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Saudi Pharmaceutical Journal (2015) 23, 463469

King Saud University

Saudi Pharmaceutical Journal


www.ksu.edu.sa
www.sciencedirect.com

REVIEW

Quality in the pharmaceutical industry


A literature review
Reham M. Haleem a,*, Maissa Y. Salem b, Faten A. Fatahallah a,
Laila E. Abdelfattah c

a
The National Organization for Research and Control of Biologicals, Cairo, Egypt
b
Analytical Chemistry Department, Faculty of Pharmacy, Cairo University, Cairo, Egypt
c
Faculty of Pharmacy, Misr University for Science and Technology, 6th of October City, Egypt

Received 14 August 2013; accepted 10 November 2013


Available online 20 November 2013

KEYWORDS Abstract Objectives: The aim of this study is to:


Quality;
Pharmaceutical industry; a. Highlight the most important guidelines and practices of quality in the pharmaceutical
GXPs industry.
b. Organize such guidelines and practices to create a guide to pave the way for other
researchers who would like to dig deeper into these guidelines and practices.
Design: A review was conducted of 102 publications; 56 publications were concerned with
the pharmaceutical quality directly while 46 publications were concerned with the general quality
practices. The content of those sources was analyzed and the following themes were identied:

a. Research theme 1: Guidelines of the pharmaceutical quality.


b. Research theme 2: General practices recently applied in the pharmaceutical industry.
Main outcome measures: The following guidelines were identied and reviewed: WHO
guidelines, FDA guidelines, EU guidelines and ICH guidelines in the research theme I.
In research theme II; the following topics were identied and reviewed: quality risk management,
quality by design, corrective actions and preventive actions, process capability analysis, Six Sigma,
process analytical technology, lean manufacturing, total quality management, ISO series and
HACCP.

* Corresponding author. Tel.: +20 966565464776.


E-mail address: rehamhaleem@hotmail.com (R.M. Haleem).
Peer review under responsibility of King Saud University.

Production and hosting by Elsevier

1319-0164 2013 King Saud University. Production and hosting by Elsevier B.V. All rights reserved.
http://dx.doi.org/10.1016/j.jsps.2013.11.004
464 R.M. Haleem et al.

Results: Upon reviewing the previously highlighted guidelines and the practices that are widely
applied in the pharmaceutical industry, it was noticed that there is an abundant number of papers
and articles that explain the general guidelines and practices but the literature lack those describing
application; case studies of the pharmaceutical factories applying those guidelines and signicance
of those guidelines and practices.
Conclusions: It is recommended that the literature would invest more in the area of application
and signicance of guidelines and practices. New case studies should be done to prove the feasibility
of such practices.
2013 King Saud University. Production and hosting by Elsevier B.V. All rights reserved.

Contents

1. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 464
2. Methods . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 465
2.1. Research theme 1: guidelines of the pharmaceutical quality . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 465
2.1.1. WHO guidelines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 465
2.1.2. FDA guidelines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 465
2.1.3. EU guidelines. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 465
2.1.4. ICH guidelines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 466
2.2. Research theme 2: general practices recently applied in the pharmaceutical industry. . . . . . . . . . . . . . . . . . . . 466
2.2.1. Quality risk management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 466
2.2.2. Quality by design . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 466
2.2.3. Corrective action and preventive actions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 466
2.2.4. Process capability analysis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 466
2.2.5. Six Sigma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 466
2.2.6. Process analytical technologies. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 467
2.2.7. Lean manufacturing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 467
2.2.8. Total quality management. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 468
2.2.9. ISO series . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 468
2.2.10. HACCP . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 468
3. Results . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 468
4. Discussions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 468
References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 469

