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Rajakumari Rajendran

This document provides background information on ICH Q9 Quality Risk Management. It discusses the ICH process and how ICH Q9 relates to other ICH guidelines like Q8 and Q10. It explores how the pharmaceutical industry has moved from focusing solely on risk to implementing a more formal approach to quality risk management. The document outlines both opportunities and challenges for quality risk management, noting it can help companies make more informed quality decisions across the product lifecycle from development through distribution.

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Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 1 ICH Q9 QUALITY RISK MANAGEMENT Quality Risk Management ICH Q9 Background Disclaimer: This presentation includes the authors views on quality risk management theory and practice. The presentation does not represent official guidance or policy of authorities or industry.
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 2 ICH Q9 QUALITY RISK MANAGEMENT Purpose of this part  To provide information on the background of the ICH Q9 document  Give an aid by providing some points of discussions on the understanding of the quality risk management concept
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 3 ICH Q9 QUALITY RISK MANAGEMENT Agenda  The ICH process  ICH Q9 and other ICH guidelines  From “Risk” to “Quality Risk Management”  Opportunities, Challenges and Benefit
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 4 ICH Q9 QUALITY RISK MANAGEMENT Agenda  The ICH process  ICH Q9 and other ICH guidelines  From “Risk” to “Quality Risk Management”  Opportunities, Challenges and Benefit
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 5 ICH Q9 QUALITY RISK MANAGEMENT International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 6 ICH Q9 QUALITY RISK MANAGEMENT Expert Working Groups (EWG) EWG’s include observers and constituted from both authorities & industry Guidelines on Quality Chemical and pharmaceutical QA Safety In vitro and in-vivo pre- clinical studies Efficacy Clinical studies in human subject Multidisciplinary General topics
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 7 ICH Q9 QUALITY RISK MANAGEMENT Agenda  The ICH process  ICH Q9 and other ICH guidelines  From “Risk” to “Quality Risk Management”  Opportunities, Challenges and Benefit
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 8 ICH Q9 QUALITY RISK MANAGEMENT ICH Q-Documents  Q1 Stability  Q2 Analytical Validation  Q3 Impurities  Q4 Pharmacopoeias  Q5 Quality of Biotechnological Products  Q6 Specifications  Q7 Good Manufacturing Practice  Q8 Pharmaceutical Development  Q9 Quality Risk Management  Q10 Pharmaceutical Quality Systems Different: - not a recipe - not a “SOP” just a guidance
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 9 ICH Q9 QUALITY RISK MANAGEMENT ICH Q9 Link back to patient risk Process Materials Design Manufacturing Distribution Patient Facilities Opportunities to impact risk using quality risk management G.- Claycamp, FDA, June 2006
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 10 ICH Q9 QUALITY RISK MANAGEMENT Risk Management across the Product lifecycle for drug (medicinal) products Research Preclinical Phase Clinical Phases Launch Quality ICH Q9 Safety Efficacy Manufacturing & Distribution GLP GCP GMP GDP End of life cycle
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 11 ICH Q9 QUALITY RISK MANAGEMENT Source: basic model adapted from FDA (1999). Managing the Risks from Medical Product Use. Managing the risk of drug (medicinal) product use Known Side Effects Avoidable Unavoidable Medication or Device Error Product Defects Preventable Adverse Events Injury or Death Unexpected Consequences Public Health CONSIDERATIONS ICH Q9 Safety Efficacy Quality
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 12 ICH Q9 QUALITY RISK MANAGEMENT New Regulatory Paradigm  ICH Regulators: > FDA: New paradigm with the 21st Century GMP initiative > EMEA: Revised EU directives > MHLW: Revised Japanese law (rPAL)  EU & Japan became involved at ICH GMP Workshop in July 2003: 5 year vision agreed: “Develop a harmonised pharmaceutical quality system applicable across the life cycle of the product emphasizing an integrated approach to quality risk management and science”  Consequent ICH Expert Working Groups (EWG): > ICH Q8, on Pharmaceutical Development, doc. approved 2005 > ICH Q9, on Quality Risk Management, doc. approved 2005 > ICH Q10, on Quality Systems, topic accepted 2005
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 13 ICH Q9 QUALITY RISK MANAGEMENT “risk-based” concepts and principles The new paradigm
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 14 ICH Q9 QUALITY RISK MANAGEMENT Pharmaceutical Development (Q8) Past: Data transfer / Variable output Present: Knowledge transfer / Science based / Consistent output Pharmaceutical Quality Systems (Q10) Past: GMP checklist Future: Quality Systems across product life cycle Quality Risk Management (Q9) Past: Used, however poorly defined Present: Opportunity to use structured process thinking Incremental steps Changed Paradigm Q9
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 15 ICH Q9 QUALITY RISK MANAGEMENT How Q9 interacts with Q8 and Q10 Base: J. Ramsbotham, Solvay Pharm. NL / EFPIA Risk from Manufacturing site Product / Process Risk High Low High Low Using Q9 Quality Risk Management principles c o n t i n u a l i m p r o v e m e n t Q10 Pharm. Quality Systems Q8 Pharmaceutical Development
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 16 ICH Q9 QUALITY RISK MANAGEMENT Q10 Q8 ICH Q9 Link back to patient risk Process Materials Design Manufacturing Distribution Patient Facilities Opportunities to impact risk using quality risk management G.- Claycamp, FDA, June 2006 Q9
