substances. These limits are crucial for setting acceptance criteria in cleaning validation.
Risk assessment: They evaluate the potential health risks associated with residual substances that may remain after cleaning processes.
Determining safety factors: Toxicologists apply appropriate safety factors when calculating acceptable residue limits, considering factors like route of administration and patient population.
Reviewing toxicological data: They analyze available toxicity data on active ingredients, excipients, and cleaning agents to inform safety assessments.

For extractable and leachable studies:

Toxicological evaluation: Toxicologists assess the potential health impacts of identified extractables and leachables from packaging materials or manufacturing equipment.
Setting thresholds: They help establish Safety Concern Thresholds (SCT) and Analytical Evaluation Thresholds (AET) for E&L studies.
Risk characterization: Toxicologists evaluate the toxicological significance of detected leachables in relation to patient exposure.
Providing expertise on regulatory guidelines: They ensure studies comply with regulatory expectations regarding toxicological risk assessment.
Interpreting study results: Toxicologists help interpret the significance of E&L findings in the context of patient safety.

Toxicologists provide critical expertise in assessing the potential health impacts of trace contaminants or leached substances. They also ensure that cleaning processes and packaging materials do not introduce unacceptable risks to patient safety. Their input is essential for developing scientifically sound and regulatorily compliant approaches to these critical pharmaceutical quality and safety aspects.

Transparency at the FDA

Leveling Up Agency Disclosures

I fully agree with this excellent post and its closing line “The public should therefore not need to request such materials from the agency, but should have easy, online access to them at any time.”

All 483s, complete response letters (CRL), and other FDA decisions should be easily accessible. This would be a net positive gain for our profession. I know I’ve reached out to my congress critters about this as the FDA is going through budgeting (and Congress continues to not fund the agency enough).

ICH Document Structure, a Call for Change

The International Conference for Harmonization (ICH) has guidelines categorized into four main categories:

Quality (Q) Guidelines focus on the chemical, pharmaceutical, and biological quality standards, including stability testing protocols to ensure the longevity and consistency of drug products.
Safety (S) Guidelines address non-clinical and preclinical safety evaluations, guiding the toxicological assessments necessary to protect patients’ health.
Efficacy (E) Guidelines cover the clinical aspects of pharmaceutical development, providing standards for designing, conducting, and analyzing clinical trials to ensure therapeutic benefits.
Multidisciplinary (M) Guidelines encompass guidelines that do not fit neatly into the other categories, dealing with genomics, terminologies, and technical aspects of drug registration.

Any Q document is instantly and rightly viewed as a GMP guideline. This includes the quality trio, which, while they have a good philosophy, are still written specifically for GMP purposes. So, if you write your paper, good practice guide, standard, article, or what-have-you and refer heavily to the Q trio, you are either writing a GMP-centered piece or losing most of your audience.

The frustrating thing is that quality-by-design (Q8), risk management (Q9), and quality system management (Q10) are core concepts that apply across the pharmaceutical lifecycle, and there are best practices across all three that can and should be universal, especially Q9(r1), which can really better define risk management as defined in E6, and Q10, which can really shore up parts of E8.

What I would love to see the ICH do is write a technical reference document on risk management. Then, E6 and Q9 would have specific implementation aspects related to their focus. Put all the shared approaches in one place and build on them. The amusing thing is that they are already doing that. For example, Q13 applies the Q trio to continuous manufacturing, and Q14 applies it to the analytical lifecycle.

But for now, if you are writing and just referring to Q9 and Q10 don’t be surprised when all your clinical and safety colleagues tune you out.