1. Introduction Since 2002, FDA began an initiative to address cGMP for


the 21st century (Woodcock, 2004). This effort involved taking
The quality in the pharmaceutical industry has become a very new looks at both the regulatory and industrial systems for
important topic. Since the world has gathered together to insuring drug quality (Larson, 2006).
harmonize its practices and guides and the launching of the A literature review was conducted on the quality in the
FDA current good manufacturing practices the cGMP; pharmaceutical industry, identifying 102 publications that
for the 21st century there has been a growing awareness focus on conceptual issues, methodological issues, or the
for the signicance of the quality of the pharmaceutical prod- application of different practices and/or guidelines applied in
ucts (Woodcock, 2004). This awareness is represented the pharmaceutical industries. The content of these sources
through the appearance of several denitions dening exactly was analyzed, and a number of themes were identied.
what the quality of the medicine should be (LEE and Webb, The literature review has two objectives concerned with the
2009). Many articles were written to demonstrate the special quality guidelines and practices of the pharmaceutical industry
nature of the product-customer relationship of medicine and and the organization such as practices and guidelines to make
patients (Woodcock, 2004). Also the important role of gov- a guide for others to use.
ernments was emphasized through the joint statement be- A research of this kind serves to integrate past research and
tween the international pharmaceutical federation; FIP; and can help current and future researchers, and practitioners
the international federation of pharmaceutical manufacturers employing the suitable guideline or practice to develop their
associations; IFPMA; to ensure the safety of medicinal prod- methodological decisions in upgrading the industry.
ucts in order to protect the patient (FIP Council, 1999), pro- This article introduced some issues regarding what is so
viding that the pharmaceutical industry is one of the special about pharmaceutical quality and different drivers of
most closely regulated industries for more than 50 years quality are then identied (Fraser, 2005; Dean and Bruttin,
(Woodcock, 2004). 2001). This is followed by the identied research themes and
Quality in the pharmaceutical industry A literature review 465

their development. Finally, managerial implications are 2.1.2. FDA guidelines


discussed. Pharmaceutical manufacturers have just begun to understand
and apply the FDAs cGMPs for the 21st century: A Risk-
2. Methods Based Approach; the initiative outlines immediate, near and
longer-term stages that FDA believes will take two years to
A search was made of the following databases: WHO, FDA, be implemented (Larson 2004).
ICH, and EU to download their corresponding guidelines. On the technical side, FDA states three concepts that will
Using the Google search engine; also a number of papers guide the reevaluation process: advances in risk management
and articles were downloaded. Search words used were: science, advances in quality management science and advances
pharmaceutical quality, quality and pharmaceutical industry. in pharmaceutical science and manufacturing technology
Papers that were not academic in nature were rejected (for (Larson, 2004).
example, those that did not provide reference citations). The most important guidelines are Code of Federal
The nal sample consisted of 102 publications; 56 publica- Regulation 210, 211.
tions were related to the pharmaceutical quality directly while 21CFR Part 210: The regulations contain the minimum
46 publications were concerned with the general quality current good manufacturing practice for methods to be used
practices. in, and the facilities or controls to be used for, the manufac-
Two research themes could be identied in the articles stud- ture, processing, packing, or holding of a drug to assure that
ied in this literature review. such a drug meets the requirements of the act as to safety,
They included: and has the identity and strength and meets the quality and
purity characteristics that it claims to possess.
 Guidelines of the pharmaceutical quality. 21CFR Part 211: The regulations in this part contain the
 General practices recently applied in the pharmaceuti- minimum current good manufacturing practice for prepara-
cal industry. tion of drug products for administration to humans or
animals.
For each of these research themes the authors synthesize The FDA has concluded that modern quality systems to-
the main ndings and offer suggestions for further research. gether with manufacturing processes and product knowledge,
can handle many types of changes to facilities, equipment
2.1. Research theme 1: guidelines of the pharmaceutical quality and processes without the need for regulatory submission
(Fraser, 2005).
The most important guidelines that are widely applied in the
2.1.3. EU guidelines
pharmaceutical industry are:
The core of European Union legislation in the pharmaceutical
2.1.1. WHO guidelines sector is gathered in Volume 1 and Volume 5 of the publica-
tion; The rules governing medicinal products in the European
WHO has published a handbook on the GMP in particular,
Union.
entitled: Quality assurance of pharmaceuticals, a compendium
of guidelines and related materials, Volume 2: good manufac-
 Volume 1 EU pharmaceutical legislation for medicinal
turing practices and inspection (Quality Assurance of Pharma-
products for human use.
ceuticals, 2004).
 Volume 5 EU pharmaceutical legislation for medicinal
It consists of 4 chapters:
products for veterinary use.
Chapter 1: WHO GMP: main principles for pharmaceutical
The basic legislation is supported by a series of guidelines
products.
that are also published in the following volumes of The rules
Chapter 2: Good manufacturing practices: starting
governing medicinal products in the European Union:
materials.
Chapter 3: Good manufacturing practices: specic pharma-
 Volume 2 Notice to applicants and regulatory guide-
ceutical products.
lines for medicinal products for human use.
Chapter 4: Inspection.
 Volume 3 Scientic guidelines for medicinal products
for human use.
And 7 annexes:
 Volume 4 Guidelines for good manufacturing practices
for medicinal products for human and veterinary use.
Annex 3: Radiopharmaceutical products.
 Volume 6 Notice to applicants and regulatory guide-
Annex 4: Good manufacturing practices for pharmaceutical
lines for medicinal products for veterinary use.
products: main principles.
 Volume 7 Scientic guidelines for medicinal products
Annex 5: Model Certicate of GMP.
for veterinary use.
Annex 6: Sterile pharmaceutical products.
 Volume 8 Maximum residue limits.
Annex 6: Guidance on GMP inspection.
 Volume 9 Guidelines for pharmacovigilance for medic-
Annex 7: Pre-approval inspection.
inal products for human and veterinary use.
Annex 8: Quality system requirements for national GMP
 Volume 10 Guidelines for clinical trial.
inspectorates.
466 R.M. Haleem et al.