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 17 ICH Q9 QUALITY RISK MANAGEMENT A Vision of the future becomes fact Old Approach New Approach Remarks Broad Concept Quality decisions divorced from science and risk evaluation. Adherence to filing commitments. Quality decisions and filing committments based on Process Understanding and Risk Management. Quality by Design. Design Space concept introduced to integrate process knowledge with regulatory evaluation. Quality Post-factum sampling and quality testing. Process Validation. Management of variability Process control focused on critical attributes. Continuous Quality Verification. Quality by design definition applied. Measure critical process parameters to control output product quality. Systems Systems designed to inhibit changes & minimize business risks. Discourages improvement & innovation. Changes managed within company's quality system. Real time batch release feasible. Regulators and industry place higher reliance / trust / understanding on systems. Multidisciplinary evaluation and decision making. Regulatory Compliance focus. Changes require prior approval. Regulatory scrutiny adjusted to level of Process Understanding. Continuous improvement allowed within Design Space. Requires mechanisms to communicate Process Understanding data ("inspectable rather than reviewable") . Based on EFPIA, PAT Topic Group, 2005 CONSIDERATIONS
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 18 ICH Q9 QUALITY RISK MANAGEMENT Continuous Improvement Process Understanding Risk CMC regulatory oversight Company’s Quality system cGMP regulatory oversight Continuous Improvement Process Understanding Risk CMC regulatory oversight Company’s Quality system cGMP regulatory oversight Q8 & Q9 Based on A.Hussain, FDA, September 2004 Q10 & Q9 Process Understanding Risk (P/R) CMC regulatory oversight Company’s Quality system cGMP regulatory oversight Post approval change Process Understanding Risk (perceived & real) CMC regulatory Oversight (Submission) Company’s Quality system cGMP regulatory oversight (Inspection) Post Approval Change (PAC) PAC to Continuous Improvement Process Understanding Risk CMC regulatory oversight Company’s Quality system cGMP regulatory oversight PAC to Continuous Improvement Process Understanding Risk CMC regulatory Oversight (Submission) Company’s Quality system cGMP regulatory oversight (Inspections) CONSIDERATIONS
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 19 ICH Q9 QUALITY RISK MANAGEMENT Agenda  The ICH process  ICH Q9 and other ICH guidelines  From “Risk” to “Quality Risk Management”  Opportunities, Challenges and Benefit
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 20 ICH Q9 QUALITY RISK MANAGEMENT ICH Q9 Quality Risk Management What does it mean? What is it worth? Where does it lead?
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 21 ICH Q9 QUALITY RISK MANAGEMENT Managing risk is a behavior “The investigation of risks is at once a scientific activity and an expression of culture” Kasperson, Renn, Slovic et al. (1988) CONSIDERATIONS
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 22 ICH Q9 QUALITY RISK MANAGEMENT Risk Management as a discipline provides multiple benefits  Understand and influence the factors (hazards) which impact regulators and industry business  Create awareness and a culture > Supports an effective pro-active behaviour > Open factual dialogue > Make decisions traceable and consistent  Provide assurance > Risks are adequately managed > Compliance to external and internal requirements  Recognise risks at a desired level > Zero risk not possible CONSIDERATIONS
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 23 ICH Q9 QUALITY RISK MANAGEMENT ? The Hurdles Increasing external requirements for best practice, transparency and compliance • Public / Community • Governments • Regulators • Patients • Investors / Creditors Growing complexity and scope of risks • Globalisation “Multinational” • Multi-factor approaches • Regulatory expectations • Acceptance of risk and uncertainty Increasing efforts and costs for sustainability • Documentation • Projects • Systems • Interfaces Based on D. Geller, Roche
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 24 ICH Q9 QUALITY RISK MANAGEMENT Quality Risk Management Empowerment & Flexibility Proactive disclosure build trust and understanding Improve communication through sharing best practice and science based knowledge An appropriate integrated approach helps to meet requirements more efficiently Master complexity Convert data into knowledge e.g. by using methodology and tools Based on D. Geller, Roche
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 25 ICH Q9 QUALITY RISK MANAGEMENT Different meaning of risk  Individual > Risk is a cognitive and emotional response to expected loss  Technicians > Risk is usually based on the expected value of the conditional probability of the event occurring multiplied by the consequences of the event given that it has occurred  ICH Q9 > Combination of the probability of occurrence of harm and the severity of that harm CONSIDERATIONS Based on G. Claycamp, FDA, September 2005
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 26 ICH Q9 QUALITY RISK MANAGEMENT Different meaning of risk  Organizations might use many different meanings of risk > Depending on the type of risk management program  In general, "probability" and "severity" must be considered > In a given program definitions will fine-tune the concepts so that a risk management program can be created and applied > Make the detail in the definition fit the objective of the program  Accept the different "realities" among the stakeholders > Harmonized guidance needs to focus concepts into useful terms for the purpose (e.g. protection of patient [Q9]) CONSIDERATIONS Based on G. Claycamp, FDA, September 2005
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 27 ICH Q9 QUALITY RISK MANAGEMENT Severity and Probability are simple concepts?  Which consequence is more severe? > 300 lives lost in single, fiery plane crash. > 300 lives lost on US roads over a weekend. > 300 lives potentially lost from cancer within the next 20 years  Which probability is probable? What does a “30% chance of rain tomorrow” mean? > 30% of the days like tomorrow will have at least a trace of rain. > 30% of the area will have rain tomorrow. > 30% of the time tomorrow, it will rain. Gigerenzer, et. al (2005) G. Claycamp, FDA, September 2005 CONSIDERATIONS
