Are assessments of foreign regulatory (USFDA & EDQM) inspections fair?

Youll be surprised with our findings. 

In which parts of the world, can a company whose manufacturing operations, are approved year after year by the local ministry of health, always found to be in GMP compliance, have the same facility inspected by an international regulatory agency, and fail the inspection?

After the failure of the international inspection, would it be appropriate for the local ministry of health, to renew the GMP certificate?

You will be surprised with our findings since the answer is not so obvious.

An in-depth analysis of the inspection statistics available at the EDQM and USFDA websites, (summarized in tables 1 and 2 below), have revealed some startling facts:

  • There is no obvious consistency in the results of inspections conducted by European and USFDA inspectors. Facilities, which have been approved by one agency, fail to meet the requirements of the other.
  • EU-GMP Certificates are issued to European companies who fail USFDA inspections, and even to those who are on the FDA Import Alert List. 

Table 1/ List of companies - USFDA Non-Compliance, EU Compliance

  Site Name 

Country 

USFDA Inspection Date

FDA Warning Letter Issue Date

Other Updates

EU GMP Inspection Date

EU GMP Compliance Issued

Nobilus Ent

Poland

Sep 2011

Mar 2012

Import Alert - Mar 2012

Dec 2012

Feb 2013

Ebewe Pharma Ges.m.b.H. Nfg. KG

Austria

Oct 2012

May 2013

 

Oct 2012 & Oct 2014

Nov 2012 & Jan 2015

Novo Nordisk A/S

Denmark

Mar 2012

Dec 2012

WL Closed Out - Jan 2014

Sep 2012

Jan 2013

B.M.P. Bulk Medicines & Pharmaceuticals GmbH

Germany

Nov 2011

May 2012

 

June 2014

Oct 2014

SmithKline Beecham (Cork) Limited

Ireland

Oct 2013

Mar 2014

 

Dec 2013

Feb 2014

TRIFARMA S.P.A.

Italy

Jan 2014

Jul 2014

 

Jun 2014

June 2014

Hemofarm A.D.

Serbia

Nov 2011

Jun 2012

 

24 Nov & 30 Nov 2012

May 2013

A NELSON AND COMPANY LIMITED

United Kingdom

Nov 2011

Jul 2012

 

Nov 2013

Mar 2014

ERCROS, S.A.

Spain

Jul 2011

Jun 2012

 

Jul 2010 & Jun 2013

Feb 2011 & Apr 2014

Hameln pharmaceuticals gmbh

Germany

Jun 2012

Dec 2012

 

Mar 2012 & Nov 2014

May 2012 & Dec 2014

SANUM-Kehlbeck GmbH & Co. KG

Germany

Mar 2013

Apr 2014

Import Alert - July 2013

Feb 2012 & Jul 2014

Sep 2012 & Oct 2014

 

Table 2/ List of companies - USFDA Compliance, EU Non-Compliance

  Site Name 

Country 

FDA Inspection Date

FDA Inspection Outcome

EU GMP Inspection Date

EU GMP Non-Compliance Issued

Thibiant International Incorporated

United States

May 2010 & Oct 2011

Voluntary Action Indicated

Mar 2011

June 2011

Monosol Rx

United States

Jun 2011 &

Sep 2012

Voluntary Action Indicated

Jan 2012

Feb 2012

Scm Pharma Limited

United Kingdom

Nov 2013

Voluntary Action Indicated

Mar 2014

April 2014

Zhejiang Apeloa Kangyu Bio-Pharmaceutical Co. Ltd.

China

Jul 2010 & 

May 2014

No Observations (2010) / Voluntary Action Indicated (2014)

Oct 2014

Nov 2014

If we take the case of Huashu Pharmaceutical Corporation (Shijiazhuang, China), it is even more puzzling, as within the course of a year, their assessment varied from being issued a non-compliance report by the United Kingdom Ministry of Health in September 2011, to being found in compliance by both the USFDA and the Greek Ministry of Health in January 2012 and June 2012 respectively.

How about the performance of companies in Asia?

In table 3 we summarized the overall inspection statistics from the EDQM and USFDA websites, here are some other surprising facts:

  • The success rate of Indian and Chinese companies in USFDA and European inspections is more than 90%.

     
  • Two out of three (about 66%) non-compliance reports issued by European regulators are to Indian and Chinese companies. Comparatively the USFDA issues only 20% of their negative assessments in India and China.
  • The highest number of non-compliances observed by the USFDA were for facilities in the United States.
  • The inspections in Taiwan have the highest possibility of a non-compliance report being issued by both European and US inspectors, Europe has the lowest probability.