2.1.4. ICH guidelines 2.2.3. Corrective action and preventive actions


The International Conference on Harmonization of technical QMS nonconformities and other system deciencies, including
requirements for registration of pharmaceuticals for human legal noncompliance, should be analyzed to detect patterns or
use (ICH) is a special project that gathers the regulatory trends. Identifying trends allows the manufacturer to antici-
authorities of Europe, Japan and the United States and experts pate and prevent future problems (EPA, 2009).
from the pharmaceutical industry in the three different regions; The organization should focus on correcting and preventing
to discuss scientic and technical aspects of product problems. Preventing problems is generally cheaper than xing
registration. them after they occur. The organization should also start think-
The objective of such harmonization is a more efcient use ing about problems as opportunities to improve (EPA, 2009).
of human, animal and material resources, and the removal of Root cause analysis is a process by which the manufac-
any delay that is not essential in the global development and turer can identify causes and preventive actions (EPA, 2009).
availability of new medicines while maintaining safeguards In general, CAPA experts recommend that root-cause
on quality, safety and efcacy, and regulatory obligations to investigations follow a four-step process (Bartholomew, 2006):
protect public health.
 Identify the problem.
2.2. Research theme 2: general practices recently applied in the  Evaluate its magnitude, which includes assessing risk.
pharmaceutical industry  Investigate and assign responsibility.
 Analyze and document the root cause of the problem.
2.2.1. Quality risk management
All products and all processes have an inherent element of risk For example a new corrective action tracking system had
(Grifth, 2004). helped Alcon Laboratories Inc. unite its many corrective and
In an organization that is intending to apply an effective preventive action systems worldwide resulting in faster time
quality risk management approach, a clear denition of what of closure on corrective action, both access and speed to infor-
is considered risk should be agreed upon because of the mation are much greater and nally quality professionals are
too many stakeholders in the pharmaceutical industry and able to focus on more important issues (Davis, 2003).
their corresponding diverse interests (ICH Q9, 2003).
The FDA has noticed that it needs to reorganize its proce- 2.2.4. Process capability analysis
dures and processes to merge the use of risk management pro- Process capability is the comparison of the Voice of the Cus-
grams (RMP) within the agency and within the industries it tomer (VOC) with the Voice of the Process (VOP). VOC,
regulates. Consequently, the FDA has started publishing posi- which is built on customer requirements, is dened by the spec-
tion papers and guidelines on what it expects to see in an RMP ication limits of the process, which are xed, while VOP is de-
(Grifth, 2004). ned by control limits, which are based on performance data
Risk management plans should be used to identify risk and vary over time (Tarpley, 2004).
(Grifth 2004). Metrics such as capability index namely Cp and Cpk were
Quality Risk Management is dened as a method for the developed several years ago to calculate this comparison be-
assessment, control, communication and review of risks to tween control and specication limits (Tarpley, 2004).
the quality of the drug (medicinal) product through the prod- The capability index a ratio that compares process spread
uct lifecycle where decisions can occur at any point in the pro- to tolerance spread and results in a single number. It is a man-
cess (ICH Q9, 2003). agement tool which is used to compare process performance
In the guideline entitled Medical Device Use-Safety: incor- (Ruth II, 2005).
porating human factors engineering into risk management; it
claries how hazards related to medical device use should be 2.2.5. Six Sigma
directed during device development as part of the risk manage- Harry and Schroeder (2000) dene Six Sigma as . . .a business
ment process (CDRH, 2000). process that enables companies to increase prots dramatically
by streamlining operations, improving quality, and eliminating
2.2.2. Quality by design defects or mistakes in everything a company does. . .. It can
ICH Q8 denes design space from the concept that quality help an organization reduce defects and improve protability
cannot be tested into product but has to be built in by design using several basic tenets (Harry and Schroeder, 2000; Johnson
(ICH Q8, 20052008). and Swisher, 2003; Pande et al., 2000; Williams 2003; Goeke
Based on the ICH Q8; which concerns pharmaceutical and Offodile, 2005)
development with targeting designing quality into the ingredi- Six Sigma Projects are based on the DMAIC model
ents, formulation and manufacturing process to deliver the in- (Stamatis, 2002).
tended performance of the product. Design space is presented The DMAIC model is the generic model of six sigma meth-
by the applicant and is subject to regulatory assessment and odology. It is an acronym that stands for; Dene, Measure,
approval (ICH Q8, 20052008). Analyze, Improve and Control. Sometimes this model includes
In these situations, opportunities exist to develop more ex- recognize as an awareness item to the model. Each of the com-
ible regulatory approaches. ponents addresses a different aspect of the overall improve-
The design and conduct of pharmaceutical development re- ment and breakthrough strategy (Stamatis, 2002).
search should be consistent with their intended scientic pur- The pharmaceutical industry sigma level is from 2 to 3; this
pose (ICH Q8, 20052008). results in a 2535% defects (Hussain, 2005).
Quality in the pharmaceutical industry A literature review 467