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 28 ICH Q9 QUALITY RISK MANAGEMENT The “risk-based approach” severity probability Parameters for evaluating risks
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 29 ICH Q9 QUALITY RISK MANAGEMENT Parameters for “calculating” risks A picture of the life cycle Probability Detectability Severity past today future Refers to time Refers to Refers to = Risk Priority Number x x CONSIDERATIONS
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 30 ICH Q9 QUALITY RISK MANAGEMENT (Dis)Advantage calculated numbers & data  Numbers > Does the “Risk Priority Number” tell the truth?  Keep a robust data set for further evaluation! > Is the data set comparable? > Are the data plain and concise? > What about trending and use of statistics including extrapolation? > What amount of data is enough? e.g. start with the existing data set CONSIDERATIONS
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 31 ICH Q9 QUALITY RISK MANAGEMENT Hazards in Quality Anything that has the potential to harm patients, product quality or the business (loss, interruption, image) CONSIDERATIONS S. Rönninger, Roche, 2004 Potential threat - chemical reaction - manufacturing issues - facilities and equipment System defect - not detected - insufficiently prevented - emerges by degree Failure - technical breakdown - human breakdown - extrinsic effect hazard
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 32 ICH Q9 QUALITY RISK MANAGEMENT Risk and Uncertainty Time  Process Parameter  Lower Specification Limit (LSL) Upper Specification Limit (USL) today Uncertainty RISK: For a given severity of risk event, what are the chances (probability) of exceeding the USL in the next period of time? G. Claycamp, FDA, Sept. 2005 CONSIDERATIONS Tomorrow ?
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 33 ICH Q9 QUALITY RISK MANAGEMENT Risk and Uncertainty Different Risk Management Control? Time  Process Parameter  Lower Specification Limit (LSL) Upper Specification Limit (USL) today Uncertainty RISK: Control options are scenarios for risk management. Note that this scenario shows the best estimate is below the USL. G. Claycamp, FDA, Sept. 2005 CONSIDERATIONS Tomorrow ?
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 34 ICH Q9 QUALITY RISK MANAGEMENT Risk and Uncertainty Is the Risk of Exceeding USL = Zero? Time  Process Parameter  Lower Specification Limit (LSL) Upper Specification Limit (USL) today Uncertainty Take a cut at a moment in time: Risk has a distribution. G. Claycamp, FDA, Sept. 2005 CONSIDERATIONS Tomorrow ?
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 35 ICH Q9 QUALITY RISK MANAGEMENT Uncertainty and Quality Risk Management CONSIDERATIONS Hazard may cause harm Hazard may not cause harm uncertainty Hazard is less likely to cause harm Manage risks in relation to probability & severity Lack of, or inadequate knowledge
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 36 ICH Q9 QUALITY RISK MANAGEMENT Definitions Quality Risk Degree to which a set of inherent properties of a product, system or process fulfills requirements combination of the probability of occurrence of harm and the severity of that harm Systematic process for the assessment, control, communication and review of risks to the quality of the drug (medicinal) product across the product lifecycle Management QRM ICH Q9
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 37 ICH Q9 QUALITY RISK MANAGEMENT Has QRM already been implemented? Yes, however we need to firm-up and set the priorities in relation to risks  We need to know… > How good is our QRM compliance and decision making? > To what extent QRM has to be implemented or formalised?  An then focus efforts and communicate in order to… > Avoid duplication of effort and to align initiatives > Develop scope by using different viewpoints e.g. from management, internal and external customers CONSIDERATIONS
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 38 ICH Q9 QUALITY RISK MANAGEMENT Risk Management Not a new concept  ISO/IEC Guide 73: 2002 - Risk Management - Vocabulary - Guidelines for use in Standards  ISO/IEC Guide 51:1999 - Safety Aspects - Guideline for their inclusion in standards  WHO Technical Report Series No 908, 2003 Annex 7 Application of Hazard Analysis and Critical Control Point (HACCP) methodology to pharmaceuticals  GAMP Good Practice Guide ISPE, 2005 A risk-based approach to compliant electronic records and signatures  ISO 14971:2000 - Application of Risk Management to Medical Devices
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 39 ICH Q9 QUALITY RISK MANAGEMENT Risk Review Risk Communication Risk Assessment Risk Evaluation unacceptable Risk Control Risk Analysis Risk Reduction Risk Identification Review Events Risk Acceptance Initiate Quality Risk Management Process Output / Result of the Quality Risk Management Process Risk Management tools ISO 14971 (medical devices) & ICH Q9
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 40 ICH Q9 QUALITY RISK MANAGEMENT What is ICH Q9 about?  The ICH Q9 document: > Main body explains the “What?” > Annex I give ideas on the “How?” > Annex II give ideas on the “Where?”  It can be implemented by industry and regulators > Pharmaceutical development (ICH Q8) and Quality Systems (ICH Q10) will facilitate the “What?”, “How?” and “Where?”  “It helps prevent overly restrictive and unnecessary requirements being imposed by either industry or regulators” (ICH Q9)
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 41 ICH Q9 QUALITY RISK MANAGEMENT Why we have ICH Q9?  To show how it can be applied by regulators and industry to quality of pharmaceuticals (including API) > We already do a lot of quality risk management activities without identifying them as such  To enable manufacturing and regulatory flexibility  Provides the “What?” “How?” and “Where?” for quality risk management > Pharmaceutical development (ICH Q8) and Quality Systems (ICH Q10) will facilitate the “What?”, “How?” and “Where?”