Table 3/ Summary of Inspection Statistics obtained from the EudraGMP and FDA Data Dashboard 

 

European Directorate of Quality Medicines Statistics (EDQM 2006-2015)

FDA Dashboard Statistics FY2012-2015

Country

Total Inspection Results

Non-Compliance

Reports

% Non-Compliance Reports

Drug Quality Assurance Inspections

Non-Compliance Reports (OAI)

% Non-Compliance Reports

China

314

26

8.3%

192

10

5.2%

India

591

39

6.6%

295

25

8.5%

United States

609

4

0.7%

3200

98

3.1%

Europe

10538

16

0.15%

785

12

1.5%

Canada

18

0

0.00%

91

4

4.4%

Australia

84

0

0.00%

14

2

14.3%

Japan

45

2

4.44%

75

3

4.0%

Taiwan

21

2

9.52%

20

3

15.0%

Others

455

10

2.20%

235

13

5.5%

Overall Total

12675

99

0.78%

4907

170

3.5%

*the European results indicate total records and not total inspections, for this reasons the non-compliance percentages have not been used to draw comparative conclusions.

These statistics clearly demand the need to define a uniform set of global compliance standards, along with a global system of evaluation for drug manufacturing facilities.

However, it is also important to understand if there are other issues, which create all the negative press.

So where are the compliance problems?

With India being the largest exporter of medicines and accounting for almost 40% of the generic and over-the-counter drugs used in the United States, global pharmaceutical majors continue to expand their manufacturing operations across India.   

Almost 20% of the inspections, which resulted in non-compliances in India, were at the Indian operations of global companies like Apotex, Watson (now Actavis), Hospira and Fresenius Kabi.

This brings about another question, which needs to get answered; if the same company has facilities across the world failing inspections, is it a problem of the company, or the country where they are located? 

There seems to be a pattern emerging as some corporates cannot seem to be in compliance regardless of location (see table below).

Table 4/ USFDA Warning Letters Issued to global pharmaceutical companies. Source: FDA Website

Company

Warning Letter Issue Date

Country

Closeout Date

NOVARTIS

     

Ebewe Pharma Ges MBH Nfg KG

May 2013

Austria

 

Sandoz Incorporated

Nov 2011

United States & Canada

Jul 2014 

GSK

     

SmithKline Beecham Limited

Oct 2011

United Kingdom

Mar 2013

SmithKline Beecham (Cork) Ltd

Mar 2014

Ireland

 

APOTEX

     

Apotex Inc.

Feb 2013

Canada

 

Apotex Pharmachem India Pvt Ltd.

Jun 2014

India

 

Apotex Research Private Limited

Jan 2015

India

 

HIKMA

     

Hikma Farmaceutica, (Portugal) S.A.

Oct 2014

Portugal

 

West-Ward Pharmaceuticals Corp.

Feb 2012

United States

Mar 2014 

HOSPIRA

     

Hospira Australia Pty Ltd.

Sep 2014

Australia

 

Hospira, Inc.

Apr 2010

United States

 

Hospira Healthcare India Pvt. Ltd.

May 2013

India

 

Hospira S.p.A

Mar-15

Italy

 

BOEHRINGER INGELHEIM

     

Boehringer Ingelheim Pharma GMBH & Co

June 2013

Germany

06/05/2014 

Ben Venue Laboratories, Inc.

Nov 2007 

United States

Not closed. facility sold to Hikma

NOVACYL

     

Novacyl Wuxi Pharmaceutical Co., Ltd.

Dec 2014

China

 

Novacyl (Thailand) Ltd.

Feb 2015

Thailand

 

 

The data above clearly indicates a much more deep rooted problem on the actual reasons why companies globally fail inspections.

Our take: 

Drug manufacturing quality is facing a monumental perception challenge. In the quest for affordable, safe drugs, the pharmaceutical world needs to know more about the over 90% success rate in European and U.S. inspections by companies in India and China.

While some Indian companies like Granules India and Kemwell Biopharma do announce their recent successes in their FDA inspections (both had zero Form 483 observations in their March 2015 inspections), much more needs to be done by Indian and Chinese companies to change the perception of their manufacturing quality. Celebrating and communicating their positive outcomes would be a good start.

As the United States and Europe do not have consistency on standards, conversations of trade protectionism and individual inspector bias get initiated but little happens to improve overall product quality.

The difference in standards has already started conversations where Indian and Chinese inspectors may start global inspections of manufacturing sites that supply into two of the world's largest populations.

It's worthwhile to mention that additional inspections and tests do not mean better quality; after all that is the fundamental principle of Good Manufacturing Practices (GMP)!


 

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