An example of the pharmaceutical rms that adopted the drug substance and drug product at Sano-Aventis (Shanley,
methodology of Six Sigma is AstraZeneca where the opera- 2005).
tions and quality staff were trained to apply DMAIC princi-
ples every day, to measure and improve performance 2.2.7. Lean manufacturing
through cross-functional continuous improvement (CI) Japanese manufacturers re-building after the Second World
teams (Shanley, 2005). Two years ago, at Westborough, Mas- War were facing declining human, material, and nancial re-
sachusetts, cross-functional CI teams involving QA, engineer- sources. These circumstances led to the development of new,
ing and operations applied DMAIC principles to solve a major lower cost, manufacturing practices. Early Japanese leaders
capacity problem for a key product. The teams discovered such as the Toyota Motor Companys Eiji Toyoda, Taiichi
wasteful processes, effectively adding 20 million extra units Ohno, and Shingeo Shingo developed a disciplined, process-fo-
of capacity per year. Where a capital investment of less than cused production system now known as the Toyota Produc-
$100,000 led to $60 million to $70 million in revenue gains, tion System, or lean production. The objective of this
without hiring new staff as Ron Matthews, vice president system was to minimize the consumption of resources that
of manufacturing and supply chain at the company, said added no value to a product (Womack et al., 1990).
(Shanley, 2005). Lean manufacturing is about eliminating waste across an
entire company and focusing on the big picture through learn-
2.2.6. Process analytical technologies ing how to do more with less (Nystuen, 2002).
Process analytical technologies (PAT); play a key role in en- Lean means putting the right things in the right place at the
abling quality by design and scientic aspect of manufactur- right time the rst time while minimizing waste and being open
ing. PATs main aim is to understand and control the to change. This leads to less waste, less design time, fewer orga-
manufacturing process through the application of integrated nizational layers, and fewer suppliers with more employee
chemical, physical, microbiological, mathematical and risk empowerment, more exibility and capability, more productiv-
analysis methods. PAT has been applied in non-Pharma indus- ity, more customer satisfaction and without a doubt, more
tries for many years, yielding cost savings and manufacturing long-term competitive success. Lean principles incorporated
efciencies (Fraser, 2005). in the workplace today can spell business survival for the fu-
The implementation of process analytical technology (PAT) ture (Nave, 2002).
is bringing lots of benets and improvements for many phar- In AstraZeneca; rather than being submerged into Lean,
maceutical processes. The benets are lower production cycle the company launched a limited initiative at its global facilities
times, improved manufacturing efciency, reduced rejects in 2002 which is the Pull Manufacturing; this initiative re-
and increased production operating time (Rockwell Automation, quired that the companys manufacturing teams shift their fo-
2004). cus from output to customer alignment and service. Also, the
Within pharmaceutical industry, there have been a number initiative has lead to reduction in the cycle time. In one case, it
of successful PAT-based comparability protocol submissions, allowed lead time for a key $1.5-billion-per year product to be
ranging from single-unit operation application at Glaxo- reduced by 25% during a period when demand for the drug
SmithKline to a more all-including application covering both was increasing by 30% (Shanley, 2005) (see Table 1).