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 42 ICH Q9 QUALITY RISK MANAGEMENT Quality Risk Management is NOT  Hiding risks  Writing half the truth (e.g. in an investigation report)  A means of removing industry’s obligation to comply with regulatory requirements
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 43 ICH Q9 QUALITY RISK MANAGEMENT Manage quality risks! Quality management as function of time Consequences What if disaster happens? Nowadays QRM Based on Prof. M. Haller, University St. Gallen, Switzerland Using QRM Prior use of QRM may lower the consequences
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 44 ICH Q9 QUALITY RISK MANAGEMENT Implementing ICH Q9 means The weakest chain will no longer be a problem
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 45 ICH Q9 QUALITY RISK MANAGEMENT Agenda  The ICH process  ICH Q9 and other ICH guidelines  From “Risk” to “Quality Risk Management”  Opportunities, Challenges and Benefit
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 46 ICH Q9 QUALITY RISK MANAGEMENT Integrate QRM during product life cycle Say, what you do Do, what you say Gain experience Improve it Approval Manufacture for market Analyse root cause: Continuous improvement Update documentation Quality Risk Management (QRM) (Risk of) Failure ?
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 47 ICH Q9 QUALITY RISK MANAGEMENT Risk Management & Flexibility  Definitions of “Compliance”: > Conformity in fulfilling official requirements > The act or process of complying to a desire, demand, or proposal or to coercion > A disposition to yield to others > The ability of an object to yield elastically when a force is applied: flexibility  Definition of “Flexibility”: > characterised by a ready capability to adapt to new, different, or changing requirements Source: www.webster.com, 01. Nov.04
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 48 ICH Q9 QUALITY RISK MANAGEMENT QRM may help define acceptable quality levels  Not every single detail can nor should be covered by > Specifications (product quality) > Documents (quality systems)  Set priorities and allocate resources according to the potential for protection of patients Use “science-based” and “risk-based” behavior
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 49 ICH Q9 QUALITY RISK MANAGEMENT Opportunity for the Industry & Regulators  Using the same guideline apply QRM to > Industry (development, manufacture and distribution) > Competent authorities (reviewer and inspectorate)  Facilitates common approaches to quality risk management in our every day jobs  Supports science-based decision making  Focus resources based on risks to patients  Avoids restrictive and unnecessary requirements  Facilitates communication and transparency
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 50 ICH Q9 QUALITY RISK MANAGEMENT Conclusions for ICH Q9  Over all: Positive Contribution to patient protection > Further develops Quality Risk Management awareness, that is already part of industry and regulatory culture  Ongoing change in behaviour > Identifying risks can be positive > A long list of identified risks that are assessed and controlled provides high quality capability  Awareness of quality risks > “Risk-based approach” > A potential of risks remains - No “Zero” risk!
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 51 ICH Q9 QUALITY RISK MANAGEMENT Way Forward for Industry and Regulators  Improve communication and transparency  Adapt existing structures, organizations and systems > Raise awareness of rationales for decision making > Develop training on methods and tools, as appropriate > Do not create new QRM organisations > Do not create new requirements  Adapt existing requirements using quality risk management behaviors
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 52 ICH Q9 QUALITY RISK MANAGEMENT Opportunities & Benefits  Encourages transparency > Create baseline for more science-based decisions  Facilitates communication > Matrix team approach > An aid to convince the stakeholders with trust  Encourages a preventive approach > Proactive control of risks and uncertainty > Benefit of knowledge transfer by team approach  Changes behavior > Better understanding of risk-based decisions > Acceptance of residual risks
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 53 ICH Q9 QUALITY RISK MANAGEMENT Remember  The use of Quality Risk Management is not mandatory However, if you don’t use it, you will not gain the benefits
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 54 ICH Q9 QUALITY RISK MANAGEMENT Change in behaviour Sharing information
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 55 ICH Q9 QUALITY RISK MANAGEMENT Change in behaviour From tick-box approach for compliance towards systematic risk-based thinking
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 56 ICH Q9 QUALITY RISK MANAGEMENT Change in behaviour Doing things, that do not matter for the patient
Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 57 ICH Q9 QUALITY RISK MANAGEMENT Integration of QRM into existing systems and regulatory processes will take time, trust and communication

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Q9_Background.ppt

  • 1. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 1 ICH Q9 QUALITY RISK MANAGEMENT Quality Risk Management ICH Q9 Background Disclaimer: This presentation includes the authors views on quality risk management theory and practice. The presentation does not represent official guidance or policy of authorities or industry.
  • 2. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 2 ICH Q9 QUALITY RISK MANAGEMENT Purpose of this part  To provide information on the background of the ICH Q9 document  Give an aid by providing some points of discussions on the understanding of the quality risk management concept
  • 3. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 3 ICH Q9 QUALITY RISK MANAGEMENT Agenda  The ICH process  ICH Q9 and other ICH guidelines  From “Risk” to “Quality Risk Management”  Opportunities, Challenges and Benefit
  • 4. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 4 ICH Q9 QUALITY RISK MANAGEMENT Agenda  The ICH process  ICH Q9 and other ICH guidelines  From “Risk” to “Quality Risk Management”  Opportunities, Challenges and Benefit
  • 5. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 5 ICH Q9 QUALITY RISK MANAGEMENT International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use
  • 6. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 6 ICH Q9 QUALITY RISK MANAGEMENT Expert Working Groups (EWG) EWG’s include observers and constituted from both authorities & industry Guidelines on Quality Chemical and pharmaceutical QA Safety In vitro and in-vivo pre- clinical studies Efficacy Clinical studies in human subject Multidisciplinary General topics
  • 7. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 7 ICH Q9 QUALITY RISK MANAGEMENT Agenda  The ICH process  ICH Q9 and other ICH guidelines  From “Risk” to “Quality Risk Management”  Opportunities, Challenges and Benefit
  • 8. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 8 ICH Q9 QUALITY RISK MANAGEMENT ICH Q-Documents  Q1 Stability  Q2 Analytical Validation  Q3 Impurities  Q4 Pharmacopoeias  Q5 Quality of Biotechnological Products  Q6 Specifications  Q7 Good Manufacturing Practice  Q8 Pharmaceutical Development  Q9 Quality Risk Management  Q10 Pharmaceutical Quality Systems Different: - not a recipe - not a “SOP” just a guidance
  • 9. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 9 ICH Q9 QUALITY RISK MANAGEMENT ICH Q9 Link back to patient risk Process Materials Design Manufacturing Distribution Patient Facilities Opportunities to impact risk using quality risk management G.- Claycamp, FDA, June 2006
  • 10. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 10 ICH Q9 QUALITY RISK MANAGEMENT Risk Management across the Product lifecycle for drug (medicinal) products Research Preclinical Phase Clinical Phases Launch Quality ICH Q9 Safety Efficacy Manufacturing & Distribution GLP GCP GMP GDP End of life cycle
  • 11. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 11 ICH Q9 QUALITY RISK MANAGEMENT Source: basic model adapted from FDA (1999). Managing the Risks from Medical Product Use. Managing the risk of drug (medicinal) product use Known Side Effects Avoidable Unavoidable Medication or Device Error Product Defects Preventable Adverse Events Injury or Death Unexpected Consequences Public Health CONSIDERATIONS ICH Q9 Safety Efficacy Quality
  • 12. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 12 ICH Q9 QUALITY RISK MANAGEMENT New Regulatory Paradigm  ICH Regulators: > FDA: New paradigm with the 21st Century GMP initiative > EMEA: Revised EU directives > MHLW: Revised Japanese law (rPAL)  EU & Japan became involved at ICH GMP Workshop in July 2003: 5 year vision agreed: “Develop a harmonised pharmaceutical quality system applicable across the life cycle of the product emphasizing an integrated approach to quality risk management and science”  Consequent ICH Expert Working Groups (EWG): > ICH Q8, on Pharmaceutical Development, doc. approved 2005 > ICH Q9, on Quality Risk Management, doc. approved 2005 > ICH Q10, on Quality Systems, topic accepted 2005
  • 13. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 13 ICH Q9 QUALITY RISK MANAGEMENT “risk-based” concepts and principles The new paradigm
  • 14. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 14 ICH Q9 QUALITY RISK MANAGEMENT Pharmaceutical Development (Q8) Past: Data transfer / Variable output Present: Knowledge transfer / Science based / Consistent output Pharmaceutical Quality Systems (Q10) Past: GMP checklist Future: Quality Systems across product life cycle Quality Risk Management (Q9) Past: Used, however poorly defined Present: Opportunity to use structured process thinking Incremental steps Changed Paradigm Q9
  • 15. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 15 ICH Q9 QUALITY RISK MANAGEMENT How Q9 interacts with Q8 and Q10 Base: J. Ramsbotham, Solvay Pharm. NL / EFPIA Risk from Manufacturing site Product / Process Risk High Low High Low Using Q9 Quality Risk Management principles c o n t i n u a l i m p r o v e m e n t Q10 Pharm. Quality Systems Q8 Pharmaceutical Development
  • 16. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 16 ICH Q9 QUALITY RISK MANAGEMENT Q10 Q8 ICH Q9 Link back to patient risk Process Materials Design Manufacturing Distribution Patient Facilities Opportunities to impact risk using quality risk management G.- Claycamp, FDA, June 2006 Q9
  • 17. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 17 ICH Q9 QUALITY RISK MANAGEMENT A Vision of the future becomes fact Old Approach New Approach Remarks Broad Concept Quality decisions divorced from science and risk evaluation. Adherence to filing commitments. Quality decisions and filing committments based on Process Understanding and Risk Management. Quality by Design. Design Space concept introduced to integrate process knowledge with regulatory evaluation. Quality Post-factum sampling and quality testing. Process Validation. Management of variability Process control focused on critical attributes. Continuous Quality Verification. Quality by design definition applied. Measure critical process parameters to control output product quality. Systems Systems designed to inhibit changes & minimize business risks. Discourages improvement & innovation. Changes managed within company's quality system. Real time batch release feasible. Regulators and industry place higher reliance / trust / understanding on systems. Multidisciplinary evaluation and decision making. Regulatory Compliance focus. Changes require prior approval. Regulatory scrutiny adjusted to level of Process Understanding. Continuous improvement allowed within Design Space. Requires mechanisms to communicate Process Understanding data ("inspectable rather than reviewable") . Based on EFPIA, PAT Topic Group, 2005 CONSIDERATIONS