Table 1 ICH categories and main topics.


Q: Quality Topics S: Safety Topics
Those relating to chemical and pharmaceutical Quality Assurance:
(1) Those relating to in vitro and in vivo pre-clinical studies
(1) Stability (2) Carcinogenicity Studies
(2) Analytical Validation (3) Genotoxicity Studies
(3) Impurities (4) Toxicokinetics and Pharmacokinetics
(4) Pharmacopoeias (5) Toxicity Testing
(5) Quality of Biotechnological Products (6) Reproductive Toxicology
(6) Specications (7) Biotechnological Products
(7) Good Manufacturing Practice (8) Pharmacology Studies
(8) Pharmaceutical Development (9) Immuno-toxicology Studies
(9) Risk Management (10) Joint Safety/Efcacy (Multidisciplinary) Topic
E: Eciency Topics M: Multidisciplinary Topics
Those relating to clinical studies in human subject They are Cross-cutting topics, which do not t uniquely into one
of the above categories.
(1) Clinical Safety
(2) Clinical Study Reports  M1: Medical Terminology (MedDRA)*
(3) Dose-Response Studies  M2: Electronic Standards for Transmission of Regulatory
(4) Ethnic Factors Information (ESTRI)
(5) Good Clinical Practice  M3: Timing of Pre-clinical Studies in Relation to Clinical Trials
(6) Clinical Trials  M4: The Common Technical Document (CTD)
(7) Guidelines for Clinical Evaluation by Therapeutic Category  M5: Data Elements and Standards for Drug Dictionaries
(8) Clinical Evaluation
*
Medical Dictionary for Regulatory Activities Terminology.
468 R.M. Haleem et al.

Table 2 The cost of system improvements in Lilly.


Control system improvement % Of savings gained % Of overall cost of control system
Implementation of regulatory control systems and basic hardware 20 70
The use of advanced control procedures such as feed forward and model based 75 80
The application of optimization methods to the process 100 100