  • 18. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 18 ICH Q9 QUALITY RISK MANAGEMENT Continuous Improvement Process Understanding Risk CMC regulatory oversight Company’s Quality system cGMP regulatory oversight Continuous Improvement Process Understanding Risk CMC regulatory oversight Company’s Quality system cGMP regulatory oversight Q8 & Q9 Based on A.Hussain, FDA, September 2004 Q10 & Q9 Process Understanding Risk (P/R) CMC regulatory oversight Company’s Quality system cGMP regulatory oversight Post approval change Process Understanding Risk (perceived & real) CMC regulatory Oversight (Submission) Company’s Quality system cGMP regulatory oversight (Inspection) Post Approval Change (PAC) PAC to Continuous Improvement Process Understanding Risk CMC regulatory oversight Company’s Quality system cGMP regulatory oversight PAC to Continuous Improvement Process Understanding Risk CMC regulatory Oversight (Submission) Company’s Quality system cGMP regulatory oversight (Inspections) CONSIDERATIONS
  • 19. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 19 ICH Q9 QUALITY RISK MANAGEMENT Agenda  The ICH process  ICH Q9 and other ICH guidelines  From “Risk” to “Quality Risk Management”  Opportunities, Challenges and Benefit
  • 20. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 20 ICH Q9 QUALITY RISK MANAGEMENT ICH Q9 Quality Risk Management What does it mean? What is it worth? Where does it lead?
  • 21. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 21 ICH Q9 QUALITY RISK MANAGEMENT Managing risk is a behavior “The investigation of risks is at once a scientific activity and an expression of culture” Kasperson, Renn, Slovic et al. (1988) CONSIDERATIONS
  • 22. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 22 ICH Q9 QUALITY RISK MANAGEMENT Risk Management as a discipline provides multiple benefits  Understand and influence the factors (hazards) which impact regulators and industry business  Create awareness and a culture > Supports an effective pro-active behaviour > Open factual dialogue > Make decisions traceable and consistent  Provide assurance > Risks are adequately managed > Compliance to external and internal requirements  Recognise risks at a desired level > Zero risk not possible CONSIDERATIONS
  • 23. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 23 ICH Q9 QUALITY RISK MANAGEMENT ? The Hurdles Increasing external requirements for best practice, transparency and compliance • Public / Community • Governments • Regulators • Patients • Investors / Creditors Growing complexity and scope of risks • Globalisation “Multinational” • Multi-factor approaches • Regulatory expectations • Acceptance of risk and uncertainty Increasing efforts and costs for sustainability • Documentation • Projects • Systems • Interfaces Based on D. Geller, Roche
  • 24. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 24 ICH Q9 QUALITY RISK MANAGEMENT Quality Risk Management Empowerment & Flexibility Proactive disclosure build trust and understanding Improve communication through sharing best practice and science based knowledge An appropriate integrated approach helps to meet requirements more efficiently Master complexity Convert data into knowledge e.g. by using methodology and tools Based on D. Geller, Roche
  • 25. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 25 ICH Q9 QUALITY RISK MANAGEMENT Different meaning of risk  Individual > Risk is a cognitive and emotional response to expected loss  Technicians > Risk is usually based on the expected value of the conditional probability of the event occurring multiplied by the consequences of the event given that it has occurred  ICH Q9 > Combination of the probability of occurrence of harm and the severity of that harm CONSIDERATIONS Based on G. Claycamp, FDA, September 2005
  • 26. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 26 ICH Q9 QUALITY RISK MANAGEMENT Different meaning of risk  Organizations might use many different meanings of risk > Depending on the type of risk management program  In general, "probability" and "severity" must be considered > In a given program definitions will fine-tune the concepts so that a risk management program can be created and applied > Make the detail in the definition fit the objective of the program  Accept the different "realities" among the stakeholders > Harmonized guidance needs to focus concepts into useful terms for the purpose (e.g. protection of patient [Q9]) CONSIDERATIONS Based on G. Claycamp, FDA, September 2005
  • 27. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 27 ICH Q9 QUALITY RISK MANAGEMENT Severity and Probability are simple concepts?  Which consequence is more severe? > 300 lives lost in single, fiery plane crash. > 300 lives lost on US roads over a weekend. > 300 lives potentially lost from cancer within the next 20 years  Which probability is probable? What does a “30% chance of rain tomorrow” mean? > 30% of the days like tomorrow will have at least a trace of rain. > 30% of the area will have rain tomorrow. > 30% of the time tomorrow, it will rain. Gigerenzer, et. al (2005) G. Claycamp, FDA, September 2005 CONSIDERATIONS
  • 28. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 28 ICH Q9 QUALITY RISK MANAGEMENT The “risk-based approach” severity probability Parameters for evaluating risks
  • 29. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 29 ICH Q9 QUALITY RISK MANAGEMENT Parameters for “calculating” risks A picture of the life cycle Probability Detectability Severity past today future Refers to time Refers to Refers to = Risk Priority Number x x CONSIDERATIONS
  • 30. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 30 ICH Q9 QUALITY RISK MANAGEMENT (Dis)Advantage calculated numbers & data  Numbers > Does the “Risk Priority Number” tell the truth?  Keep a robust data set for further evaluation! > Is the data set comparable? > Are the data plain and concise? > What about trending and use of statistics including extrapolation? > What amount of data is enough? e.g. start with the existing data set CONSIDERATIONS
  • 31. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 31 ICH Q9 QUALITY RISK MANAGEMENT Hazards in Quality Anything that has the potential to harm patients, product quality or the business (loss, interruption, image) CONSIDERATIONS S. Rönninger, Roche, 2004 Potential threat - chemical reaction - manufacturing issues - facilities and equipment System defect - not detected - insufficiently prevented - emerges by degree Failure - technical breakdown - human breakdown - extrinsic effect hazard
  • 32. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 32 ICH Q9 QUALITY RISK MANAGEMENT Risk and Uncertainty Time  Process Parameter  Lower Specification Limit (LSL) Upper Specification Limit (USL) today Uncertainty RISK: For a given severity of risk event, what are the chances (probability) of exceeding the USL in the next period of time? G. Claycamp, FDA, Sept. 2005 CONSIDERATIONS Tomorrow ?
  • 33. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 33 ICH Q9 QUALITY RISK MANAGEMENT Risk and Uncertainty Different Risk Management Control? Time  Process Parameter  Lower Specification Limit (LSL) Upper Specification Limit (USL) today Uncertainty RISK: Control options are scenarios for risk management. Note that this scenario shows the best estimate is below the USL. G. Claycamp, FDA, Sept. 2005 CONSIDERATIONS Tomorrow ?
  • 34. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 34 ICH Q9 QUALITY RISK MANAGEMENT Risk and Uncertainty Is the Risk of Exceeding USL = Zero? Time  Process Parameter  Lower Specification Limit (LSL) Upper Specification Limit (USL) today Uncertainty Take a cut at a moment in time: Risk has a distribution. G. Claycamp, FDA, Sept. 2005 CONSIDERATIONS Tomorrow ?
  • 35. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 35 ICH Q9 QUALITY RISK MANAGEMENT Uncertainty and Quality Risk Management CONSIDERATIONS Hazard may cause harm Hazard may not cause harm uncertainty Hazard is less likely to cause harm Manage risks in relation to probability & severity Lack of, or inadequate knowledge
  • 36. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 36 ICH Q9 QUALITY RISK MANAGEMENT Definitions Quality Risk Degree to which a set of inherent properties of a product, system or process fulfills requirements combination of the probability of occurrence of harm and the severity of that harm Systematic process for the assessment, control, communication and review of risks to the quality of the drug (medicinal) product across the product lifecycle Management QRM ICH Q9
  • 37. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 37 ICH Q9 QUALITY RISK MANAGEMENT Has QRM already been implemented? Yes, however we need to firm-up and set the priorities in relation to risks  We need to know… > How good is our QRM compliance and decision making? > To what extent QRM has to be implemented or formalised?  An then focus efforts and communicate in order to… > Avoid duplication of effort and to align initiatives > Develop scope by using different viewpoints e.g. from management, internal and external customers CONSIDERATIONS
  • 38. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 38 ICH Q9 QUALITY RISK MANAGEMENT Risk Management Not a new concept  ISO/IEC Guide 73: 2002 - Risk Management - Vocabulary - Guidelines for use in Standards  ISO/IEC Guide 51:1999 - Safety Aspects - Guideline for their inclusion in standards  WHO Technical Report Series No 908, 2003 Annex 7 Application of Hazard Analysis and Critical Control Point (HACCP) methodology to pharmaceuticals  GAMP Good Practice Guide ISPE, 2005 A risk-based approach to compliant electronic records and signatures  ISO 14971:2000 - Application of Risk Management to Medical Devices
  • 39. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 39 ICH Q9 QUALITY RISK MANAGEMENT Risk Review Risk Communication Risk Assessment Risk Evaluation unacceptable Risk Control Risk Analysis Risk Reduction Risk Identification Review Events Risk Acceptance Initiate Quality Risk Management Process Output / Result of the Quality Risk Management Process Risk Management tools ISO 14971 (medical devices) & ICH Q9
  • 40. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 40 ICH Q9 QUALITY RISK MANAGEMENT What is ICH Q9 about?  The ICH Q9 document: > Main body explains the “What?” > Annex I give ideas on the “How?” > Annex II give ideas on the “Where?”  It can be implemented by industry and regulators > Pharmaceutical development (ICH Q8) and Quality Systems (ICH Q10) will facilitate the “What?”, “How?” and “Where?”  “It helps prevent overly restrictive and unnecessary requirements being imposed by either industry or regulators” (ICH Q9)
  • 41. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 41 ICH Q9 QUALITY RISK MANAGEMENT Why we have ICH Q9?  To show how it can be applied by regulators and industry to quality of pharmaceuticals (including API) > We already do a lot of quality risk management activities without identifying them as such  To enable manufacturing and regulatory flexibility  Provides the “What?” “How?” and “Where?” for quality risk management > Pharmaceutical development (ICH Q8) and Quality Systems (ICH Q10) will facilitate the “What?”, “How?” and “Where?”