Eli Lilly had suffered factory losses process barely capable used in the food industry. Their main aim is to prevent known
with some nonconformance and variability in product quality, hazards and to reduce the risks that they will cause at specic
the application of lean lead to system improvement and cost points in the food chain (Annex 7; WHO TRS No. 908, 2003).
savings as shown in the following Table 2 (Mohan, 2006). Procedures, including GMP, address operational conditions
and provide the basis for HACCP. HACCP is a systematic
2.2.8. Total quality management method for the identication, assessment and control of safety
Total quality management (TQM) is a concept rather than a hazards. The hazards are classied as biological, chemical, or
technique. It is a philosophy that stresses a systematic, inte- physical agents or operations that might cause illness or injury
grated, and consistent perspective that would involve everyone if not controlled. In the manufacture of pharmaceuticals, this
and everything in the organization (Isaac et al., 2004). includes the manufacture of certain antibiotics, hormones,
TQM is a management philosophy that builds a customer cytotoxic substances or other highly active pharmaceuticals.
driven, learning organization that is devoted to the total cus- Together with operations such as uid bed drying, granulation
tomer satisfaction through continuous improvement in the is an example of hazard unit operations. The use of inamma-
effectiveness and efciency of the organization and its corre- ble solvents (solutions) and certain laboratory operations may
sponding processes (Corrigan, 1995). also produce hazards (Annex 7; WHO TRS No. 908, 2003).
TQM is widely known for improving quality and other per- The HACCP system is based on seven principles (Annex 7;
formances such as productivity, prot, market share, and com- WHO TRS No. 908, 2003):
petitive edge of organizations of various types (Sun, 2000;
Isaac et al., 2004).  Conduct a hazard analysis.
 Determine the critical control points (CCPs).
2.2.9. ISO series  Establish target levels and critical limit(s).
 Establish a system to monitor the CCPs.
ISO 9000 series: ISO 9000 is concerned with quality manage-
 Establish the corrective action to be taken when mon-
ment. This means what the organization does to increase cus-
itoring indicates that a particular CCP is not under
tomer satisfaction through meeting customer and regulatory
control.
requirements and continually improving its performance
 Establish procedures to verify that the HACCP system
(ISO 9000 and 14001 in brief, 2009).
is working effectively.
ISO 14000: ISO 14000 is an environmental management
 Establish documentation concerning all procedures
system, describes the requirements for an organizations envi-
and keep records appropriate to these principles and
ronmental management system and can be used for certica-
their application.
tion/registration and/or self declaration of an organizations
environmental management system (ISO 14001, 2004).
This means what the organization does to (ISO 9000 and 3. Results
14001 in brief, 2009):
Upon reviewing the previously highlighted guidelines and the
 Minimize harmful effects on the environment caused practices that are widely applied in the pharmaceutical indus-
by its activities. try, it was noticed that there is an abundant number of papers
 Achieve continual improvement of its environmental and articles that explain the general guidelines and practices
performance. but the literature lack those describing application; case studies
of the pharmaceutical factories applying those guidelines and
ISO 17025: It gives the general requirements for the compe- signicance of those guidelines and practices.
tence of testing and calibration laboratories (ISO/IEC 17025,
2005). 4. Discussions
A specic version of this standard for Medical Laboratories
has been developed; ISO 15189:2003 then ISO 15189, 2007 was
It is recommended that the literature would invest more in the
published on 19th April 2007 (ISO 15189, 2007).
area of application and signicance of guidelines and practices.
Through the accreditation process; the testing laboratory
Also, there are some new practices that are recently applied
reaches the status of an independent institution (Mettler-
to the pharmaceutical industry though they are widely applied
Toledo GmbH, 2003).
in non pharmaceutical industries, such as: the lean manufac-
turing; the Six Sigma; the total quality management. Both
2.2.10. HACCP managers at the pharmaceutical industry and literature should
The Hazard Analysis and Critical Control Point (HACCP) focus on the adoption of such practices into the pharmaceuti-
methodology was known to be a safety management system cal industry making use of the previous research in the
Quality in the pharmaceutical industry A literature review 469

non-pharmaceutical industry application. New case studies ICH Q9, 2003. Quality risk management, available at <http://
should be done to prove the feasibility of such practices. www.ich.org/LOB/media/MEDIA3562.pdf> (accessed 26.09.06).
Isaac, G., Rajendran, C.S., Anantharaman, R.N., 2004. Signicance of
quality certication; the case of the software industry in India.
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ISO 14001, 2004. Environmental Management Systems-Requirements
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scripts/cdrh/cfdocs/cfcfr/CFRSearch.cfm?CFRPart=210> ISO 15189, 2007. Medical Laboratories-Particular Requirements for
(accessed 26.09.06). Quality and Competence, second ed., 19-04-2007.
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