  • 42. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 42 ICH Q9 QUALITY RISK MANAGEMENT Quality Risk Management is NOT  Hiding risks  Writing half the truth (e.g. in an investigation report)  A means of removing industry’s obligation to comply with regulatory requirements
  • 43. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 43 ICH Q9 QUALITY RISK MANAGEMENT Manage quality risks! Quality management as function of time Consequences What if disaster happens? Nowadays QRM Based on Prof. M. Haller, University St. Gallen, Switzerland Using QRM Prior use of QRM may lower the consequences
  • 44. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 44 ICH Q9 QUALITY RISK MANAGEMENT Implementing ICH Q9 means The weakest chain will no longer be a problem
  • 45. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 45 ICH Q9 QUALITY RISK MANAGEMENT Agenda  The ICH process  ICH Q9 and other ICH guidelines  From “Risk” to “Quality Risk Management”  Opportunities, Challenges and Benefit
  • 46. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 46 ICH Q9 QUALITY RISK MANAGEMENT Integrate QRM during product life cycle Say, what you do Do, what you say Gain experience Improve it Approval Manufacture for market Analyse root cause: Continuous improvement Update documentation Quality Risk Management (QRM) (Risk of) Failure ?
  • 47. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 47 ICH Q9 QUALITY RISK MANAGEMENT Risk Management & Flexibility  Definitions of “Compliance”: > Conformity in fulfilling official requirements > The act or process of complying to a desire, demand, or proposal or to coercion > A disposition to yield to others > The ability of an object to yield elastically when a force is applied: flexibility  Definition of “Flexibility”: > characterised by a ready capability to adapt to new, different, or changing requirements Source: www.webster.com, 01. Nov.04
  • 48. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 48 ICH Q9 QUALITY RISK MANAGEMENT QRM may help define acceptable quality levels  Not every single detail can nor should be covered by > Specifications (product quality) > Documents (quality systems)  Set priorities and allocate resources according to the potential for protection of patients Use “science-based” and “risk-based” behavior
  • 49. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 49 ICH Q9 QUALITY RISK MANAGEMENT Opportunity for the Industry & Regulators  Using the same guideline apply QRM to > Industry (development, manufacture and distribution) > Competent authorities (reviewer and inspectorate)  Facilitates common approaches to quality risk management in our every day jobs  Supports science-based decision making  Focus resources based on risks to patients  Avoids restrictive and unnecessary requirements  Facilitates communication and transparency
  • 50. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 50 ICH Q9 QUALITY RISK MANAGEMENT Conclusions for ICH Q9  Over all: Positive Contribution to patient protection > Further develops Quality Risk Management awareness, that is already part of industry and regulatory culture  Ongoing change in behaviour > Identifying risks can be positive > A long list of identified risks that are assessed and controlled provides high quality capability  Awareness of quality risks > “Risk-based approach” > A potential of risks remains - No “Zero” risk!
  • 51. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 51 ICH Q9 QUALITY RISK MANAGEMENT Way Forward for Industry and Regulators  Improve communication and transparency  Adapt existing structures, organizations and systems > Raise awareness of rationales for decision making > Develop training on methods and tools, as appropriate > Do not create new QRM organisations > Do not create new requirements  Adapt existing requirements using quality risk management behaviors
  • 52. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 52 ICH Q9 QUALITY RISK MANAGEMENT Opportunities & Benefits  Encourages transparency > Create baseline for more science-based decisions  Facilitates communication > Matrix team approach > An aid to convince the stakeholders with trust  Encourages a preventive approach > Proactive control of risks and uncertainty > Benefit of knowledge transfer by team approach  Changes behavior > Better understanding of risk-based decisions > Acceptance of residual risks
  • 53. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 53 ICH Q9 QUALITY RISK MANAGEMENT Remember  The use of Quality Risk Management is not mandatory However, if you don’t use it, you will not gain the benefits
  • 54. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 54 ICH Q9 QUALITY RISK MANAGEMENT Change in behaviour Sharing information
  • 55. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 55 ICH Q9 QUALITY RISK MANAGEMENT Change in behaviour From tick-box approach for compliance towards systematic risk-based thinking
  • 56. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 56 ICH Q9 QUALITY RISK MANAGEMENT Change in behaviour Doing things, that do not matter for the patient
  • 57. Background prepared by some members of the ICH Q9 EWG for example only; not an official policy/guidance July 2006, slide 57 ICH Q9 QUALITY RISK MANAGEMENT Integration of QRM into existing systems and regulatory processes will take time, trust and communication